Browsing: Physical Therapy

Biological Grounding – Real or Hocus Pocus?

Biological grounding immersing standing barefoot on the ground. The idea being any temporary static electricity will be drained off into the earth – like emptying out the battery, as it were. The idea has intuitive appeal. Who has not been zapped by a car door handle discharging static electricity, sometimes with an audible crack? Or, who has not taken off a shirt or blouse and heard the crackle of static discharge? The question is, is there any therapeutic benefit derived? This article explores what published science may have to offer under the practice of grounding in the context of health and wellbeing.

A university library search on the term grounding yielded 183,000 peer-reviewed publications. The meaning of the word 'grounding' ranges from the devastating grounding of a naughty teenager to grounding an issue in the facts, and beyond. Another search, this time on biological grounding, narrowed the field to almost 31,000 peer-reviewed publications. The term biological earthing yielded a manageable 600 peer-reviewed publications to winnow. This article reports on many of these publications and their relevant linked publications.

So here's the theory highly simplified. Now we all know free radicals are not a good thing. A free radical is missing an electron (and so is positively charged). When connected to the earth the earth supplies the electron to nullify the free radical. In 1994 Anisimov performed tests to show that the earth's surface is electrically charged.

Now, according to Rosalind Tan (2014) our bodies are electrically conductive. Charged ions and free electrons get good conduit via blood and other body fluids. Electrical charge builds up in people like a battery especially in a dry climate. Fuel truck drivers must discharge any possible likelihood of sparking, sometimes with wrist straps. The relevance here is that earthing or grounding a person is very much part of solid science.

Earliest and pioneering work was that of Dr White GS (1929). Ahead of his time he helped sleep deprived individuals by earthing their beds with copper wire.

In 2010 Clinton Ober et al claim in their book: “Ereting – The most important health discovery ever?” the following:

  • “Defuses the cause of inflammation and improvements or eliminates the symptoms of many inflammation-related disorders.
  • Reduces or eliminates chronic pain.
  • Improves sleep in most cases.
  • Increases energy.
  • Lowers stress and promotes calmness in the body by cooling down the nervous system and stress hormones.
  • Normalizes the body's biological rhythm
  • Thins blood and improvements blood pressure and flow.
  • Relieves muscle tension and headaches.
  • Lessens hormonal and menstrual symptoms.
  • Dramatically speeds healing and helps prevent bedsores.
  • Protects the body against potentially health-disturbing environmental electromagnetic fields.
  • Accelerates recovery from intense athletic activity. “

Ghaly & Tepliz in 2004 measured cortical (stress hormone) secret during sleep of 12 subjects. The electric field of the subjects was measured and found to decrease as a result of earthing from an average over the 12 subjects from 3.270 V to 0.007 V. They concluded that earthing a person during sleep decreases night-time levels of cortisol so improving sleep.

Ib Andersen in 1965 remarked how a person could become electrically charged in relation to his surroundings purely by walking over a Nylon carpet. He added that an electric field may electrically induce a person, if:

  1. “A person has a certain potential relative to the surroundings.
  2. A person is at earth potential while free charges occurring in the surroundings.
  3. Both 1 and 2. ”

Christian Back (1967) an electrical engineer, devoted his book “Ions for breathing” to atmospheric electricity. The term 'ion' is ill defined like a rock can range from just larger than the size of a grain of sand to massive asteroid size. The term stretches from atomic ions like household salt dissolved into Sodium cations and Chloride anions all the way to the larger aerosol size. He dissects the electric field in rooms around occupants and delves into the effect of ions on such people.

A good study of the dispersal of small air ion concentrations is a case study by Jamison et al who in 2006 measured the charged particles and molecules in an office for one person. The measurements were taken in an horizontal plane through appointed eye-level and then in a vertical plane nominally coinciding with the separated person. In the vertical plane the average number of Negative Small Air Ions per cubic cm (SNAI cm-3) was 361 per cubic cm over 276 sampling points ranged in number from 10 ions to 930 ions per cubic cm. In the vertical plane the isoline areas bounded by the upper bound concentrations completely obscured the subject subject immersing the person in the higher ranges of SNAI.

A further point of interest is the electrostatic potential measured by them in the vertical plane averaging 104.9 V and ranging from 2.2 V to 7.7 kV. The maximum values ​​were around the footrest where the operator had been rubbing shoes. Russian and Swedish guidelines stipulate less than 500 V at 50 cm from the computer.

High school science lectures about anions and cations. It should come as no surprise that the air we breathe also has ions and Charry (1984) concludes that small air ions are likely to have biological effects. Yet Krueger in 1976 had already presented experimental data that small air ions are indeed biologically active.

Just like fish swim in an ocean of Sodium and Chloride ions so too are humankind in an atmosphere of ions, positive and negative. Whilst the ions can be generated, more than one third positive ions occur naturally as a result of radioactive decay. They do not travel far and have a short life. Indoors the ions have an even shorter life (30 seconds) as they bump into things and short out. (Alpha Lab Inc) Therein lies the key to biological grounding: Shorting out by earthing with Mother Earth.

To conclude, a snippet from an invited editorial prepared by the late Dr AP Kruger in 1982 is presented from the International Journal of Biometeorology. The editorial sets many urban myths about air ions straight. He concludes his editorial with advice for prospective buyers of air ion generators:

  1. “Air ions, negative and positive, are normal constituents of our biosphere and they are biologically active.
  2. A good deal is known about the effects of air ions on bacteria, protozoa, plants, insects and small animals. Less is known about their action on humans. There is evidence that air ions can influence mood, behavior, and performance of certain tasks.
  3. There is some suggestion that air ions may be of value in the treatment of certain diseases, but more critical trials are needed before air ions therapy can be established as an acceptable addition to the medical armoury armamentarium.
  4. Some air ion generators produce ozone and should be avoided.
  5. No one as yet has found that the negative air ion concentrations produced by any properly constructed commercial generator may be harmful. ”

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How Should Children Conduct Rehabilitation Exercises Following Elbow Fracture Surgery?

Pediatric elbow dislocation and elbow fractures include supracondylar humerus fractures, humeral condylar fractures, radial and neck fractures, and proximal ulnar fractures. Following the removal of an externally fixated cast or internally fixated needle, the patient needs to actively exercise as soon as possible. Otherwise they will experience limited elbow extension, flexion, and rotation function. In several cases, the patient is left with lingering complications (sequelae) affecting the elbow's motor functions. It is very important to assist children in the early stages of their functional exercises.

In general, when resetting an elbow dislocation, a patient's externally fixated cast can be removed after 2-3 weeks, at which time they must immediately start an exercise regimen. When a child has an elbow fracture (whether it requires manual reduction and an externally fixated cast or an internally fixated needle), they must start an elbow exercise regimen 3-4 weeks later (4-6 weeks) at the latest).

Children are generally frightened by pain due to early training that produces pain. They also exhibit a low level of self-control and cooperation. You should explain to children in advance that striving for cooperation between family and children is psychological treatment. Reasonable arrangements for children's participation in daily activities such as using their elbow joints helps them avoid using their healthy limb to replace the injured one during exercise. This includes encouraging children to use their injured hand to hold objects, play ball, and move things. Most patients can regain their normal functions after participating in these exercises. Patients generally do not need professional rehabilitation institutions to help facilitate these exercises. It is not recommended for parents or non-professionals to help patients with passive activities, as this will prevent secondary fractures or malicious activities causing local hyperemia and edema, ossifying myastheniasis, later-term joint movement disorders or even rigidity.

The following is some active elbow exercise methods:

Straightened elbow exercises
Patient is in a sitting position with the elbow height at the same as the tabletop. The patient places their injured elbow on the tabletop. Fold a towel to about 125 degrees in height and pad it under the elbow. The palm is facing up with the hand holding an apple or a corresponding object that interests the patient. Instruct the patient to relax their muscles and forcibly extend their elbow to its maximum. Do this for 10 times per set with a total of 3 sets every day. The scope of extension should be gradually increased.

Elbow flexion exercises
Patient is in a sitting position with the elbow height at the same as the tabletop. The patient places their injured elbow on the table edge. The palm of their hand is facing themselves. The distal forearm of the injured limb is lying on the table edge. Using a forward movement of the body, flex the elbow forward. Do this for 10 times per set with a total of 3 sets every day. The scope of extension should be gradually increased.

Elbow rotation exercises
Patient is in a sitting position with the elbow height at the same as the tabletop. The patient places both of their forearms flat on the table with both hands making a fist. Thumb is in the neutral position. The thumb rotates inward with a forward rotation. The thumb then rotates out with a backward rotation. Do this for 10 times per set with a total of 3 sets every day. The scope of extension should be gradually increased.

Be careful not to rush through these exercises. As long as the patient has a little bit of progress every day, most patients' elbow function can be restored to normal. It is recommended that under a doctor's guidance, the patient will adopt the correct methods during the movement exercises.

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Medical Marijuana: An Insight Into a Patient’s Journey

BACKGROUND

To date, medical marijuana is legalized in the United States in 30 states including the following:

Alaska, Arkansas, California, Colorado, Connectiut, Delaware, DC, Florida, Hawaii, Illinois, Maine, Maryland, Massachusets, Michigan, Minnesota, Montana, Nevada, New Hamshire, New Jersey, New Mexico, New York, North Dakota , Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington and West Virgina.

Each of these states have their own regulations and guidelines regarding use and qualifications.

Here in Florida, the Medical Marijuana Legalization Initiative, also known as Amendment 2, passed on November 8, 2016 for qualified patients under the supervision of a qualified and licensed marijuana doctor. Furthermore, this amendment passed with a total of 6,518,919 (71.32%) YES votes and 2,621,845 (28.68%) NO votes.

The federal government has reclassified Marijuana as a Schedule 1 drug making it illegal for doctors to prescribe marijuana to their patients. These marijuana doctors can only make recommendations for medical cannabis in compliance with the state law which can be valid up to 1 year. Patients can not go to a pharmacy to fill a prescription for medical marijuana.

Under strict regulations, medical marijuana doctors are prohibited to be affiliated with any medical cannabis distributors or dispensaries.

Only certain patients with “debilitating ailments” are afforded legal protection under this amendment. Ailments classified under its provision include PTSD (Post Traumatic Stress Disorder), Chronic muscle spasms, Multiple Sclerosis, Seizures, Epilepsy, Glaucoma, Crohn's Disease, Cancer, HIV / Aids, Amyotrophic lateral sclerosis or Lou Gehrig's Disease and Parkinson's Disease.

Although the above ailments were indicated as “primary debilitating conditions”, under this provision, Amendment 2 also stated: “or any other ailment / condition of similar severity / symptoms, as determined by a physician's opinion that the medical use of marijuana would outweigh any potential health risks “.

There are currently about 56 known and listed marijuana doctors on Florida.

More information and specifics regarding this topic can also be obtained from the website of the Florida Department of Health ( http://www.floridahealth.gov ) on how to become a medical marijuana patient in Florida. More in-depth information about Amendment 2 can also be found here.

PARKINSON'S DISEASE

A few months ago, I came across a video on Facebook about a man with Parkinson's disease who was given a shot of medical cannabis. The before and after videos were quite impressive. Before the treatment, you can see this man's significant tremors, stuttering and abnormal posturing. The after video showed a very different person. His speech was intelligent and audible. He had no stuttering, tremors and he showed very controlled movements. This man was walking and talking as any normal person would. He also shared how it has improved his quality of life.

As a physical therapist with exposure to various cultural backgrounds, I personally have mixed feelings about medical cannabis. As a healthcare professional however, it is quite an epiphany to witness one of my patient's significant change with medical cannabis use.

Mr. JL with Parkinson's Disease

For over five years, Mr. JL has been coming to me for physical therapy treatment off and on for problems brought on by his Parkinson's disease. Knowing the progressive nature of the disease, I watched this gentle soul deal with the effects of this debilitating affliction. His primary physicist would refer him for treatment when he starts to develop weakness, rigidity, tremors and most of all, balance problems where he reported falls at home.

We would see him for a period of about six to eight weeks each time. We worked on improving his coordination, strength, flexibility and balance for the primary purpose of keeping him safe and self sufficient at home as he lives alone. It is also to keep from falling which predisposes him to more severe injuries and complications.

The Change

About a few weeks ago, he came to the office to schedule for Physical Therapy as he was referred again by his doctor. Having worked with this patient through the years, I was trying to figure out what changed in him. I looked, and observed intentionally as I did my initial evaluation. He may have noticed the curiosity that was nagging me because he got me a knowing smile. No longer able to contain my curiosity, I asked him: “Mr. J, what have you been up to?” Mr. J just laughed and asked me why the curiosity!

Well, it finally dawned on me that. J. barely had no tremors on his right hand where he used to exhibit the typical pin-rolling tremors of this disease. His neck was aligned and was not shifted towards the right side. Furthermore, his speech was clear! Another thing that stuck me was that he was walking better. Not great, but he was able to turn around without having to shuffle which I have seen him do for years.

He finally shared with me that he started taking medical cannabis for over a month as recommended by his neurologist. A friend of his allegedly mentioned to him a video on Facebook about a man with severe Parkinson's disease. This man received a shot of medical cannabis and the change was visible after only a few minutes. This apparently prompted him to consult with his primary physician and then his neurologist.

The change I have seen with Mr. J after only over a month of being on medical cannabis is significant. His speech improved. His voice deeper and more audible. He had no stuttering and he had more control of his right hand than almost a non-existing tremor. He is also standing straighter. His balance and coordination have improved, even more so with the advanced balance retraining he is currently receiving.

During his therapy sessions, Mr. J could bounce a ball on the floor faster with better accuracy. We saw him throw and catch a ball in standing without anyone holding on to him. We used to have somebody stand behind and hold him as he had slow reactions and reflexive responses. His walking also improved. Just months ago, he would drag his right foot and walked with very short shuffling steps. He would lose his balance with the slightest attempt to turn around or lift his leg higher to stand on one leg.

These seemingly subtly changes in him for just about over a month of using medical cannabis has made a difference in his life. He shared that he feels more relaxed and is less anxious about falling. He can do simple house chores with more confidence and he is able to tolerate more advanced therapeutic exercises during his physical therapy sessions. He does not feel as tired and is able to do more tasks throughout the day.

Mr. J is still on this journey and wanted to share this experience and for me to tell his story. Knowing him and his background, he is not the type of person who would take marijuana indiscriminately for mere recreation and self indulgence.

About JL

Mr. J is originally from Central New York and has moved to Florida. He was diagnosed with Parkinson's Disease approximately seven (7) years ago. It used to be a designer for a very prestigious Syracuse China manufacturer which customers include the White House, 5 star hotels and prestigious restaurants. He also was a member of a Barber Shop Quartet as a tenor for the SPEBSQSA (Society for the Preservation and Encourage of Barber Shop Quartet Singing in America) and has been on several amateur Broadway shows in New York. He was an art teacher to middle school students teaching drawing.

His life changed when he was called to ministry sometimes in 1986. He became involved with a healing ministry which he revealed was mostly with people who had tumors. He has traveled abroad to expand his healing ministry. This has garnered so much attention that even the media noticed and did several coverage on his ministry. He is now retired and lives in Palm Bay Florida.

It is a privilege to know this special person who has done so much during his younger days. He has dedicated so much time and commitment to helping others. I deeply appreciate the humanitarian service. J has rendered and how his ministry has touched so many lives. I consider him another unsung hero of his time.

His willingness to have me share a snippet of his story is a privilege. Moreover, to be able to work with him to further his progress and see his motivation and determination through the years is a very inspiring experience.

Mr. JL's personal battle with Parkinson's Disease.

Mr. J as he shared, was officially diagnosed with Parkinson's Disease some seven years ago. He has been under the care of a doctor of Internal Medicine practicing in Palm Bay, Florida.

About Parkinson's Disease

As described by the Mayo Clinic staff: “Parkinson's Disease is a progressive disease of the nervous system that affects traffic. disease, the disorder also commonly causes stiffness or slowing of movement. ”

Subsequent effects of the disease include the following: expressionless face also known as masked facies or hypomimia and decline in speech quality that can be slurred, soft, even stuttering. These are very common in patients I have worked with. A patient's walking ability is also affected. There is loss of arm swing from trunk rigidity, stiffness and shuffling steps from resulting incoordination.

Unfortunately, this disease is progressive and current medications are aimed to improve the symptoms but not necessarily a cure.

There are currently many ongoing researches for cure including surgery to regulate certain regions of the brain and electrostimulation.

Still, there is no standard treatment for cure at this time, as per the National Parkinson Foundation.

Additionally, medication, lifestyle modification, exercise and rest are recommended.

Medications Prescribed

Current medications prescribed include the following: Carbidopa-Levodopa, Carbidopa-Levodopa infusion, Dopamine Agonists, MAO-B inhibitors, Catechol-O-Methyltransferase (COMT Inhibitors), Anticholinergics and Amantadine. -Source: The Mayo Clinic Organization

Parkinsons and Surgery

Deep Brain Stimulation (DBS) ia procedure where electrodes are implanted in specific areas of the brain with a generator implanted in the chest area near the collarbone which sends out impulses to the brain aimed at reducing the symptoms. It is not a cure however and there are many risks and side effects involved. Both the medication and DBS will not halt the progress of the disease.

Parkinson's and Physical Therapy

Physical Therapists get to work with these type of patients during the different stages of the disease. This is primarily because of the functional decline resulting from incoordination, dyskinesias (involuntary movements) and rigidity which makes purposeful and spontaneous movements very tedious.

These problems can make even the most basic functions as feeding, grooming and toileting very difficult. Walking becomes very unsteady. Shuffling gait is very common where it is difficult for them to make the first step (because of bradykinesia – very slow movement) but once they go, it is also very difficult to stop. Many of these patients are at a high risk for falling and a large number during the advanced stages become fully dependent for care.

When referred to Physical Therapy, patient education regarding appropriate exercises, movement strategies, task modification, gait training and fall prevention strategies are a part of the overall plan of care and functional intervention. They are also often referred to Speech Therapy for speech and feeding problems, and to Occupational Therapy for basic self care and hand or upper extremity functions.

Mr. J's Battle

I first worked with Mr. J about 5 years ago. Although he was not on the advanced stages of the disease at that time, he already identified the primary visible symptoms of the disease: Hand and neck tremors, masked facies, rigidity and significant incoordination. He walked very slow, was shuffling and took a long time walking even from room to room as he was unable to make quick turns. When he does turn, he tends to lose his balance and fall. His reflexes were very slow. He could hardly catch a ball or bounce it. His speech was slurred, barely audible and he had a stutter. He had difficulty getting up and down simple curves and stairs. He had fallen a few times from balance issues.

Mr. J persevered with the physical therapy program and was always very motivated. For each of the episodes that he was referred to us through the years, he always showed improvement and always followed through with the specific exercise program we prescribed. Due to the progressive nature of the disease however, he would have a physical decline and we had to work with him again.

He shared the story of how he first noticed the change in him from Parkinson's. Foremost he mentioned was when he was teaching drawing to middle school students in his art class in New York. He said that he was progressively having difficulty drawing and using his right hand as he had developed tremors. The rest followed including a change in his facial expression, rigidity and feeling stiff all the time.This became progressively worse through the years until his move to Florida.

Once under the care of an intern, he was prescribed Sinemet and other medicines which he had taken through the years.

The last time I saw him for treatment was in early 2016 where he had significant tremors on his right hand and an involuntary twitching in his neck. His masked facies had progressed, his face almost droopy and he was walking with so much shuffling and difficulty. He was barely able to move one foot in front of the other. He also reported of falls because of worsening balance problems.

This was why when I saw him in March of this year, I saw the significant change in him which he attributed to medical cannabis.

Medical Cannabis: Capsules and Gummies

He further shared his story. Upon hearing about the potential benefits of medical cannabis for Parkinson's disease, he consulted with his primary physician who directed him for further consult with his neurologist. His neurologist recommended trying medical cannabis due to the advancing nature of his Parkinson's disease.

Mr. J then got started on medical cannabis capsules where he said it contained about 30 pieces of 25 mg capsules. This cost him about $ 80 or so including shipping. With his shipment came a sample pack of the gummies version of about 5 gummies in a pack. The capsules were bitter, according to him and he took 1 capsule daily.

He added that after taking the first capsule ever, he felt so relaxed and calm. He could move around, get in and out of bed easier, get in and out of his chair better. He also noticed that his tremors were much less that first time.

Mr. J stated that he liked the cannabis gummies better as it tasted much like candy and was tastier than the capsules. Even more so, the effect of the gummies appeared much faster than that of the capsules and was much cheaper. The capsules per piece costed about $ 3 each and the gummies would amount to about $ 1 a piece he added.

So as to mimic the effect of the gummies, Mr. J said he tried melting the capsule under his tongue to take off the edge of its bitterness. He also chewed regular gummy bear candy. This worked for him.

To date, Mr. J continues with physical therapy where we see him better able to tolerate and execute high level balance training tasks that he was unable to do so before. He has very little to no tremor on his right hand, he no longer exhibits the twitching on his neck, and his reflexes improved. I see this by his ability to make a turn and not lose his balance. We do not have to hold him while he catches, throws or builds a ball to improve his protective righting reflexes necessary for him not to fall. he can lift his feet higher when walking and his shuffling is so much lesser.

Still aware of the progressive nature of this disease, it is just inspiring to see this very soft-spoken, kind-hearted, intelligent and talented individual overcome simple daily functional obstacles caused by this debilitating and irreversible disease.

For the population afflicted with debilitating diseases, a day to day victory of being able to move about and perform tasks that seem so trivial to most of us, is a blessing.

Legalizing medical marijuana currently is, and will be an ongoing battle in congress. We all have varying stands and strong opinions about this issue. Researches are ongoing about its pros and cons. I foresee more awareness of its existence as an alternative treatment to various diseases who do not respond to conventional medicine and treatment.

As a medical professional however, it is just fulfilling to be able to witness the functional changes in Mr. J., how he is able to stay independent and self sufficient his where injury.

I am currently working on finding an individual who can share with me the negative effects of medical marijuana as well. I would like to hear from you and be able to share your journey and experience as well, anonymously, of course.

Please reach out to me if you have something to share.

My greetings for a wonderful day and until my next article!

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What Is Occupational Therapy Anyway?

Occupational Therapy is a relatively new field since World War I, or the early 1900's. Many still do not know what type of therapy service it is or provides. I am an occupational therapy practitioner, and I find that although more know what this field entails as time goes on, many are still at a loss to understand its function. Since it is rather a broad field, this also contributes to the general confusion and lack of clarity regarding the type of therapy it is.

In general Occupational Therapy addresses a patient or person's function and activities of Daily Living (ADL's) and a healthy balance of this being achieved through appropriate work, play, rest and recreation. This can further be broken down into four main, wide-spectrum areas of the population that is serviced. Adults, Pediatrics, the elderly and Mental Health. There are almost infinite sub-groups of therapy that each area addresses. Some certain to and apply to all of the main areas and some are exclusive and specific to one area. For example, ADL's are addressed in adults, children and the mental health areas, however the needs in each area varies and changes. A balance of work, play, rest and recreation applies to all, but again this is variable according to the area / population being served.

For example, adults' needs in their ADL's differ from a child's.The obvious reason is that children are in the process of developing and adults (although still developing through stages of life) are different in their developmental needs. This is further complicated by the condition or conditions that are being treated. A premature baby with Cerebral Palsy is surely given a different treatment plan than an adult with let's say Carpal Tunnel Syndrome. This brings us to the many specialties within the category of Occupational Therapy. Hand Therapy would be one area of ​​which Carpal Tunnel Syndrome falls under. Occupational Therapists can specialize in a multitude of endless areas, much too many to go into detail here.

Before I proceed any further, I would like to give a brief history about the development of Occupational Therapy as a profession and its basic philosophy. Occupational Therapy's goal is to help patient's reach their maximum potential and function in life in the general areas mentioned above, simply put, the ADL's. The very name 'Occupational Therapy' entails the act of occupying oneself. The theory and philosophy of Occupational Therapy is the process of restoring or reaching one's functional ability through employing actions. The basic premise of OT is that a balance of work, rest, play and recreation brings about, maintains and improves ADL's and optimum quality of life.

Historically, Occupational Therapy of theory / philosophy developed during World War I to help disabled veterans return to work, and it continues to develop. The word “disabled” in itself can aggravate many conditions, not excluding mental health illnesses, such as Post Traumatic Stress Disorder. It was discovered by Occupational Therapists that one very critical aspect of recovery from any disability is through meaningful occupation. The term 'occupation' used in this sense means many things. Doing crafts is a form of 'occupational' therapy. Preparing a meal or getting dressed is another one. Most of us take these things for granted, but people with disabilities often need to re-learn to do these things that most of us do not give a second thought to.

Many confuse Occupational Therapy with Physical Therapy, and there is overlap – yet they are two very distinct and separate fields. An Occupational Therapist works on improving physical and cognitive function as it addresses ADL's and a Physical Therapist focuses on the restoration of injured body function through physical exercises. Both forms of therapy are similar in many ways, but in the process they address different areas. Both PT and OT are very important fields and work together well and complement one another.

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Physical Therapy And Various Diseases

Bone infections are the result of fractures, which vary in size according to the force that led to bone fraction. There is a closed fraction, which occurs in the bones without penetrating the skin wall of the body and the open fraction, the bones are transverse or longitudinal, deviate from their place and penetrate the skin wall opposite them, and can be seen with the naked eye, and this type of the most difficult species, and requires urgent surgery.

  • Transverse fraction, which occurs in the width of bones.
  • Spiral fracture, which occurs as a result of bone exposure to two different forces such as twisting.
  • Pathological fraction, a fracture resulting from the exposure of bones to various diseases, such as bone cancer and osteoporosis.

After the fixation of the fracture by the surgeon, the role of physical therapy comes directly, as it has a vital role in restoring the movement of joints and muscles, and use ultrasound devices immediately after the fracture to increase the ability of fracture to heel, and increases the proportion of minerals forming those bones and increase bone density.

Neurology:

The nervous system in humans is composed of the brain, spinal cord, peripheral nerves, and cerebral nerves. When the brain becomes infected by stroke or a part of the spinal cord, paralysis occurs in different species. There is paraplegia, which affects one half of the body, right or left, and there is quadriplegia that affects all parts of the body, and there is partial paralysis, which affects either the upper half of the body or the lower part of the body , resulting in injury to the spinal cord, then The affected limbs do not move at all or move very slowly. The goal of natural therapy here is to re-move these affected limbs and then strengthen them and restore them to their normal position.

Pediatric:

There is a broad base of children suffering from diseases whose treatment depends entirely on physical therapy, such as Cerebral Palsy, postpartum and post-natal necrosis (Torticollis) and cervical nerve plexus injuries. In such cases, the doctor relations on therapeutic exercises, and teach the child motor skills such as sitting and then standing and then walking. These stages precede the child's ability to crawl and his ability to sit.

Obesity:

Obesity is one of the most serious diseases on the medical scene, and is next to diabetes, blood pressure, heart and arteries, especially as it is a major cause of these diseases in a large proportion of patients. Scientists have developed a measure of the proportion of obesity in humans, which is the measurement of body mass by the equation = body weight in kilograms per square meter body length, which shows the diagnosis of obesity in the patient. Once the patient has been diagnosed with obesity, he or she should have a healthy diet, as well as exercise. Scientists have recently proven that the treatment of obesity by diet only, or exercise only, does not fit, both are two sides of a single coin, especially that exercise maintains muscle mass and strength, while the diet alone does not do so, and help exercise to break fat The excess of the body, increases the efficiency of the heart muscle, reduces the chances of arterial disease and various types of diabetes diseases. For exercise, the researchers put in the following conditions: Exercising 3 to 5 days a week, each time for a minimum of 20-60 minutes.

Obstetrics and Gynecology:

Physical therapy has succeeded in alleviating and restoring a lot of pains in this regard, especially menstrual pain and birth pains, using various physiotherapy and exercise exercises, strengthening exercises to strengthen the back muscles, and pelvic muscles .. those forgotten muscles that women know nothing about, except Few of them, which are of great importance at birth. Recent studies have shown that women in sports give birth without acute birth pain than any other woman.

Internal diseases:

Of course, the most common problems to the life of the owner are respiratory infections, and the most common respiratory problems that help natural treatment in the treatment: Asthma, there are exercises to train the patient on how to breathe correctly, and how to cope with the crisis, as well as teaching how to use muscles attached to the thorax that helps To breathe when he feels asthma.

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8 Benefits of Physical Therapy

If you suffered an injury and want quick recovery, we suggest that you check out physical therapy. A good physical therapist will help you get your wellness back. They will help you choose the right therapies so you can get recovered as soon as possible. The exercises are designed to solve problems that you may be suffering from. After the therapy, your range of motion and flexibility will get better. Aside from this, physical therapy will help you to reduce pain and inflammation. Given below are 8 benefits of physical therapy.

Reducing Pain

After an injury, pain is what you suffer from. If the injury was severe, the pain may also be severe. For pain reduction, your therapist may recommend manual therapy techniques and therapeutic exercises to help you get rid of joint and muscle pain. Aside from this, the therapy will also help you prevent the pain from coming back.

Regaining Balance

After an injury, if you become bed-ridden, it may be hard for you to maintain your balance while walking. Physical therapy can help you regain your balance so you can prevent falls. Apart from this, the exercises will enable you to boost your coordination.

Avoid surgery

After an injury, the doctors will decide if you need surgery. Since surgery involves complex procedures, you may want to avoid it if possible. Physical therapy reduces pain. As a result, you do not have to opt for surgery. Even if you have to get surgery, the therapy will help you get stronger for the procedure. Afterwards, you will be able to recover faster.

Improving mobility

Another benefit that you can enjoy is stretching and strengthening of your muscle. No matter what type of daily activities you perform, physical therapy will help you improve your motion. As a result, you can perform better.

Slowing the Aging process

When you are young, your body has a better ability to fight with diseases and infections. But as you get older, you are at a higher risk of developing osteoporosis or arthritis. With the help of a physiotherapist, you can manage these conditions more easily.

Recovery from a stroke

A stroke will make you lose your range of motion. The reason is that it weakens certain part of your body. On the other hand, if you work with a physical therapist, you will be able to move around your house more easily. You will not have to rely on others to get out of bed and go to the washroom. You will be able to perform these functions on your own.

Recovery from injury

The professional will customize the treatment to treat your specific problems. As they say, not the same treatment can be given to every patient. So, you will be suggested exercises that will be suitable for you.

Prevention of Falls

Prevention of falls is the largest benefit of physical therapy. Since the exercises will help you maintain your balance, you will be able to walk properly, which will prevent falls through your recovery period.

So, if you have been looking to recover fast after an injury, we suggest that you hire a good physical therapist.

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Necessity of Physiotherapy

Physiotherapy is important as it helps in the restoration of function and movement if at all a person is affected by disability, illness, or even injury. Physiotherapy helps in reduction of risk in future. Usually, it is a holistic kind of approach that involves a patient in own care.

When is it used?

Physiotherapy can help all people regardless of their age for a very wide range of conditions related to health and affecting areas like:

Soft tissues, joints and bones : this includes sports injuries, shoulder pain, neck pain and back pain.

Nervous system or brain : this includes issues with movement that result from Parkinson's disease, multiple sclerosis, or even stroke.

Heart and the whole circulation : this includes things like rehabilitation after a person has had a heart attack.

The lungs and breathing : this includes cystic fibrosis and the chronic obstructive pulmonary disease.

Physiotherapy can be very important in the improvement of physical activity and also in helping in the prevention of any other injuries that may occur.

Physiotherapists

Physiotherapy is usually provided by a practitioner who is specially trained and also regulated called a physiotherapist. These professionals usually work as a team that is multi-disciplinary in different areas of medicine as well as different settings. This includes:

· Home visits

· Workplaces, charities, clubs and sports teams

· GP surgeries

· Clinics and community health centers

· Hospitals

What they do

The professionals consider the entire body instead of individual aspects of an illness or injury. There are different approaches that a physiotherapist can apply and they include:

Advice and education : these are people that can give you some general advice regarding the things that affect the daily living like post, the correct way to lift heavy things, best carrying techniques and so on so as to stop injuries.

Physical activity, tailor exercise and movement advice : they can recommend exercises that can help in the improvement of the general health as well as mobility. This helps in the strengthening of very specific areas of the body.

Manual therapy : this is where hands are used so as to relieve stiffness and pain and to also encourage your body to move.

There are many other techniques that the physiotherapist can use and they include aquatic or hydrotherapy as well as acupuncture.

How you can find a physiotherapist

There are a number of avenues that you can use so as to find the ideal physiotherapist. In some places, you may be required to produce a referral from your GP, while others you can simply refer yourself. Your GP can recommend the best place to get treatment. Typically, the private physiotherapist accepts any direct referrals.

Other areas where you can access a physiotherapist is through voluntary sector, patient groups, charities, occupational health services and so on. In some areas, there are bodies funded by the government that offer the services free of charge, but they usually have very long waiting lists, therefore may not be really ideal for your needs especially when you have an emergency.

The internet can be a very helpful tool in locating a physiotherapist near you.

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Advantages of Sports Physiotherapy

At such times it is the sports physiotherapists who are responsible in getting them on their feet as fast as possible.

The place of sports physiotherapy in the world of sports has come to be recognized as the one of prime importance. Sports physiotherapy centers come to the rescue of professional athletes not just in treating sports injury, but also in enhancing their performance through physiotherapy. The benefits offered by them are:

Builds Physical Toughness of the Athlete
Professional athletes have to bear blows in sports which involve direct contact such as rugby, football, boxing and basketball. Being under the statute of a physiotherapist enables the athletes to improve their body's sturdiness and toughness. Their muscles, bones, ligaments and joints are strengthened and this helps the athletes to withstand the high physical stress demanded of their sport.

Prevention of Injury
Physiotherapy centers offer customized workout regimes for the athletes. These regimes are drawn based on the observations made by the physiotherapist during the training sessions. The physiotherapist knows where exactly the athlete stands with regard to his flexibility, joint flexion and strength. Therefore his workout rule ensures that the incidence of the athlete suffering from cramps, sprains, stress and torn ligaments is greatly reduced.

Enhances Muscle & Joint Flexibility
Contrary to common perception it is not only the gymnasts who require a supple and flexible body but sportsmen from all sports. Every sportsman involved in differenting sports such as baseball, swimming, cricket etc requires his or her body to be flexible though the degree may vary from sport to sport. Sport physiotherapy helps the athlete to enhance his or her body flexibility so as to be able to give an optimum level of performance.

Promotes Relaxation of the Body
All sportsmen like to unwind after a long and exhausting day at the workouts or on the field. A few medical fitness centers offer sports physiotherapy programs that not only offer injury related assistance but also enable the sportsman to relax and recoup his body's energy so that he can return to the field with his full vigour.

Sports Injury Treatment & Rehabilitation
In spite of taking precautions and care, some injuries are bound to happen. Some of the renovated Physiotherapy rehabilitation centers help the athlete to recover at a faster rate without the injury becoming too complicated. Specific physiotherapy sessions involved in sprained ankle treatment, frozen shoulder therapy etc enable the affected sportsman to recuperate from his dislocation, sprain, pressure or torn ligament problems quickly without the threat of complications creeping in.

Other Health Issues
Sports physiotherapy centers offer assistance for tackling cardiopulmonary issues. Their regime improves the endurance and breathing of the sportsmen which enable them to perform their daily activities in a better way. Sports therapists also offer benefits when it comes to treating spinal cord injuries, neurological disorders, multiple sclerosis etc.

Summarizing
Sports injuries are certainly different from everyday injuries. Athletes have to give high level performances and as such a greater stress is placed on their bodies at all the times. Sports physiotherapists are equipped with sports-related knowledge that help to address severe, persistent and overuse injuries and therefore their prime place in a sportsman's life is an undisputed one.

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All About Sciatica and Its Treatment

Do you know sciatica is relatively common affecting 15% to 40% people during their lifetime? Sciatica is more than leg pain. It is a global problem and hampers the overall capacity as well as productivity of a person. People not only feel distinct tingling or numbness in the whole body, but also feel weakness an entire day long. Of course, it is not a fatal thing, but still could be dangerous if not treated properly. It can originate at any point of time in the lower back region of the body, in fact, you will be surprised to know that it will gradually travel through the buttock and down the large sciatic nerve in the back of each leg, which makes the problem quite difficult especially for older people.

Some older people report that they feel constant pain

Some older people report that they feel constant pain in only one side leg, which is also a distinct case because it occurs in both legs and cause huge pain. In fact, the intensity of pain arises if a person sit whole day long; they also start feeling burning or tingling sensation and doctors call it a severe condition that should be addressed as soon as possible. Because such acute pain is sometimes unbearable and restrict people to move or walk smoothly.

Some people unable to stand up or walk due to extreme pain

They even unable to stand up or walk due to extreme pain that goes down to the leg and even toe. Of course, its signs and symptoms are appropriate because of its pain. Doctors also report that prolonged sitting can be dangerous and damage the nerve as well. That is why, it is important to address such problems as soon as possible and report the symptoms to doctors.

Age, obesity and prolonged sitting

Do you know that age, obesity and prolonged sitting could be the prime cause of sciatica? Today, there are many available available treatment options and non-invasive remedies are available that can provide relief to people irrespective of their age. Doctors suggest regular exercise because it is quite easy and shows immediate improvement.

Proper exercise regimen

Proper exercise regimen can go a long way toward alleviating the pain. However, if the pain is unbearable doctors prepare a structured treatment plan that often involves surgery, because sometimes it is the only way to relive pain and minimizing pain and / or prevent dysfunction. The main objective of non-invasive sciatica treatment is to relieve pain and provide relief. Of course, there are a wide range of options available for sciatica treatment, but it is wise to choose the best one in order to balance the life.

According to some physiotherapists

According to some physiotherapists, sciatica improvements with proper rest, regular exercise, as well as other self-care measures. In fact, certain Physiotherapy Treatments are ideal for the symptoms of sciatica. According to some experienced physiotherapists, some specific exercises are very beneficial both patients in any of their phase.

Conclusion

In fact, treatment of sciatica works best when combined with other treatment options. Some doctors also suggest some over-the-counter medications because they often effective in minimizing overall pain. So, report your problem to your doctors to get the best possible Sciatica Treatment.

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Best Treatment to Manage an Injury of the Knee

A 23 year old active male patient presented to the clinic complaining of pain in the anteromedial region of his right knee which commenced 2 – 3 weeks ago. The pain could be reproduced with active standing squats felt when going down into the squat position increasing as the patient deepened into greater knee flexion. The pain is only noted when the knee joint is 'on load', there is no complaint of pain with passive knee flexion or knee flexion actively produced in single leg status or in supine. He also complained of stiffness in the thoracic region and subjectively that he feels stiff with both covered rotation and supine lumbar rolls although there is no pain elicited with either of these movements. The knee pain was the main concern until 2 days ago when doing power cleans during a CrossFit session he felt a pinch in the right groin / hip flexor during actions where the pelvis was in an anterior tilt.

He attends the gym 4 -5 times per week and focuses on Cross fit style training. The CrossFit prescription is performing “functional movements that are constantly varied at high intensity.” CrossFit is a core strength and conditioning program. The CrossFit program is designed to elicit as broad an adaptational response as possible. CrossFit is not a specialized fitness program but a deliberate attempt to optimize physical competency in each of ten recognized fitness domains. They are as follows: Cardiovascular and Respiratory Endurance, Stamina, Strength, Flexibility, Power, Speed, Coordination, Agility, Balance, Accuracy. The CrossFit Program was developed to enhance an individuals competency at all physical tasks. [1]

The patient also has occasional bilateral cases pain with left greater than the right, this can be provoked with resistance training in varying upper limb movements including shoulder press, incline bench press, and single dumbbell overhead press. This is episodic and abates in 2 to 3 days if left untreated and non-compromised with resistance work to the region. The patient is a working physiotherapist so has a grounding in education for exercise prescription, injury prevention and structural and functional alignment of the body. He could demonstrate both good form and function during his assessment and confirmations 'best posture' during his functional, active movement patterns.

A study of Injury Rate and Patterns Among CrossFit Athletes was conducted and documented by Sage Journals whereby 486 CrossFit participants completed the survey, and 386 met the inclusion criteria. The overall injury rate was determined to be 19.4% (75/386). Males (53/231) were injured more frequently than females (21/150; P = .03). Across all exercises, injury rates were significantly different (P <.001), with shoulder (21/84), low back (12/84), and knee (11/84) being the most commonly injured overall. The shoulder was most commonly injured in gymnastic movements, and the low back was mostly commonly injured in power lifting movements. Most participants did not report prior injury (72/89; P <.001) or discomfort in the area (58/88; P <.001). Last, the injury rate was significantly reduced with trainer involvement (P = .028). [2]

The literature above was valuable because it provides confirmation regarding the injuries described by my patient.

Assessment included full strength testing using of the neurolymphatic reflexes. Results were that the patient was strong in both functional back lines as represented in isometric strength of the latissimus dorsi and strong in hip flexion, knee flexion and ankle dorsiflexion. His ankle range of movement was free although limited to less than 5-7%. He had poor range of pelvic rotation greater stiffness noted with the bent knees falling passively to the left. He could illit the notable painful symptom in the knee during testing of a squat, we did not assess for pain, strength or stability in a 'pistol' squat or one legged squat due to the fear of pain and aggravation in the region of the knee .

Treatment Consistent of stimulation of the various Chapmans Reflex points for the diaphragm and included 10 diaphragmatic breaths, psoas, gluteus maximus at the direct region only, the lateral sling on the ASIS points, the thoracic defense points, his rectus abdominus, internal and external obliques , deep neck flexor and SCM component and concluded with the jaw. On repeat testing we found that the calf ROM was still poor so I added activation of the neurolymphatic points for the calves and tibialis anterior. Other treatment contracted of Lumbar muscle energy technique and fixation of the lower limb into rotation in both directions working into the reduced range first, completing the initial treatment with stretches to the gluteal / hip rotators and quadriceps / hip flexor groups.

Upon reassessment of strength and movement into the squat the client was pain free and noted considerable improved stability and strength. We then added the single pistol squat and managed 99% pain free. The patient also noted that standing body twisting (described by him as lumbar rotation) felt looser and moved with greater freedom.

Advice – daily facilitation of the Chapmans Reflexes including diaphragm (plus breathing), psoas, gluteus maximus, ASIS, thoracic region, SCM, jaw and abdominal regions. The full activations taking no longer than five minutes in duration. He was also to stretch the hips and gluteal region and continue with squats being monitored by pain response.

Follow up 48 hours later found that the 'pistol' squats had returned to some pain but the full squats and freedom in the back had remained pain free and loose.

References:

1. http://www.crossfitdefined.com/what-is-crossfit/

2. http://journals.sagepub.com/doi/full/10.1177/2325967114531177

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Question and Answer Session: How This Physical Therapist Successfully Uses Hydrotherapy

Carolina Spine & Neurosurgery Center (CSNC) has a thriving hydrotherapy practice. It is one of the largest private neurosurgical and spinal care centers in Western North Carolina. CSNC operates as an independent part of the Mission Hospital System and is a major reason the hospital was named one of the top 101 hospitals for spinal care by Becker's Hospital review.

The therapists at CSNC understand the beneficial properties of water and use hydrotherapy as a successful tool for patient recovery, well-being, and rehabilitation. Here's how they achieve success.

The hydrotherapy room includes a warm-water (94-degree) therapy pool with independent performance zones at depths of 4 feet, 5 feet; and 6 feet. The pool generates a water current with 99 speeds and can accommodate patients at all stages of recovery to safely improve mobility, balance and confidence.

QUESTION AND ANSWER
with Roger Meade, DPT, director of physical therapy at the Carolina Spine & Neurosurgery Center.

What are the common diagnoses where you utilize hydrotherapy?

We work with the following:

A: Orthopedic: all joint replacements (once incisions heal); strain / sprains all joints, trauma fractures to limbs requiring multiple joint limitations in rehab (once incisions heal); all sports injuries especially with sooner initiation of Rehab post injury; arthritic issues to improve movement and conditioning.

B: Neuro / Orthopedic: all spinal surgeries, basic head trauma with difficulty in coordinated movement patterns, CVA varied levels depending on cognitive and bladder / bowel issues, Parkinson's (to work patient outside comfort zone), MS if we can keep pool cool; or central neurological systemic issues depending on physician's projection of recovery. Most spinal paralysis except high quadriplegic.

Balance issues not related to inner ear issues or Menier's Disease; but more related to CVA, physical de-conditioning, dementia, and proprioceptive loss lower extremities.

C: Pediatrics for birth defects, injuries during delivery, or early trauma. Extremely effective with children 1-8 years old.

What does a typical week look like for pool hours and scheduling?

Our pool is open 7AM to 7PM, 5 days per week. Patients are scheduled for 45 minute slots and up to four may be scheduled in same slot depending on difficulty. We schedule “high water current” patients together.

Who do you have on staff for hydrotherapy?

We have 5 therapists and 5 PTAs on staff. All PTAs work in the hydrotherapy pool. I am the only therapist at the present time that works in the pool. Patients are evaluated and treatment plans proposed to the physician. If approved, the PTA will follow the plan as outlined with the therapist checking at least every 4-6 visits for changes needed.

How do you schedule therapists?

Each PTA will work one half day in the pool – AM or PM. This is rotated by schedule through the 5 PTAs. I see complicated patients and would be the only one working with patient in the pool.

PTAs are required to be in the pool with patients. We have a waterproof computer at side of pool for writing notes, charges, and reviewing patient's history and physician notes.

How many patients do you schedule in one session?

We see up to 4 patients per 45 minutes depending on the difficulty of the patient, however we leave this up to the therapist to decide the number to schedule.

How do you bill for hydrotherapy?

We charge in 15 minute increments, and we have a number of different systems to maximize billing. But all insurance is different and it's important to understand parameters specific to each state, plan and region.

Do you use your pool in other ways?

We hold classes in pool that are offered at specifically blocked times. These group classes are very successful and generate extra revenue. They include Aqua Yoga and Tai Chi.

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How To Avoid Knee Manipulation After a Total Knee Replacement

When it comes to undergoing a total knee replacement, the majority of your time will be spent in your physical rehabilitation work on regaining your leg strength, learning how to walk properly again and, obtaining as much range of motion in the surgical knee as possible.

When it comes to working on your range of motion, this is considered the toughest part of the physical rehabilitation due to the pain level when it comes to flexing and extending the knee.

Some patients will become appreciative when it comes to flexing and extending their knee during physical therapy and will not put in the effort in it will take to make their knees as fully functional as possible.

When this part of the rehabilitation process is not emphasized, many patients can end up with a contracted knee due to the musculature surrounding the knee and allows chronic long-term pain due to the accumulation of scar tissue.

How do you avoid this? I have listed below three tips to help you avoid having to go back into the hospital to have your knee manipulated.

Learn to Relax. You will find if you can learn to relax as your rehabilitation professional is working on your knee, you will have much more success in obtaining the motion needed for a full and painless recovery. Trying to resist movement of the knee during this process only makes it harder on you and more painful. Anxiety is a major problem here so learning relaxation skills prior to surgery will be beneficial.

Use Heat 30 Minutes Prior To Physical Therapy. Yes, you read it right use heat. Use a large heating pad that has the capabilities to apply a moist heat to your thighs or quadriceps and hamstring muscles. Heat will allow the muscles and surrounding tissue to become more pliable and will allow greater flexibility within the knee. Just be sure you do not place the heating pad directly over your knee this will only increase your swing making your knee more difficult to work with.

Think Long-Term Success. Think and visualize how your knee is flexing and extending properly and how you will look and feel once you are able to walk again pain-free with a normal functioning knee. You will have to pay a short-term price today to have your knee moving and operating smoothly tomorrow. Remember, like many things in life you either pay the price of today's discount or live with the pain of regret tomorrow.

I have worked with knee replacement patients for close to 23 years now and have found those patients that were not willing to pay that short-term price of allowing their knee to be properly rehabilitated due to anxiety or discomfort will have lost the benefit of the surgical procedure, to begin with, and do not recover fully which invites long-term discomfort in the future.

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Preparing For Elective Total Joint Replacement Surgery

Making the decision to have either total joint replacement surgery or another elective surgery is one that takes time and forethought to prepare your mind and body.

In my years working in the field of physical rehabilitation, I have found many that decide to go through with total joint replacement surgery find out once they get home that there is more to the procedure then what they may have expected.

To be properly prepared for total joint replacement surgery, there are pre-operative classes that you can attend at the hospital that you and your surgeon may have recommended for the procedure, however, there is more to the surgical process than the general information you will receive once you get home.

To help your surgical procedure go as smoothly as possible, I recommended your begin to prepare in three ways.

1. Become Physically Fit. Generally, due to joint pain, your overall physical fitness has suffered and you have become deconditioned. I recommend that you find an activity like stationary biking, water aerobics, and strength training to prepare for a smoother transition when it comes to your physical rehabilitation and maintaining your energy levels.

Your body will absorb a serious shock to it once you go through the procedure and the medications involved and by taking the time to get your body stronger prior to surgery, you can diminish the effects of the procedure.

Make sure you discuss this with your general practitioner and surgeon before you embark on an exercise program if you do not have experience in this area. This will depend on other medical issues you may or may not have and medical clearance may be required.

2. Become Mentally Tough. This is another area where I will find patients that had no idea that the pain, swelling or discomfort was going to be at the level it is. Of course, pain is subjective and some can mentally handle it better than others.

Learn to deal with the fact that even though the surgical procedures today have become minimally invasive, there will still be some pain and discomfort to deal with.

In other words, learn to be comfortable being uncomfortable for the first week to 10 days after surgery. Be mentally tough and disciplined to make sure you use your pain medication as prescribed and listened to your body for the signs and symptoms of chronic fatigue and pain due to overactivity as well.

And understand that being mentally tough during your recovery means doing the things you may not feel like doing, for instance, completing your home exercise program as prescribed by your physical rehabilitation professionals and resting for the recovery needed to ensure optimal strength.

3. Learn To Never Quit. This is an area that no matter what we are going through in life we ​​need to heed importance too. I come across patients that become so frustrated with the events that may take place after surgery once they get home that they decide to back down or stop the physical rehabilitation process altogether.

This is non-negotiable after surgery as not having that mental toughness mentioned earlier to finish something can have negative repercussions later when it comes to your physical ability to functionally operate in your day to day activities.

Understand that whatever you are going through after your surgery will be temporary and that if you stay with the plans and goals set forth by your surgeon, physical rehabilitation specialist, and more importantly yourself, you will then begin to feel better and stronger and thankful you had the surgery performed to improve your overall quality of life.

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Attempt to Raise the Predictive Accuracy in Binary Logistic Regression Analysis

Many reports have used Functional Independence Measure (FIM) gain (FIM at discharge minus FIM at admission) as the dependent variable in multiple linear regression analysis. Binary logistic regression analyzes have also been taken out using 1 for FIM gains equal to or greater than the median value and 0 for FIM gains less than the median value. The deliberate conversion of quantitative FIM gains into 0/1 binary data is thought to be advantageous in that this does not require as much rigor in terms of the type or distribution of data.

While multiple regression analysis envisages a linear relationship between independent variables and dependent variable, there are in fact many cases where no such linear relationship exists. Especially, there is no linear relationship found between FIM at admission and FIM gain. Correspondingly, it has been reported that, rather than relying on a single predictive formula, the predictive accuracy of motor FIM (mFIM) gain will be increased by creating two predictive formulas by stratifying mFIM scores at the time of admission (mFIMa) into two groups

In binary logistic regression analysis, as well, stratifying mFIMa to create two predictive formulas may improve the predictive accuracy of mFIM gain. In addition, because it is possible to categorize independent variables in binary logistic regression analysis, it may also be possible to heighten the predictive accuracy of mFIM gain by categorizing mFIMa.

This study conducted binary logistic regression analysis with mFIM gain as dependent variable among stroke patients admitted to convalescent rehabilitation wards in Japan. The aim of this study was to compare the predictive accuracy of mFIM gain (a 0/1 binary value) between “mFIMa used as quantitative data”, “categorized mFIMa into 4 groups, and” creation of two predictive formulas. ”

We used patient data from the Japan Rehabilitation Database (JRD). The subjects were selected from 6,322 stroke patients hospitalized in convalescent rehabilitation wards and registered with the JRD in April 2015. To reduce the influence of exceptional cases that could have been seen as outliers, the subjects were limited to patients who fulfilled the following inclusion criteria: age 15 to 99 years, duration from sunset to hospital admission of 5 to 90 days, admitted to convalescent rehabilitation wards for 21 to 210 days, total score of 13 to 90 for mFIMa, FIM gain of 0 or higher, and having entries for all items to be examined. The remaining 2,542 patients were included in this study.

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Home Workouts Make Physical Therapy Work

Receiving treatment from a physical therapist can be a wonderful soothing, not to mention … well … therapeutic experience. The skills involved in diagnosing, manipulating and restoring natural movement to patients with musculoskeletal and other issues are unique and can be quite wonderful. And those who think of it as a reliably new discipline may by surprised to learn that its first practitioner was Hippocrates who, according to the open knowledge resource Physiopedia, advocated massage, hydrotherapy and manual therapy treatments as long ago as 460 BC

But an important and oft-overlooked part of the therapist's repertoire is to devise a program of home workouts based upon the patient's specific complaints and well as of course to his or her physical abilities.

A Bespoke Approach

All types of people use the services of physical therapists, often referred by general practitioners who recognize their particular expertise in their chosen field. Some patients may be sports people who have sustained injuries whilst performing. Others may be people who already experience mobility issues in their everyday lives – older people, people with a disability or even those who are physically restricted in their movements due to their own personal condition. The approach taken by the therapists will always be one that is mindful of and adapted to the unique circumances of the patient.

What every patient has in common is that they are inhibited by pain or a lack of movement, sometimes both, the causes of which need to be identified before they can be remedied. Once the therapist has a handle on what is involved, a program of treatment can be devised which will usually entail a bespoke exercise statute which can be followed at home once the session has ended. The type of exercise prescribed will of course depend upon the nature of the condition involved. Generally speaking they will belong to one of four categories – balance, range of motion, strengthening and general conditioning exercises.

The Onus for Compliance is on the Patient

Whilst the application of the correct exercise program is the responsibility of the physical therapist, the onus for compliance with the program rests entirely with the patient. A study contacted by academia from the University of Bristol and recorded in the British Medical Journal revealed that non-compliance was common, and that while the reasons for not following advice were rational they were not usually predictable.

Performed diligently, and properly, home workouts are an essential facet of the rehabilitation process. Often recovery is only possible by the affected area receiving regular, organized movement which it is intended will over the course of time restore normality to the joint, nerve or muscle. No matter how great the therapist's expertise, this is not a thing that can be achieved at the practice alone.

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