PT-Helper's February Blog Posts for Physical Therapists

Hip or Knee Osteoarthritis (OA) Exercises
Published on Feb. 21, 2019
The GLA:D™ Osteoarthritis Exercise Program for knee and hip is presented. Clinicians can search the exercise library in our exercise prescription web-service CONNECT with “GLA:D” to quickly and easily view and select these exercises.

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


Diversity In PT-Helper’s Exercise Illustrations
Published on Feb. 14, 2019
PT-Helper expands our diversity representation in our exercise illustrations to provide a more inclusive environment for physical therapy patients.


The Importance of Nutrition On Injury Recovery
Published on Feb. 7, 2019
By guest blogger Paul Fisher
Paul presents nutritional guidance on maintaining a healthy lifestyle after an injury and following a rehabilitation program. Consuming foods that reduce inflammation, managing caloric intake, and managing macronutrients while injured are discussed.

Hip or Knee Osteoarthritis (OA) Exercises

While at the 2019 American Physical Therapy Association’s (APTA) Combined Sections Meeting (CSM) conference, I had the opportunity to attend Urban Poling’s ACTIVATOR® Course where founder Mandy Shintani presented the foundations and different techniques of using their poles as a replacement to canes, walkers and crutches. I primarily wanted to attend the course to see how physical therapists responded to the use of the poles as PT-Helper recently added exercises using the ACTIVATOR poles into our library.

The therapists in attendance were very interested and attentive despite having spent a full day at CSM. During one of the discussions, Mandy mentioned that Canada had implemented the GLA:D™ Osteoarthritis Exercise Program where 1 in 4 people in Canada have osteoarthritis. As a non-clinician and ex-patient, I am always interested in learning about new exercise programs that we can add to the PT-Helper library to enable therapists to prescribe exercises to their patients.

Further research revealed that the GLA:D program (Good Life with Arthritis: Denmark) is an educational and exercise program developed in Denmark which showed up to 30% pain relief for people with hip or knee osteoarthritis symptoms. We were able to identify some exercises within the GLA:D program at the TREK Translate Research Evidence and Knowledge website.

Many of the exercises were already available within the PT-Helper exercise library. We have added a few exercises such as Knee Extension Resisted and Step-Down/Step-Up (Forward). We have also added the metatags “GLA:D” to all the related exercises so that clinicians can search the exercise library in our exercise prescription web-service CONNECT with “GLA:D” to quickly and easily view and select these exercises.

Exercises with PT-Helper that are metataged with GLA:D are:

• Bridge on Ball - Lie on your back with both feet on top of an exercise ball. Engage your abdominal muscle then raise your hips up trying to make a straight line from shoulders to feet. Hold. Slowly lower your hips back to the ground. Repeat.

• Chair Rise - 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.

• Chair Rise With Support - Sit on a chair which is not too low. Place the feet behind the knees. Lean forward over your knees. Push off with one or both hands as recommended by your therapist to stand up. Sit back down. Repeat.

• Hip Abduction – Resisted - Secure the band to a stationary point, place both feet inside the band. Keep both thighs tight. Facing perpendicular to the attached point of the band, kick out to the side keeping toes straight ahead and both legs straight, then return to starting point.

• Hip Adduction – Resisted - Secure the band to a stationary point, place inside foot in the band. Keep both thighs tight. Step far enough away to create resistance, allow band to take inside leg in, then pull in towards your standing leg. Keep both legs straight and try to keep moving foot off the ground.

• Knee Extension Resisted - While sitting in a chair, attach a band around the back leg of the chair and wrap the other end around your foot. Make sure that there is tension in the band while at rest. Raise your leg by straightening your knee fully while contracting your quad. Slowly lower your leg. Weights may be placed around your ankle. Repeat

• Step-Down/Step-Up - Stand on a step or stool with one leg, the other leg hanging off the end of the step or stool. Slowly bend the leg on the step, lowering the other foot to the floor. Return to the starting position by straightening your front leg.

• Step-Down/Step-Up Forward - Stand on a step or stool with both legs, facing the edge of the step or stool. Slowly bend one leg, lowering the other foot to the floor in front of you. Return to the starting position by straightening your rear leg.

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

You can find these exercises (and many more) in the Geriatric 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. You can also set up 3 daily reminders to notify you when to do your exercises.

Start your Free 30-day Trial of the PT-Helper CONNECT service for physical therapists and other wellness professional, to prescribe Home Exercise Programs.

Download the PT-Helper mobile app for patients and exercise enthusiasts to create your exercise program.

                       

                     

Diversity In PT-Helper’s Exercise Illustrations

When I first started PT-Helper, the idea was to help all physical therapy patients complete their home exercises. Our first exercises were represented by male models as our exercises were based upon my demo videos doing my own prescribed shoulder exercises from my separated shoulder injury and broken clavicle.

Even though I was the initial model for our exercises, I will readily admit that our illustrations are not an embodiment of my physical characteristics. Our graphic artist, principal illustrator and co-founder, Andrew Kwan, took artistic liberties and created a character with strong musculature that we felt would be appropriate for a health product.

Once we created a reference model for our male character, it was simple to continue creating exercise illustrations using our available model to add additional exercises, recommended by physical therapists, to our library.

As we attended several conferences, we started receiving requests to include female representation in our exercises which resulted in creating a reference model of our female character.

During the 2019 American Physical Therapy Association’s (APTA) Combined Sections Meeting (CSM), we were approached by a therapist that asked about African-American representation in our exercises, specifically for the Pelvic Floor section. We have since created a reference model for an African-American female character and have created additional exercises within the Pelvic Floor exercise library.

We will continue to expand our exercise library based upon recommendations from physical therapists and other health professionals. If you would like us to create additional exercises for your practice, please let us know at info@pt-helper.com.

We hope that creating a diverse set of exercise illustrations will help motivate all physical therapy patients to complete their home exercises and improve their outcomes.

Thank you,
Fred & Joan

Start your  Free 30-day Trial  of the PT-Helper CONNECT service for physical therapists and other wellness professional, to prescribe Home Exercise Programs.

Download the PT-Helper mobile app for patients and exercise enthusiasts to create your exercise program.

                      

The Importance of Nutrition On Injury Recovery

By guest blogger Paul Fisher

Injuries are a part of everyday life, even more so for athletes and people with high levels of physical activity.  Patients rely on Physical Therapists to help them make a full recovery and resume their job, sport, or day to day activities.  Physical Therapists work hard to design a comprehensive rehabilitation plan that will produce optimal results for the patient.   Incorporating nutrition into the plan is one way to add value to the patient and optimize the plan for their success.

A well-balanced diet is not only important for living a healthy, active lifestyle, it can play a big role in supporting and even increasing recovery time from injury.  The most important thing to consider about nutrition as it relates to injury recovery is to avoid nutrient deficiencies.   Maintaining energy, protein intake, and other nutrients can make a difference in the patient’s progress.  Incorporating some key dietary factors into the rehab plan can not only support a patient through the immobilization and rehabilitation phases, but also help them maintain long-term healthy practices. 

If your patient already follows a nutrition plan, some of the points in the article may only require small changes or reinforcement.  Even for those who do not have a nutrition plan, many of these considerations are very straight-forward and can be included in their diet without much effort.  Consuming whole foods or products with ingredients made from whole foods is a good starting point.  Understanding current nutrition habits of your patient can make it easier to scale calorie and macronutrient consumption as the course of rehabilitation evolves. 

Injury and Immobilization Phase

Early in the recovery process, when a patient is injured or immobilized, reducing inflammation, managing caloric intake, and maintaining protein are key factors to aid recovery. 

• Consume foods that reduce inflammation
• Healthy fats, like Omega 3 fatty acids, play a role in muscle building, recovery, and decreasing inflammation
• Antioxidants and adaptogens found in plants, roots, and fruits help the body handle oxidative stress and support the adrenal system, which can assist recovery and help maintain muscle mass

• Often, when an injury occurs, physical activity decreases.  Managing caloric intake is critical to support this stage of the injury
• Less severe injuries may allow for some physical activity, but it may still be less than normal.  Therefore, fewer calories are needed to avoid weight gain
• Include plenty of fruits and vegetables.
• Severe injuries requiring surgery or crutches will require more calories to allow the body to maintain strength through healing
• Managing macronutrients during the early phase of an injury can also assist with recovery, managing weight gain, and maintaining muscle. 
• Protein helps maintain and repair muscles
• Muscle loss can occur when immobilized or activity is reduced
• RDA is .8 grams of protein per kg body weight
• Athletes may require more protein to maintain muscle
• Protein pacing or consuming a consistent amount of protein (20-40g) with each meal
• Consuming protein before bed can also support muscle growth and recovery overnight
• Go smart with the carbohydrates
• Carbohydrates are still required, but less may be needed to avoid weight gain during a low activity phases
• Include complex carbs and whole grains as opposed to refined sugars and sweets
• Healthy fats are important for muscle building and reduced inflammation
• Swap out the friend, greasy, and saturated fats for healthier fats from fish, plants (avocado, coconuts), and nuts.  

Rehabilitation Phase

The same basic principles apply during rehabilitation, but increased activity and energy utilization can change the patient’s nutritional needs.  Changing the caloric intake and nutrient balance is important to ensure the patient is properly fueled for performance and recovery. 

• Increase calories to match the increase in physical activity
• Additional calories may come from adding in more carbohydrates, especially for athletes that reduced carbohydrates after the injury
• Maintaining or even increasing protein intake to support muscle recovery and growth
• Healthy fats continue to play a role during the rehabilitation process, as they will help with the healing process
• Additional nutrients to consider during recovery for patients
• Protein (20 – 40 g per meal) containing leucine is recommended for recovery
• Calcium and vitamin D help recovery for fractures and strengthen bones
• Zinc, vitamin C, and vitamin A can assist with wound healing
• Creatine can help build healthy muscles
• General health recommendations for healthy lifestyle and recovery from injury
• Maintain a healthy body fat %
• Proper hydration – drink at least half your body weight in ounce of water
• Getting ample sleep is important in the recovery process.  The National Sleep Foundation recommends between 7-9 hour of sleep each night for adults

Helping the patient understand that nutrition does play a role in helping your body recover is the first step.  Our bodies are amazing at healing themselves, if nourished properly.  Food really is our best medicine.  Working with a wellness coordinator or nutrition program are options for Physical Therapists to consider if they prefer to keep their focus on the therapy part of the plan.  Adding additional nutritional services for the patient can differentiate your practice and provide better service to your patient. 

About Paul Fisher

Paul is a health and wellness consultant who is passionate about helping people feel their best from the inside out.  He believes that food can be the best medicine and help set the foundation for living our best lives.  Paul specializes in helping people with weight-loss, stress reduction, reduced inflammation, and athletic performance.  He works in-person and virtual with individual clients as well as with businesses and health practices. 

Paul became interested in health and nutrition when his father, a runner for over 40 years, had heart disease and needed open heart surgery.  It was that moment when he realized that food and nutrition so important to living a long, healthy life.  His father is doing great now and has adapted many healthy dietary changes to help keep him as active as ever.

Paul lives in Cranberry Twp, PA with his wife and daughter.

You can contact Paul on social media @pfisher26 on Facebook, Instagram, and LinkedIn