Monday Memo 3/19/18

The Monday Memo

March 12, 2018                                                                           PITT DPT STUDENTS

A Guatemalan Spring Break

This past spring break, 13 of my fellow classmates and I had the opportunity to travel to the beautiful country of Guatemala and provide physical therapy services to those who needed it. The trip was organized through Hearts in Motion, which is an organization that provides services both domestically and internationally to people in impoverished environments by “empowering […] volunteers to change lives of people in poverty”. Our entire trip was coordinated by Hearts In Motion, including our travel arrangements within Guatemala, day-to-day itinerary, and most of our meals as well, which was very helpful!


After driving to the Cleveland airport, catching a flight from Cleveland to Atlanta, GA, and then taking a second flight from Atlanta to Guatemala, we finally arrived in Guatemala City on Saturday afternoon. When we landed, we were greeted by Nancy Winiecki, The Hearts in Motion representative who worked with our team for the whole week. Nancy is a physical therapist herself and works in different physical therapy clinics located near Zacapa, Guatemala in addition to coordinating all of the service teams that come to Zacapa through the Hearts in Motion organization. After meeting Nancy, we loaded our luggage onto a bus and drove about three and a half hours northeast of Guatemala City until we reached our hotel, Hotel Atlántico, in Rio Hondo. The hotel was a beautiful complex with colorful buildings each consisting of two bedrooms that slept two people each. There was also a pool, a little park in the middle of the complex, and a lobby with a bar that served beer and wine for any guests desiring a late night beverage!


The first night after we arrived, we settled in to our rooms and then all gathered for a group dinner and orientation meeting. Then, we went to sleep so that we would be well rested for our first day in the clinic.


For our first clinic day, we packed up the bus with all of the donated medical equipment that we brought down with us from the U.S. which included suitcases full of pediatric and adult AFOs, braces for multiple different joints and extremities, theraband of various resistances, and adult and children’s shoes. We also loaded the portable treatment tables and documentation materials onto the bus and then proceeded to drive about 45 minutes away to the town of Chiquimula. When we arrived, Guatemalans were already lined up outside of the building waiting to be seen, so we quickly set up our workspace, divided into groups of about 3-4 people, and then began seeing our first patients! This pop-up clinic turned out to be extremely busy, and we ended up evaluating and treating a total of 43 patients by the time we finished up for the day!


The next day, we set up another pop-up clinic in an old indoor basketball court in the town of Santa Cruz, and this clinic proved to be just as busy as the first pop-up clinic! We evaluated and treated just fewer than 50 patients with a large variety of orthopedic and neurologic impairments. Some patients lived close by to the clinic, but some had travelled from multiple hours away to seek our care!


On Tuesday, after awakening to the beautiful sunrise and getting a yummy breakfast in our stomachs, we stopped by a children’s nursery where we got to meet nine Guatemalan children (3-4 years old) and play duck, duck, goose (or as they say in Guatemala: pato, pato, gonzo) with them. It was so fun to interact with the kids and to see their endearing little smiles! For the remainder of the day, we split into two groups. One group stayed in the Teculutan clinic to treat patients, while the other group went to a nearby special needs school to paint some of the rooms. We painted the sensory room a dark blue to promote calming and relaxation, and we painted the other classroom a bright yellow so that it would be more of a stimulating environment for the children to learn in. The kids at the school were so welcoming to us, and some even hugged and kissed us as we entered. Needless to say, the students were very curious as to what we were doing in their school, and they kept checking up on our painting progress throughout the day. While it was definitely hard work to transform the original dirty grey walls into bright blue and yellow ones, it was rewarding to know that we helped to make the children’s environment more conducive to their needs, and hopefully they enjoy the new wall colors! After finishing up painting for the morning, we washed off all of the sweat and paint from our bodies as best as we could and headed over to the clinic to treat patients for the next 4 hours! When our work in the clinic was completed, we quickly changed and headed to a small restaurant right outside the hotel to get some homemade empañadas as a little appetizer before dinner!


On Wednesday, we worked in one of the Hearts in Motion clinic’s stationed in Zacapa for the entire day. We got to see many patients here too! The patients I treated had diagnoses and complaints ranging from cerebral palsy, to back and neck pain, to a lady with foot pain after a toe amputation, to a two-year-old child with microcephaly (possibly due to the Zika virus) and significant extensor tone. We also had the opportunity to tour the Range of Motion Program (ROMP) building that was situated right next to the physical therapy clinic and see where they make different orthotics and prosthetics. After spending about eight hours in the clinic, we headed back to the hotel and had a poolside yoga class led by our fellow student volunteer and yoga instructor, Hillary Cummings! We definitely all benefitted from a little stretching out after some long days of work!


Thursday, some members of our team went to a pop-up clinic, and the rest of us went to a nutrition center in Gualan. Here, we evaluated and treated patients and also participated in a large “group feed” in which we assisted over 50 children who are enrolled in a program at the nutritional center to obtain the free lunch that they are entitled to each week. The view outside of the clinic was beautiful here with mountains stretching out as far as you could see in either direction.


Then, after five days of hard work in the clinic, we woke up around 4:15 am Friday morning and headed for the city of Antigua, where we stayed for the last two days of the trip. Some highlights from Antigua were attending the large local market that was full of colorful Guatemalan souvenirs and accessories, making chocolate from scratch, and of course hiking the Pacaya Volcano! The volcano hike was about 7 kilometers up a very steep, narrow path consisting of rocks, gravel, and volcanic debris and was challenging to say the least. However, the view from the top definitely made the hike worthwhile! We also got to roast marshmallows over an opening in the lava field that was still hot from the most recent eruption!


In the end, the experience was full of memories to last a lifetime. It was so satisfying to be able to apply all of the knowledge that I have learned the past two years in PT school to help the wide variety of patients that we saw. This experience also increased my ability to think outside of the box and provide effective interventions for patients with limited time, resources, and information about their impairments available. I also loved having the opportunity to work with my fellow classmates and the three very knowledgeable clinicians that accompanied us on the trip to treat patients as a cohesive team. This strategy enabled each person to draw upon his or her individual clinical experiences and knowledge to come up with unique intervention and treatment ideas. We were then able to combine everyone’s individual ideas into a unified treatment plan for the patient, and I feel like this cooperation really helped to elevate the quality of care that we were able to provide to the patients. All in all, 9 days after we had departed from the U.S., my classmates and I returned to snowy Pittsburgh with hearts not only warmed by the Guatemalan sunshine, but also warmed with the knowledge that hopefully we were able to help at least a few people in Guatemala move better and experience less pain. To me, that definitely qualifies as a productive spring break!

-Hannah Zangara, SPT Class of 2019

March 19, 2018 |

Monday Memo 3/12/18

The Monday Memo

March 12, 2018                                                                           PITT DPT STUDENTS

Combined Sections Meeting: New Orleans

A few weeks ago over 17,000 Physical Therapists descended upon New Orleans for the annual APTA Combined Sections Meeting (CSM). I had the fortuitous opportunity to join this mass of rehab professionals and enjoy my first professional conference, both as a bright-eyed student physical therapist (SPT) and volunteer. Immediately after arriving in New Orleans with several of my classmates, we were all instantaneously met with anxious excitement for what the next few days would bring. While everyone attends CSM with different goals in mind, my list included listening and learning from some of the foremost experts in the field, as well as gaining a better idea of employment paths I could choose after graduation. While I certainly focused on these professional and academic objectives, I would be lying if indulging in a few beignets wasn’t on the list too.

As a student with an expansive series of interests within the world of PT, I attempted to sit in on a wide array of presentations. I listened to debates about post-concussive rehabilitation, absorbed new movement diagnoses appropriate for patients with neurodegenerative disorders, and was pleasantly intrigued by the possibility of combining my love for pediatrics with my interest in sports physical therapy. Even as a novice SPT, I was constantly ruminating on how I could integrate what I was hearing at CSM with what I had already learned in school. This critical thinking and assimilation of ideas is what continually moves physical therapy forward towards evidence based practice and it was reassuring that even as a student I challenged myself to do this. On top of the presentations, it was impossible to not explore the expansive and slightly overwhelming exhibit hall. Filled with hundreds of booths representing APTA sections, new and improved anti-gravity treadmills, blood flow restriction equipment, enticing travel companies, and more it was easy to spend hours meandering through it all (which is exactly what I did). However, beyond the booths and their allure of free pens, cookies, and giveaways, I found dozens of poster presentations lining the walls. This combination of new technology and ground-breaking research was riveting to peruse because it was a physical embodiment of how the profession is perpetually moving forward to try and refine our skills. Bursting with opportunities, ideas, and entertainment the exhibit hall was a lively component of CSM. Lucky for me, the vibrant city of New Orleans enveloped all of this. I aimlessly roamed the streets of the French Quarter with classmates, witnessing everything from the pop-up live music to the iconic architecture. Frenchman Street enchanted us with local art markets, jazz bands, and the best pecan pie I’ve ever tasted. Unsurprisingly, beignets, jambalaya, and gumbo became daily necessities for all of us. I think most attendees would agree that “the Big Easy” was a perfect backdrop for this year’s conference.

As I sit and reminisce about the conference, the vivacious city of New Orleans, and the balmy temperatures which were a welcomed contrast to Pittsburgh’s incessant winter, I am confident the entire experience was an impactful adjunct to my education. I am eager to apply what I took away from this year’s conference and I am already looking forward to CSM 2019 in Washington D.C.


-Caroline Talda, SPT Class of 2019



March 12, 2018 |

Monday Memo 2/26/18

The Monday Memo

February 26, 2018                                                                        PITT DPT STUDENTS


Winter Fun For Everyone


With the winter Olympics coming to a close, I figured now would be a great time to share what I have learned about adaptive skiing this winter. Three Rivers Adaptive Sports (TRAS) offers individuals with with disabilities the opportunity to participate in skiing and snowboarding along with other sports throughout the year. Adaptive skiing is one of their most popular events, with outings almost every weekend.


Adaptive skiing has equipment that allows for individuals with many disabilities and skill levels to ski the slopes just like the rest of us. Two large categories of equipment can be broken down into individuals who participate either standing or seated. Most skiers begin tethered to an instructor for their safety and the safety of others. As skiers advance their skills they may be able to independently descend the slopes but only need help for loading and off loading the chair lift.


Standing skiers can stand independently or with the assistance of outriggers or ski legs. These might be people with multiple sclerosis, cerebral palsy or a lower extremity prosthesis. Outriggers are essential forearm crutches with skis on the bottom allowing the skier to have better balance and control, and additional contact points with the ground.These would be used for individuals who have the ability to stand independently and move dynamically without assistance. The ski legs could be likened to a walker on skis. These allow for greater stability and trunk support. The ski instructor also can also control the ski legs with tethers or handlebars.


Seated skis can accommodate those who might have a higher level of disability but that is not always the case. Some of these skiers go down the slopes faster than I can. Others such as single leg amputees might opt for seated skiing because they don’t want to risk injury to their intact leg by skiing standing. Seated skiers sit in a bucket style ski on either a mono or bi ski. The mono-ski allows for greater maneuverability along with that the skier needs a greater amount of trunk control. Bi-skis allow for greater stability and are often used by many first time skiers until they can progress to a mono ski. The bucket of the ski can be unpinned while loading to allow for the skier to be lifted on the lift chair.


Adaptive skiing can be enjoyed by almost anyone allowing them to participate in winter sports. Next time you’re skiing you will have a better idea of what equipment other skiers are using. If you ever want to get involved TRAS is always looking for volunteers to help their skiers. Below are photos of the equipment mentioned above.


Photos: PSIA-E/AASI Adaptive Study Guide:

-Bobby Jesmer, SPT



February 26, 2018 |

Monday Memo 2/19/18

The Monday Memo

February 19, 2018                                                                        PITT DPT STUDENTS


This coming weekend, I will be participating in the Tip Off at Trees 3vs3 Wheelchair Basketball tournament, along with another classmate and DPT program professor. After signing up, I wanted to learn a little more about the sport of wheelchair basketball so I looked into the background of the game. I wanted to write this piece to highlight the history of the sport and the state that it is in today.


The game of wheelchair basketball was born in Veteran Administration (VA) Hospitals in Birmingham, CA, Framingham, MA, and the Corona Naval Station, CA post World-War II in 1945-1946. Initially, the veterans at the Birmingham VA hospital competed against the medical staff, but traveled to the Corona Naval Station in 1947 to compete in the first game between two wheelchair basketball teams. Over the next couple years, six teams formed across the country representing various VA hospitals, and in 1948 the National Wheelchair Basketball Association (NWBA) and the first NWBA Tournament were assembled. Time Nugent, lead the way to form the NWBA and went on to become a Hall-of Fame inductee. At the same time, Sir Ludwig Guttmann, organized a very similar sport called wheelchair netball at the Spinal Rehabilitation Hospital in Stoke Mandeville, Great Britain.


By 1960, wheelchair basketball had immensely grown in popularity, and was included as one of the 8 sports in the Inaugural Paralympic Games held in Rome, Italy. Wheelchair basketball for women began to rise in the 1960’s, and would officially become its own NWBA division in 1977 after a proposal submitted by Hall-of-Famer, Bob Szyman. Today, the NWBA has grown to an amazing 200 plus teams in its five divisions: Championship Division, Women’s Division, Division III, College Division, and Junior Division. The sport now has an amazing international involvement from hundreds of teams from various continents, governed by the International Wheelchair Basketball Federation (IWBF).


The Game

The game itself is played on a regulation basketball court with all of the same dimensions, scoring lines, and hoop heights. The player is allowed two pushes between dribbles while the ball is in their lap or hands, and this can be repeated as many times as they would like. It is called a travel if more than two pushes occur without dribbling. According to the IWBF, a foul is, “An infraction of the rules concerning illegal personal contact with an opponent – the wheelchair is considered a part of the player.” This year, the National Wheelchair Basketball Tournament will be from April 12-15, in Louisville Kentucky.


I am excited for the opportunity to participate in this sport, and thankful to the Students for Disability Advocacy – University of Pittsburgh, and the Pittsburgh Steelwheelers for putting on this great event.


-Jim Tersak, SPT, CSCS



“History.” National Wheelchair Basketball Association,

“Wheelchair Basketball.” British Paralympic Association,




February 19, 2018 |

Monday Memo 2/12/18

The Monday Memo

February 12, 2018                                                                        PITT DPT STUDENTS


Holly Lewis, a first year SPT, is currently involved with teaching an exercise class to older seniors in the community. I had the pleasure of interviewing her to find out more about what she does every Monday evening.


So, tell us a little bit about the program.


 Every week, 6-8 participants meet at Parkside Manor, an independent living facility, to instruct an exercise class for the residents. Parkside Manor is a facility for the underserved, community-dwelling older adults. The main goal of this program is to provide simple and functional exercises that will benefit the residents both physically and mentally. Some of the exercises we incorporate are walking, seated exercises, and obstacle courses.


How did this program start?


Molly Bachmann, a third year SPT, reached out to seek other students in the program to help her. Molly is a Pittsburgh Schweitzer Fellow, which is where she originally came up with the idea for this endeavor.


How have the participants been responding?


They have been doing really well! A lot of them are more confident with navigating stairs and ambulating on their own. We have people from many different functional levels including Rollators and walkers. We accommodate to all and integrate exercises for any level.


What has this experience provided you with?


So much. It has made me much more confident leading exercises and working with the elderly. I initially had an interest in working with the geriatric population and this has stimulated it even more.


Beyond simply exercising, what are the other goals of this program?


A lot of seniors are in social isolation. This gives them an enriched environment and stimulation. We try to maintain the positive outcome they have earned in class by giving the residents education about what they can do outside of class to maintain the benefits.


What do you recommend others in the physical therapy community to do to help with enriching the lives of seniors?


While working with a patient, it is important to keep in mind that you may be the only person they talk to the entire day. Stay involved and alert. No matter what your experience level, volunteering and getting involved in the community is never a bad idea!


What is in the future for the program?


The next year in the program, we would really like to add another facility so that the effects of the program may be expanded throughout the community.


Special thanks to Holly Lewis for giving her time for this interview.


-Layne Gable, SPT





February 12, 2018 |