Monday Memo: 2/6/2017

The Monday Memo

February 2, 2017                                                                           PITT DPT STUDENTS

Optimal Care vs. Acceptable Care

 

If you’re a clinician, you probably want to provide your patients with the absolute best possible care in order to help them regain control over their bodies and lives. This is exactly why the research arm of the physical therapy profession exists — to bring us the most relevant evidence that will help guide our treatment and equip us with the most effective therapeutic strategies to reach our goals. In an ideal world, every method we use would be backed with Grade-A research, but is this always possible?

 

Oftentimes, a skilled therapist has devised a comprehensive plan for their patient that has been guided by the initial evaluation. It’s inevitable that we will encounter resistance from our patients, either as a result of their busy lives or from their preconceived notions. There are more than a few barriers that may prevent us from giving our patients what can be considered “optimal care,” including jam-packed work schedules, varying patient values, lack of equipment, and more. The challenge for us is to consider how we can navigate these barriers and adjust our plan in order to provide the patient with the most effective strategies available at the time.

 

An expert clinician must be able to skillfully develop alternative therapeutic exercise options, educate the patient to help change or guide their beliefs, and create a therapeutic environment where the patient feels comfortable and cared for. No two patients will present the same, so you must equip yourself with the skills to manage a variety of personalities and belief systems. This is your challenge as a therapist — How well can you adjust on the fly and deviate from your plan, while still providing care that will improve the status of your patient?

-Charlie Badawy
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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)
  • Follow @Pitt_PT on Instagram!
February 6, 2017 |

The Monday Memo: 1/30/2017

The Monday Memo

January 30, 2017                                                                           PITT DPT STUDENTS

The Birmingham Clinic

When you picture yourself treating patients in a Physical Therapy clinic, what does it look like? Do you see adjustable treatment tables, a plethora of free weights, ankle weights and therapy balls? What about treadmills, stationary bikes, or trampolines?

 

I’ve had access to these tools at all of my previous clinical internships, and when I pictured myself at a clinic, those tools have been in that image, without question. This semester I am at the Birmingham Clinic, an amazing interdisciplinary facility that is now offering Physical Therapy for uninsured patients. Because Birmingham is a free clinic that relies on donations, our treatment space consists of two basic tables, a few rolls of theraband, two stretching straps, and a couple pairs of free weights. The presence of numerous health professions means our physical space is busy and limited.

 

What I have realized is that the amount of equipment or space does not change the quality of care we can provide. The space does not alter my evaluations or treatment sessions. In essence, I find myself spending more time teaching my patients how to do exercises at home by using items that they may already have, or by being creative. Many of my treatments now focus on functional exercise. Warm ups consist of repeated sit to stands, as compared to five minutes on the treadmill. Doing this kind of warm up is effective from a comprehensive strength and cardiovascular stand point, but it also gives me the opportunity to provide cues on technique for such a fundamental movement. By taking a patient who is deconditioned outside to improve endurance and practice assistive device technique, I’m given the opportunity to navigate real world challenges with him or her such as potholes, gravel, cars and curbs of unexpected heights. Creative strength training that involves exercises crossing multiple joints and incorporation of core stabilization provides a physical and cognitive challenge for the patient.

 

Having to be innovative and flexible with the minimal physical space, lack of exercise equipment, and serving patients with complex medical histories or no knowledge of the English language keeps me on my toes and teaches me something every day. Realizing that all we truly need to help our patients is the knowledge and skills we can teach them, without necessarily needing high tech equipment or fancy gyms, is empowering and rewarding. The only tools we need, we already have, and anything additional to our disposal is a welcome asset, not a prerequisite.

 

If you know anyone, patient or otherwise, who may be worried about losing their medical insurance in the future, please point them toward the Birmingham Clinic in the South Side for free comprehensive care.
– PT services offered Mondays and Wednesdays 12:30-4pm
– https://www.dom.pitt.edu/dgim/phcup/clinics.html
– 412-692-4706

 

– Neele Holzenkaempfer, DPT Class of 2018

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)
January 30, 2017 |

The Monday Memo: 1/9/2017

The Monday Memo

January 9, 2017                                                                           PITT DPT STUDENTS

Psychology and Physical Therapy

 

Physical therapy is a profession that relies heavily on relationships. The psychology behind human interaction and health care plays a critical role in the success of our interventions. Today we’ll touch on two incredibly important relationships: The patient /therapist relationship, and the relationship between the patient and their own self-image.

 

Patient / Therapist

Obviously, patient/therapist interactions play a major role in the effectiveness of therapeutic interventions. It’s imperative that the therapist fosters a therapeutic environment where the patient feels comfortable and cared for, encouraged, and empowered to take an active role in their treatment. The psychosocial aspects of healing are undeniable: There is plenty of research that shows the psychological state of the patient will dictate how effective evidence-based protocols will be. This is one of the reasons why a risk factor for becoming a chronic pain patient is a high Fear Avoidance Belief Questionnaire score. Our mind matters.

 

As therapists, we often focus too heavily on selecting the “correct” protocol and interventions. Remember that there are always multiple paths to a given destination and it can often be more useful to choose a protocol that the patient believes in to foster a psychologically supportive environment rather than solely the therapist’s choice. This is a tactful way to generate patient buy-in and trust, and may open the door for you to sample your more desirable protocols later on in the process. This is not a call to use unscientific methods, but instead encouragement to use your clinical judgment in deciding which interventions will work best for the individual patient in front of you.
Patient / Self-Image

This relationship is one where the therapist may have the least control, but a proactive approach to assisting the patient in this capacity can go a long way. I’m not advocating the therapist plays the role of counselor, but I am suggesting that the environment you create, the words you choose, and the actions that you take will affect the way the patient feels and the therapeutic benefits of your session.

 

One of the reasons I chose to pursue a career in physical therapy is that I wanted to play an active role in providing patients with the tools to fix themselves. Patients need to understand that what they do away from therapy is, in many cases, more important than what they do while in your office. We give them the strategies. We provide them with activity modifications. We provide the framework for the patients to take control of their condition and actively “fix” themselves. If we can also foster a psychological environment of self-belief and positive thinking, our patient compliance and intervention success will be greatly improved.

 

This post simply scrapes the surface when it comes to the psychological influences of our profession. It’s an aspect of therapy that we need to contemplate every single day with every single one of the patients we see. It’s our job to achieve a grasp of our patient from a pathoanatomic perspective and a psychological perspective, and design our interactions and interventions tailored towards the patient in front of us. Each patient will present differently and the mark of an expert clinician is the ability to adapt and adjust in order to achieve positive outcomes for all of our patients.

 

-Charlie Badawy, 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)
January 9, 2017 |

The Monday Memo: 11/14/2016

The Monday Memo

November 14, 2016                                                                           PITT DPT STUDENTS

2016 PPTA Annual Conference

 

Two weekends ago several first-year DPT students and I traveled to the bucolic Lancaster County to volunteer at the 2016 PPTA Annual Conference, one of Pennsylvania’s largest annual continuing education conventions. The conference consisted of various poster and lecture-style platform presentations and exhibits, hosted by students, physical therapists, and notable professors from DPT programs around the country.

 

Our role as student volunteers consisted mainly of passing out contact hour sheets and informational pamphlets before and after our respective platform presentations that we were assigned to. We were fortunate in that while we were able to provide a helping hand to the PPTA community and assert our presence as Pitt students, we were still able to reap the benefits of the various educational opportunities around us in between our volunteer times. The particular lectures that I was able to attend were “Rehabilitation in MS: Promoting Functional Recovery and Neuroplasticity” and “Medical Screening for the Physical Therapist: The Sherlock Holmes Approach.” Though the first lecture was slightly outside of our current scope of practice as first year students, the latter was particularly relevant as it highlighted the importance of a thorough screening process in qualifying physical therapists as first contact practitioners. Although we do not typically make medical diagnoses of potential “red flag” pathologies that might warrant imaging or extensive medical work-up, our extensive screening process allows us to rule in or out the likelihood of those pathologies, and therefore the need for further imaging or medical referral. This process decreases the imaging-as-default technique that physicians tend to favor, resulting in decreased costs and increased overall efficiency of the health care continuum.

 

Advancing the field of Physical Therapy via increased direct access has been a recurring theme in Pitt’s DPT program and throughout the field in general, but there are other less-emphasized methods by which the field can be progressed that I picked up on during the exhibition tables in particular. Most of these tables were showcasing their PT-related products, such as visual feedback machines to work on balance, as well as apps to facilitate extracurricular therapy for patients during their period of treatment and after discharge. In addition to physical therapists’ evolution within the clinic in terms of the progression of our abilities and general scope of practice, we should also be thinking about how we can improve the overall therapeutic process for both patients and therapists. This can be accomplished by emphasizing creativity and intuition in our practice in ways similar to the above examples. We, especially as new and young practitioners with relatively minimal preconceptions and clinical habits, need to ask ourselves: what is the current state of Physical Therapy practice? How can we raise the bar upon our entry into the field? How can we apply the ideas and strengths of our generation to advance the field of physical therapy?

 

It is critical, therefore, to expose ourselves early on in our educational and professional careers to the field’s current level of thinking; the variety of ideas, techniques, and technologies circulating now; in order to get us thinking about how we can push our practice past the current status quo. The Annual Conference was a great way to get us thinking in that context.

 

A special thanks to Connor McGee, Doug Reeves, Rhadika Shah, and Ryan Thompson for making the long drive to join me in this experience.

 

Brooks Kenderdine, DPT Class of 2019

 

monday-memo-ppta-conference-11142016

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)
November 14, 2016 |

The Monday Memo: 11/8/2016

The Monday Memo

November 8, 2016                                                                           PITT DPT STUDENTS

Rock the Block Experience

The professional duty of a physical therapist extends beyond the walls of a clinic or hospital.  Physical therapists also have a role in advocacy and education about health, wellness, disease and disability management.  I joined several second year DPT students to act as health educators and advocates at the “Rock the Block” event in Squirrel Hill this October.  The event offered an outdoor market, live music, and a wellness fair hosted by Pitt’s APhA-ASP Chapter.  The proceeds from the drinks available for purchase were donated to benefit Uncover Squirrel Hill, Squirrel Hill Urban Coalition, and the American Diabetes Association.

 

While the majority of the “rocking” that occurred was provided by the live musicians, we were “rolling” with students from a variety health disciplines to educate the public about the prevention and management of diabetes. We represented the University of Pittsburgh’s schools of physical therapy, pharmacy, nursing, and dentistry and highlighted how each profession could be involved in the prevention and management of diabetes.

 

At the physical therapy tent, we challenged the public to play in a “Myth or Fact” trivia game that included general questions about diabetes, exercise, and physical therapy’s role in diabetes management.  For those not interested in participating in trivia, we brought foam pads for balance activities, which, by the end of the night, was quite the competitive event among the children. We educated participants about common impairments associated with diabetes, such as loss of foot sensation and balance deficits, and encouraged those with the disease to be vigilant about checking their feet for cuts or other wounds.  Several participants even received a monofilament foot screening to test for foot sensation.  We handed out pedometers for those who participated in the trivia or the balance games after discussing the importance of exercise and daily activity.

 

The majority of people who came by our tent had no idea that physical therapists are essential medical professionals for the treatment and management of diabetes.  This lack of knowledge about the assistance our profession is able to offer to the public for the treatment of diabetes and other diseases emphasizes the importance of physical therapists participating in health promotion events such as “Rock the Block”.  The community needs to be educated about the broad scope of physical therapy practice, and how physical therapists are qualified to help patients with more than joint pain.  Future physical therapists need to recognize the need to educate members of our community about what physical therapists are capable to treating and how physical therapists are essential allies in preventing the development of diseases associated with poor lifestyle choices and inactivity.

 

Thank you to Kathryn Accetturo, Luke Novosel, and Julian Vesnovsky for organizing and working this event along with me.  We had a great time educating the public about physical therapy’s role in the treatment and management of diabetes and look forward to participating in events such as this in the future.

 

Emily Barno, DPT Class of 2018

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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)
November 8, 2016 |