Tuesday, July 17, 2018

In-Home Physical Therapy Exercises for Fall Risk and Prevention

Physical Therapy is often prescribed for rehabilitation after an injury or surgery. However, physical therapy can also be useful prior to surgery to maintain strength, mobility and flexibility. Another area that physical therapy can be applied is Fall Risk and Prevention.

Fall Risk and Prevention

According to the U.S. Centers for Disease Control and Prevention, one in every four Americans age 65+ fall each year.

Working with your physical therapist can identify strength imbalances and weaknesses to prevent falls and improve independence.

PartnerMD Health Coach created a simple exercise plan that can easily be done in your home to improve leg strength. We’ve added their exercises into a Home Exercise Program (HEP) using the PT-Helper CONNECT platform and presented on the PT-Helper mobile app. These sample exercises can be quickly downloaded into the PT-Helper mobile app using


HEP code: 2974C248

You can also find these exercises in the Knee and Hip category in the PT-Helper mobile app to add to your Favorites which allows you to customize each exercise’s repetitions, sets, and hold time.



Reminder: Please consult your physician or physical therapist before engaging in any physical activity and stop if you experience pain or discomfort.


The recommended exercises include:

  1. Knee Extension (sitting)

  2. While sitting, raise your leg by straightening your knee fully while contracting your quad. Slowly lower your leg. Weights may be placed around your ankle.

  3. Seated Knee Flexion

  4. Sit on the edge of a chair or bench. Extend one leg to the front so that your foot is further out in front of the remaining bent leg. While pushing your foot down into the ground, drag your extended foot back towards your other foot. Repeat.

  5. Chair Rise

  6. Sit on the edge of a chair with both feet flat on the floor. Stand upright without using your hands. Return back to the seated position using the "nose over toes" posture, leaning forward so that your nose is over your toes while slowly bending your knees.

  7. Hip Abduction with Support

  8. Stand with good posture beside a solid table, bench or kitchen sink. Look straight ahead. Rest your hand on the bench. Keep both thighs tight. Kick out to the side keeping toes straight ahead and both legs straight, then return to starting point. If you loose balance, grasp the table, bench or kitchen sink to regain your balance.

  9. Leg Cross

  10. Stand with good posture beside a solid table, bench or kitchen sink. Look straight ahead. Rest your hand on the bench. Lift one foot off the ground slightly in front of you. Cross your lifted foot across the mid-line of your body so that it is on the outside of the planted foot. Hold. Return to your starting point. Repeat. If you loose balance, grasp the table, bench or kitchen sink to regain your balance.


Start your Free 30-day Trial of the PT-Helper CONNECT tool for physical therapists and other therapy providers, so you too may create and prescribe Home Exercise Programs like the one shown above.




Tuesday, July 10, 2018

Creating a Simple Exercise in PT-Helper CONNECT

PT-Helper provides an easy mechanism for the physical therapist or wellness professional to create their own exercises. This blog will walk through the process of creating a stretch exercise and a dynamic motion exercise.


Stretch Exercises

Simple stretch exercises include a starting position, a stretch (Hold) position, and a recovery position between stretches. For exercises consisting of multiple sets, the starting position is also used as the resting position between sets.

Using Gastrocnemius Stair Stretch as an example, we’ve created 3 illustrations to indicate (1) starting position, (2) hold position, and (3) recovery position as shown below. The PT-Helper mobile app will use these illustrations (from left to right) to walk the user through the Gastrocnemius Stair Stretch.


For this example, we have set the Hold Time to 3 sec, Recovery Time to 2 sec, and Rest Time to 4 sec. The exercise will include 2 repetitions and 2 sets. The behavior of the mobile app is shown below to help the patient or client complete their home exercise.




When creating your own stretch exercises, you can use photos instead of illustrations.


Dynamic Exercises

Dynamic exercises are similar to stretch exercises with a starting position, a concentric (Hold) motion, and an eccentric (Recovery) motion.  For exercises consisting of multiple sets, the starting position is also used as the resting position between sets.

Using the Abduction exercise as an example, we’ve created 3 illustrations to indicate (1) starting position, (2) concentric motion, and (3) eccentric motion as shown below. The PT-Helper mobile app will use these illustrations (from left to right) to walk the user through the Abduction exercise.


For dynamic exercises, we can utilize the Hold Time and Recovery Time to slow down the motion of the exercise. In this example, we have set the Hold Time to 5 sec, Recovery Time to 2 sec, and Rest Time to 5 sec. The exercise will include 2 repetitions and 2 sets. Slowing down the rate of motion of the exercise can prevent injury in the user or build strength during the eccentric phase of an exercise.

The behavior of the mobile app is shown below to help the patient or client complete their home exercise.


When creating your own dynamic exercises, you can use photos instead of illustrations.


Videos

PT-Helper does not use videos within our exercise app as videos don’t provide the ability to modify exercise parameters for each user. The goal of the mobile app is to have the user follow along with the app to actually do their exercises.

If you have a video of the exercise that you are creating, you can include the URL link within the exercise’s description or the PT Comment field. The user will be able to click on the link to watch the video before doing their exercises.

All user created exercises on PT-Helper CONNECT will be kept private to subscribers and will not be shared with other users.

We hope this helps you create your own exercises to help your patients and clients complete their exercises.


Start your Free 30-day Trial of the PT-Helper CONNECT tool for physical therapists and other therapy providers, so you can create and prescribe Home Exercise Programs.




Tuesday, July 3, 2018

How YOU Can Benefit from Physical Therapy

By guest writer Ben Shatto, PT, DPT, OCS

I can’t tell you how many times someone will ask me what I do for a living, and upon hearing that I am a physical therapist, he or she will immediately divulge his/her complex personal medical history about a health issue or describe some past experience with a physical therapist (PT).  The stories are usually exceedingly positive or as one may expect, very negative and unfortunate.  This in no way upsets me to hear about one’s personal experiences or medical history.  However, it is concerning that so many people live with chronic aches and pains and (apparently) aren’t able to resolve the problem.  I can’t promise that physical therapy is the panacea of all cures for what ails you, but I have seen it work miracles in people’s lives.  The most amazing thing is the diversity of people I have had the privilege to interact with and help!

Often the answer or treatment plan for a person’s particular issue is not what is expected.  For example, a common complaint is shoulder pain.  Many people struggle to lift overhead properly and often have shoulder pain.  This pain is typically from what is known as shoulder impingement syndrome leading to tendonitis of the rotator cuff.

There are many “standard” treatments for this ailment depending on the medical practitioner you ask.  For example, a physician is likely to offer pain medications (and possibly an anti-inflammatory medication); advice on icing and taking it easy; and if particularly progressive, a physician may even provide a hand out regarding elastic band exercises.  Some physical therapists would likely offer similar advice, such as icing and elastic band exercises to strengthen a muscle group known as the rotator cuff muscles.  (The rotator cuff is a group of four muscles that are important in the movement and stability of the shoulder.)

Time and time again, after a thorough examination of the client, I understand why the shoulder is hurting.  The person has no thoracic mobility likely due from: years of poor posture; office work; washing dishes; taking care of children; or sitting watching TV for hours.  Maybe these activities have led to a very rigid and immobile thoracic spine.

Poor thoracic mobility is a big deal when it comes to shoulder mobility.  The shoulder joint is made up of the scapula (shoulder blade) and humerus (the arm bone to the elbow).  The shoulder blade and the thoracic spine also make a type of joint.  If the thoracic spine is stiff, the shoulder blade is unable to rotate correctly–affecting the way the ball of the humerus spins in the socket of the shoulder blade.  This leads to impingement of the rotator cuff and biceps tendon which causes pain.  If you don’t treat the lack of thoracic mobility, it will be very difficult to ever resolve the shoulder pain.

This real and all too common example of why a person develops shoulder pain is to illustrate why seeing a physical therapist is so valuable.  How would a person know the real cause of the shoulder pain if he or she didn’t ask a physical therapist?  The answer is that he or she wouldn’t know.  Unfortunately, he or she would likely go round and round from one treatment to the next without fully recovering or understanding the real reason why the pain developed in the first place.

Worse yet, as the shoulder pain worsens so does one’s ability to function and his/her quality of life.  In an older adult, this so often begins a downward spiral away from healthy aging and toward an abnormal aging process.  This same example is seen in many of the most common orthopaedic complaints from foot and ankle pain to knee or low back pain.

The dichotomy of the human body is that it is very simple and fragile, yet a complex and robust machine!  The body is truly remarkable and full of surprises.  Many of the most common aches and pains a person may have can be described in a similar scenario like mentioned above. 

Physical therapy can help!  Some issues are not so black and white.  Many issues are like peeling an onion with many layers to the problem.  I believe it is crucial to have a physical therapist on your team to help you live a long, happy life performing the activities that you want for as long as you want!

Age is relative, and movement is the key to healthy living. The goal for health aging is to improve health span, which means the length of time that a person is healthy and thriving in his or her life and not just alive.  Physical therapy can help with healthy aging by improving health span and assisting in a more successful aging process.  We are all capable of successfully aging if we are intentional about the process.

Physical therapists can help you improve, restore or maintain your ability to move and function in your daily life.  As a physical therapist, I help people participate in life, whatever that may be for each individual.  To learn more about physical therapists, visit the American Physical Therapy Association (APTA).

How Can Physical Therapy Benefit You?

  • Assist in recovery from a surgery (assisting in complete recovery and integration back into daily life or sport)
  • Assist in recovery from a stroke or heart attack
  • Assist in improving strength or endurance after an illness or prolonged inactivity
  • Assist in improving balance and walking ability to prevent falls
  • Maintain independence
  • Pain management including low back pain, shoulder pain, hip or knee pain and/or arthritis pain
  • Improve athletic performance by optimizing movement patterns
  • Health and injury prevention in sport and in life (work or play)


Physical therapists can help guide you through any array of recovery or rehabilitation: return to work, sport, running, and CrossFit.  Whatever your desired activity may be, a physical therapist can help you get moving and “living” again!  Fundamentally, movement is life!



Editor’s Note:  This article was written by Ben Shatto, PT, DPT, OCS.  Ben is Director of Operations at MultiCare Home Health & Personal Care Services, founder and editor of the website www.thePhysicalTherapyAdvisor.com, and owner of The Medical Fitness Center in Eagle, Idaho.  Ben teaches and helps guide proactive adults how to safely implement the proper exercise prescription to improve quality of life and prevent or manage chronic disease and illness in order to age well.

Tuesday, June 26, 2018

Why Do Patients Not Know How To Do Their Exercises


We frequently hear stories from physical therapists and physical therapist assistants that their patients can’t seem to remember how to do their home exercises. The typical story goes like this:

Patient comes into the clinic.
PT/PTA,  “Did you do your home exercises this past week?
Patient, “Yes I did.
PT/PTA, “Great. Let’s get you started with this exercise.
Patient stands around looking a little lost.
PT/PTA, “Is there something wrong?
Patient: “How do I do this exercise again?

If you’ve experienced this exchange with your patients, you’re not alone. What were your thoughts after this exchange?

Perhaps you would think, 
“Clearly he/she hasn’t been doing their exercises!”

One other thing therapists might think is,
“If I can do a better job of teaching him/her how to do this exercise, then they’ll remember how to do this exercise.”

However, as an ex-patient, I can honestly say that I was able to remember how to do all of my exercises as I left the clinic. I believe that the challenge is when the patient never or doesn't regularly do any of their exercises and then shows up at the clinic the following week. After days without doing their exercises, it is unlikely that the patient is going to remember how to do an exercise even if they had it memorized the previous week.

Since learning how to do an exercise is not the issue, then getting your patients to do their exercises is! 

One of my good friends recently had back surgery 3 months ago. Even though she’s a nurse and fully understands the benefits of doing her home exercises, she confessed to me that she often doesn’t do it as she gets busy and can’t allocate the time to do all of her exercises. She said something always gets in the way. 

I wonder if she’s ever had this discussion with her therapist. I know that she’s made significant progress since the surgery but after standing at a corner of a bike race for a few hours directing riders and traffic, she started to exhibit significant limping and was clearly in pain. 

How can a therapist overcome the excuse of “no time”. Would breaking up her exercise program into multiple shorter sessions allow her the opportunity to complete at least some of her exercises instead of doing none? Maybe reducing the number of exercises in her program would be enough to overcome her no time excuse.

Each patient is different and may also have different behaviors depending upon how far away their injury or surgery occurred. Keep an open communication channel with your patient to stay on top of how well they are completing their home exercises.

… and if they tell you they’ve been doing their home exercises, they just might not be telling you the truth…

Start your Free 30-day Trial of the PT-Helper CONNECT tool for physical therapists and other therapy providers, so you may create and prescribe a Home Exercise Programs. Share the HEP program with your patients using the PT-Helper mobile app.







Photo by Jon Flobrant on Unsplash

Tuesday, June 12, 2018

Physical Therapy Exercises for Plantar Fasciitis

Plantar Fasciitis is a common cause of heel pain and can cause pain at the bottom of the foot while walking. Approximately 2 million Americans are treated for plantar fasciitis every year. It is particularly common injury for runners and people who stand for long periods of time.

Fortunately, plantar fasciitis can be treated by physical therapy treatment, including icing, manual manipulation, and stretching.

The Cleveland Clinic also suggests other treatments such as:

  • Heel gel pads
  • Orthotic arch support
  • Night splints
  • Walking cast
According to the American Academy of Orthopaedic Surgeons, “more than 90% of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods.” Recovery from plantar fasciitis is not a quick process and often includes activity modification or rest to reduce the activities that make the pain worse.

The AAOS recommends doing calf stretches and the plantar facia stretch:
  • Soleus Stretching - Stand in front of a wall with feet staggered, one in front of the other. Lean towards the wall, bend back knee but keep back leg’s heel to the floor. Feel gentle stretch in back calf and Achilles area. Make sure back foot is facing straight ahead, not turned out.
  • Standing Gastroc Stretch - Stand in front of a wall with one foot in front of the other, keep the back leg straight. Lean towards wall while keeping back heel down, feel gentle stretch in calf of back leg. Make sure back foot is facing straight ahead, not turned out.
  • Plantar Fascia Stretch - While seated, cross your foot over the knee of your other leg. Grasp the toes of your foot and slowly pull them toward your shin in a controlled fashion. Place your other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold. Slowly return your toes to their starting position. Repeat. 


Athletico Physical Therapy recommends additional exercises for plantar fasciitis.
  • Towel Calf Stretch - Sit with knee straight and towel looped around the ball of one foot. Gently pull on the towel until a stretch is felt in the calf. You can also sit in a chair with leg straight, heel on the ground
  • Tennis Ball Exercise 1 & 2 - While sitting, place a tennis ball under your foot. GENTLY press into tennis ball then move your foot forwards and backwards so that the ball moves down the middle of your foot from heel to toe. Then roll the ball side to side under the ball of your foot. May be tender but should not cause pain
You can find the above exercises in the Ankle and Foot category in the PT-Helper mobile app to add to your Favorites which allows you to customize each exercise’s repetitions, sets, and hold time.


Reminder: Please consult your physician before engaging in any physical activity and stop if you experience pain or discomfort.


Start your Free 30-day Trial of the PT-Helper CONNECT tool for physical therapists and other therapy providers, so you too may create and prescribe Home Exercise Programs like the one shown above.




Tuesday, June 5, 2018

How to Save Time by Creating Exercise Protocols

A physical therapist or health professional can save time prescribing exercises to patients or clients after creating a home exercise protocol or template. The template function in PT-Helper CONNECT allows the therapist to group exercises together to be able to quickly add these exercises into a home exercise program.

To create a template, follow the steps below to easily add exercises to a template:

Select Settings in the pull-down menu found at the top right of the browser window.


This will take you to the organization’s or clinic’s configuration menu. Press the Manage Templates button at the bottom left of window.


Select Add Template to create a new template.


The Edit Template page will appear where you can provide a name for your template/protocol, add exercises to the template and assign the template to everyone within your organization or to specific individuals.


Once you’ve provided a name for your template, press Advanced Search to visually select exercises to be added into the template.


You can use the Search field or the By Category pull-down menu on the left of the screen to filter exercises to match your search. 

Once you’ve finished selecting all the exercises that you would like to add to the template, press the Add Selected Exercises button at the top or bottom of the exercise list page.


This will take you back to the Edit Template page where you can select the “Is Available To Everyone” button or select specific therapists within your organization or clinic that will have access to this template.


If you select specific therapists, this template will only appear in the Add Exercise page when the specified therapist is also selected as the treating therapist for the patient’s specific injury. 

One reason why templates may be only available for a specific therapist is the therapist may have a unique specialty such as Hand & Finger. Then Hand & Finger templates created for that therapist would not need to be seen by other therapists within the organization.  

Once a template has been created, it can be selected in the Add Exercise page of a patient’s treatment plan. 



Exercises within a template or protocol are meant to be a guide to the treating therapist to ease the process of selecting exercises for the patient. The therapist can select individual exercises within the template and change the exercise parameters to match the patient’s condition and progression. 

Start your Free 30-day Trial of the PT-Helper CONNECT tool for physical therapists and other therapy providers to create and prescribe Home Exercise Programs.




Tuesday, May 29, 2018

PT-Helper's May Blog Posts for Physical Therapists

Physical Therapy Exercises for Mommy’s Thumb/Phone Thumb
Published On May 22, 2018
“Mommy’s Thumb” or "Phone Thumb" (De Quervain's tenosynovitis) is a common repetitive use injury suffered by parents with infants or extreme smartphone users. Michael Curtis, PT recommends strengthening exercises as part of treating De Quervain's tenosynovitis. We’ve added his exercises into a Home Exercise Program (HEP) using the PT-Helper CONNECT platform and presented on the PT-Helper mobile app. 

The HEP program can synchronized with the PT-Helper mobile app with HEP code 7BBF1AC2.

Reminder: Please consult your physician before engaging in any physical activity and stop if you experience pain or discomfort. 


Published On May 15, 2018
Peer pressure, humor, camaraderie are potential avenues for you to motivate to get your patients to take meaningful action in their recovery process to get better outcomes.


Exercises to Recover From Carpal Tunnel Syndrome
Published On May 8, 2018
Carpal Tunnel Syndrome (CTS) has become a prevalent injury with the rise of computer technology. Martin Kielema at Always Fysio recommends a combination of stretching and strengthening your lower arm muscles to help you recover from CTS. We’ve added his exercises into a Home Exercise Program (HEP) using the PT-Helper CONNECT platform and presented on the PT-Helper mobile app.

The HEP program can synchronized with the PT-Helper mobile app with HEP code 520BE86B.

Reminder: Please consult your physician before engaging in any physical activity and stop if you experience pain or discomfort. 


How to Know If Your Physical Therapy Patient is Completing Their Home Exercise Program
Published On May 1, 2018
Some therapists will be able to tell immediately if their patients have not been doing their home exercises once they start manipulating them on the table. They can tell by the patient’s range of motion or by their strength improvements (or the lack of it). For others, PT-Helper CONNECT and the mobile app will keep track of when your patient completes each exercise.


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