The National Institute of Neurological  Disorders and Stroke have given new light to the fact that patients who participate in intense physical therapy at home show the same amount of improvement compared to using expensive high tech body weight supported treadmill devices.

These researchers also demonstrate that these patients continue to improve walking ability up to a year following the initial stroke. This is yet another pat on the back for those of us in PT who work so hard with patients during the recovery. Neuroplasticity is a very slow and sometimes agonizing process for the therapist and patient. Read the full story

Current work with patients who have had a stroke tends to lean more toward the explicit side of motor learning. Basically giving the patient a series of directions to instruct them on how to perform a task. A recent research article from the Journal of Physical Therapy suggests a completely different approach.

The new direction that the research suggested was an implicit approach to task instructions. Simply put, you give the patient no instruction and let them figure it out in an error free environment. Implicit learning is not a new concept but it is a unique approach especially when working with patients that have decreased mental processing from a stroke. Read the full story

The Spotlight section of our website is designed to collect a grouping of articles and posts that deal with a specific pathological condition or an area of focus in the field of Physical Therapy. Read the full story

Patients with COPD can be very challenging. Just simple AROM exercises can stress them to the point of exhaustion. Recovery for them takes most of your intervention time. In this recent article I found from Medical News Today it emphasizes finding activities during the day that the patient can enjoy.

This will allow the patient to get several bouts of exercise spread out through the day and week. I think you will find it an interesting and simplistic approach to managed care for patients with COPD. Read the full story

I will be describing a basic guideline to use when managing a patient in the acute phase of rehabilitation following a capsular reconstruction surgery. Remember that any of the guidelines can be adjusted, along with the exercises in order to adapt them to your patient. Each patient is different and for optimal quality of care needs to be evaluated based on their status.

Surgical Protocol

During the first 24 hours the surgeon will see the patient and allow for the appropriate bandage replacement. Usually after the first 72 hours the bandages can be replaced with sterile tape strips. The patient is educated on the appropriate care for the surgical site. This includes refraining from submersing the site in water, along with any range of motion limitations.

The range of motion limitations will be in response to how stable the shoulder was prior to surgery. The general immobilization procedure keeps patients at 90 degrees of abduction, 45 degrees of external rotation and 30 degrees of forward flexion. This position will be kept for a period of 2 weeks. Posterior repairs will remain in immobilized for 3-4 weeks. Read the full story

I would like to begin this discussion by defining what the Acute Stage of injury is as mentioned in the previous post.

The Acute Stage (inflammatory response) has a vascular or cellular response immediately after the insult. This response is characterized by swelling, redness, heat, pain at rest and loss of function. When taking the patient through the range of motion for the area involved they will usually guard at some point during the movement. Read the full story