Why Patients Don’t Exercise – What’s a Therapist to do?

Suzanne Clark[/caption]

Post from Education Resources Faculty Member: Suzanne Clark

You do a great job putting together an exercise program for your patients with chronic disease. You teach them how to do the exercises and they return the demonstration. You give them a written program to do at home. When you see them again you say “let’s see how you’re doing with those exercises” and they either tell you they did not do them or when you ask them to demonstrate the exercises it’s obvious they have not been following through with their programs. This gets in the way of their progress and your ability to meet your goals. So you lecture that they need to do their exercises if they want to progress. You ask them if they have any questions and they say no but the non-compliance continues. What’s a therapist to do??

Fitting exercise into a daily routine is a lifestyle behavior change. Behavior change does not come easy for many people. Think about yourself – are you having trouble sticking to a diet or exercising the recommended 150 min per week?   It can be especially hard for people who are also trying to manage a chronic disease such as arthritis, diabetes, Parkinson’s Disease, CAD, or COPD. One of the ways to promote behavior change is to ask your patients what is getting in the way – what are their barriers. Perhaps your patients do not see how exercise is relevant to their goals. Have you asked what the patient’s goals are? Maybe they have fear that the exercise will increase their arthritis pain, induce their asthma or cause a heart attack. Cognitive issues could be impairing their ability to initiate or sustain an activity. You do not know what the barriers are until you engage your patients and ask. There are many other motivational techniques you can use to promote behavior change including adult learning principles, health literacy, goal-setting, and building confidence in their ability to change.  Exercise can help prevent chronic disease or slow its progress but it doesn’t work unless it’s used consistently.

In Education Resources new course; Evidenced-Based Therapy for Chronic Disease:  Intervention, Documentation and Reimbursement you will learn to implement evidenced based treatment for chronic disease and how to motivate your patients to improve adherence to their exercise programs that will allow them to progress towards their functional goals.

Please share your successful tips on how to motivate patients 

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School Based PT – Policies and Procedures

Sarah posts:

DEAR ERI COMMUNITY:
I am looking for PT eligibility/discharge criteria for school based PT. My district is working on beefing up their policies and procedures and I would like to know what is typical in other districts. 

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CEUs for NDTA re-certification

 

Do you need NDTA Re-certification?

We do offer many NDT courses taught by active NDTA instructors, helping you to meet your required 20 hours of CEUs within 3 years:

Intensive Handling and Problem Solving for Function: An NDT Approach

This intensive course is designed for experienced pediatric physical, occupational, and speech therapists who are interested in improving their problemsolving skills in order to achieve more efficient functional outcomes for children with Neuro-Motor disorders such as Cerebral Palsy and Down Syndrome. Emphasizing a NDT (Neuro-Developmental Treatment) framework, the course will utilize client videos as a basis for problem solving sessions and handling labs. Therapists will have the opportunity to develop realistic short and long-term functional outcomes, analyze multi-system and single-system impairments and develop treatment plans. Labs will focus on handling strategies that address the priority impairments and facilitate optimal control of posture and movement. Collaborative/Carryover strategies for home, school and community will also be discussed. – See more at: http://www.educationresourcesinc.com/course-details?courseid=61#sthash.TeTkYFqi.dpuf

 

Linda Kleibhan Linda Kleibhan

Linda A. Kliebhan is a delightful speaker who is able to share her wealth of knowledge in a clear and engaging manner. As a physical therapist in private practice in Mequon, WI she has accumulated over 30 years experience in pediatrics treating children with cerebral palsy and other neuro-motor disorders. Linda A. Kliebhan, PT, is a NDT coordinator-Instructor teaching the NDT/Bobath Course in the Treatment of Children with Cerebral Palsy, advanced NDT courses and other workshops related to NDT and pediatric therapy. She is also co-founder of Partners for Progress Inc. a nonprofit organization providing and researching intensive therapy. Ms. Kliebhan is also a consultant with the Medical College of Wisconsin Department of Orthopedics. 

 

 

Pharmacology Fundamentals for Therapists

Pharmacology Fundamentals for Therapists 

Patients undergoing therapy routinely take both prescription drugs and OTC medicines that ultimately influence treatment outcomes. Therapists with knowledge of these medicines practice safer, more effective therapy. The course will examine Rx and non-Rx medicine used in the therapy setting and will cover side effects that influence treatment and outcomes. Information will focus on drug actions and patient errors when treating pain, as well as common disorders of the musculoskeletal, neurologic, cardiorespiratory, and endocrine systems. Common OTC drugs and herbals are examined for occult hazards and drug interactions. 

[caption id="" align="alignleft" width="103" caption="Mark Nash"]Mark Nash[/caption]

Mark S. Nash, Ph.D., FACSM is a dynamic instructor who is highly regarded for his ability to take complex information and make it meaningful and clinically relevant. His pharmacology courses have earned widespread kudos for ease of understanding and relevance to therapy practice. 

We are thrilled to be able to offer this course:
November 16th, 2013 – Pensacola, FL
January 31, 2014 – Portsmouth, NH
March 15, 2014 – Hollywood, FL
May 9, 2014 – White Plains, NY
November 8, 2014 – Tulsa, OK

 

 
 
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Therapist is seeking your suggestions and strategies for treating an autistic patient with JRA, and Total Hip Replacement

Samantha Posts:

DEAR ERI COMMUNITY: I am a relatively new physical therapist and have an interesting patient that I would appreciate tips/suggestion for treatment techniques. I work in an acute care setting. I typically work with orthopedic patients (adults), those both who have recent TKA/THA and orthopedic trauma patients. I have a new pediatric patient, age 8 accelerated and progressive JRA and a history of hip dysplasia. This patient had received prior physical therapy prior to surgery, although I do not have assess to the notes as it was at another facility, so I am not sure of what interventions the previous therapist performed. The patient had dislocated her hip x2 prior to admission. The patient underwent a total hip replacement. Secondary to the age of the patient and the surgical intervention, the patient is currently TDWB, strict posterior hip precautions, and a Hip Spica Brace that is to be worn at all times. The patient is to be seen BID for a stay of 1 week to 1.5 weeks. Along with the significant orthopedic history, the patient has a past medical history of autism. With regards to the autism spectrum, this patient is nearly non-verbal, somewhat resistant to touch, and displays a lack of interest in general. I have had one treatment session with this patient which was very difficult for the patient to focus and she was very agitated throughout the treatment session with an obvious lack of interest in the treatment session. She had a extreme difficulty with maintaining WB status and ambulation with use of assistive device. As far a “play” therapy or activities to engage the patient, do any experienced therapist have suggestions/strategies for interventions allowing for minimal agitation and overall compliance with WB and hip precautions in order for a successful session? Thank you for your help.

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