physical therapy

Here’s an interesting infographic on the benefits of biking and the dangers of a sedentary lifestyle. The image outlines how much Americans drive, how much pollution of this driving causes and how biking instead of driving can have a dramatically beneficial effect.

Not only is biking better for the health of Americans and for the environment, the infographic also attempts to illustrate how biking could save America billions of dollars.

As always such infographics need to be taken with a grain of salt. However, I don’t think it’s too hard to imagine that less driving and more biking would benefit all of us.

Thanks to healthcaremanagementdegree.com for putting this on together.

Here’s another nice infographic, this time about the perils of cushy running shoes. Barefoot or minimalist running is all the rage these days. This illustration points out some of the history of running shoes as well as a few common ailments that are now being blamed on the increased heel strike often associated with running in padded running shoes.

The infographic was created by www.xraytechnicianschools.net

 

 

 

An Epub ahead of print at the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) describes a study done comparing outcomes following Total Knee Arthroplasty (TKA; also sometimes known as TKR for ‘Total Knee Replacement’). Two rehabilitation protocols were followed by the two different groups in the study.

The two groups 8 were age and sex-matched. One group followed a standard, lower intensity rehabilitation program while the second group followed a higher intensity program that progressed as tolerated. The high intensity (HI) group had an additional month of treatments but there were already significant differences between the two groups at the 3.5 weeks post TKA. The HI group also utilized machine-based strengthening while the lower intensity group only progressed to ankle weights or resistive bands.

The study found that those in the higher intensity group had superior strength and functional outcomes while not experiencing any increase in pain or decrease in range of motion (ROM). The HI group showed significantly greater short-term and long-term strength and function as measured at 3.5 weeks, 12weeks and 52 weeks .

It’s worth noting that the study only involved a small sample size and lacked randomization and blinding. However, the researchers believe that this illustrates that larger similar studies are warranted.

J Orthop Sports Phys Ther. 2011 Sep 30;

Authors: Bade MJ, Stevens-Lapsley JE

Please see the Journal of Orthopaedic & Sport Physical Therapy (JOSPT) site for more topics.

Physical activity is essential for combating many physical problems yet current figures suggest that older Americans aren’t getting enough. This infographic effectively breaks the numbers down for you.

Highlights:

• 22% of those 65 and older report regular physical activity
• estimated cost of falling injuries by 2020 is $32.3 billion
• 4 in 10 of people 65 or older have difficulty with at least one basic activity of daily living (ADL)

Physical Activity and Older Americans Infographic via Evergreen Rehab

This is a great infographic about the negative effects of sitting. It was created by Medical Billing & Coding and is definitely worth a look.

A few of the interesting items on the graphic are:

• we spend more time sitting than sleeping
• sitting 6+ hours a day makes you 40% more likely to die within 15 years than someone who sites less than 3
• obese people sit 2.5 more hours per day than thin people
• calorie burning drops to 1 per minute when you are sitting
• each extra hour of watching tv = 11% higher death risk
• sitting in a reclined position puts less strain on your back

 

Via: Medical Billing And Coding

The University of West Indies, School of Physical Therapy, recently conducted a study on the use of the Wii as a adjunct to physical therapy treatment for children with cerebral palsy. The study was a small one, only involving six children, but the results they found were very positive.

The Wii was chosen largely because of it’s affordability compared to other gaming consoles, making it a much more likely candidate to be purchased by the families of children requiring treatment. Compared to standard physical therapy treatment costs the Wii is very affordable.

One of the primary reasons cited for the success of using video games as therapy is because of the much greater likelyhood that the children will actually take part in the therapy. The video games, while being physically challenging, are also engaging and make the children what to do their therapy.

It is believed that the neurological connections in the brain are strengthened by the new activities offered by the ‘virtual reality’ game play and that the plasticity of the brain allows it to do some ‘re-wiring’ as a result of the mental and physical stimulation.

Although this study involved children with cerebral palsy, the researchers are excited to explore the possibilities of using the Wii with people with cardiovascular impairments as well.

You can read more about the study in the Jamaica Observer here: http://www.jamaicaobserver.com/news/-Wii–care_8980080

Many physical therapists use orthopaedic/orthopedic rehab protocols frequently throughout their daily practice. Former Calgary Flames and Canadian Olympic Team Physical Therapist, Terry Kane, runs a website called OrthopaedicProtocols.com . The site links to dozens of orthopaedic/orthopedic protocol documents from all over the internet. The documents included come from sites such as:

• Advanced Orthopaedics and Sports Medicine
• Bringham and Womens Hospital
• Cappagh National Orthopaedic Hospital
• Cochrane Review
• WorksafeBC
• Massachusetts General Hospital
• Cincinnati Sportsmedicine and Orthopaedic Center
• Dr. Millet / Steadman Hawkins
• Gundersen Lutheran
• PureSportsMed
• University of Kentucky
• University of Minnesota Orthopaedics
• University Sports Medicine – University of Buffalo
• Massachusetts General Hospital
• Kevin Freedman MD, Orthopaedic Specialists

…and many more. Protocol documents available are varied,  from ankle sprains to post-op artificial discs and almost everything in between. Outcome and radiological documents are also available.

From the site:

Ownership / Editor: The site is 100% privately owned and edited by Licensed Canadian Physical Therapist, Terry Kane (www.terrykane.ca)

Authors: This database consists of hypertext links to protocols authored by licensed healthcare professionals or academic institutions. All protocols are currently part of the public domain on the internet or have been submitted by the authors themselves.

Mission: The site was designed to help students and clinicians find diagnostic, treatment and rehabilitative protocols to help them in managing their patients.  The protocols are not presented to replace the care and advice of a licensed healthcare professional but rather for educational purposes of healthcare professionals only. This website does not endorse any of the protocols presented, but rather, provides them as a library for visitors to access and evaluate for themselves independently.

Target Audience: The site was designed and authored for an audience of licensed healthcare professionals and students.

Terry has put together a very useful resource with this vast collection of protocols available online. Much can be learned from studying the differences and similarities between the many available. The site also offers the ability for practitioners to submit their own protocols to be added to the system.

One feature that I would like to see added to the site is the ability for site visitors to rate the various protocols available. Doing so would require that users register with the site, something that is not currently required or possible. I believe the lack of registration required is for ease of use and to prevent people from being concerned about privacy issues. However, I feel that allowing those interested in registering to give their ratings would make the site even better.

Check out the site at OrthopaedicProtocols.com

Boing Boing has an interesting article on the (fairly) new AlterG treadmill. From the article: “The AlterG is no ordinary treadmill, though. It is a super fancy, super-expensive treadmill that isolates the lower body in a vacuum and literally takes off percentages of your body weight using technology developed by NASA.”

The treadmill can significantly reduce stress through the joints during ambulation or running and allows the user to set what percentage of their body weight they have to support. It sounds like a great way to enable early rehabilitation or to allow physical activity for disabled and overweight people who might otherwise not be able to get effective cardiovascular exercise. It can also be used to allow injured athletes to train through injuries.

The treadmill looks futuristic and comes with a price tag that is also somewhat out of this world coming in at around $24, 500 USD. While this sounds expensive, it’s probably not that outrageous if you were to compare it to the cost of purchasing exercise equipment such as swimming treadmills which aim to acheiving similar goals.

The AlterG is supposedly showing up increasingly often in physical therapy clinics.

A bouncy, anti-gravity workout with the new AlterG treadmill – Boing Boing.

The Wii has been been a top seller in the game console market for years and continues to become more prevalent in homes around the world. Unlike gaming systems such as the Xbox and the PS3, playing games on the Wii often involves more gross motor skills than fine motor skills. Used correctly this makes the Wii potentially effective in improving coordination, balance, range of motion as well as general strength.

Physical therapists are increasingly bringing the Wii into the rehabilitation setting. Patients see it as a great alternative to often boring and repetitive exercises programs. The incorporation of gross limb and body movements into a game setting seems to keep patients much more engaged.

Popular therapy games include tennis and bowling as well as games like ‘Wii Fit’ which directly focused on actual balance and strength training. Not only can these games can be played individually but they can also be played by multiple players at the same time, which can increase engagement even more.

The Wii is being used in many different rehabilitation settings such as basic health maintenance in the elderly, youth physical therapy, stroke rehabilitation, post-surgical rehabilitation and brain injury rehabilitation. Clinicians feel that the benefits are even more broad and may aid in stress reduction as well as offering benefits to the treatment of diabetes, asthma and even heart disease. An early case study in PT Journal found that the rehabilitation program of a of a cerebral palsy when augmented with the Wii resulted in “positive outcomes at the impariment and functional levels”.

The price point on the gaming systems is very appealing as well. In an industry where equipment is usually very expensive, the appeal of the small $250 cost of a console, a cost that includes several games and a controller, is hard to deny. Most equipment in a rehab setting is very specialized for the small rehabilitation market; small in relation the the mass appeal of a commercial product like the Wii.

As the Nintendo Wii becomes more prevalent in the treatment programs for many conditions there is one condition that we may see begin to proliferate; the dreaded ‘Nintendonitis.’

A small trial recently showed that a simple eccentric wrist twist exercise can be very effective in the treatment of ‘tennis elbow’ ( lateral epicondylitis ). Adding these simple exercises to a home program dramatically improved functional scores and pain reduction.

The exercise can be performed anywhere and serves the same purpose as very expensive isokinetic machines. Instead of expensive machines the exercise involves the use of a small rubber bar similar in size and shape to a baton used in running relay races. Using the rubber bar, “twist with the wrist of their uninjured arm and then slowly untwist with eccentric wrist extension of the injured arm over a period of about four seconds. Three sets of 15 repetitions were scheduled each day.”

The trial was reported at the annual meeting of the American Orthopaedic Society for Sports Medicine in Keystone, Colo.

Read more at Medpage Today.