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Educating a patient before surgery improves many things: Approach to education focuses on how each patient processes pain Low back pain is still one of the most common painful conditions in the world, and although most people who have it will eventually improve, some go on to deal with long-term issues. Chronic low back pain (CLBP) is a term used to describe any condition in which an individual experiences pain for more than three months, and it is a major problem. There are many strategies used to address CLBP, and one of these is called neuroscience education. This type of educational strategy focuses on how and why each patient is experiencing pain, with the goal of decreasing the amount of pain they have and improving their overall attitudes. Neuroscience education has been found to be helping individuals cope with pain, and one way it is used is to better prepare patients that are about to have surgery. Many patients have certain fears and misconceptions about surgical procedures, and this education can help to correct them. To evaluate this type of strategy, a study called a case report was conducted on a 30-year-old woman. Woman had been dealing with CLBP for four years The patient studied in this case report was a healthy 30-year-old female professional dancer that had a four-year history of CLBP. She had been treated with various interventions from a physical therapist and underwent several MRIs of her spine. Her most recent MRI showed that she had a herniated disc in her lower spine, and believed that her pain was the result of the continuous stress placed on her back when dancing. The patient's neurosurgeon told her that surgery was likely the best option due to her long history of ongoing pain, her high level of performance, and the results of her most recent MRI. Neuroscience education delivered in a 30-minute one-on-one session A detailed assessment showed that the patient had moderate CLBP, left leg pain and high levels of fear associated with physical activity and work, as well as limited knowledge of pain and various beliefs regarding her surgery. The neuroscience education was delivered to the subject during one 30-minute one-on-one session with a researcher. The session included open-ended questions for the patient to answer, as well as drawings and other educational tools on how the nervous system works and how pain is processed. The goal of this session was to reduce the woman's anxiety and promote positive expectations and beliefs from surgery. A number of physical measurements were taken of the patient before and after the neuroscience education session, including four functional MRIs (fMRIs). Three fMRIs were taken before and one after the session, and their purpose was to identify certain areas of the brain that were activated during certain tasks to develop a more in-depth understanding of the woman's reactions and beliefs on pain. Patient experiences several positive changes after neuroscience education Results from the physical evaluation and fMRIs generally revealed that the patient experienced several positive changes following the neuroscience education session. In particular, her scores for back disability and pain catastrophizing (the tendency to believe pain is far worse than it actually is) both decreased to a notable degree, and she was able to raise her leg more easily than before. She also showed improved beliefs and attitudes regarding her upcoming surgery, as she reported feeling more prepared and less fearful about the procedure than prior to the neuroscience education. Finally, the fMRI scan taken after the education session revealed that the patient appeared to be in less discomfort than she was during the first scan. These findings show that just one 30-minute session of neuroscience education can actually affect the mindset and physical abilities of a patient preparing for surgery. Since the case report was only performed on a single patient, this is anecdotal and further research must be performed on a larger group of subjects in order to confirm these outcomes. Nonetheless, patients with CLBP scheduled for back surgery should consider neuroscience education from a physical therapist to better prepare them for what to expect after the procedure. -As reported in the September '15 issue of Physical Therapy Theory and Practice http://l.ptclinic.com/2nx09wI
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Motivational Monday: -David Viscott http://bit.ly/2EkC44j
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=?utf-8?Q?_Success_with_New_Year's_Resolutions?=: =?utf-8?Q?_Success_with_New_Year's_Resolutions?= Here is our latest monthly video. http://bit.ly/2E4hKnr
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Recipe Wednesday - Savory Brown Rice: Looks delicious! Click here for the recipe! http://bit.ly/2n8oNDL
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Strengthening exercises are recommended for instability of shoulders: Clear guidelines will help medical professionals give the best available treatments Glenohumeral instability—or shoulder instability—is a condition that occurs when the head of the upper arm bone (humerus) falls out of the shoulder "socket," which is called the glenoid. It affects approximately 2% of the general population and can either happen due to an injury or develop gradually over the course of time. The shoulder is the most mobile but least stable joint in the body, which is one of the major reasons this condition occurs. Athletes who engage in activities that involve overhead motions like baseball, swimming, volleyball, football, tennis and weight lifting repeatedly place stress on the shoulder and increase their chances of developing shoulder instability. Patients with shoulder instability generally experience pain and weakness in the front and back of the shoulder joint, as well as a possible tightening and/or clicking sensation in the back of the shoulder. Several treatments are available for addressing shoulder instability, but there is a need for clear guidelines to better assist medical professionals making treatment decisions. For this reason, a powerful study called a systematic review was conducted, which collected all the highest-quality research available on the topic and compared their findings with the goal of establishing a connection between them. Three medical databases searched for appropriate studies Investigators conducted a search of three major medical databases to find relevant studies on different types of rehabilitation programs for shoulder instability. This search led to 101 studies being identified and assessed, and of these, only five met the necessary criteria and were used for the review. Each of these five studies was evaluated to determine its level of quality and then analyzed to find similarities between their findings. Strengthening of several muscles around the shoulder appears best for condition Results of this review found strengthening exercises for the rotator cuff and deltoid muscles were most effective for treating shoulder instability by reducing pain and instability, as well as increasing function. A rotator cuff is a group of tendons and muscles that surround the shoulder and keep it stable, and the deltoid is a rounded muscle located on the top of the shoulder. Another component of treatment that was found to be beneficial was scapular stabilization exercises, which are another form of strengthening exercises that target the shoulder blade (scapula) and help keep it stable during movement. Based on these findings, researchers recommend a rehabilitation program that focuses on rotator cuff and deltoid strengthening exercises, and they believe that performing scapular stabilization exercises beforehand may lead to even better results. Medical professionals should take note of these findings, and individuals dealing with shoulder instability to any degree should view physical therapy with strengthening exercises as a strong option to address their condition and help them improve. -As reported in the November '16 issue of Physical Therapy in Sport http://bit.ly/2DOuSNC
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Back condition lessens after adding physical activity: No studies have evaluated this specific type of intervention yet Ankylosing spondylitis (AS) is a form of arthritis that mainly affects the spine, although other joints throughout the body may also be impacted by it. The condition results from inflammation of the spinal joints, or vertebrae, which can lead to severe, long-lasting pain and discomfort. Due to these symptoms, individuals with AS usually experience a reduction in their physical fitness, work productivity and quality of life. As a result, physical activity is considered a key component of treatment for AS patients. Increased exercise has been found to improve physical function, mobility, and quality of life in those with AS, which is on top of its ability to reduce the risk for heart disease, obesity, cancer, type 2 diabetes, and osteoporosis. But despite these and other benefits of regular exercise, most individuals with AS are not physically active and do not comply well with exercise programs prescribed to them. Getting through to these patients and others with arthritic conditions is a major challenge faced by medical professionals and requires better strategies. One suggestion is to address these individuals with a brief intervention, which includes verbal advice, discussion, and encouragement to make certain changes. Although this type of approach has been researched for treating other conditions, no studies have investigated it on AS patients. Therefore, a powerful study called a randomized-controlled trial (RCT) was conducted to determine if a brief intervention could improve physical activity levels in individuals with AS. Patients assessed over the span of six months Patients between the ages of 18-64 diagnosed with AS were invited to the study and screened to determine if they could participate. This process led to 40 AS patients being accepted, who were then randomly assigned to either the brief intervention group or the control group. Participants in the intervention group attended several 30-minute consultations with a physical therapist over three months—the range for number of sessions was 2-6—where the goal was to motivate and support these individuals to engage in a more physical activity. In efforts to accomplish this, each participant was given an information booklet on AS, provided with resources on local physical activity classes and programs, and set individual physical activity goals and a plan to accomplish them with the physical therapist. All participants also scheduled follow-up sessions with the physical therapist at their discretion to track their progress and review their goals as they worked towards them. Participants in the control group did not attend these sessions over this time and were simply instructed to continue with their normal physical activity. All participants were assessed at the start of the study, after the three-month intervention and another three months later using various outcomes for physical activity, fitness, and quality of life. Brief interventions lead to increased physical activity and better quality of life On the whole, the brief intervention approach seemed to be effective for increasing physical activity levels and bringing about other benefits in AS patients. After six months, 70% of participants in the intervention group were adhering to the guidelines for aerobic physical activity, which was significantly higher than the adherence rates in the control group. In addition, intervention group participants experienced a moderate improvement on scores for their spinal flexibility, as well as a significant improvement in their quality of life. Finally, the brief intervention approach was well tolerated by participants, who were able to choose and moderate their personal activities according to their personal abilities and goals. This may have increased the chances of them being able to boost their regular activity levels. Overall, these findings show that using a brief intervention to advise and motivate patients with AS to become more physically active can be effective for accomplishing this task, while also leading to other positive changes. AS patients should, therefore, seek out the services of a physical therapist, who can offer them with this type of intervention and monitor them along the way to help ensure they continue working towards their physical activity goals. -As reported in the January '17 issue of the Journal of Physiotherapy http://bit.ly/2EApGff
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Recipe Wednesday - Baby Spinach With Golden Raisins and Pine Nuts: Simple ingredients and only 10 minutes for this delicious dish? Click here for this great recipe! http://l.ptclinic.com/2DerZVT
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Elastic bands in physical therapy improves several physical features: Bands can be a useful exercise tool in the elderly population Falls remain a major problem in the elderly population. In general, falls result from poor balance and a fear of walking, and they can lead to injuries—like hip fractures and traumatic brain injuries—or possibly death in extreme circumstances. Fear of walking can also lead to reduced physical activity in older adults, which may, in turn, create a vicious cycle of more fear and less physical activity. The risk of falling increases with older age, which is why it's important to develop strategies that will reduce this risk. Exercise programs are commonly used to address this problem since they are capable of increasing strength and improving balance and flexibility. Elastic bands, in particular, are one tool that can be very helpful in these exercise programs for the elderly. These bands are portable, inexpensive and easy to use, and may, therefore, be ideal for improving strength and reducing the risk for falls in older adults. For this reason, a study was conducted to determine if elastic bands could improve balance and other physical features in order to lower the fall risk in the elderly population. Two groups of participants follow different treatments for eight weeks Adults aged 65 and older were asked to participate in the study, and a total of 45 accepted the invitation. These participants were then evenly divided into two groups: the experimental group and the control group. Both groups underwent a physical therapy program that took place during three 60-minute sessions per week for eight weeks. These sessions included ice or heat, ultrasound, electrical stimulation and a variety of stretching exercises that targeted the spine. The experimental group also followed a course of elastic band exercises in addition to physical therapy. This took place during three 30-minute sessions per week for eight weeks after physical therapy was finished, and consisted of several strengthening exercises for the ankles, knees, and hips using the elastic bands. All participants were evaluated before the treatment began and immediately afterward for a number of variables related to balance and falls. Both groups improve, but elastic bands lead to better overall results Results showed that both groups improved in all measurements taken, but the experimental group reported greater overall changes than the control group. This was found to be the case in scores for balance, flexibility, fear of falling and gait ability, which rated how well each participant walked. These findings show that while physical therapy is independently capable of improving physical features related to falling in older individuals, the addition of elastic band exercises may lead to even greater improvements. Perhaps most important of all, adding these exercises may also reduce the fear of falling in the elderly, which is a major contributing factor to falls. Based on these results, it appears that a physical therapy program that includes elastic band exercises can lead to several benefits and reduce the risk of falls in the elderly population. Using this type of program can, therefore, help to build confidence in older adults and may in time lower the overall rate of falls. -As reported in the November '16 issue of the Journal of Physical Therapy Science http://l.ptclinic.com/2E5Q8gG
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Fitness Trainers - 12 Things You Should Know First: Fitness Trainers - 12 Things You Should Know First Here is our latest monthly video. http://l.ptclinic.com/2BV12Gh
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Cost for Physical Therapy can be more effective for elbow conditions: Lack of guidelines makes it difficult for some doctors to determine the best treatment Lateral epicondylitis, which is commonly referred to as tennis elbow, is a painful condition that results from overuse. It occurs when tendons that connect the muscles of the forearm to the outside of the elbow become damaged and inflamed, which leads to pain or burning in this region. Tennis elbow is—unsurprisingly—most common in tennis players, but it can also affect other athletes and anyone who performs a motion that involves the elbow over and over. Although there are several treatment options available for tennis elbow, there are no national guidelines or overall consensus for the best way to treat the condition in Australia and the U.K. One treatment that is still commonly used is steroid injections, even though several studies have shown that physical therapy and a "wait and see" approach lead to better results in the long term. An important tool that patients can use to determine whether a treatment is worth using is called cost-effectiveness, which calculates its value based on the cost and how beneficial it is. With this in mind, researchers decided to analyze the findings of a powerful study called a randomized-controlled trial (RCT) to compare the cost-effectiveness of steroid injections to physical therapy for treating tennis elbow. Four groups of patients compared to one another In the original RCT, 154 individuals with tennis elbow for at least six weeks were randomly assigned to one of four treatment groups. Group 1 only received a saline injection, which was the placebo treatment, while group 2 received the placebo plus physical therapy, group 3 received the steroid injection, and group 4 received a combination of a steroid injection and physical therapy. Injections of either saline or steroids were administered to each patient's elbow, and they were all told to rest for 10 days, and then gradually return to activity afterward. Patients in the physical therapy groups received treatment through a program of eight 30-minute sessions. These sessions consisted of various strengthening exercises for the wrist and upper body, as well as manual treatments given by the physical therapist, and all patients were instructed to follow a home-exercise program as well. Following these interventions, all participants were evaluated to see whether they improved and which treatments were most cost-effective. Investigators advise against the use of injections and recommend physical therapy instead On the whole, the results of this RCT favored physical therapy over steroid injections for tennis elbow. Physical therapy was found to have a greater initial cost since it was carried out over eight treatment sessions, but it was the only intervention that resulted in a significantly greater quality of life for patients. Steroid injections led to some short-term benefits, but they did not last in the long-term when compared to physical therapy and placebo. Furthermore, there was little evidence to support these injections as a cost-effective treatment for tennis elbow. On the other hand, a detailed analysis suggested that physical therapy is highly likely to be a cost-effective intervention for this condition based on its impact on patients. The combination of injections and physical therapy produced both high costs and very variable outcomes for patients. Based on these findings, investigators advise against the use of steroid injections and instead recommend physical therapy as the first-line treatment for tennis elbow. Individuals with this condition should, therefore, keep this information in mind when making treatment decisions and strongly consider physical therapy services to in order to experience the greatest improvements. -As reported in the November '16 issue of the British Journal of Sports Medicine http://bit.ly/2DA726I
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