The Monday Memo: 9/26/16

The Monday Memo

September 26, 2016                                                                           PITT DPT STUDENTS

Optimizing Movement Through Dance

Among the American Physical Therapy Association core values is “Social Responsibility, Advocacy, and Public Policy.”Social Responsibility incorporates understanding current public policy that enables us as Physical Therapists to provide the best care for our patients and policy limitations. But it also encompasses patient advocacy both inside and outside of the clinic. It begs the questions; How can we uphold the APTA’s vision statement “Transforming society by optimizing movement to improve the human experience” to the best of our ability? What opportunities can we support and participate in for patients outside of our clinical practice?” ? As students of Physical Therapy, this seems to be one of the more difficult core values in which to participate while in school. Pittsburgh provides many opportunities to create these positive experiences.

 

Such an organization is called “Yes You Can Dance!”. I was first introduced to the program at “Pitt Preview Day” when Dr. Delitto discovered I was a dancer. “Yes You Can Dance!” is a local organization that uses dance to promote and improve wellness for patients who have disabilities, special needs, and chronic degenerative diseases. Using ballroom dance as its primary mode of therapy, it provides extensive social opportunities in addition to mobility training.

 

This fall, “Yes You Can Dance!” initiated a program for patients who have Multiple Sclerosis. It has proved to be an especially powerful experience both for the students and mentors. As mentors, we support the dancers moving forwards and backwards, swinging their hips in the Cha-Cha, and turning in the Rumba. Students giggle with delight discovering they have learned the basic steps of dance style or that they are able to dance moving backwards without fear of falling. Even the music alone seems to elicit beaming smiles.

 

With or without sequined costumes, bright lights, or sophisticated audiences, a stage can be set in our streets, in our schools, in our churches, and in our communities. As students and Doctors of Physical Therapy, we are called to such the stage as dancers, choreographers, directors. The stage whether big or small, sturdy or unstable, extravagant or dilapidated, must be a place for all to participate. We have a responsibility to care for, engage and encourage all people, if not as Physical Therapists, then as human beings.

 

If you’d like to get involved or would like more information about “Yes You Can Dance!”, please go to http://www.yesyoucandance.org/.

 

Weekly Shout Out: Congratulations to Neele Holzenkempfer (a current second year DPT student) for completing her first Triathlon and to Emily Barno for running the Great Race!

 

Check the Calendar for Class Schedules and Events

Social Media Updates
  • #DPTstudent –  WEDNESDAYS , 9-10pm EST!   Check out #DPTstudent page for details!
  • Unite Physical Therapy Students – If you haven’t yet, please check out the “Doctor of Physical Therapy Students” Facebook page. More than 9,500 students have already joined!
  • Our own page! Pitt Physical Therapy, thanks to the Social Media Team, has created an official PittPT Facebook page!
  • #SolvePT (meets on Tuesdays Twitter from 9-10pm EST)
September 26, 2016 |

The Monday Memo: 9/19/2016

The Monday Memo

September 19, 2016                                                                           PITT DPT STUDENTS

PPTA September Meeting Highlight

 

Last Tuesday, the Southwest division (SWD) of the Pennsylvania Physical Therapy Association (PPTA) held their September meeting. At this meeting, they invited Professor Michael Timko to speak. Professor Timko gave a presentation titled “The Treatment Based Classification System for Low Back Pain: 20 Years and Still Moving Forward.”  He started off by talking about how the current system of treating back pain called “the Treatment-Based Classification System” (TBC) developed in 1995. This system broke down clinical decision making into three levels.  Level 1 involves whether or not a patient should be seeing a physical therapist, or is there some sort of pathology present that requires a referral?  Level 2 involves staging the patient’s back pain at either Stage I, II, or III.  Level 3 involves the therapist deciding what techniques and interventions should be used to treat a patient depending on their pain stage. This ranking system has been widely accepted in the physical therapy profession for 12 years, and it was recently revised in 2007 to make it more evidence based. The system still has its limitations though.

 

In 2015, a new system of classifying back pain was created. Led by one of Pitt’s faculty, Dr. Muhammad Alrwaily, he and several other faculty members came up with the new treatment based classification system, which streamlined the levels and stages into an algorithm for the therapist to use during evaluation and treatment. In July 2016, this new system was published in Physical Therapy, Journal of the American Physical Therapy Association. The newest DPT class at Pitt had a full lecture on this system during Boot Camp 1.0 conducted by Professor Chris Bise. Level 1 has been replaced with deciding which management approach the first contact provider should take, because now physical therapists fall under that category with direct access. The three different approaches are red for medical management (should not be seen by a physical therapist because red flags or comorbidities were discovered), yellow for rehabilitation management, and green for self-care management.  If a patient falls in the yellow category, then one of three rehab approaches is determined. The determining factors are based on the degree of disability from the injury (high, moderate, or low), symptom status (volatile, stable, or controlled), and pain level (high, moderate, low, or absent).  A patient with high disability, volatile symptoms, and high to moderate pain is placed in the “Symptom Modulation” group and treated with directional preference, manipulation/mobilization, traction, and active rest. Patients with moderate disability, stable symptom status, and moderate to low pain are placed in the “Movement Control” group. These patients are treated with sensorimotor exercises, stabilization exercises, and flexibility exercises. The final group, “Functional Optimization,” are for patients with low disability, controlled symptoms, and low to absent pain. When a patient reaches this group, the treatment is strength and conditioning exercises, work or sport specific tasks, aerobic exercise, and general fitness exercises.

 

Professor Timko emphasized the key to these new groups as compared to the previous system is that patients are able to move from group to group during the course of treatment. Someone might come in to the clinic one day in the movement control group, aggravate the injury over the weekend, and then come back to the clinic in the symptom modulation group. The algorithm they created was developed to ensure a patient never gets stuck in a group and to act as a guide for the therapist in assessing the status of a patient and which treatment strategies are appropriate for resolving the injury.

 

Professor Timko had one more message underlying his presentation that a lot of our faculty have been emphasizing as well. Physical therapy as a field in medicine is changing dramatically. We are lucky as Pitt students to attend a program that Justin Moore, CEO of the APTA, stated is at “the forefront of reforming the field” from professors who are “very active in where the profession is going.” Physical therapists are gaining more and more recognition as experts in the human movement system within health care in this country. Professor Timko stated that there are jobs for physical therapists that will exist in 5 years that don’t exist today.  He doesn’t want us to just graduate, go out into the clinic and only regurgitate treatment styles; he wants us to enter the field and keep pushing it forward. Our faculty are constantly doing just that and they want us to follow suit.

 

If you would like further information, take a look at “Treatment-Based Classification System for Low Back Pain: Revision and Update”  by Muhammad Alwaily, Michael Timko, Michael Schneider, Joel Stevans, Christopher Bise, Karthik Harharan, Anthony Delitto.

 

References:

Alrwaily, Muhammad, Michael T, Michael Schneider, Joel Stevans, Christopher Bise, Karthik Hariharan, and Anthony Delitto. “Treatment-Based Classification System for Low Back Pain: Revision and Update.” Physical Therapy 96.7 (2016): 1057-066. Web.

Timko, Michael, PT, MS, FAAOMPT. “The Treatment Based Classification System for Low Back Pain: 20 Years and Still Moving Forward.” West Penn Hospital, Pittsburgh. 13 Sept. 2016. Lecture.

 

– Connor McGee, DPT Class of 2019

 

Check the Calendar for Class Schedules and Events

Social Media Updates
  • #DPTstudent –  WEDNESDAYS , 9-10pm EST!   Check out #DPTstudent page for details!
  • Unite Physical Therapy Students – If you haven’t yet, please check out the “Doctor of Physical Therapy Students” Facebook page. More than 9,500 students have already joined!
  • Our own page! Pitt Physical Therapy, thanks to the Social Media Team, has created an official PittPT Facebook page!
  • #SolvePT (meets on Tuesdays Twitter from 9-10pm EST)
September 19, 2016 |

The Monday Memo: 9/12/16

The Monday Memo

September 12, 2016                                                                           PITT DPT STUDENTS

Broadening Perspectives

 

Physical therapy can be practiced in a very diverse group of settings, many of which I was not aware of prior to starting PT school. One of our professors here at Pitt likes to tell us to “Practice at the top of the profession”, and I believe one of the ways that can be taken is to push boundaries, recognize areas where your profession is needed but not being utilized, and then advocate for your profession. My experience with this happened when I was abroad in Sydney, Australia for my full time 6 week clinical.

 

I was fortunate enough to be able to travel to Sydney this summer for a clinical at a small, private orthopedic clinic. It was much like any other orthopedic clinic with a fair share of shoulder, back, and knee patients, however we also saw a number of musicians. David Peterson, the director of the clinic and my CI, worked closely with a number of orchestras in Sydney, bringing care to an area of the performing arts not previously attended to strongly by physical therapists. While some musicians do come out to the clinic to see him, David also works part-time on site with the orchestras during certain times in their seasons. He conducts pre-tour physical preparation classes with the Sydney Symphony Orchestra, and then accompanies them on tour to keep them all moving and healthy to help manage any injuries that occur during the busy couples of weeks away.

 

While I was in Sydney, I got the chance to accompany him to work with the Australian Opera and Ballet Orchestra (AOBO), and Opera Australia (OA), as they finished up a long season. For their last three weekends, we would see patients backstage at the Sydney Opera House between their matinee and evening performances. The treatment sessions were short and sweet to fit as many people in as possible, and they were made up of mostly hands on treatment and patient education. These sessions opened my eyes to the immense variety of physical therapy needs, even among the performing arts population. Many of the patient cases were singers who were physically exhausted after standing on a raked stage for a 4-hour opera, or musicians who felt stiff and sore after being cramped into the pit and constantly turning in one direction to look at the screen. There were also a lot of jaw and throat problems in the singers, including a woman who had marked tightness in her laryngeal muscles, and reported that it was affecting her vocal production.

 

Many of our patients were new to being seen by a physical therapist backstage, and after just learning about it myself, I got the chance to educate many of patients about what physical therapy could do for them as singers in the chorus, soloists, and pit musicians. I got to advocate for my profession with a population who don’t typically benefit from it but definitely should. In Sydney, it’s becoming more common for musicians to be seen by physical therapists, and there are number of very skilled therapists at the University of Sydney who are dedicated to research in this field, but elsewhere, it has a long way to go.

 

As I return to the states after a very educational clinical, I want to share this experience with my classmates and colleagues, so that I can be an advocate for this unique niche of physical therapy. I was fortunate enough to get some experience with this, and I want to continue to do my part in pushing the boundaries of the profession to be better and to reach more people, and to broaden people’s perspectives of physical therapy, as my own perspectives were broadened this summer.

 

-Emer O’Reilly, DPT Class of 2018

 

Spotlight: Congratulations to Neele Holzenkempfer for completing her first triathlon. Awesome job, Neele!

 

Check the Calendar for Class Schedules and Events

Social Media Updates
  • #DPTstudent –  WEDNESDAYS , 9-10pm EST!   Check out #DPTstudent page for details!
  • Unite Physical Therapy Students – If you haven’t yet, please check out the “Doctor of Physical Therapy Students” Facebook page. More than 9,500 students have already joined!
  • Our own page! Pitt Physical Therapy, thanks to the Social Media Team, has created an official PittPT Facebook page!
  • #SolvePT (meets on Tuesdays Twitter from 9-10pm EST)
September 12, 2016 |

The Monday Memo: 9/5/2016

The Monday Memo

September 5, 2016                                                                           PITT DPT STUDENTS

Patient-Centered Care

 

This past week was a very special one for the University of Pittsburgh’s Physical Therapy department.  Last Monday marked the beginning of the Fall 2016 semester as well as the start of our program’s inaugural “PT Boot Camp” for the DPT Class of 2019.  The week revolved around preparing us for our upcoming clinical internships. One of the major themes was the importance of providing what is known as “patient-centered care.”

 

As physical therapists, it’s absolutely critical for us to understand that our patients are more than just their medical diagnosis.  Your 2PM appointment is not just the “middle-aged woman with chronic low back pain.”  She’s Jennifer, a 36 year old certified public accountant, mother of two, treasurer of the Pittsburgh Jewish Community Center, and avid Penguins fan.  These roles require her time, attention, and energy.  They complicate our intervention strategy and require us to make adjustments that are unique to Jennifer’s situation if we want to provide the best possible care.

 

As musculoskeletal experts, we drill human anatomy and physiology into our heads, exploring the finer points of scapulohumeral rhythm and the difference between upper and lower motor neuron lesions.  While these aspects are important, we also need to realize that each and every one of our patients will have their own unique set of social and psychological factors that will impact their plan of care.  It is our job to help them overcome these challenges and provide strategies for incorporating their therapy into the constraints of their life.

 

This philosophy should challenge practitioners to examine the way they interact with their patients, from the initial examination through their final physical therapy session.  It should affect the tone that you set, the words that you say, and the interventions that you choose.  For instance, the desk jockey recovering from an ACL tear will require a radically different progression scheme than the college-level running back hoping to return to competition.  Operating under this model will not only improve patient outcomes, but it will create more well-rounded, knowledgeable, and skilled therapists.  I challenge you to join the ranks of those who have already embraced this philosophy, and witness the positive impact on your ability to change the lives of those around you.

 

– Charlie Badawy, DPT Class of 2019 President

 

Check the Calendar for Class Schedules and Events

Social Media Updates
  • #DPTstudent –  WEDNESDAYS , 9-10pm EST!   Check out #DPTstudent page for details!
  • Unite Physical Therapy Students – If you haven’t yet, please check out the “Doctor of Physical Therapy Students” Facebook page. More than 9,500 students have already joined!
  • Our own page! Pitt Physical Therapy, thanks to the Social Media Team, has created an official PittPT Facebook page!
  • #SolvePT (meets on Tuesdays Twitter from 9-10pm EST)
September 5, 2016 |

The Monday Memo: 7/11/2016

The Monday Memo

July 11, 2016                                                                           PITT DPT STUDENTS

Promoting the Profession

 

Promotion of the physical therapy profession is of the utmost importance. On the first of July, a group of 16 Pitt DPT students educated over 150 high school students on not only the importance of physical therapy, but also how a physical therapist can steer their career in many different directions. Three separate hour and a half sessions were required to give the high school students of the Health Career Scholars Academy Summer Camp a taste of what physical therapy was all about. Starting each session, most of the high school students willingly admitted that they did not see themselves going into a physical therapy career. However, by the end of each session, more than 75% of each group inquired more about the profession and how they could continue to learn more.

 

With the Pitt DPT students demonstrating their passion for the profession, the high school students were able to receive hands-on experience and practice skills that physical therapists incorporate into everyday work. For instance, each high school student had an opportunity to teach their partner how to properly fit crutches and teach a “patient” how to ascend and descend stairs with the correct technique safely. Students were able to palpate each other’s collateral ligaments in the knee and learn how to perform varus and valgus stress testing. Students participated in an intense core workout to strengthen their “abdominal brace,” and in addition, tested each other’s balance through various exercises and pieces of equipment. Finally, the students downloaded an app on their phone that easily allowed them to observe their partners’ dynamic stability and break it down step-by-step to observe both proper and improper biomechanics. The Assembly Room at the William Pitt Union was filled with energy as the students gained hands-on experience while exploring the profession. Activity, education, and happiness were combined into one fun event that sparked interest in the physical therapy profession from the future leaders of health care. I am very proud of our class and the hard work they contributed to help the expansion of our profession. Hail to Pitt!

 

-Mike Thomas, DPT Class of 2018

 

Check the Calendar for Class Schedules and Events

Social Media Updates
  • #DPTstudent –  WEDNESDAYS , 9-10pm EST!   Check out #DPTstudent page for details!
  • Unite Physical Therapy Students – If you haven’t yet, please check out the “Doctor of Physical Therapy Students” Facebook page. More than 9,500 students have already joined!
  • Our own page! Pitt Physical Therapy, thanks to the Social Media Team, has created an official PittPT Facebook page!
  • #SolvePT (meets on Tuesdays Twitter from 9-10pm EST)
July 11, 2016 |