MyPhysicalTherapySpace.com - A part of the 1T - the "One Thing" you need for PT practice.

MyPTConnect Tip of the Day #2

The first 5 users to upload a video to YouTube showing you or someone else logging onto MyPhysicalTherapySpace will receive a free registration to an Evidence in Motion course in 2007. This is a $425 value! To receive the voucher, individuals must submit the url within MyPTConnect by inviting ‘childsjd’ to a discussion. Submissions sent by email will not count. We will, however, quickly remind you of the rules so you can submit on MyPTConnect. We already have 1 winner, Joey Cadena from Texas State University. Congrats Joey! Click here to view his submission. 

So, there are 4 free spots remaining. The wittier and more funny the better. The individual submitting the video judged as being the best of the 5 submissions will also receive a free manipulation CD of his or her choice. So, get our your video cameras and login to the 1T!

Note: This post will also be posted in the 'Learn about MyPTConnect' group on MyPTConnect. All comments and questions should be added there. The comments feature on the blog is turned off for this post. Email us at info@myptspace1T.com if you have any questions. See you on MyPTConnect!

Evidence for the effective use of slump sit

The intrepid Dr. Josh Cleland has completed a small trial demonstrating the effectiveness of the slump sit position as a  treatment mode.Download slumparticle_man_ther2.pdf  A cohort of 30 patients with buttock or lower pain, negative for SLR, but positive for slump-sit tests were randomized to receive either slump sit stretching or mobilization/exercise. All subjects were seen for 6 treatments. The slump sit treatment group had a significantly greater reduction in Oswestry (9.7 pts) & pain score (NSPRS 0.98)...that's difference between the groups folks! I smell a low back pain treatment subgroup emerging. Thanks, Josh,

Britt

MyPTConnect Tip of the Day #1

Most of our readers have now heard about MyPhysicalTherapySpace and may know how to join and invite their colleagues. We will now be starting a regular 'Tip of the Day' feature on the blog to help you mazimize your use of MyPTConnect, the 1T's professional network, the first network specifically deisgned by PTs for PTs and other PT stakeholders.

For the first tip, did you know that you can join any number of discussion groups on MyPTConnect? Anyone can create a new discussion and contribute to existing discussions. Simply click on the 'View All Groups' link to see currently available groups. You can join any group that you may be interested in following. For discussions that you want to follow closely, you have the option of 'subscribing' to a discussion, which will send you an email each time someone adds a comment to the discussion, keeping you immediately apprised of any updates. Be sure to check back frequently as new groups are always being added.

The possibilities on MyPTConnect to collaborate with colleagues, students, and other physical therapist stakeholders are endless! If you haven't already, click here to sign up for MyPTConnect! It's completely free! Let us know if you have any questions. Looking forward to seeing you on the 1T!

The MyPhysicalTherapySpace Team

Note: This post will also be posted in the 'Learn about MyPTConnect' group on MyPTConnect. All comments and questions should be added there. The comments feature on the blog is turned off for this post. Email us at info@myptspace1T.com if you have any questions. See you on MyPTConnect!

Spread the 1T Virus!

We announced the launch of MyPhysicalTherapySpace.com (The 1T) last week. Many are already starting to jump on board the 1T's MyPTConnect. We're up to 200 profiles in 72 hours! Professional networks grow exponentially due to their 'viral' nature and ease with which you can invite others to join. The 1T is one virus you want to spread! So, if you haven't set up your free account yet, do so today! If you have, be sure to invite any and all colleagues, students, etc. to join. It's very easy to do using the 'Invite a Colleague' link. The more critical mass, the better the communication and ability to link with others, have discussions, meet online, chat, etc. The goal is to have 50K PTs and other stakeholders registered by mid 2007!

Also, users will soon be able to create restricted groups that require an invitation to join. This will allow any group you might imagine to form private groups for internal communication, online meetings, chat, etc. Lots of possibilities.

Thanks again for jumping on board the 1T! Let us know how we can serve you better or if you have any questions! 

The MyPhysicalTherapySpace Team

Note: This post will also be posted in the 'Learn about MyPTConnect' group on MyPTConnect. All comments and questions should be added there. The comments feature on the blog is turned off for this post. Email us at info@myptspace1T.com if you have any questions. See you on MyPTConnect!

Leveraging Technology - Telerehabilitation

Good Afternoon.

One of my goals has been to look at ways to leverage technology to improve our profession.  Most of what I have focused on is imaging tools that assess our ability to assess movement dysfunctions.  Well, this weekend I heard two great presentations by Donald Shaw and Beverly Newman regarding their work based out of Texas State University in San Marcos, TX on telerehabilitation. 

They have found a way to leverage technology to allow for home health PTs to improve their quality of care by having telerehabilitation technology in place.  In a nutshell, individuals with high risk that are being seen by home health PTs can now have electrocardiogram (ECG) monitoring during the exercise regimen.  Additionally, they have found a way to convince an home health agency to train these PTs in ACLS, have AEDs in their vehicles, and CPR masks on-hand at all times to help safely manage these individuals.

Think about this:

1.  Patients are going home sooner and sicker from the hospital

2.  Rehabilitation that would be traditionally done in the hospital under supervision (telemetry) with assets to handle a code is now being done at home with a PT present.

3.  There are numerous guidelines: American Heart Association, American College of Sports Medicine, and American Association of Cardiovascular and Pulmonary Rehabilitation that have set guidelines on how individuals with different risk stratification are suppose to be monitored.

4.  Although these guidelines exist, there is a LARGE gap between what is suggested and what is actually being done based on resources, individuals being treated in their own home instead of in a medical facility, training, and reimbursement issues.

5.  Most home healthcare providers recognize that their patients are "sicker" and that they don't have the right technology to progress them through an exercise program safely...So, what are the options?  To be more conservative?  Does that hamper our ability to progress them to the highest level of independence?

Their success in finding a way to leverage technology to monitor the patients vital signs, ECG, and oxygen status is a perfect fit!  This allowed the treating therapist to have real-time information about their patient.  This real-time input from someone > 450 miles away allowed for on-the-spot changes in the therapy regimen in order to ensure a safe rehabilitative environment.  Further, the patients felt safer exercising knowing that they were being monitored (does this mean they were willing to do more exercise?  test their limits better?). 

I really believe Don Shaw and his colleagues have developed the next big telerehabilitation tool that will (at some point) be required for all of these at-risk individuals being cared for in their homes. 

Congratulations Don, Beverly and colleagues for thinking outside of the box and pushing our profession to another level of excellence.  Your ability to find a way to shrink the gap between evidence and practice is wonderful for our profession.

This is huge for our profession- Congratulations!

Deydre

Clinical Consult

In Baton Rouge, there are "pain clinics" popping up everywhere and the docs are injecting anything that moves. The internists and primary care MDs are getting marketed hard by the pain docs to send musculoskeletal patients to them.  Of course there is no manual therapy or therapeutic exercise associated with them. Is anyone aware of studies comparing manual physical therapy and/or exercise to epidural steroid injections?

Seth Kaplan PT, OCS, MHA
President and CEO
BRPT-LAKE
Rehabilitation Centers, L.L.C.

Clinical Consult

I am looking for references on the sensitivity of the Homan’s Sign/Test for ruling out DVT in a patient s/p arthroscopic knee surgery.  I have found several references concerning reliability, specificity, risk factors, clinical signs and symptoms, etc (and even an article that suggested it was not sensitive, but didn’t elaborate or reference this statement).  I have yet to encounter any reference that reports sensitivity numbers.  I would also appreciate any thoughts on what would be considered “entry-level” knowledge in terms of screening for DVT.  Is it enough to recognize risk factors and clinical signs and symptoms (such as the Homan’s sign), or would entry-level clinicians be expected to know algorithms such as the Wells criteria (as studied in the PT population by Riddle, et al, Physical Therapy, August 2004)?

Thanks,

Mike

 

Welcome To MyPhysicalTherapySpace! The 1T! It's Free!

From the company that brought you the first PT blog and online EBP course, Evidence in Motion is excited to announce the launch of MyPhysicalTherapySpace.com, the 1T, 'One Thing', you need for PT Practice!

Whether you are a physical therapist, physical therapist assistant, student, payor, consumer, legislator, advertiser, or member of the media, there is something for all stakeholders in physical therapist practice on the 1T!

- Expand Your Network - Search, match and connect with other members

- Schedule Times to Connect - Plan online or offline meetings 

- Build Business Relationships - Grow your network of industry contacts

One very important part of the 1T is MyPTConnect, the first professional networking site exclusively dedicated to the Physical Therapy world! Similar in functionality to other social networking sites, MyPTConnect is specifically geared for physical therapist stakeholders. MyPTConnect allows you the opportunity to meet, consult, join in discussions, form online communities, share information, and collaborate with other physical therapist stakeholders with whom you share similar interests!

The easy-to-use matching, searching, and visualization tools enable you to quickly identify other community members with whom you would like to exchange knowledge, develop a business partnership, or share best practices. Get In, Get Connected, and Get Out...or stay online to participate in live chat, engaging forum discussions, and collaborate on-line.

The best part about MyPTConnect is that it’s FREE! Click here to join MyPTConnect! Get connected on the 1T today!

Also, participating in MyPTConnect is easy, private, and secure. Other members will be able to view the profile information you supply, but they will NEVER know your name, e-mail address, or any other contact information about you--until you are ready and explicitly agree to share it with them.

Committed to transparency and collaboration, we will be constantly adding new features to the 1T in the coming weeks and months. We are fiercely committed to offering you unparalleled access that allows you to be more connected than ever within the PT profession. Stay tuned and give us feedback on how we can serve you better! Regular updates will be posted on the blog.

The EIM/MyPhysicalTherapySpace Team 

MyPhysicalTherapySpace.com is a web2.0 company brought to you by your friends at Evidence in Motion.

Note: This post will also be posted in the 'Learn about MyPTConnect' group on MyPTConnect. All comments and questions should be added there. The comments feature on the blog is turned off for this post. Email us at info@myptspace1T.com if you have any questions. See you on MyPTConnect!

Lumbar Stenosis RCT!

All,

I have attached the recently published lumbar stenosis RCT by Whitman et al. Patients were randomly assigned to 1 of 2 physical therapy intervention programs. One group received manual physical therapy, exercise and body weight supported treadmill ambulation while the other group received flexion exercises and a walking program. At 6 weeks the manual physical therapy and exercise group exhibited significantly greater perceived recovery (79% vs 41%). This calculates to a number need to treat of 2.6 (95% CI, 1.8 to 7.8). At the time of a 1 year follow-up this interaction was no longer significant but perceived recovery still favored the manual therapy, exercise and body weight supported treadmill group (62% vs 41%).

At the time of the long term follow-up (yes longer than 1 year; 29 months- wow!) the perceived recovery was 38% for the manual therapy and exercise group and 21% for the flexion exercise and ambulation group. The majority of the secondary outcome measures favored the manual therapy and exercise group at the 6 week and 1 year follow-up. This is a tough population to work with yet this study provides evidence that physical therapy management programs can result in favorable outcomes.

Spine has a new feature that allows authors to provide a flash file to augment their manuscript. Check out the flash file accompanying this manuscript. 

Also check out the APTA Press Release.

Be sure to share this one with the local Spine Drs!

Once again- Nice work JW!

Josh.    

Download whitman_stenosis_spine.pdf

Does Referral for Profit Cause Harm?

Since the Evidence in Motion blog started back in 2005, there have been multiple blog posts related to the pitfalls associated with referral for profit scenarios (ie, POPTS or other similar arrangements that may lead to over utilization, limited choice, etc.). Here are just a few for historical sake:

http://blog.evidenceinmotion.com/evidence/2006/05/popts_coming_to.html
http://blog.evidenceinmotion.com/evidence/2005/05/effects_of_phys.html
http://blog.evidenceinmotion.com/evidence/2006/03/identifying_an_.html
http://blog.evidenceinmotion.com/evidence/2006/09/doctors_of_phys.html
http://blog.evidenceinmotion.com/evidence/2005/12/tps_healthcare_.html

There are numerous examples in these posts regarding how referral for profit has disrupted markets, increased utilization and costs, limited choice, etc. Although these issues are important, the purpose of this blog post is not to further debate the merits of referral for profit (although debate is fine and welcome). Instead, we are interested in hearing from our readers SPECIFIC examples in which referral for profit has actually resulted in suboptimal care or harm to the patient. Any specific examples of flat out shoddy care are ok too. Do not violate any HIPAA rules, but to the extent possible, let's hear specifics on situations you may be familiar with regarding how referral for profit may have caused harm.

Looking forward to the input. We suspect there are many blog readers in practice who might be able to offer some insight. Thanks!