Archives : 2012 : May

The Benefits of Aquatic Therapy Part 2: Case Study

Today’s blog is a continuation of last week’s submission written by Laura Markmann, PTA, ATRI and Licensed Black Belt Nia teacher. She has ran the Aquatic Therapy program at Rockwood South Hill since September 2011, two days a week under the supervision of a licensed PT.

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Aquatic Therapy (AT) consists of an exercise program that is performed in the water. It is a beneficial form of therapy that is useful for a variety of medical conditions by using the physical properties of water to assist in healing and exercise performance. At Rockwood South Hill in Spokane, AT is an integrated and tailored exercise program that guides residents through a combined aquatic and land therapy program.

The AT program at Rockwood South Hill is indicative of the innovative and unique ways Infinity Rehab therapists treat patients at facilities across the country. Below is a case study highlighting the progress of single patient who participated in the AT program at Rockwood South Hill.

CASE STUDY:  AC, 87-year-old male with generalized muscle weakness, abnormality of gait and late effects of CVA including left foot drop necessitating the wearing of an AFO with additional diagnoses of DM II, HOH, fused L4-L5, and hx of multiple falls. The resident participated in PT 3x/week, attending land therapy 1x/week and AT 2x/week. The focus of aquatic intervention: Improved ROM, and strength of bilateral hip abduction, external rotation, hip extension balance, flexibility, agility and mobility. Modalities used in the pool were ambulation with 5 lb ankle weights, utilization of ankle floats for resistance, and use of neck doodles for lumber spine water traction.  Resident reported pain in the water as 2/10 while on land 4/10.  Therapy results were increased hip strength per manual muscle test of left hip from a 3+/5  to a 4+/5  and reaching his functional maximum; using a custom articulating AFO allowing him to continue to go out within the community with friends and family; attending the hydro balance and tone classes 2x a week.  To date he has had no further falls.

Since our program began in 2011 we have successfully graduated five residents with diagnoses ranging  from  CVA with left foot drop to chronic back pain, sciatica, lumbago ( low back pain), Osteoarthrosis-generalized multiple sites, chronic pain, degenerative joint disease, rotator cuff  repair and lateral peripheral neuropathy. A current resident just began AT with bilateral AFO’s due to a crushing accident and is ambulating in the pool with a Bobath wrap on her bilateral lower extremities.

The Benefits of Aquatic Therapy

Today’s blog is written by Laura Markmann, PTA, ATRI and Licensed Black Belt Nia teacher. She has ran the Aquatic Therapy program at Rockwood South Hill since September 2011, two days a week under the supervision of a licensed PT.

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Exercising in the water is nothing new. Most early aquatic venues were in natural settings, such as mineral pools, ocean waters, streams and springs. The development of specific aquatic rehabilitation programs arose out of the evolution of earlier techniques translated into new aquatic venues.

Aquatic Therapy (AT) consists of an exercise program that is performed in the water. It is a beneficial form of therapy that is useful for a variety of medical conditions by using the physical properties of water to assist in healing and exercise performance. At Rockwood South Hill in Spokane, Aquatic Therapy is an integrated and tailored exercise program that guides residents through a combined aquatic and land therapy program.

How does it Work?

One benefit of AT is the buoyancy provided by the water. While submerged in the water, buoyancy assists in supporting body weight. This decreases the amount of weight-bearing which reduces the force of stress placed on the joints. This is very important to our residents with arthritis, fractures, or who are overweight. The viscosity of water provides an excellent source of resistance that can be easily incorporated into an AT program. What is really great is the resistance allows muscle strengthening without the need of weights. Using resistance coupled with the water’s buoyancy allows a person to strengthen muscles groups with decreased joint stiffness that cannot be experienced on land. Our program also includes hip and back rehab and a very rigorous core stabilization program. Eighty-percent of these problems come from muscle imbalance. Our job is to provide minimal load to damaged tissue while incorporating a bit of challenge!

AT goals are written to directly relate to functional skills necessary for quality of life.  The goals address areas such as improved leg strength to facilitate weight bearing during transfers or LE dressing, improved arm & leg flexibility, improved grasp and release and eye-hand coordination, increased relaxation to allow for better positioning while sitting, and increased physical activity tolerance to continue with community-based activities and exercise.

AT also utilizes hydrostatic pressure to decrease swelling and improve joint position awareness. The hydrostatic pressure produces force perpendicular to the body’s surface. This pressure provides joint positional awareness to the resident, which also improves proprioception. This especially assists residents who have had joint sprains with ligament tears. Lastly, the warmth of the water (90-94 degrees) assists in relaxing muscles and vasodilates vessels increasing blood flow to injured areas. People with muscles spasms, back pain and fibromyalgia find this aspect of Aquatic Therapy especially therapeutic.

Aquatic Therapy at Rockwood South Hill

At Rockwood South Hill we have a private pool for residents with a lift purchased in 2011. Laura Markmann, PTA, ATRI, and Licensed Black Belt Nia Teacher, runs the program two days a week under the supervision of a licensed PT.

Since our program began in 2011 we have successfully graduated five residents with diagnoses ranging  from  CVA with left foot drop to chronic back pain, sciatica, lumbago ( low back pain), Osteoarthrosis-generalized multiple sites, chronic pain, degenerative joint disease, rotator cuff  repair and lateral peripheral neuropathy. A current resident just began AT with bilateral AFO’s due to a crushing accident and is ambulating in the pool with a Bobath wrap on her bilateral lower extremities.

It is important to know however, that Aquatic Therapy is not for everyone. Certain conditions and diagnoses are not appropriate for pool therapy. These include: cardiac conditions, fevers, open wounds, infections, and bowel/bladder incontinence. We always request Aquatic Therapy as a therapy modality that is specifically ordered by a medical provider.

There are challenges to running any specialized program. Our time is valuable and we had to be creative in finding ways to make the time to develop the protocols, and work with the retirement community on schedules, transportation, rules & regulations. The community has been very supportive and agreed to purchase several pieces of specialized equipment and exercise software. Our program is now a valuable part of the marketing materials and has drawn the attention of healthcare providers in the community.

May is National Bike Month: A Story and a Challenge from Mike Billings

I was traveling home from work last Friday going over in my mind some of the events of the past week as well as thinking about the week ahead.  It was a typical spring day here in Portland, OR – partly sunny, mild temperature, yet with the ever threat of a sudden shower.  About half way home, the skies darkened and unleashed a massive rain and hailstorm.  Not really a big deal, except that I had chosen to commute by bike that day.  In addition, because it was mostly sunny and warm when I left the office, I had also chosen to pack my rain gear and gloves deep in my backpack.

As I was cycling up that hill in the pouring rain and hail, hands numb from the sudden drop in temperature and hail pounding my head through the slits of my bike helmet, I actually started laughing.  I have many reasons for choosing to ride my bike, but mostly because it is fun.  On this cold, wet Friday afternoon, I felt like a little kid again, playing in the rain and could feel all the stress that had accumulated from the week melting away. You too can experience this delight by rethinking your daily commute by swapping the car for your bike.

May is National Bike Month.  This is a good opportunity to try active transportation if you typically use a car for commuting to and from work and running errands.  Like many of you, my work schedule as well as personal life requires that I use a car for most of my travel.  However, I try to commute by bike as often as possible – even during the wet NW winters.  Consider this:
•    40% of all trips in the U.S. are shorter than 2 miles yet Americans use their cars for 87% of all trips between 1-2 miles
•    27% of trips are shorter than 1 mile yet 62% of these trips are done by car
•    Half of all trips made in the U.S. could be done with a 20-minute bike ride
•    A quarter of all trips could be done with a 20-minute walk

People choose active transportation for many reasons:
•    Public Health Benefits
o    Bicycling and walking levels fell 66% between 1960 and 2009, while obesity levels increased by 156%.
o    Between 1966 and 2009, the number of children who bicycled or walked to school fell 75%, while the percentage of obese children rose 276%.
o    In general, states with the highest levels of bicycling and walking have the lowest levels of obesity, hypertension, and diabetes and have the greatest percentage of adults who meet the recommended 30-plus minutes per day of physical activity
•    Economic Benefits
o    Bicycling and walking projects create 11-14 jobs per $1 million spent, compared to just 7 jobs created per $1 million spent on highway projects
o    Cost benefit analyses show that up to $11.80 in benefits can be gained for every $1 invested in bicycling and walking
o    Households that walk and cycle as their primary modes of travel save an average of $694 per month
o    One mile of a four-lane highway costs about $50 million.  That same amount can pay for an entire network of bicycle and pedestrian facilities for a mid-sized city
•    Help the Environment
o    70,000 deaths every year in the U.S. are attributed to air pollution

So choose your cause and leave the car behind when you can.  Here are just a few suggestions to get you started:

o    Take a map and draw a one-mile radius around your home.  Try walking or biking trips within this circle
o    Go multi-modal – If you live a great distance from your destination consider combining public transportation with walking or biking.  Or drive part way and then bike the remainder.
o    Participate in any of the following:
o    May 9 – National Bike to School Day – Accompany your child to school by bike
o    May 13 – CycloFemme – The International Day of Women’s Bicycling
o    May 14 – 18 – National Bike to Work Week
o    May 18 – National Bike to Work Day

Enjoy the ride!

Tailwinds,

Mike

Angus Brown, Infinity Rehab Regional Sales Director, Joins the Washington Health Care Association Future Leaders Program

Infinity Rehab would like to congratulate Angus Brown, Regional Sales Director, for being chosen as a member of the Washington Health Care Association’s Future Leaders Program. The WHCA Future Leaders Program is comprised of eight

healthcare professionals that have been diligently selected from the three primary constituency groups (Assisted Living, Skilled Nursing, and Associate Business Members) and WHCA’s Women in Long Term Care Committee. Members have been identified for their passion and commitment to improving the quality and standards of care in the State of Washington.

2012 marks the inaugural launch of the Future Leaders Program. Its core mission is to prepare future leaders of both WHCA and the healthcare industry in Washington to anticipate change and to successfully advocate on behalf its constituents. The program consists of quarterly meetings and annual courses where members take part in a multitude of curriculum.

Angus Brown says he is deeply committed to improving the health care industry and long-term care services for seniors in the Pacific Northwest. “I think this is a terrific opportunity for me. Being a part of the Future Leaders group will give me the chance to truly make a difference.”

For over fifteen years, Angus has accumulated a unique managerial skill set by leading teams in a multitude of fields; including medical staffing services. His professional achievements and team-building credentials are highlights in his prominent success story. Angus is a frequent moderator and guest speaker at professional events. His passion for coaching and mentoring others has greatly attributed to the continued growth of Infinity Rehab.