Danielle Angulo

#CC #PT582 Study compared US/TENS/PT for treating OA finding no difference. All did the same stretching & isometric ex. on top of their treatments. B/c of this I would just stick w/ PT b/c US & TENS doesn’t really seem to make any more of a difference. …rd-biomedcentral-com.libproxy.nau.edu/articles/10.11…

#TT #PT582 Iontophoresis could be good alternative for pain management b/c it only affects one area of the body rather than the whole body like oral meds. Both have possible side effects, pt needs to decide what is worth it. pt preference needs always needs to be considered.

@BiesemeyerEllie If patient was not responding to traditional OP therapy or maybe aquatics, I would probably recommend hippotherapy. A different environment and stimulation might be more effective. I would try therapies that I could personally facilitate before sending them elsewhere #EB #PT582

@DanielleAngulo4 Fantastic! When would you personally recommend hippotherapy to a patient over traditional outpatient therapies? #PT582 #EB

#EB #PT582 As patients improved with anticipatory mechanisms their need for compensatory ones decreased. The patients rode in different positions: forward, backwards, & side sitting. As they rode the horses they performed therapeutic activities. academia.edu/17886635/Impro…

#RO #PT582 I think that the muscle contraction that the NMES would cause more specific muscles to activate. Combining it with PNF would allow specific muscles to be activated during these functional exercises, allowing for better movement in these functional patterns.

Here is my overview of the great discussion we had on aquatic therapy and cardiac rehab. Thank you for joining in! #PT582 #DA

#PT582 #DA Thank you all for participating in my discussion tonight! I think one thing we all learned is how much more research needs to be done on aquatic therapy and CVD. Have a great night!

@jacquedompier #PT582 #DA Once again we see how important patient education is in the effectiveness and progression of PT! Great answer, and you're right patients may not know they like something until they try it!

@DanielleAngulo4 #PT582 #DA It really depends! I think there needs to be some compromise to get patients motivated and education is key! I think explaining that even if they like AT, having balance could really be beneficial. In addition, I would hope we could find SOMETHING they love on land!

#PT582 #DA 1/3 This is a really good discussion idea! We discussed patients with venous issues could possibly benefit from some extra help from the hydrostatic pressure utilizing aquatic therapy. This study actually discusses how profoundly journals.physiology.org/doi/full/10.11…

@jacquedompier AT is a fantastic starting point, but I had patients that were in AT for YEARS (bc they liked it so much) & not making much progress. would you encourage these pts to do land therapy to keep progressing or will they become discouraged & drop fully bc they dont like it? #PT582 #DA

@DanielleAngulo4 #PT582 #DA Honestly, I think a huge piece is that it's different and fun BUT it also allows the patient to have more autonomy than they do on land. They can do more for longer, and I think feeling the success and having carryover to land is really powerful for patients (and PTs)!

@RecarteAdabelle I think that is a great plan! I think monitoring the factors that the articles did through exercise is a good idea, bc patients may downplay how they are feeling. Monitoring those factors is a extra measure of safety no matter if they are mild/severe patients. #PT582 #DA

@DanielleAngulo4 #PT582 #DA I know both articles looked at monitoring BP, VO2 and HR. Mild-Severe pts. can vary even within the same category so I would take into consideration each individual's level of conditioning and go from there

#PT582 #DA These 2 explorative studies: 1.pdfs.semanticscholar.org/da11/45a164ad5… 2.scholarworks.bgsu.edu/cgi/viewconten… found a lack of research on the effects of AT on CVD regarding the physiologic response. AT appears to be safe for pts with mild conditions but questionable for more severe pts.

@Kiernan20732093 #PT582 #DA I would consider other conditions a pt may have. If they have a hard time doing land exercises because of another condition on top of the heart condition it might be worth it to try the pool. Everyone needs exercise and to find what works best. what do you think?

@HubbertKaytlin #PT582 #DA I really like the list of conditions that you believe should be considered for this intervention! I am glad you were able to observe this type of therapy, it is an experience not many have due to a low amount of clinics with pools!

#PT582 #DA I have observed in a clinic with aquatic PT & they did utilize it for their CV pt's. I think some conditions to consider for this would be CAD/ MI/ TIA/ Stroke. W/ the hydrostatic pressure of the pool we need to be aware of what type of load we're putting them under.

@Karmae20 #DA #PT582 Why do you think that aquatic therapy is considered to be a safer option for these patients, when others may say it is a contraindication? But I do agree that more research needs to be done on this topic!

#PT582 #DA There is not much research on using aquatic therapy for heart disease. I found one article that stated that aquatic aerobic and strength is found to be safer for CHF and CAD pts. It also states that CVS pts may feel more comfy and have better ROM in the water.

@JacquelineTorpy #DA #PT582 I think this is a great plan when starting with a patient! Better to start slow and be safe! How would you determine when it would be safe for the patient to progress and increase water height and exercise intensity?

@DanielleAngulo4 #PT582 #DA Aquatic Tx may be useful for cardiac pts with arterial deficits. The water would provide an added resistance to work against, but Id start them in shallow and progress to deeper water to slowly increase the hydrostatic pressure and venous return.

@NathanTurley4 #DA #PT582 This is great news! Especially for those that may have this condition but may not be able to exercise on land easily due to other issues. I wonder if it could help reverse/regress the condition?

#PT582 #DA In the research that I found, it appears that aquatic could be a safe alternative exercise for someone in early stages of Congestive Heart Failure. However, I appears that more research needs to be done. ncbi.nlm.nih.gov/pmc/articles/P…

@TateTsingine #DA #PT582 I am glad to see that there are some guidelines that have been established! Does the duration/intensity/increases differ depending on the level of submersion in the water because of the effects of hydrostatic pressure?

#PT582 #DA When using aquatics for cardiac rehab, exercise sessions should be short duration, low intensity, w/ gradual increases. Target HR should be 12-17 bpm lower than land-based, with continued monitoring of vital signs pre, during, and post exercise physiotherapy-treatment.com/aquatic-cardia…

#PT582 #DA Welcome to PT582 Twitter Thursday! Join in the discussion!

@Kiernan20732093 I think that this could be incorporated into the treatment plan. And the plan should be adjusted as the pt progresses or hits road blocks. One plan may not work the entire time through treatment. #KJ #PT582

Depression makes adherence hard but there are strategies to make it easier. Identify what type of exercise the person likes bc theyre more likely to do it, support from mental health professionals, set reasonable goals, and prepare for setbacks #PT582 #KJ mayoclinic.org/diseases-condi…