Wednesday, April 12, 2017

You Can Do It! (Your HEP That Is!)

We have a guest article written by Dr. Will Boyd, PT, DPT

I Don't Have Time
"I know I need to do my exercises. I just get busy."

Dr. Will Boyd, PT, DPT

I talk with dozens of physical therapists, chiropractors, and other health professionals on a weekly basis, and I hear some version of this sentence repeated over and over. People are busy. We all need reminders throughout the day to keep us accountable.

I spent some time this week thinking about home exercise compliance. Here are three potential ways to help keep your patients accountable when it comes to their home exercise program.

#1 - Why?
Finding out why your patient wants to recover is the biggest key in keeping them accountable. Pain is a symptom, not a reason. Is it to play with their grandchildren for longer periods of time? Is it to return to gardening? Establishing a patient's "why" is critical to helping a patient see the value in completing their HEP.

#2 - When?
Reminders, reminders, reminders. We live in a fast-paced world. Luckily the majority of our patients have a cell phone with the capacity to set reminders. Walk through setting up reminders with them. PT-Helper has built in reminders for your patients.

#3 - Celebrate
Nothing beats that feeling of being recognized for your hard work. Viewing patients' consistency of performing their HEP as an achievement, rather than an expectation, lights up that feel-good center of our brain. Take a moment to celebrate a patient's consistency and they'll likely want to repeat it!

Thursday, March 30, 2017

Bicycle Fit

Now that we are into the spring season, my mind automatically turns to my favorite outdoor activity: bicycling. The warmer weather and longer days is wonderful for long distance cycling. However, cycling does have its risks with crashes and repetitive use injuries from poor bicycle fit. I have invited my good friend and Master Fitter, Mark Bedel, to write an article on bike fit.

Bicycle Fitting:  What is it and why should I Have One Done?

As we all know, the human body is an amazing machine.  It is able to perform surprisingly complex while at the same time precise movements.  And with sport specific training, is able to perform these complex and precise movements with a great deal of power, speed and endurance.

There are a few sports however that require the athlete to become one with a machine to perform.  For all the wonderful attributes that the human body has on offer, symmetry, especially bi-lateral symmetry is not one of them.  These imbalances manifest themselves to a greater or lesser degree depending upon the activity, (cycling and rowing), and the degree to which that activity is performed.

Locking an asymmetrical body into a symmetrical machine often time will present issues as minor as performance loss and discomfort to as major as injury.  Modern bicycle fitting is the result of many years of examination and collaboration by experts in kinesiology, bio-mechanics and orthopedics, resulting in protocols for examination and assessment as well as evaluation and adjustment.

A qualified, certified and experienced professional bicycle fitter will be able to perform these protocols and assess each cyclist based upon their unique physical presentations and provide appropriate adjustments combined with when necessary, individualized equipment selection to achieve that “oneness” with our bicycles we all strive for.

The fit process should start with making sure that the cyclist is matched to the appropriate sized bicycle.  Next, a pre-fit question and answer session is performed to determine what the current style and level of the cyclist is and also what type of cyclist they want to become.  Once status and goals are determined, and brief accounting of any previous injuries and concerns is reviewed.  This then leads to a 20 step physical assessment in which measurements are taken, many are performed on both sides of the body to determine and compare flexibility, movement and position of joints and potential bone length discrepancies. 

There are of course what are considered “normal” ranges for all physical and structural assessments and these are taken into account as the cyclist is moved to the final “on bike” fitting process which in the case of Specialized Body Geometry protocol  is 15 steps.  Much of what was observed during the Physical and Structural Assessment process will provide clues for the fitter on what to anticipate and adjust for during the “on bike” fitting process.

Some cyclists will note an immediate improvement in many areas while other adjustments may take a few weeks of riding to adjust to.  This is why a scheduled follow up with the freshly fitted cyclist is a must!  In some instances, a mild refitting of certain areas may be required as the body adjusts to the new measurements and an additional follow up.  It is suggested depending upon frequency and level of the cyclist that a “fit check” or refit be performed every couple to few years later anticipating continuing adaptations.

While attending a recent Body Geometry Master Fit class at Specialized, Dr. Andrew Pruitt was asked what statistics were available to the performance oriented cyclist as to what they can potentially expect in gains from a professionally performed fitting.  He said that the long term data indicates on average, a 10% increase in performance over a cyclist that has never had professional fit.  He personally conducted a study to back this up while he was head of the Boulder Center for Sports Medicine in Colorado. 

Comfort and injury reduction potential are also two important results to be expected from a thoroughly performed fitting.  After all, who doesn’t want to feel less fatigue when out enjoying a ride!

Mark Bedel
Specialized Body Geometry Certified Master Fitter
USA Cycling Level 2 Coach

Specialized Bike Fit Video

Tuesday, February 7, 2017

Parkinson's Disease: Exercise and the Mind

I recently came across this article from the NY Times, "Exercise Can Be a Boon to People With Parkinson’s Disease" which reports on the benefits of exercise on alleviating Parkinson's symptoms.

“The earlier people begin exercising after a Parkinson’s diagnosis, and the higher the intensity of exercise they achieve, the better they are,” Marilyn Moffat, a physical therapist on the faculty of New York University, said. “Many different activities have been shown to be beneficial, including cycling, boxing, dancing and walking forward and backward on a treadmill. If someone doesn’t like one activity, there are others that can have equally good results.”

The article further reports that another patient's tremors disappeared while riding a bicycle. Unrelated to this article, I also stumbled upon this YouTube video "Cycling for Freezing Gait in Parkinson's Disease" which shows a patient perfectly riding a bicycle on his own.

Similar to my previous blog on the effects of music on a Parkinson's patient, the transformation in the patient during the activity is amazing.

In The Knowbodies podcast "Can Your Brain Heal Your Body? with Erik Vance", Erik discusses the deficiency of dopamine in Parkinson's patients and how dopamine is involved in the reward system. As a result, the placebo response is high for Parkinson's patients. He further discusses how belief and how physical therapy treatment is presented can impact the placebo response in PT patients. A very interesting podcast to listen to.

Recently I have had the pleasure to meet with another Pittsburgh entrepreneur, Courtney Williamson, PhD., who founded abiliLife. AbiliLife has developed Calibrace+, the only back brace designed specifically for Parkinson's patients. Courtney developed the product after recognizing that her mother, a Parkinson's patient, suffered from poor posture and balance. Calibrace+ is covered by Medicare and private insurance.

PT-Helper has added a set of MOVE BIG exercises to our portfolio of exercises. Search for 'Move BIG' in CONNECT's exercise list to display the available exercises.

Monday, January 23, 2017

Effects of Music on a Patient with Parkinsons Disease

I was delighted to find this video post on Facebook by Anicea Renee Gunlock of the immediate and stunning results that music has on her patient with Parkinsons Disease. Please watch the video to see for yourself.

Tuesday, December 6, 2016

Otago Exercise Program To Reduce Falls

During the 2016 Pennsylvania Physical Therapy Fall Conference, we were approached by a few therapists asking if PT-Helper included Otago exercises. At the time, we were not aware of Otago and decided that we needed to find out more. A quick online search revealed that the Otago Exercise Program is an evidence-based program developed in New Zealand to reduce falls among older adults.

The Carolina Geriatric Education Center at the UNC School of Medicine has been training physical therapists to use the Otago Exercise Program resulting in a 35-40% fall reduction rate.

Every year, as many as 1/3rd of all older adults will suffer a fall. Reducing these fall rates with a progressive prevention program can save serious injury and many other complications.

PT-Helper has added Otago exercises to its database for therapists to prescribe to their patients. The exercises can be quickly found by searching for "Otago" in the Add Exercise page or duplicating the global Otago Exercise template into your local CONNECT template.

For older adults with significant balance concerns, you may want to recommend that they do their balance exercises with their hand over the kitchen sink providing them with an easy mechanism to grasp the edge should they loose balance. Dr. Stephen Kanter PT, DPT, ATC of the International Multiple Sclerosis Management Practice recommends this safety approach to his neuromotor patients.

Sign up for the FREE 30-day trial for CONNECT exercise prescription service, it's only $20/month with unlimited number of patients after the free trial. Sign up here today.

Thursday, September 29, 2016

Pediatric Physical Therapy Exercises

We have added pediatric exercises to our CONNECT library which are also accessible via the mobile app. Infant Pediatric Physical Therapy Exercises are for parents to work with their children. Our animated illustrations on the app show parents the correct positioning and process for each exercise. Feel free to share with your patients in need!

Some examples of illustrations for Left Torticollis:

Wednesday, September 21, 2016

Neuromotor Exercises for people with Multiple Sclerosis

We have added Neuromotor exercises that are recommended for people with Multiple Sclerosis to our CONNECT library which are also accessible via the home exercise mobile app. Working in conjunction with Dr. Stephen Kanter PT, DPT, ATC, the exercises that have been added to PT-Helper include both good and bad behavioral instructions, safety preparatory positions, and active exercises. Dr. Kanter has worked with patients with Multiple Sclerosis and patients with balance, gait and endurance impairments. Dr. Kanter is currently the Supervisor, Rehabilitation Services at International Multiple Sclerosis Management Practice.

PT-Helper will be participating in the 19th Annual MS Patient Education Symposium on October 16, 2016 hosted by the TISCH MS Research Center of New York. People with Multiple Sclerosis, their family members and caregivers are welcome to attend for FREE! Registration is required at

PT-Helper is proud to sponsor Team Tisch MS.