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: https://www.psia-e.org/download/ed/adaptive-ed/AdaptiveStudyGuide.pdf

-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

 

References:

“History.” National Wheelchair Basketball Association, www.nwba.org/.

“Wheelchair Basketball.” British Paralympic Association, paralympics.org.uk/paralympicsports/wheelchair-basketball.

 

 

 

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 |

The Monday Memo 2/5/18

The Monday Memo

February 5, 2018                                                                        PITT DPT STUDENTS

Student Spotlight

 

Student: Marcin Szczyglowski, Class of 2019


Q: Hello Marcin: Thanks for joining us today! To get started, would you mind telling us a little bit about yourself: Where did you grow up? Where and what did you study for your undergraduate education?

 

A: I was born in Lansing, Michigan, but grew up in London, Ontario, Canada. I went to the University of Western Ontario for undergrad and studied Kinesiology. My undergrad program was mostly based in physiology and biomechanics, but also included electives in rehab, sport literature, sport law course, and more. I took a 5-year undergrad simply because our curriculum was rather strict and flooded with physiology/biomechanics, but there were a ton of electives I wanted to take.

 

Q: You have a Master Degree, don’t you? Tell us a little about that.

 

A: I completed my Master of Science at the University of Oklahoma. It was a degree in Exercise Physiology with a concentration in Muscle Function and Metabolism. My thesis topic was The Effects of Exercise-Induced Muscle Damage on Critical Torque and Mitochondrial Function. My lab also did quite a bit of work on pain science, ergogenic aids with endurance performance, carbohydrate mouth-rinsing for improved performance, and other various properties of muscle function. We were also jokingly termed ‘The Pain Lab’ because a) we studied pain quite a bit and b) a lot of our studies required strenuous physical testing as well as twitch interpolation, which, if you’ve never done, is not the most enjoyable experience.

 

 

Q: “No pain no physiological gain”, am I right? You’re also a published author. What are the titles of your publications and would you mind giving us a brief description of your involvement/the major takeaways?

 

A: Currently, my thesis is published in the European Journal of Physiology under the title The Effects of Exercise-Induced Muscle Damage on Critical Torque. Critical torque is an analogue of critical power, which is defined as the highest attainable work rate that still results in steady-state aerobic energy production. It is usually expressed as an individual’s exercise intensity, such as critical speed, critical torque, etc., and is arguably the best physiologic predictor of endurance performance. Any exercise above this ‘critical power’ will ultimately result in task failure. Exercise above critical power is thought to have a fixed amount of work (making time to exhaustion, or task failure predictable), and is termed W’. The article covers exercise-induced muscle damage (EIMD) and critical power in depth, however the main discussion points were as follows: EIMD significantly reduced absolute critical torque by ~14% as well as ∫T total, a surrogate for W′, by 33% following EIMD. These findings suggest that EIMD would lead to a decline in CT and ∫T total providing evidence that EIMD likely impacts aspects of both aerobic and anaerobic metabolic functions during exercise.

 

Literally as I was typing this interview up, I was notified that a second research study I was heavily involved in was published in the Journal of Strength and Conditioning Research under the title Carbohydrate Mouth Rinsing Does Not Prevent the Decline in Maximal Strength Following Fatiguing Exercise. CHO mouth rinsing without the need for ingestion is an interesting technique which has been shown to improve performance, whether that be in a time trial, time to exhaustion, repeated sprint bouts, or simply slow the decline of maximal voluntary contractions (so long as the given exercise is short enough in duration that glycogen stores do not become a factor). This is likely due to central mechanisms as opposed to peripheral. Our study added to the notion of peripheral fatigue not being impacted by CHO mouth rinsing. While % voluntary activation of the quadriceps did not differ between conditions or pre-post exercise, indicating peripheral as opposed to central fatigue, we observed no changes in muscle contractile properties vs placebo. To sum it up, while CHO mouth rinsing has been shown to improve performance, this ergogenic effect does not seem to extend to enhancement of high-intensity ‘one-off’ events such as 1-RM or a single sprint.

 

I also presented a poster titled Consistency of the Effects of Caffeine on Strength and Motor-Unit Recruitment at the American College of Sports Medicine Annual Meeting in 2015. Caffeine, in the appropriate dosage (evidence ranging from roughly 3-13 mg/kg bodyweight), has been shown to improve muscular strength and motor-unit recruitment in athletes. This study was conducted on untrained individuals, and did not see the same ergogenic effect suggesting that caffeine has more of a fine-tuning effect on motor-unit recruitment.

 

 

Q: With such an extensive background in Exercise Physiology, the field of Physical Therapy was probably a natural transition for you. What got you interested in the field of physical therapy?

 

A: My undergraduate degree exposed me to physical therapy and rehab quite a bit, but science and research run in my family. I love physiology, which is what drove me to the University of Oklahoma. However, during my undergrad, I took quite a few ‘hands-on’ courses, volunteered in the field of physical therapy, and worked as a personal trainer/strength and conditioning coach at two gyms and for UWO women’s field hockey team. As much fun as research was, I missed this kind of treatment/training interaction. I got the opportunity to shadow the physical therapist for the Sooners’ track and field team and really enjoyed his treatment approach as well as the whole ‘behind the scenes’ atmosphere of collegiate sports. This, along with several long discussions with friend’s back home, swayed me away from doing a PhD in exercise physiology and, instead, a DPT.

 

 

Q: I know that you’re pretty involved in the sport of Powerlifting, so the competitive atmosphere that is collegiate athletics is probably a natural fit for you. What are your best lifts and how long have you been training?

 

A: I got into training powerlifting my sophomore year, and competed for the first time in my junior year. My undergraduate gym had a solid powerlifting culture led by a couple of the trainers I worked with, and I got sucked in. I’ve competed three times (last one in 2015…so I’m washed up). Best lifts (lbs): 505 Squat, 335 Bench (paused), 600 Deadlift. Best comp total: 650 kg / 1433 lbs at 93kg bodyweight.

 

 

Q: Any competitions in the near future?

 

A: Hopefully April (Comeback SZN!), and hopefully breaking a 1500lb total.

 

 

Q: What are your career goals or next steps after your graduate?

 

A: My main short-term goal is to get accepted into a sports physical therapy residency. Long-term I would love to end up working with a sports team, as well as contribute to the movement of therapists working toward bridging the gap between physical therapy and strength & conditioning. Long-long term dream goal? Own a hybrid of a physical therapy clinic and a strength and conditioning gym. Is Szczyglowski Strength too much of a tongue twister?

 


Q: Anything else you’d like to share with the readers?

 

A: Pizza is kind of a boring food, and I don’t understand why people love it so much. Get something better, like a taco or a burger. But if you do get pizza, put some pineapple on it.


Q: Thanks for stopping by, Marcin! Good luck with the rest of the spring semester!

 

Links to studies:

https://www.ncbi.nlm.nih.gov/pubmed/29334582 – CHO Mouth Rinsing

https://www.ncbi.nlm.nih.gov/pubmed/28900719 – Critical Torque

February 5, 2018 |