Monday Memo 10/14/2019

The Monday Memo

October 14, 2019                                                                           PITT DPT STUDENTS

 

We Need to Talk About Sexual Assault

            A recent study by Hawks, et. al, published in JAMA Internal Medicine indicated that 1 in 16 women in the United States report rape as their first sexual encounter. This number may be astonishing, but the true number is likely much higher since the study only surveyed women ages 18-44. The study was also completed before the #MeToo movement began, so Hawks et. al. believe the number would increase if the study was repeated today. Women may feel more comfortable saying that they were sexually assaulted following the rise of the #MeToo movement.

You may be wondering how this relates to physical therapy. Well, Hawks, et.al. found that the women whose first sexual encounter was rape were more likely to suffer from health problems later in life. These health problems include an increased risk of endometriosis, pelvic pain, and psychiatric issues. Not only do physical therapists help treat patients with pelvic pain, but we are a very hands-on profession. We are often touching patients in intimate places and spend a lot of time in a patient’s personal space. Being aware of a patient’s past traumas, especially sexual assault, can make us better clinicians and provide better patient care.

Trauma-informed care is often taught extensively in medical school but is not emphasized as much in physical therapy school. The CDC states that one in five women and one in 71 men have experienced rape at some point in their life. This is an extremely important fact to know as a health professional. People who have been sexually assaulted often have post-traumatic stress and can be triggered by even the lightest touch. Whether a PT is working in an outpatient or inpatient setting, we are often placing our hands in sensitive areas. For example, an outpatient PT may palpate a patient’s gluteal muscles to see it they are activating appropriately. An inpatient PT may place their hands on a patient’s ischial tuberosities to do a transfer.

Trauma-informed care suggests that practitioners should be thorough in our exam, explaining every step of the way, and always ask consent before touching a patient. We need to do everything we can to make our patients feel comfortable before beginning an exam. This may include having a family member nearby or letting the patient ask as many questions as they would like. We need to be compassionate and understanding and accept the fact that not everyone is as comfortable with physical touch as we are. Not everyone has had the same experiences or is from the same background, so being able to adapt to each patient’s needs will show excellence as a professional.

Dr. Lincoln, a primary care physician at MGH, suggests that health professionals ask their patients “Is there anything in your history that makes seeing a practitioner or having a physical examination difficult?” or “is there anything I can do to make your visit and exam easier?” These questions can easily be integrated into our physical therapy examination. Similar to how it’s important to know about a patient’s history of hypertension or COPD, it’s important to know about a patient’s past psychological traumas as they can all equally affect their care.

Sexual assault should not be a taboo topic that we feel uncomfortable talking about. It is unfortunately not uncommon, and it not only affects the survivors, but it affects their partners, their family, and their friends as well. Since more physical therapists are obtaining direct access, now is the perfect time for PTs to become more educated in trauma-informed care and the long-term health deficits associated with sexual assault.

 

-Kara Kaniecki, SPT

 

References

Hawks, L., Woolhandler, S., Himmelstein, D., Bor, D., Gaffney, A., & McCormick, D. (2019). Association Between Forced Sexual Initiation and Health Outcomes Among US Women. JAMA Internal Medicine.

Tello, M. (2018, October 16). Trauma-informed care: What it is, and why it’s important. Retrieved from Harvard Health Publishing.

October 14, 2019 |

Boot Camp for Lumbar Spinal Stenosis

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Dr. Carlo Ammendolia, DC, PhD

Boot Camp for Lumbar Spinal Stenosis

Dates: Postponed- future dates TBD

Price: $400

Continuing Education Units: 7 hours

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All proceeds from this course will be donated to the Foundation for Physical Therapy as part of the Mercer-Marquette Challenge

 Sorry, but we are unable to issue refunds

Course Description

The Boot camp program is an evidence-based multi-modal approach suited for practitioners who use manual therapy. The approach is focused on improving functional status especially walking ability. The program is directed to the multi-faceted aspects of DLSS that includes physical impairments (patho anatomy, spinal stiffness, lower extremity weakness and overall deconditioning), pathophysiology (neuro-ischemia) and psychosocial aspects (poor expectations and depression). This workshop will provide step-by-step training on how to perform all necessary patient exercises, manual therapy techniques and how to provide patents with self-management strategies. At the end of the workshop the learner will be able to implement the Boot Camp Program in their clinic.

Workshop Learning Objectives and Outcomes

Lecture Portion

  • Understand the etiology, patho-anatomy, patho-physiology, prevalence and burden of disease in symptomatic LSS
  • Understand the key features of the history and physical examination for patients presenting with back/lower extremity symptoms impacting walking and standing ability
  • Know common differential diagnoses for neurogenic claudication due to lumbar spinal stenosis
  • Know how to differentiate each of the diagnoses know red flags for potential serious disease among patients who present with back/lower extremity symptoms
  • Know the role of imaging for assessing patients with back/lower extremity symptoms impacting walking ability
  • Know when to recommend a surgical consult/epidural injection
  • Know potential effective non-surgical treatments for neurogenic claudication
  • Understand the chronic disease model of care and management
  • Understand the role of patient self-management and self-monitoring
  • Learn how to monitor patient outcomes and instruct on patient self-management
  • Learn results from clinical trials on the Boot Camp Program for LSS

Demonstration/Hands-On Portion

  • Learn to perform all the specific manual therapy techniques
    • Understand the rationale and learn to perform all the manual techniques in the boot camp program
  • Learn to perform all the specific patient exercises
    • Understand the rationale and learn to perform all patient exercises in the boot camp program
  • Learn how to implement the boot camp program in your clinic
    • Understand the rationale for the Boot Camp Program and its underlying principles
  • Learn how to integrate and implement program in your clinic

Course Education Materials

Lumbar Spinal Stenosis Patient Workbook

  • Written background information on the causes, common symptoms and available treatments for Lumbar Spinal Stenosis
  • An overview of the Boot Camp Program for Lumbar Spinal Stenosis 
  • Instructions and illustration of all patient exercises and self-management strategies
  • A schedule to record intensity and frequency of each exercises over the 6-week program

Lumbar Spinal Stenosis Patient Instructional DVD

  • Video presentation by Dr. Ammendolia on the causes, common symptoms and available treatments for Lumbar Spinal Stenosis and overview of the Boot Camp Program for Lumbar Spinal Stenosis 
  • Video demonstration of all exercises and self-management strategies including proper sitting/driving/standing/walking and sleeping postures

Lumbar Spinal Stenosis Practitioner Treatment Protocol DVD

  • Video demonstration on all manual therapy techniques
  • Instruction on how to implement the Boot Camp Program into clinical practice

Lumbar Spinal Stenosis Practitioner Implementation Guide

  • Written step-by-step and visit by visit instruction on implementing and integrating the boot camp program into clinical practice
  • Recommended patient schedule and progression for daily exercise intensity and frequency over the 6-week program

About the Speaker

Dr. Carlo Ammendolia is the Director of the Spine Clinic and the Spinal Stenosis Program at the Rebecca MacDonald Centre for Arthritis and Autoimmune Diseases at Mount Sinai Hospital. He received his MSc degree in Clinical Epidemiology and Health Care Research and his PhD in Clinical Evaluative Sciences from the University of Toronto. Dr. Ammendolia is an Assistant Professor in the Institute of Health Policy, Management and Evaluation, the Department of Surgery and the Institute of Medical Sciences at the University of Toronto. 

In 2012 and 2017, Dr. Ammendolia was recipient of the Professorship in Spine Award from the Department of Surgery in the Faculty of Medicine. In 2015, he was awarded the Chiropractor of the Year Award from the Ontario Chiropractic Association and in 2016 the Researcher of the Year Award from the Canadian Chiropractic Association. Dr. Ammendolia has been in clinical practice for over 36 years and now combines clinical practice, research and teaching in the areas of non-operative treatment of mechanical, degenerative and inflammatory spinal disorders. He is the founder of spinemobility, a not-for-profit Research and Resource Centre aimed at developing and testing programs for spinal and other musculoskeletal conditions. Dr. Ammendolia developed the Boot Camp Programs for lumbar spinal stenosis, persistent low back pain, persistent neck pain, ankylosing spondylitis, sciatica, persistent shoulder pain, knee and hip OA and fibromyalgia. He conducts workshops worldwide on his boot camp programs.

October 12, 2019 |

Medical Therapeutic Yoga: Foundations for Yoga Practice in Physical Therapy

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Dr. Ginger Garner PT, DPT, ATC/L

Medical Therapeutic Yoga: Foundations for Yoga Practice in Physical Therapy

Dates: February 21-22, 2020 [Fri 4-7pm, Sat 8am-4:30pm]

Price: $375

Continuing Education Units: 10 hours

Location:  Bridge Side Point I

100 Technology Drive

Pittsburgh, PA 15219

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All proceeds from this course will be donated to the Foundation for Physical Therapy as part of the Mercer-Marquette Challenge

 Sorry, but we are unable to issue refunds

Course Description

Discuss the medical Therapeutic Yoga (MTY) biopsychosocial model and its use in lifestyle medicine, pain management & health promotion across the lifespan in physical therapy. Participants will also apply the 10 MTY Precepts to physical therapy practice in order to increase clinical efficacy and safety of yoga prescription in healthcare and wellness care.

Clinical Objectives

  • Discuss the Medical Therapeutic Yoga (MTY) biopsychosocial model and its use in lifestyle medicine, pain management & health promotion across the lifespan in physical therapy.
  • Apply the 10 MTY Precepts to physical therapy practice in order to increase clinical efficacy and safety of yoga prescription in healthcare and wellness care. 
  • List indications for using the MTY Functional Movement Assessment (FMA) algorithm in physical therapy practice. 
  • Demonstrate knowledge of guidelines to practice, teaching, manual cueing, and instruction in yoga postures, breathing techniques, and mindfulness, and meditation. 
  • Verbalize the tenets of trauma-informed yoga in physical therapy practice.

Course Outline:

Part I – Foundations 

  1. Meditation & Opening Practice 
  2. 10 Precepts of MTY in Physical Therapy Practice
  3. Lifestyle Medicine in Physical Therapy Practice: The Pentagon of Wellness Model & Health Promotion 
  4. Vector Analysis
  5. Common Factors & General Therapeutic Effects

Part II – Practice

  1. Applying the Vector Analysis
  2. Lab – Breathwork
  3. Lab – Movement 
  4. Lab – Case Studies

Weekend Schedule:

Friday (4-7pm)

  • 3:00 PM Registration
  • 4:00 PM – Welcome, Introduction, Pre-Test 
  • 4:30 PM – Introduction to MTY – Precepts, Pentagon of Wellness Biopsychosocial Model, Lifestyle Medicine & Health Promotion in PT Practice, Vector Analysis 
  • 7 PM – Adjourn

Saturday (8 AM – 4 PM)

  • 8 AM – Q&A
  • 8:30 – Using the Vector Analysis 
  • 9:30 – Break
  • 9:45 – FMA Foundations – Experiencing Mindful Movement (LAB)
  • 11:15 – FMA – Breaking it Down – Breathwork & Meditation 
  • 12:30PM – FMA – Breaking it Down – Movement & Meditation 
  • 2:00 – Break
  • 2:15 – Putting it All Together – Using the Model in Practice
  • 3:00 – Closure, Post-Test
  • 3:30 – Adjourn

Speaker: Dr. Ginger Garner PT, DPT, ATC/L

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Emergency Medical Response for Non-EMS Personnel

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Rick Joreitz PT, DPT, SCS, ATC

Emergency Medical Response for Non-EMS Personnel

Course Provider: American Safety & Health Institute

Dates: Feb 1-2, 2020

Intended Audience: Physical therapists who wish to become Board-certified Sports Clinical Specialists require certification in Acute Management of Injury and Illness for conditions encountered in sports medicine.

Price, current board certified sports specialists: $450

Current Board Certified PT Registration:

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Price, those who wish to become board certified: $350

Current Student/Resident Registration:

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All proceeds from this course will be donated to the Foundation for Physical Therapy as part of the Mercer-Marquette Challenge

 Sorry, but we are unable to issue refunds

Course Description

Physical therapists who work with athletes on and off the field need to excel in the acute management of injuries and illnesses commonly seen in the sports medicine setting. This course tests your competency in this subject, as part of the Sports Description of Specialty Practice (DSP). The course will consist of a didactic and lab component, reviewing the recognition and appropriate care of athletes in emergent situations both on and off the field. A written test and lab practical will assess proficiency in each area.

Content Areas:

  • Emergency management systems and emergency action plans
  • Legal issues 
    • Laws, ethics and morals
    • Scope of practice
  • Disease transmission
  • Primary and Secondary Assessment
  • Airway emergencies and oxygen
  • Epipen administration
  • Chain of survival and cardiac emergencies
    • Cardiopulmonary Resuscitation 
    • Automated external defibrillation 
  • Injury incidence, etiology, & management 
    • Bleeding & wound management 
    • Head injuries 
      • Concussion recognition and management 
    •  Spine injuries 
      • Equipment removal 
      • Spine boarding 
    • Facial injuries 
      • Nasal and ocular 
    • Chest, thorax, and abdominal injuries 
    • Injuries to the extremities 
      • Fracture & dislocation recognition
      • Splinting
    • Environmental conditions in sports
      • Heat and cold illnesses/emergencies
      • Lightning, altitude injuries

Agenda:

Day 1 8:00-6:00
Introductions and Overview 8:00
Emergency management systems – including EAPs 8:15
Legal/Scope of Practice 8:30
Primary and Secondary Survey – including Lab  9:00
Break 10:00
CPR and AED Review – including Lab 10:15
Environmental emergencies in athletes 11:15
Lunch 12:00
Disease transmission, Bleeding, Wound Care – including Lab with glove removal 1:00
Airway Emergencies and Epipen usage  2:30
Break 3:30
Shock 3:45
Orthopedic injuries to extremities and splinting – including Lab 4:15
Day 2 8:00-4:30
Review 8:00
Spine injuries – including spine boarding with equipment removal.  

Includes a break

8:15
Lunch 12:00
Head injuries and Concussion 1:00
Facial, chest, abdominal injuries – including Lab 2:00
Break 2:45
Written Test and Practical 3:00

Speaker: Rick Joreitz PT, DPT, SCS, ATC

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Monday Memo 10/07/2019

The Monday Memo

October 7, 2019                                                                           PITT DPT STUDENTS

 

Be Fluid

Most, if not all PT students chose this career path because they discovered a symbiotic relationship working with patients during their shadowing experience or otherwise: We help them cure their physical ailments while giving ourselves a sense of altruism by helping others. In fact, I remember a few weeks ago taking the popular “Color Personality Test”. For those who are unfamiliar, the “blue” personality is described by compassion, empathy, and being social. Around 8% of the world’s population fits into this category, while 40% of our class alone had blue as their dominant personality type.

Getting into PT school is one thing. But once we are in, how do we know which setting within the PT realm fits our personality the best? Many people know exactly what they want when they apply for school and I applaud them. But most of us are just trying to survive and figure out this thing called graduate school. The ultimate example that immediately comes to my mind are previous athletes. Many previous athletes are attracted to the ortho/sports route because they can relate from their own personal rehab for their injuries sustained during their playing career. But through clinical experiences and volunteering opportunities in different settings, they also find enjoyment in settings they never really considered. Personally, upon entering PT school, I was dead set on neuro. Something about the brain and its intricate circuits sparked an interest in me. But after a few ortho rotations and even an inpatient one has me pondering which setting I will thrive in the best.

So, a few personal words of advice to prospective PT students or 1st years who are somewhat lost from a current 2nd year who is still somewhat lost.

  • Come into PT school with an open mind – pick a setting you think you would never see yourself doing and see where the road leads to; you may find a passion you never knew you had. We grow the most from learning in uncomfortable/challenging situations
  • Volunteer, volunteer, volunteer! – Get involved! This helps you discover new things as well as making a positive impact within your community.
  • Be a sponge – absorb as much knowledge as you can while in school and trust the process. Don’t just memorize for exams but apply your knowledge clinically to any setting you are in and I promise, you will come out a better clinician from it.

 

-Sam Yip, SPT

 

References:

https://truecolorsintl.com/the-four-color-personalities/

October 7, 2019 |