Archive for the ‘Professional Rehab Students’ Category

Yoga Therapy In Hand and Upper Extremity Rehabilitation

Thursday, March 3rd, 2011

As past president of the International Association of Yoga Therapists I have dedicated many years of effort to bring their mission to fruition.

It has been a long, slow process as we've worked together to fulfill that mission of:

"Our mission is to establish Yoga as a recognized and respected therapy."

 

It is with a great deal of satisfaction and pride that I'm happy to announce that mission has come one step closer to reality with the publication of the 6th Edition of Rehabilitation of the Hand and Upper Extremity from Elsevier in February of 2011, considered to be the "Bible" of rehabilitation principles by conventional medicine.


 

 

 

 

 

 

 

Chapter 121 is titled as:

 

 

 

 

 

 

 

The handheld video graphic indicates that in addition to the 13 page chapter there is available online video clips of the referenced asanas, mudras and meditations.

This shot summarizes the chapter to describe how the work is far more than "Asana for Hands":

 

 

 

 

 

 

 

 

And here is a clip of the section on manual therapy:

 

 

 

 

 

 

 

 

 

 

 

The 2-volume set is a 1900 page reference set that sells for $299 and will be a fixture in clinics and graduate programs for years to come.

To purchase the textbook visit here

 

To cite:  

Taylor MJ, Galantino ML, Walkowich H,  "The Use of Yoga Therapy in Hand and Upper Quarter Rehabilitation." In Skirven, Rehabilitation of the Hand and Upper Extremity, 6th Ed. Philadelphia: Elsevier, 1548-1562, 2011.

 

Please pass on this information to those that share the mission!

CPR needed for Clinical Prediction Rules?

Wednesday, June 2nd, 2010

 

 

 

What's a clinician to do when the rules of certainty….uhmm, aren't certain?

What do we use then to know we "know" what our patients need?

Well, that's the conundrum the certainty crowd faced  with this report  in June 2010. Now the certainty slips even further away with this report in June 2011 on CPR's for LBP. …And now more discussion of the implications  here http://www.ozpt.com/res2.html



 

 

"The current body of evidence does not enable confident direct clinical application of any of the identified CPRs."

Clinical prediction rules in the physiotherapy management of low back pain: A systematic review   Robin Haskins, Darren A. Rivett, Peter G. Osmotherly

 



 

 

Critical Appraisal of Clinical Prediction Rules (CPR) That Aim to Optimize Treatment Selection for Musculoskeletal Conditions

Tasha R. Stanton, Mark J. Hancock, Christopher G. Maher and Bart W. Koes PHYS THER
Vol. 90, No. 6, June 2010, pp. 843-854.

 


 

Turns out there's no "good" evidence there is evidence that CPR's provide much direction or surety in treatment selection in PT.

Yikes!

I blogged about the shortcomings of this whole perspective back in April here in The Player Piano.

To my way of seeing this world, the whole fear-based scramble for certainty strips rehab of its vitality and creative process, short circuiting innovation and what Seth Godin describes as art in his latest book Linch Pin.

Surely we can invest more time and effort into innovation than we do in predicting? Failure to do so robs the next generations of rehab students being prepared to offer care that feeds them literally and spiritually as I wrote in May here on PT Education: A formula for craziness.

So where do you turn now that there isn't a map of surety?

I have some ideas as my mission is to return the sarcredness or artistry back to rehab, but want to hear yours…

what now?

PT Education: A formula for craziness…

Saturday, May 15th, 2010

Einstein is famous for his formula to the right. It quite literally changed everything.

He's also widely attributed as having said,

"The definition of insanity is doing the same thing over and over again and expecting a different outcome."                

A little searching suggests he probably didn't say that….but the formula sure rings true in most instances.

How does this relate to P(hysical) T(herapy) education?

If I understand it correctly, the schools search for educators "qualified" to teach what will be on the test about topics that will be tested.

What gets tested is what has been vetted for many years through countless committees.

A surprisingly small number of the people creating the questions have recently been in the clinics delivering a product and if they were, they were doing what they'd been taught and working for pennies through the tired reimbursement system, only now doing even more paperwork to "support" their efforts. (Hence the over and over again).

Meanwhile, we fiddle with facets or expensive balance equipment, wondering why our clients won't pony up cash to consume the same old products dressed in ties called "Doctor" or new technology???

Over and over again, except now we're going to show them, at least in NY, and not provide services for one day just to shake things up!

Really???    Seriously???

That's the best response we have to a systemic craziness of doing the same thing….

Over and over again?

I'm sorry but that is nuts.

Overhaul our education system where the students not only learn science, but more importantly learn how to utilize the latest incredible findings in practical, caring ways with patients from a full biopsychosocial perspective (yes, the science says movement is affected by technique and relationships far beyond the over and over again mantra of research evidence creating a one best practice  and the need for CPR for CPR's.) .

This of course would be new, different and confusing without the purity of wholesome, white-bread sliced services. We might even find some novel ways that would get our patients excited AND results so good they'd actually pay us a full doctor's fee for the service no matter what their insurance covered….really! (They all do at my clinic)

So am I crazy to be thinking crazy like this,

or do you agree we're in some sort of vicious systems loop where

we're trapped in generating dated, boring and unvalued service?

 

I have more details on what this vision my look like pending publications in the APTA's PT in Motion and Private Practice section….stay tuned, we're just getting started!

Player Piano PT?

Wednesday, April 21st, 2010

 

 

Why do so many rush headlong for the 'right' treatment sequence/protocol?

Is it fear?

Boredom?

Lack of confidence?

Whatever the reason, the push for a 'formula' of care results in just this kind of performance….

and too often the final clip is what happens to the 'audience'…no one is moved or touched, often literally….to include the "player".

 

We are better than this!

 

Only when the heart is involved, playing with mastery (clinical) and to the audience (patient values), does the truly memorable and moving performance happen!

 

How do you thrill your audience?

Rehab Professionals and the Wellness Industry: Where Do We Belong?

Sunday, January 17th, 2010

When it comes to fitness and wellness, I'm afraid most rehab professionals too easily step into the ruts of the industry rather than consider "What might be?".

I was fortunate enough to be thrust into the wellness arena the first year of my professional rehab career. The US Army was big into the new buzz word of 1982: Corporate Fitness.   OUCH…some one is getting old and hopefully for those of you new to wellness you get some perspective on how "Un-new" wellness in the workplace really is!

What disappoints me is that almost every article on rehab and wellness gravitates to the same old models of flexibility assessment, posture screens, standard ergonomic assessment….YAWN! Is that the best we can do?

So what should we be doing? CREATING SOMETHING NEW & BETTER!

At the AZAPTA Fall Conference in 2009 the theme was wellness and fitness. Here is the short one page position paper I distributed articulating a call for us to step forward to LEAD a true biopsychosocial revolution in fitness. Click here to read. 

Here a couple of things I am creating:

 

 

 

What are you doing to bring forward new programming in fitness and wellness that we weren't doing 10, 15 or 20 years ago? 

Let me know…we can and MUST do better than what is out there now!

Physical Therapy’s role in Genetics

Saturday, December 5th, 2009

 

The December 2009 PT in Motion magazine has the cover story: "Rooting Out Genetic Links" by Eric Ries. A beautiful cover, but once again a reactionary perspective with little vision of our role in rehab affecting genetics…why are we always so passive?

 

The article concludes quoting Steve Wolf, PT, PhD, FAPTA: 
 
For Wolf, heightened awareness cannot come fast enough, given the frantic pace of scientific discovery.
"It's only a matter of time—some people say less than 5 years—before human stem cells and other progenitor cells start being produced that can change the way in which a pathological gene is expressed," he says. "These things are happening. We must be prepared to deal with them."
 
Too late! It has already happened and we're standing on the sidelines waiting for the genome to act rather than stepping up to work with the genome!
 
UPDATE: May 2010 U of Michigan reports PTSD and its role in gene expression
 
What if PT's had clinical skills within their scope of practice that had been shown to "manipulate"…(I guess technically mobilize as manipulate is now to mean high speed, low amplitude thrust) gene expression?
 
Well, I had the honor of introducing Dean Ornish, MD as our keynote speaker at our 2009 Symposium on Yoga Therapy and Research. In the TED talk below Dean describes how using education, movement with awareness, breathing exercises, group social connection and interaction and nutritional changes in a positive social setting it has been demonstrated you can modulate genetic expression in men with prostate cancer. Here's the research article

Hmmmm…does that sound like the scope of practice of any profession we know and care about?

 

Don't just imagine rehab altering genetic expression….empower your clients today!  …and we got excited when we started moving facet joints!!! 

Isn't this amazing???!!

Now…do we "flex" or "extend" the genes?…the next great debate!

Our Future: The Professional Rehabilitation Students

Sunday, November 22nd, 2009

A special welcome to those of you that are presently studying to become licensed rehabilitation professionals!

Please know that your faculty has many constraints on what and how it can teach…after all schools are part of the larger systems of regulation and accreditation. So be patient…you are garnering amazing tools for being of service to others in the future. But, if you find things a little dry or mechanistic in approach to what you know from your "real" world, hang on. 

There is a growing number of we "old" pro's quietly working to bring our methods up to date with the basic science discoveries of movement, neuroscience and the entire biopsychosocial model. 

If I can be of any assistance to you in locating resources for special projects/papers, etc. let me know. This is what I do as part of a larger effort to expand our professions in being more comprehensive and compassionate. 

Research, clinicians specializing in integrative approaches or just some encouraging words…you've found a place to drop in for any or all of that. 

 

Here's an oasis of "different" thinking from my doctoral days…it was a website I built to galvanize some of my integral thinking at the time:  A Fork In the Road   

Send your classmates and your faculty here to generate great discussions and good luck with your studies!