[re+think]

As the year winds down, we all take stock of how 2013 went and what’s to come in the New Year.  [re+active] has undergone a lot of changes in the last year – as I’m sure you’ve all experienced changes as well.  With this year coming to a halt and the excessive stimulation of the holiday season ending, it is nice to take a moment to reflect on what we’ve learned and what we plan to change or implement for the next year. Over the past year, I spent approximately 186 physical hours in education courses.   That is about 23 workdays – over 3 weeks – spent learning in one year!   As I try to reflect on all of the knowledge I’ve gained this year, it is hard to rate one experience over another.   However, the course that really made the most impact on my practice was not technically a neuro course, but an ortho one!   I completed the 6-month series on Advanced Functional Biomechanics of the Lower Quarter by Dr. Chris Powers in December.   This was a course recommended by Julie, who too

I write this blog as I sit in car after about 6 hours of driving. We are travelling home from a Thanksgiving trip to Sacramento and I am reading a recent LA Times article, “Don’t   just sit there. Really”   http://articles.latimes.com/2013/may/25/health/la-he-dont-sit-20130525 And I am understanding why I feel like the life is being sucked out of me as I sit—every hour of sitting cuts about 22 minutes from my lifespan according to the article.     "Sitting is the new smoking," says Anup Kanodia, a physician and researcher at the Center for Personalized Health Care at Ohio State University's Wexner Medical Center. As physical therapists, we are blessed to have a job where we rarely sit, but we are constantly battling the ill-effects of sitting in our clients.   Tight hip flexors and hamstrings, weakened LE muscles, weakened respiratory function, deconditioning - the list goes on and on.   What the article brings to light is that this is not simply a proble

Answer:  Yes, if it is the RIGHT class! There is growing evidence that working in groups is beneficial for people with PD for motivational reasons, accountability, emotional and psychological support, and for socialization (among other things).  Since we started group exercise classes at [re+active], we were curious about whether a patient doing group therapy could actually improve function or would participation just help them maintain at the same level (or just slow progression since it is a neurodegenerative disease!).  So we decided to test our hypothesis in a patient case and see. We created our [re+move] High Intensity Parkinson’s Exercise class to target specific problems that people with Parkinson’s disease have, such as difficulties with balance, walking, turning, agility, coordination, functional movement, bradykinesia, and stiffness.  We put this all into one fun group class set to music!  The time frame for this trial class was 1 time per week for 12 weeks.  As

Dr. Caudill and I have the privilege to teach in the Doctor of Physical Therapy program at USC, where we recently taught in the Neuropathology course.  As many of my students know, I love the cranial nerves!  There is something charming and lovely about the 12 small pairs of cranial nerves exiting from the brainstem.   More importantly, the cranial nerves provide exquisite insight for neurologic differential diagnosis.    I cannot emphasize enough the importance of completing an efficient and accurate cranial nerve screen for patients with neurologic dysfunction.  The students in our class are now completing their final internships and I received a request from one of them to post “5 minute Cranial Nerve Screen” video that I had filmed for our class.   I put this short video together in my kitchen one afternoon with my then 4 year old daughter in order to demonstrate that a brief cranial nerve screen could be done in 5 minutes or less (I believe we completed it in 4:05).   I hav

As a nice follow up to last month's post, we thought we'd put together a little resource for physical therapists who work with patients with dystonia.  Dystonia is a difficult diagnosis to treat and requires such a broad approach.  Traditional PT has not been shown to benefit those with dystonia.  And the more Julie and I learn, the more we realize this, so we thought it would be nice to put together some resources for physical therapists.  Today's blog includes a treatment approach and ideas for working with patients with cervical dystonia.  It was adapted from the Sensorimotor learning article (actually an article for focal hand dystonia, but with many relevant concepts) by Byl, Archer, McKenzie, 2008 and from our recent course "Sensorimotor Processing Dysfunction and Movement Dysfunction" presented by Byl, McKenzie, and Merzenich in July 2013.  I think it's a nice little jumping off point for a therapist to work with this incredibly challenging diagnosis. P