Saturday News

Contents of This Week Saturday News:

• Headline - Physiotherapist / Physical Therapy
• Eclectic - Many articles from many Guest Bloggers about Stroke
• Pilot Study of Split Belt Treadmill Based Gait Rehabilitation System for Symmetric Stroke Gait
• Life as Rehab
• Therapy 1
• Community Ambulation Falls Thru the Cracks
• Wii Fit: Fun Therapy
• Physical Therapy - Again
• Mixing It Up
• Experience
• Unbrace Yourself
• Goodbye, Urvashi
• Dangerous Phrases
• Elliptical Timeline
• In The Swim
• The Rest of the Story…
• PEI Stroke Care Model "Caregiver Handbook"
• Time to Reflect
• A Caregiver's Christmas
• Mentoring: Speech Therapy for Aphasia/Developmental Language Delay
• Top Ten Brain Posts 2014: 1-5
• Weekly Columnists
• Sunday Stroke Survival: I Got One, But Not the Other
• Jackie The Jester: Okoboji Museum
• TED Talks - Michael Rubinstein: See Invisible Motion, Hear Silent Sounds. Cool? Creepy? We Can't Decide.
• Rick Mercer Report: Rick and Jann Arden on Tour
• Laid-Back Administration: No Posts This Week
• Daily Comics: FB Or FW, Dilbert, Mayes, Doonesbury

Definition: Physiotherapy / Physical Therapy

Physical Therapy From Wikipedia, the free encyclopedia

Physical Therapy / Physiotherapy
Military physical therapists working with patients on balance problems,
orthopedic / musculoskeletal injuries, amputee, compression wrapping
to control edema, and during evaluation/assessment of strength,
flexibility, and joint range of motion, massages, etc.

Physical therapy or physiotherapy (sometimes abbreviated to PT) is the health care profession primarily concerned with the remediation of impairments and disabilities and the promotion of mobility, functional ability, quality of life and movement potential through examination, evaluation, diagnosis and physical intervention. It is carried out by physical therapists (known as physiotherapists in most countries) and physical therapist assistants (known as physical rehabilitation therapists or physiotherapy assistants in some countries). In addition to clinical practice, other activities encompassed in the physical therapy profession include research, education, consultation, and administration. Definitions and licensing requirements in the United States vary among jurisdictions, as each state has enacted its own physical therapy practice act defining the profession within its jurisdiction, but the American Physical Therapy Association (APTA) has also drafted a model definition in order to limit this variation, and the APTA is also responsible for accrediting physical therapy education curricula throughout the United States of America. In many settings, physical therapy services may be provided alongside, or in conjunction with, other medical or rehabilitation services, including occupational therapy.

Overview

Physical therapy involves the interaction between therapist(s), patients or clients, other health care professionals, families, care givers, and communities in a process where movement potential is assessed and diagnosed and goals are agreed upon. Physical therapy is performed by a therapist and sometimes services are provided by a physical therapist assistant (PTA) acting under their direction. Physical therapists and occupational therapists often work together in conjunction to provide treatment for patients. In some cases, physical rehabilitation technicians may provide physiotherapy services.

Video: Physiotherapy / Physical Therapy

SSTattler: Below is a sample of the first year, approximate, of a stroke (by YouTube).  Much more available on YouTube / Vimeo / ...

I Wanna Be a Physiotherapist

Published on May 13, 2014

Jesse goes behind the scenes with Renee to find out what a day in the life of a Physiotherapist is all about. Want to see more career videos from Student Edge?

Click here: http://s-edg.com/careervideos

Standard YouTube License @ Student Edge

Eclectic Stuff

Definition: Eclectic(noun) a person who derives ideas, style, or taste from a broad and diverse range of sources.

Pilot Study of Split Belt Treadmill Based Gait Rehabilitation System for Symmetric Stroke Gait

Dean Reinke
Deans' Stroke Musing

Thursday, January 17, 2013

When I was still getting physical therapy 4 years ago my PT told me about a colleague of hers that was doing a trial of this technology. Who is going to compare this to the displayed foot placements on the treadmill? or the auditory cueing one?

Pilot Study of Split Belt Treadmill Based Gait Rehabilitation System for Symmetric Stroke Gait

Abstract

A split belt treadmill for gait rehabilitation was developed to improve the symmetry of the stance phase time of patients with stroke. The system, which increases the stance phase time of the affected leg and then realizes a well-balanced gait, is divided into two components. First, the stance phases of the sound and affected legs were measured and presented visually in real time to the patient and physical therapist as biofeedback. Second, using stance phase biofeedback, the physical therapist sets two different velocities of treadmill belts for sound and affected legs. In an experiment, 11 patients with chronic stroke participated in a short-term intervention trial (20 gait cycles) of the developed treadmill system. Three of the five subjects who had lost balance between the stance phase of the sound leg and that of the affected one improved their gait balance in the intervention trial. In addition, one subject kept the well-balanced gait after the intervention.

Full text available at the link.

See the original article:

Pilot Study of Split Belt Treadmill Based Gait Rehabilitation System for Symmetric Stroke Gait

in

Deans' Stroke Musing

Life as Rehab

Robin
Rocky Mountain Stroke Survivor

June 24, 2013

My perfect day: Having slept in as late as I wanted, I woke up in my beautiful and peaceful bedroom to the feel of a light breeze coming through the open window.  I close the window and curtain before the heat of the day and pad into the kitchen where my husband has breakfast waiting for me.  Everyone smiles at me and I at them as I walk into the room.  The kids are already diapered/pottied and dressed for the day.  They are each settled into an age appropriate, interesting, and educational activity.  My husband is wiping down the completely clear table after their breakfast (did I mention they were already fed too?) and as soon as I finish my breakfast, my dish is whisked into the dishwasher in order to not dirty the freshly scrubbed sink. Supper is already in the crock pot and my husband announces that he has a picnic lunch already packed so the kids and I can go on a little jaunt while he finishes up a project in the back yard.  I put on the clothes that were laid out for me and away we go.  When we get home an hour or so later, my husband has gotten an amazing amount of work done around the house and yard; he takes over the kids while I take a 2-3 hour nap.  I wake up refreshed.  We spend a little time together as a family before supper and everyone stows themselves neatly in bed nice and early.

My real day: Our daughter, age 1, has a fever and wakes me up with her piteous cries at 4am.  I kick my husband until he wakes up enough to understand that I need him to fetch the infant ibuprofen from the bathroom.  By the time he comes back, I’ve fallen asleep in an uncomfortable position holding my daughter.  As soon as he wakes me up and hands me the syringe of medicine, he’s konked out (in an uncomfortable position).  I dose the baby and spend the rest of the night in that weird sort-of sleep that only parents of sick kids and political prisoners understand…you’re exhausted so you fall asleep instantly but the instant you fall asleep, you are awoken by kicks and screams.

Therapy 1

Steven H. Cornelius
Music and Stroke

February 7, 2012

When released from intensive care, I was moved Mass General’s neurology ward. Things were coming along nicely. Already I could raise my left shoulder, slowly bend my elbow, and even move my thumb.

That day, a physical therapy intern came in to see me. After few niceties, she put a comb on the bed table, and then asked me to comb my hair. If I could have spoken more than a couple words at a time, I would have tried to explain why hers was a stupid request. (Nearly 30 years of college “professing” makes ideal teaching moments hard to pass up.) But alas, I could manage neither the words nor organize the concepts.

So being a good sport (and appreciating her attention), I gave it a try. After some struggle, I captured the comb between palm and thumb. With much shoulder raising, head lowering, and eventually some elbow bending, I eventually got comb to head, which knocked the comb out of my hand.

So I tried again, and again, and for what seemed like an eternity, as she looked on encouragingly. I could go through the gory details of the repeated attempts, but not much changed.

So, the teaching moments…

Community Ambulation Falls Thru the Cracks

Rebecca Dutton
Home After a Stroke

August 16, 2014

Walking in PT gyms and on a deserted sidewalk did not prepare me for walking in community settings, like maneuvering around carts and people in a grocery store, squeezing past closely placed chairs and tables in a restaurant, and dealing with children in a shopping mall who do not look where they are going.  PTs do not know walking requires divided attention because they walk clients in wide empty spaces that provide no cognitive challenges.  Equally unfortunate, OTs who are trained to assess and treat cognitive issues do not assess community ambulation because walking is PTs domain.  So community ambulation falls through the cracks.  Stroke survivors are left to figure out how to walk safely in the community.

A recent study addresses the unpredictability of walking in the community.  Inness learned what stroke survivors did when they were not told they were about to experience a fall hazard (1).  Stroke survivors were asked to stand with each foot on one of two force plates.  At an unexpected time the two force plates were tipped forward and subjects had to recover their balance by stepping forward onto a third force plate.  Clinical tests like walking speed and the Berg Balance Test did not have a significant correlation with the unexpected stepping test results.  Subjects who did poorly or did well on the unexpected stepping test had a similar range of Berg Balance scores (25-55 and 20-56).  The Berg Test does not measure real world balance because clients can concentrate fiercely on their own body and get to decide when they want to initiate movement.

Bottom Line: Being afraid to walk in crowded environments is a major barrier to participating in valued community activities.  Limiting gait training to walking in the home contributes to social isolation and depression.

1. Inness E, Mansfield A, Lakhani B, Bayley M, McIlroy W. Impaired reactive stepping among patients ready for discharge from inpatient stroke rehabilitation. 

See the original article:

Community Ambulation Falls Thru the Cracks

in

Home After a Stroke

Wii Fit: Fun Therapy

Jeff Porter
Stroke of Faith

Tuesday, July 01, 2008

While I don't need a Wii Fit for physical therapy, I'd love to try one out just for the sheer fun of it. It sounds like a way to help some recovering stroke survivors. This one is from The Plain Dealer, in Cleveland, Ohio.

From the article in The Plain Dealer in Cleveland:

▶︎ Physical therapy is best served with a little camaraderie and light conversation, but therapist Nancy Ditzel also dished out some fun to recovering stroke patient Marilyn Smigelski recently.

▶︎ The LakeEast Hospital therapist put Smigelski to work on the latest Nintendo Wii video system game, called Fit. While the American Physical Therapy Association magazine recently reported widespread use among members of Wii games that simulate sports like tennis and bowling, the Lake hospital system is the first locally to use the Fit game in physical therapy.

See the original article:

Wii Fit: Fun Therapy

in

Stroke of Faith

Physical Therapy - Again

Andrea
A Year of Living In My Head

Sunday, April 14, 2013

Went to a new physical therapist yesterday.  As part of my wrapping up medical things while they are fully paid for before the divorce... I went to this PT for getting my lesser muscles back online.  I notice my muscle mass is decidedly different on the left side of my body. After the ever-fun assessment it was decided, yes, my left leg and torso have lost strength.  He gives me such simple exercises.  Ridiculously easy and slow and they don't take much time.  And, after, I feel like I have run a marathon and swam the English channel AND climbed Mt. Rainier.  My body has been slacking big time.  (Really, I wonder why.)  Once I get over the shock that I have no strength (what is getting me up in the morning? because it is obviously not muscles) I do my exercises and freak out my body.  Connections. All about those connections. Thank god I am such a stubborn person.

See the original article:

Physical Therapy - Again

in

A Year of Living In My Head

Mixing It Up

Pamela Hsieh
Rehab Revolution

20 May 2010

A key strategy to ward off that dreaded plateau -- that point of flatlining improvement everyone hates -- is to vary your routine.

Variety?! But my routine knows not that word! In fact, that is exactly the opposite of routine!

Not if you don't let it. What I do is have my physical therapist write me a new full-body program every eight times I've gone through one. Now, this tip is clearly aimed at people farther along in their rehab, where independent and/or more advanced techniques are part of their daily gig (because earlier on, your rehab is more or less guided completely by your therapists).

If you keep your body guessing, you'll keep it on track rather than getting bored with the same-old, same-old.

An easy way to implement a regular mix-up? On a drizzly day you feel too sluggish to hit the gym yet feel guilty for playing hooky (um, like today, for me), stay in and pop in an exercise video or DVD. I've got them all: yoga, dance, capoeira, Bosu Ball, Bender Ball, pilates. (Apparently, there's a whole rehab aspect to pilates that I've never officially tried with a practitioner before, but I'll definitely get more information on that for you.)

Experience

Amy Shissler
My Cerebellar Stroke Recovery

October 18, 2014

The first couple of years that I was a practicing physical therapist, I was scared of everything.  It’s really scary when someone that’s already in a lot of pain and coming to you for help tells you that the exercises that you asked them to do caused more pain.  That’s a scary thing.  That’s when confidence and experience become critical.  Now, I only have 4 years of work experience so I don’t want to give the wrong impression but that being said, I kinda know a lot and I was really good at what I did.  I only have 4 years of work experience but I have personal experience now that most health care practitioners with decades of work experience don’t and never will have.  It took a few years after getting a lot of good results with people to have the confidence to say to someone “I know it hurts a little more or in a different spot, that’s ok.  Keep doing the exercises and I promise you’ll feel better.”  That wasn’t always the case of course but I knew what to do and how to deal with it after a while.

When I got sick, and when I was doing inpatient rehab, I could have done a whole heck of a lot more than I was asked to do.  But I’m sure my therapists were absolutely terrified of me.  First of all, I was the youngest person in the stroke unit so that alone probably scared them.  I was bald, I had an enormous scar on the back of my head, I was shaking uncontrollably due to my tremors and ataxia, I could barely speak.  I looked like absolute, utter hell.  So I’m sure they were scared shitless and were terrified to ask me to do any real exercise. It’s not their fault, it’s what they were taught and how they’re told to treat.  In therapy I was tired as hell because I wasn’t allowed to sleep when I needed to be asleep.  I was scheduled to go therapy based on THEIR schedule, not mine.  I wasn’t AT ALL getting what I needed.

Unbrace Yourself

Marcelle Greene
Up Stroke

Wednesday, October 5, 2011











I left rehab with an Ankle-Foot Orthosis (left) to support my ankle and keep my foot from dragging. I hated it. I hated having to wear long socks in hot weather. I hated having to put on a brace and shoes in the morning just to walk to the kitchen for a cup of coffee. I hated wearing shoes that were two sizes too big so they could fit the brace.

I googled alternatives and found the Freedom Soft Footdrop Brace (center). I discussed it with my since-dismissed physical therapist who said it wouldn’t give me enough support. I ordered it anyway (July 2010, $120). By allowing more ankle flexibility, my muscles strengthened.

When I started with Arbi (Feb. 2011), he said, "Marcelle, why are you wearing shoes that are too big for you? No wonder you walk funny." He directed me to a  sports brace (right). It was only $20 and I could wear it with my regular shoe size!

The first few days wearing that brace my foot felt like it was going to roll over and break off at the ankle. I questioned Arbi – but he was firm and so was the brace. Within weeks, my ankle strengthened and, in July 2011, I stopped using a brace. Period.

I read in a fellow survivor’s blog that she had become dependent on her AFO because it had prevented her muscles from developing. I don't know if what I did would work for everybody. But I am glad I ignored the skepticism of my first PT and trusted Arbi enough to follow his advice. Half the battle is knowing who to listen to and when to listen to yourself.

See the original article:

Unbrace Yourself

in

Up Stroke

Goodbye, Urvashi

Grace Carpenter
My Happy Stroke

Monday, August 23, 2010

Torturer. Slave-driver. These are some of names I call my physical therapist, Urvashi. But actually, she's been great. She works me hard but always makes me laugh.

So I'm a little sad that Thursday I finished with PT.  I'm also worried: I still have a lop-sided gait; a ten-minute walk exhausts me; and my knee is very, very wobbly. But Urvashi says that I'm much stronger, and I can do most of the exercises by myself. She also said that my gait will improve as my sensation returns, and maybe I will need more PT down the road.

I will miss her.

See the original article:

Goodbye, Urvashi

in

My Happy Stroke

Dangerous Phrases

Peter G. Levine
Stronger After Stroke

Friday, August 22, 2014

In the Seinfeld episode "The Kiss Hello" George Costanza describes his physical therapist as “… so mentally gifted that we mustn't disturb the delicate genius.” This could describe many of us involved in neurorehabilitation. We assume that we’re making the treatment choices for stroke swurvivors because we have a lot of experience. A lot of experience is a good thing, right?

Not necessarily.

“It works in my patients”

Neurorehabilitation research is now in a “golden age” with an exponential rise in diagnostics. This allows researches to test new treatments ever more accurately. We can now see, with functional magnetic resonance imaging (fMRI), the work of the brain as it attempts to control movement. Triangulate changes in fMRI with computer-driven kinematic data capture, movement outcome measures and algorithmic data analysis and a three dimensional view of patient progress become startlingly clear. But like the proverbial tree falling in a forest, are therapists listening?

Elliptical Timeline

Joyce Hoffman
The Tales of a Stroke Patient

Oct 25, 2012

There's an old joke: Call me anything, but please don't call me late for dinner. And please don't call me a hypocrite, either. Three days a week, I have done physical therapy at Rehab X, twelve times so far.

If you read my book, "The Tales of a Stroke Patient," though I said horrific things about my stay there for seven weeks, I didn't say one bad word about the physical therapists. So I was not being a hypocrite when I returned to Rehab X for physical therapy. That's a roundabout way of saying the physical therapists were the best, at least according to the sign they have plastered in the therapy window for winning the local newspaper's award.

Anyway, there were three parts to the routine that lasted for about an hour and was the same every time. First, I got stretched on the mat with the physical therapist helping me lift, spread, and bend my legs. My hamstrings, quadriceps, and ankles were challenged, and though it hurt, it was a good hurt. Next, I went on the elliptical, a cardio training machine that mirrors walking up the stairs and running, working large muscle groups, in my legs and one functional arm in a continuous movement.Finally, I used the parallel bars, with exercises like side-stepping and lifting my leg on the affected side as high as it would go.  My therapist gave me all her time, but occasionally, when the therapy center was crazy busy, the therapist at most had two patients.

In The Swim

Barb Polan
Barb's Recovery

1st February 2013

Last summer I met a woman at a friend's party; she was kind and friendly, and quite deaf, so we sat in chairs next to each other and had a very loud conversation. She told me about a nearby pool (that I didn't know existed) that has a wonderful aquatic physiotherapist. Every therapist I ever worked with plus my physiatrist and my husband have encouraged me to go to aquatic sessions because, they said, it would be easier for my weak muscles to bear my weight if I were buoyant; made sense to me. But my only opportunity (I thought) was at the Y, where the buoyancy theory did not work for me - in fact, none of them could even get me set up to keep me afloat. All through the fall, my torn meniscus kept me from looking up this newly recommended therapist because in the pool I tend to put more weight on my unaffected leg, which aggravates my knee (and me). I finally started sessions with her (twice a week) about a month ago. I LOVE the therapy; I LOVE the therapist. She was the very first to get me to keep my head out in water over my head - floats around my arms just under my armpits work. Even then, I had trouble controlling my leg, so instead of making my leg lighter to help my atrophied muscles, she put a 2-pound weight around my ankle. How counter-intuitive was that? It kept my leg extended down and gave me far more control over it. From the first session, I've been able to "run" in the deep end. I'm heading to one later this morning. Next post, I'll have to rant about bathing suits!

See the original article:

In The Swim

in

Barb's Recovery

The Rest of the Story…

Robin
Rocky Mountain Stroke Survivor

December 31, 2014

I started my stroke blog in the weeks after my strokes as a way to process everything that happened.  Since that time, it has grown to be so much more.  In 2014, over 13,000 views provided thousands of people with a personal view of life after a stroke.  I receive touching emails from stroke survivors and loved ones thanking me for helping them explain to their family what it’s like.  It’s really rewarding to know that I’ve been able to make a difference in this way.  This blog will always be here for people who need it.

At the same time, life is complicated.  A year ago, I started a different blog to write about what was going on in the rest of my life.  It didn’t seem right to clutter up my stroke blog with information about my kids and work.  But I desperately needed to write about it.  Initially, that blog was almost exclusively about some very specific struggles at the time.  But it has gradually evolved to be about everything, including my strokes and my life post stroke.  I recently realized that it was time to bring it all together and invite all my readers here to go visit there.  I did mention it in a comment at one point, and a couple astute readers noticed and have been over there.  But I feel as if I’ve kind of left everyone else hanging.

I’ll still post here once in awhile when I am itching to write about something so strokey that it just doesn’t fit on the other blog, but most of the time the other blog is where you’ll find me: Our Own Flavor: Creating Our Family with Some Unexpected Ingredients.

See the original article:

The Rest of the Story…

in

Rocky Mountain Stroke Survivor

PEI Stroke Care Model "Caregiver Handbook"

Gary Gray
PEI Stroke Recovery

Saturday, December 27, 2014

Did you know that over 300 strokes occur on Prince Edward Island every year?

Are you a family member, caregiver or friend of a stroke survivor on Prince Edward Island.

Here is a valuable information resource for Prince Edward Islanders seeking information about recovering from stroke on Prince Edward Island.

PEI Stroke Care Model  "Caregiver Handbook"

• Click Here to open the "Caregiver Handbook" PDF

and Heart & Stroke's "Let's Talk About Stroke" booklet

• Click Here to open the "Let's Talk About Stroke" PDF

Both of the above PDF's can be downloaded to your computer's hard drive and/or printed out on your printer as handy reference material.

Please share the link to this post with others who may need this information.

Thanks,
Gary
Stroke survivor since 2002

See the original article:

PEI Stroke Care Model "Caregiver Handbook"

in

Prince Edward Island Stroke Recovery

Time to Reflect

Sas Freeman

December 29, 2014

Stroke Awards 2015

With Christmas now behind us and the New Year fast approaching people have many mixed emotions, some people love New Year while others feel the exact opposite and even find it sad. This can be a particularly difficult time for some stroke survivors, particularly those affected by Post-Stroke Emotionalism (PSE). This causes uncontrollable, unprovoked crying after having a stroke and feeling depressed and or anxious. There is still very little known about how and why it can continue so long after stroke.

The Stroke Association has funded a study to learn more about this condition, which will be led by Dr Niall Broomfield – Head of Stroke Neuropsychology at NHS Greater Glasgow and Clyde. He is confident the findings will help overcome this impact in the future.

For now I think it is important we stop and remind ourselves, especially as stroke survivors of exactly what we have done and enjoyed this year and celebrate all our personal achievements each and every one of them. This way we go into 2015 with the fighting spirit and self-belief required to continue our journey of recovery and to begin the year in a positive frame of mind.

With this thought for most in mind: how about nominating someone for the ‘Life After Stroke Awards 2015’. Think of someone you have perhaps met at a stroke group, a fellow survivor who you believe to be truly inspirational, a healthcare professional, or a carer, that person who really has gone that extra mile to help you.

You can get your form at stroke.org.uk/lasa but it will need to be completed and submitted by 30th January 2015. Start the year by making someone happy, if they were to win you then would go to the awards ceremony in London.

Let’s start the year by continuing the progress positivity and helping one another.

I wish you all and your families a healthy and happy 2015.

See the original article:

Time to Reflect

in

Sas Freeman