Category Uncategorized

Do I need to see my physician before I come to physical therapy?

by philib in Uncategorized

Do I need to see my physician before I come to physical therapy?

-In the state of California, patients are able to see a physical therapist for 12 sessions or 45 days, whichever comes first. Being able to see a physical therapist directly will allow you to start your recovery much faster. In the healthcare system, patients sometimes have to wait days or weeks until they can see their physician. In this time period, these patients could have already been examined have treated by a PT, decreasing potential progression of their problem.

-Although physical therapists are restricted in making medical diagnoses, they are able to perform a physical examination and determine if they are able to treat you within the scope of practice of a physical therapist. If needed, your PT will refer you to the appropriate healthcare practitioner.

-In a recent study, researchers analyzed claims and outcomes data for 447 patients receiving physical therapy for back or neck pain, either via direct access or from a medical referral. Both groups received the same guideline-based care using the same outcome measures. Improvement was similar in both groups, but those patients who saw PTs via direct access incurred $1,543 lower average costs than those who were referred by a physician.

See article abstract here:

https://www.ncbi.nlm.nih.gov/pubmed/29073842

-Some insurance companies still require you to obtain a referral in order to receive physical therapy, but you can contact your PT provider and have them perform an insurance verification to let you know if you need one. In any case, being able to see physical therapist directly will allow you to be evaluated sooner, decrease your recovery period, and potentially decrease healthcare costs.

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Negating Cognitive Decline of Aging with Exercise

by philib in Uncategorized

Negating Cognitive Decline of Aging with Exercise

From my experience working here at OptimisSport PT and the Senior Center in Malibu, CA, I have observed the many health complications that arise from aging. Many elderly people experience aches and pains trying to stay active or even performing everyday activities. Along with the pains of ageing, there are cognitive declines that coincide with getting older. Standing, walking, writing, etc. seem to get harder. These factors make staying active more difficult and sometimes more dangerous for the elderly, so inevitably people become more sedentary. But in fact this is the worst thing we can do!!! The solution to these side effects of growing older is in fact staying active!

It is widely perceived that youth is the time to try new experiences and learn new things. I’m here to say that is not the case; we can always learn new skills and try new activities. These things help both the mind and the body. Being physically active keeps our body healthy, and what better way to stay active than to try new physical activities. Learning new skills also challenges our minds; we build new neural connections that keep our brains clear and active.

 

An interesting study that I stumbled upon tested the ability to learn new motor tasks between different age groups of subjects. The researchers taught over a thousand subjects how to juggle, and they looked at the number of juggles each person did during a pretest 1, a pretest 2, and a test round. They found that every age group was able to increase the number of juggles with every session, and that there was no statistical decrease in motor plasticity for the senior subjects. Additionally, the older adult’s performance was comparable to children (10-14), and the adults between 25-59 years old. Thus we all have the capacity to learn new skills, even when we get older. It’s never to late to try new things!!

Another study that I found interesting looked at the effects of exercise on patients with Parkinson’s disease. Parkinson’s is an aggressive neurodegenerative disorder that currently has no cure. Parkinson’s causes a loss of dopamine (neurotransmitter) that leads to: slowness of movement, tremors, and postural instability. These can have debilitating effects on quality of life, and current treatments are invasive and expensive. The researchers looked at the effects of patients going at a set intensity of aerobic exercise that is a high intensity for the subjects.  They found that there were improvements in cognition, metabolism, and a potential progression of the neurodegenerative disease. These are important findings that highlight the positive effects of exercise on neurology of not only people with Parkinson’s, but also everyone as we age.

I firmly believe that living an active lifestyle is one of the most important ways to make sure we live a quality of life that we all strive for. An active life style, while continuing to challenge our minds keeps us both physically and mentally healthy. I challenge all of you to try a fun new activity to learn, you may just have the time of your life. Bellow are the articles that I read, if you are interested, check them out!

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What exactly does a PT do?

by philib in Uncategorized

What exactly does a PT do?

Physical therapists are experts in movement analysis. The vast majority of physical therapists have received a Doctor of Physical Therapy from an accredited university link: http://aptaapps.apta.org/accreditedschoolsdirectory/AllPrograms.aspx?UniqueKey=. The programs are about 3 years in length, bringing their university education to about 7 years in total. Although physical therapists are well trained and have had intense curricula, the general public doesn’t have a clear understanding of what physical therapists do. When I first came out of physical therapy school, the first thing my friends would ask me is if they could get a free massage. I would also get patients who were expecting to be massaged during their entire session, and then leave without doing any exercise. This perception of what I did for a living led to my desire to make people understand what PTs are capable of doing.

So, what can you expect when you see a physical therapist?

-When you come in to the clinic for your initial evaluation, your therapist will take a look at your PT prescription if you have one, look at your medical history, and ask you a series of questions regarding your symptoms. Some questions may regard when your pain started, what makes the pain better or worse, if you’ve had any xrays or MRIs, what you do for a living, what your exercise regimen is like, and what your goals are. With each question asked, your PT is formulating a hypothesis as to what is causing your symptoms. Sometimes I have 2 or 3 diagnoses that I am hypothesizing. Also of note is that you don’t have to have pain to see a PT. If you have any movement problems, such as impaired balance or decreased walking endurance, physical therapists are capable of working with you.

-Once the interview portion is complete, your therapist will then perform a series of tests that will examine your posture, range of motion, balance, strength, flexibility, muscle quality, and joint mobility. He or she may also ask you to demonstrate some functional motions, such as squatting, sit to stands, stair climbing, or running, in order to assess your movement quality. This portion of the evaluation, also called the objective exam, is used to rule in or rule out the hypotheses your therapist had after the interview.

-After the object exam, your therapist will formulate the best treatment plan that is specific to your impairments. The treatment may consist of manual therapy, exercises, stretches, and modalities. Because physical therapists are trained in movement analysis, they are able to figure out what the cause of your symptoms are, versus covering up the symptoms. For example, if, when walking, you are experiencing knee pain, your therapist may see that your hip is moving in a non ideal manner. After performing the objective exam, your therapist may explain to you that because of problems in your hip, you are experiencing pain in your knee. Therefore, in order to treat your knee fully, your therapy will focus a lot on your hip.

-Physical therapists are an integral member of the health care team. Your therapist will communicate with your physician regarding your progress. Therapists may refer to other practitioners if they feel that a patient is not appropriate for physical therapy. For example, if your back pain doesn’t seem truly related to a neuromusculoskeletal (related to nerve, muscles, or bone) injury, your therapist may refer you back to your physician, as your symptoms may be related to organ impairments. In the state of California, consumers are able to see a PT directly for 12 sessions or 45 days, whichever comes first. Some insurances still require you to see a physician first, but this will allow you to see a physical therapist sooner, which may help get to the root cause much faster and help to speed up your recovery.

I hope you have a clearer understanding of what physical therapists are capable of doing. Make an appointment to see a therapist and start your road to recovery!

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Physical Fitness Throughout the Lifespan

by Thomas Williams in Uncategorized

Physical Fitness Throughout the Lifespan

Why is physical activity important as we age and who is at risk? 

 

We have all been told over and over that we need to engage in regular exercise to maintain our health, but just how important is exercise to our health? Research has shown that regular physical activity improves bone density, decreases adipose tissue, can decrease feelings of depression, decreases blood pressure and resting heart rate. As we age the affects of physical activity are even more important in maintaining and improving health.  It is estimated that as many as 60 percent of adults over 50 years old do not achieve the recommended levels of daily activity (See chart below regarding these recommendations). With age there is a decline in muscle mass known as sarcopenia.  Around the age of 30, we begin to lose muscle mass at a rate approximately 1% every year. Coinciding with the loss of muscle mass is a 3 times greater decline in muscle strength. Some of this process is unavoidable, however with regular physical activity the course of sarcopenia can be slowed and the effects of the process can be decreased. It is important to try to decrease the incidence of declining muscle mass because decreased muscle mass has been associated with increased risk of dementia, loss of functional independence, increased fall risk, and increased mortality. The best way to reduce your loss of muscle mass is to engage in regular physical fitness that includes resistance training. This is because resistance training helps to build up muscle through imposing increasing loads on the tissue, forcing the tissue to grow to accommodate this stress.

 

How do you know if you are engaging in the appropriate amount of exercise?  

 

                The gold standard of exercise prescription comes from the American College of Sports Medicine (ACSM).  The ACSM is a large organization that focuses on expanding the science of sports medicine through scientific research. When looking at these recommendations listed below you will see the abbreviation RPE. So what is RPE and what does it mean? RPE stands for rate of perceived exertion. This is an important factor especially in elderly adults because the measurement of heart rate max is not always an accurate measure of exertion among the elderly population. An RPE scale allows an individual to place a numerical rating on how hard they perceive they are working during a particular task. The higher the number on an RPE scale represents a higher level of perceived exertion.

 

 

American College of Sports Medicine (ACSM) Exercise Recommendations for elderly Adults:
Aerobic Training·          ≥ 5 days/week for moderate intensity OR

o    5-6/10 on RPE scale

o    30-60 minutes per session in bouts of at least 10 minutes each

·          ≥ 3 days per week for vigorous intensity

o    7-8/10 on RPE scale

o    15-30 minutes per day

 

Resistance Training·          Each major muscle group should be exercised 2-3 days/ week

·          40-50% of your one repetition max (the maximum amount you could lift only one time) performed at 10-15 repetitions x 2-3 sets

 

Flexibility Training

 

·          ≥ 2 days/week

·          Stretch to feeling of tightness or slight discomfort

·          Hold static stretch for 30-60 seconds

 

Balance Training

 

·          No specific guidelines are available, however ACSM recommends:

o    Progressively difficult postures that gradually reduce the base of support (example: moving from standing with wide feet to standing with feet together)

o    Dynamic movements that place the individual outside of their center of mass (located approximately midway between your hips)

o    Stressing postural muscle groups

o    Reducing sensory input such as moving objects or a soft surface

 

What can you do to improve your physical fitness?

 

A great place to start if you are trying to become more active is joining a local gym or attending a community center that offers group classes. Group classes can be a great motivational tool in the early stages, as well as provide an outlet for meeting new people who are also trying to improve their physical fitness level. If you are concerned about your safety when initiating an exercise program because you suffer from co-morbidities such as chronic pain, cardiovascular disease, or severe de-conditioning seeking care from a licensed physical therapist may be a great option for you. Physical therapists are experts in movement and exercise performance.  This means that as physical therapist we received a specialized education that allows us to improve functional independence and fitness levels in individuals who have complicated medical histories.  Physical therapists work with you to create wellness goals, which will help improve your physical fitness level and overall daily life.  Remember it is never too late to improve your overall health so that you can live a longer and more fulfilling life, if you have further questions or need guidance contact us at Beachside Physical Therapy.

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