FORCE Therapeutics attended the Private Practice Section Conference (PPS) 2012 at the Wynn Las Vegas last week. We are excited to share what we learned with our readers! The next few posts will be dedicated to our synopsis of the underlying PPS themes and some of the new cutting edge innovations we discovered there.
On the first night we attended the opening keynote where Brian Gullbrants, Executive Vice President and General Manager of Wynn and Encore Hotels, presented PPS attendees with a compelling talk entitled “Business Management and Customer Service – The Wynn Model”.
In his presentation he shared what makes the Wynn and Encore hotels so successful and how these principles for success can be applied to Private Practice Section. Wynn Las Vegas and its sister property Encore Las Vegas collectively hold more Forbes five-star awards than any other resort and casino in the world, so hearing from the Executive Vice President and General Manager of these hotels was an honor and extremely informative.
The Wynn prides itself on excellent staff, cutting edge service, and the ability to hold a competitive advantage by not being afraid of change. Staying ahead means hiring only the best employees and providing them with training, coaching, and an orientation where the culture is defined and they are taught how to provide excellent customer service. Success entails increasing communication between employees where expectations and accountability are constantly expressed.
Brian recommends going over your core values with your employees every morning, afternoon, and night. He sends out an email to his employees every night expressing the values they should uphold. He says they focus their core values around their guests. As Steve Wynn stated, “It’s all about the guest experience, and nothing else”. For PPS attendees, Brian says this should be adopted as “It’s all about the patient experience, and nothing else”. Do your employees know it’s all about the patient?
In order to provide the best service to patients, Brian says you can’t be afraid of change. “If you dislike change, you’re going to dislike irrelevance even more”. Patients are always going to search for the best service to make their experience easier and more pleasant. If everyone around you is changing and you don’t take action or adopt new technologies don’t expect to hold a competitive edge. In order to stay ahead you need to embrace continuous change and reinvention. Any way that your organization is able to provide cutting edge service, management and efficient and effective communication, do it. It’s the only way you’re going to thrive in a competitive landscape. What are you currently doing to give your practice a competitive edge?
To quote Jack Welch, CEO of GE: “An organization’s ability to learn, and translate that learning into action rapidly, is the ultimate competitive advantage”. At PPS, physical therapists attended information sessions where the theme seemed to be implementing new technologies to provide the best service to patients. In the exhibit hall, we saw many vendors who provide cutting edge advantages for physical therapists. Make sure to check back for our upcoming posts on the exhibit hall and exciting new technology available for PTs and their patients!
FORCE Therapeutics designs web and mobile applications for injury rehabilitation and prevention.
FORCE TherEx and FORCE Premium are known to be the BEST EMR and HEP products in Physical Therapy and Rehab.
Technology has made a big impact on the physical therapy profession. Evaluating muscle and joint function in patients rehabilitating from procedures like hip replacement is done more easily with today's technology, as is monitoring patient progress. High-tech therapy tools are allowing therapists to help patients for whom rehabilitation might have proven difficult or impossible 20 years ago. However, like any treatment, new therapy tools and procedures do have some potential risks.
Body-Supported Treadmill Training
Body-supported treadmill training is a relatively new technology that has fast become the primary form of technology-aided physical therapy for hip replacement rehabilitation, helping patients who aren't ready to place much weight on the joints begin therapy sooner. Starting therapy as quickly as possible after a replacement procedure is important to both short-term and long-term results. Patients who get up and moving within 24 to 36 hours after surgery have less risk of common post-surgery complications, such as blood clots. In the long-term. prolonged periods of immobilization can inhibit healing and recovery. Patients who begin therapy directly after surgery have shorter recovery times, regain more range of motion and higher levels of mobility, and have less pain and stiffness than those in whom rehabilitation is delayed.
By supporting as much as 80 percent of a patient's body weight, these machines allow exercise without joint stress, allowing therapy to begin earlier and progress faster than would otherwise be possible. Computerized sensors used with many of these high-tech treadmills monitor muscle and joint function, strength and stress levels to allow therapists to determine how much progress is being made, making it easy to increase or decrease exercise intensity according to each patient's changing needs.
These easy-on-the-joints treadmills can be a great help to patients who have undergone revision surgeries, which are often more complex than the original hip replacement and involve longer, more intensive rehabilitation. Patients who have had revisions due to replace faulty implants, such as the recently recalled Stryker Rejuvenate hip implant, might have joint damage due to complications, reducing their tolerance for the weight-bearing exercise that is so crucial to successful recovery.
Many of these patients have been affected by serious joint conditions and damage related to implant debris, such as metallosis and osteolysis. Metallosis is caused by particles of metallic debris shed from the implant that accumulate in the soft tissues, which can cause symptoms such as severe inflammation and pain in the hip and tissue or bone death, Osteolysis occurs when the body's immune system attacks the joint in an effort to clean up implant debris, causing bone loss. Both conditions can cause implant loosening or failure. Patients who have had these types of complication may emerge from revision surgery with restrictions on weight-bearing activity. Supported treadmill training can accommodate those restrictions, allowing patients to begin rehabilitation therapy and recovery sooner.
However, use of body supported treadmill training requires close supervision and capable professional assistance. Patients have reported feeling faint and dizzy during their use more often than in traditional therapy, and falls have been more frequent.
Author Bio: Elizabeth Carrollton writes about medication safety and defective medical devices for Drugwatch.com.
FORCE Therapeutics has released FORCE Connect, which extends the FORCE TherEx injury rehab platform to mobile and tablet users. FORCE Connect allows a physical therapist to program a patient's mobile device with custom exercise videos and recommended gear, track patients' compliance to their home exercise program while staying in touch through secure messaging and automatic alerts.
FORCE Connect is available for any patient of a FORCE-enabled physical therapy clinic. Physical Therapists use FORCE TherEx or FORCE Premium in their practices to manage patients, track compliance and effortlessly assign video exercises. With FORCE Connect, patients now have an easy way to manage their home rehab program in a fun and engaging environment.
We’ve seen the use of telecommunications in physical therapy become more prevalent with the changing climate in healthcare. Using telecommunications technology to provide health care, health information, and health education across a distance is referred to as telehealth.
When telehealth is used in rehabilitation practices it is referred to as telerehabilitation: the application of communication technology for supporting rehabilitation services. With all the buzz about telehealth and telerehabilitation we thought we would give an overview of how they are influencing healthcare.
Doctors and physical therapists can use telecommunications technology to correspond with their patients or other health professionals. The debate surrounding the use of telehealth is whether or not it provides the same quality care as face-to-face meetings with patients. A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation was conducted by the Department of Health Administration at the University of Montreal to collect data to try to answer this question.
In this study, twenty-eight articles on telerehabilitation were analyzed. The articles dealt with neurological rehabilitation, cardiac rehabilitation, follow up of individuals with spinal cord injuries, rehabilitation for speech-language impairments and rehabilitation for varied clienteles (1).
The study found that clinical outcomes were generally improved following telerehabilitation, outcomes were at least similar or better than an alternative intervention, consultation time tended to be longer with telerehabilitation, and satisfaction with telerehabilitation was consistently high (1). The results showed telerehabilitation was valued by the majority of patients to be effective and efficient.
In order for telehealth to be implemented there needs to be informed consent, technical standards put in place, professional standards set, and provider and end user acceptance. Some people prefer face-to-face contact with their doctor and feel videoconferencing with their providers would be cumbersome and ineffective. In order for people to accept videoconferencing as a way of communicating with their doctors, thorough instructions of equipment use would need to be provided and the experience would need to replicate that of a face-to-face visit.
In the International Journal of Telerehabilitation the benefits of its use were listed as follows: 1) decreased travel between rural communities and specialized urban health centers; 2) better clinical support in local communities; 3) improved access to specialized services; 4) delivery of health care in rural communities; 5) indirect educational benefits for remote clinicians who participate in teleconsultations; 6) reduced feelings of isolation for rural clinicians; 7) improved service stability in regions with high staff turnover; and 8 ) multimedia communication. (3)
While many of these benefits refer to the benefits brought to rural communities, it is becoming apparent that telehealth benefits people everywhere:
In a study conducted by Hatzakis within the Veterans Health Administration it was determined that veterans with multiple sclerosis have significant barriers to care as a result of their disability. Twenty percent of patients surveyed reported that parking, distance, or transportation difficulties significantly interfered with their receiving treatment. Furthermore, for individuals with sensation issues (e.g., spinal cord injury) prolonged sitting during travel can carry the potential risk of worsening a sore or decubitus ulcer. For this reason, many individuals delay or avoid necessary treatment. While issues of access are clearly magnified in rural areas, mobility restrictions and accessibility problems also decrease the quality of healthcare for individuals located in urban areas. (4)
Telerehabilitation provides a way in which patients can receive treatment and communicate with their therapists without having to leave their homes. Telerehabilitation not only allows patients to hear their therapist give instructions but also allows patients to see their therapists as they demonstrate exercises and explain treatment instructions. Telerehabilition has become more popular in cases in which travel is difficult for the patient or the patient is experiencing pain or discomfort that prohibits them from making the trip to their provider. Patients can visit their therapists’ practices but also have the option of checking in with their therapists through the use of telecommuications when a face-to-face visit is unnecessary or the trip is difficult for the patient to make.
As telerehabilitation services continue to grow as a complement to traditional face-to-face clinical services, there is an increasing need to standardize appropriate clinical uses, reimbursement, and health care policy regarding the use of telerehabilitation (2).
Licensure and practice across state lines prohibits health professionals from treating patients who are located out of state and one of the many benefits of telecommunications is that health professionals can communicate with their patients regardless of their location. The professional liability and training that needs to be conducted is extensive and quality standards need to be set in place for the devices that will be used in order to replicate a face-to-face meeting.
While the debate surrounding the use of telehealth continues and many feel the replacement of face-to-face meetings with telecommunications hinders quality of care, advances in technology and the use of telerehabilitation is showing its use in conjunction with in-person visits is extremely beneficial. Replacing a patient’s entire in-person care may not be the answer, but using telehealth as a way to complement patient care is valuable and advantageous to healthcare professionals looking to save money, save time, and provide quality care. Russel T.G. stated (after conducting a pilot study exploring the feasibility and effectiveness of an Internet-based telerehabilitation application), “A failure to integrate telehealth into routine clinical practice as the evidence emerges would constitute a grave disservice to clients” (5).
(1) D, Kairy, Lehoux P, Vincent C, and Visintin M. "A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation.." US National Library of Medicine National Institutes of Health. Disabil Rehabil., 2009. Web. 19 Sep 2012..
(2) Schmeler, Mark, Richard Schein, Michael McCue, and Kendra Betz. "Telerehabilitation Clinical and Vocational Applications for Assistive Technology: Research, Opportunities, and Challenges." International Journal of Telerehabilitation. University Library System, University of Pittsburgh , 2009. Web. 19 Sep 2012..
(3) Lemaire, E. D., Boudrias, Y., & Greene, G. (2001). Low-bandwidth, internet-based videoconferencing for physical rehabilitation consultations. Journal of Telemedicine and Telecare, 7(2), 82-89.
(4) Hatzakis, M., Haselkorn, J., Williams-Avery, B. K., & Rodriguez, A. (2001). Proportion of veterans with multiple sclerosis receiving pharmacology therapy for fatigue. International Journal of MS Care, 3(2), 4.
(5) Russell TG. Telerehabilitation: a coming of age [editorial]. Aust J Physiother. 2009;55:5–6.
As stated in our previous blog post, EHRs are being implemented more frequently in physical therapy practices as physical therapists realize the benefits they provide. But how does a physical therapist know which EHR system to choose? PT in Motion published an article recently, Selecting an EHR Vendor, about the steps physical therapists should take when selecting an EHR vendor. We’ve summarized the steps below and provided a few of our own insights.
Conducting preliminary research and investigation.
The article recommends you should research EHR vendors to determine which systems have the functionality you, as a physical therapist, desire. You should research all available methods such as speaking to other PTs, following up on advertisements in trade journals, and conducting online research.
The article advises to start with company websites. They provide information such as features, descriptions, pictures, and some websites even provide product tours right on their website. Prices are seldom posted either for modular or complete systems but you can call the number provided on their websites for specific pricing information. There are even websites that will provide a preliminary analysis of EHR systems that can help narrow down your choices, for example softwareadvice.com.
Shaping the decision team
It should be determined who is in charge of making the decision when it comes to implementing an EHR. A physical therapist should be included in the decision making process even if the office manager is the sole decision maker since they will be utilizing the system as well.
System implementation requires considerable staff training, adaption, adjustment, and can be disruptive. Having everyone involved ensures they are involved in the process and aren’t taken aback by having to use a new system they had no say in implementing. It also ensures they have a good idea of how the system works.
Determining where you’re going. Set goals and write them down.
There are many important factors to take into consideration when deciding on an EHR vendor. The entire staff should be able to use the system so the skills and attitudes of staff need to be considered. The price of EHR vendors varies greatly and you need to figure out what type of system your practice can afford.
Most importantly, you should make a list of the functionalities you want the system to have. Consider both the software and hardware you will need. Do you want the EHR system to be cloud based or do you want a system you can download onto your computer? Are you looking for an EHR system that includes a home exercise prescription tool and messaging or do you want a separate EHR? Make sure you know what you want before you make any decisions.
“You need a vendor that is attentive to your needs during the selection and implementation process, as well as afterward, for ongoing assessment and maintenance needs (1).” Additionally, EHR systems are used in many professional fields so you should consider whether the EHR system you are researching typically is marketed to physical therapist practices. You do not want a system with unnecessary fields that make it difficult for you to use.
Does the vendor make you sign a yearly contract or can you cancel at any time? Is it difficult to reach customer representatives at the company or are they readily available for support?
Requesting product demonstrations.
Product demonstrations ensure you know exactly how the system is used. If you find a product tour to be too confusing or hard to follow, you know that system is not right for you.
Narrowing your choices.
You want a system that is user friendly and won’t take too much time to teach to your staff. Make sure they have preloaded templates and codes if you do not want to enter them yourself.
“Make sure to ask references how the vendor has continued to be attentive to their needs and make sure you choose a vendor that has the ability to adapt to changing technologies and regulations (1).” Will you need to install new updates? Or will updates appear automatically?
Completing the decision
Clarify the vendor’s involvement in the implementation process, including training. What about system updates? Future costs? Also, consider the term of the contract and remedies if the vendor goes out of business.
Summing up.
The article concludes with, “Implementing an EHR system is time-consuming and can be frustrating. But the ability to enter, store, track, and exchange health information is a necessity in this dynamic era of collaborative and integrated health technology (1).”
So make sure you research all of your options and choose an EHR system that is user-friendly, provides the functionality you are looking for, and is provided by a company with good customer support. This will ensure you make the right decision.
If you’re in the process of looking for an EMR, please check out FORCE Premium at forcetherapeutics.com!
In a slideshow featured on HealthLeaders Media, 10 healthcare IT predictions were listed in regards to what patients and providers can come to expect:
1. Patients will demand to know, ‘where’s my data?’
2. Raising software prices will allow EMR makers to staff up.
3. The human touch will become a major tech issue.
4. Tablets will make expensive videoconferencing gear obsolete.
5. We will face a massive identity crisis.
6. We’ll finally develop a systematic fix for alert fatigue.
7. HIT will ensure patient adherence.
8. Medical homes and medical neighborhoods will lead to medical cities.
9. Social network-powered, peer-to-peer training will replace company-based, old-school, HR-style training.
10. People will trump technology.
Patients will expect to be able to receive their medical records easily and will be outraged by slow responses, refusals by some providers, and complex data. This will motivate providers to adopt EMRs, which will make it easy to generate data for patients. The increased demand for EMRs will cause a spike in their cost, so providers should begin to think about EMRs as soon as possible.
Doctors have largely underutilized videoconferencing but this can be expected to change as tablets make it easier for them to communicate with other doctors and with patients. Tablets can also be used to enter data during visits (saving administration time) and patients can use them to track, receive, and send data anytime, anywhere.
“HIT will ensure patient adherence. Technology is poised to make sure that patients take their meds as directed, get exercise, lose weight, and report changes in their conditions promptly. Lives will be saved. Accountable care won’t work without it.”
Patients will have the responsibility to track their health, doctors will know that their patients are complying with their treatment, and the right actions can be taken at the right time with technology making it easier to monitor patients’ health.
Health IT will give patients accountability and bring healthcare to the home. “Medical homes and medical neighborhoods will lead to medical cities”. HIT will make it easier for analysts to measure the health of entire cities and could be used as factors in health insurance premiums.
The implementation of EMRs does not necessarily mean providers will have to spend time in training as they can use social networks and other information available on the web to get answers to questions they may have.
“People will trump technology. Quantified patients, whose enthusiasm and collective tech already outweigh that of the government, will emerge as the cutting edge of medical research.” With HIT, the collection of data will be extremely substantial in medical research, with patients eager to collect, share, and communicate.
Health IT will inevitably become a major influence in the healthcare field as tech solutions are employed by providers and expected by patients who demand the convenience, communication, and information they provide. While its impossible to know when we can expect to see some of these predictions come into fruition, we can agree that its inevitable they eventually will.
Since the Supreme Court ruling that stated the Patient Protection and Affordable Care Act is constitutional, we have seen more and more articles being published stressing the importance of technology and its utilization in the healthcare field in order to increase patient engagement.
An article posted on Health 2.0 News discusses the changing consumer and technological landscapes that are successfully driving change and how they should be applied in healthcare. The article, Solving Our Health Care Crisis: Does the Answer Lie in Social Media and the Internet? states “health care providers need innovative solutions that help them move the needle toward healthy outcomes, and more accurate, thorough insight into the lifestyles of their members and patients”.
The article uses the daily use of social media as an example of what will spark consumers’ involvement in their own care. Basically: tracking, accessing, sharing, and communicating. The author lists the ability of consumers to track their health, access to health professionals and others like them to pose questions and share experiences, and a wealth of information as essential in optimizing consumer engagement.
While technology has influenced and positively impacted almost every industry, the healthcare industry has been slow in its adoption when it comes to increasing consumer engagement. The time has now come where we see consumers monitoring their health via mobile applications and health tracking websites. With doctors and therapists inevitably seeing an increase in their patient load with the health reform it’s time for them to use these devices to increase the quality of care they provide.
The article emphasizes the use of digital technology by doctors: “Digital platforms also supplement and complement the patient-to-provider episodic relationship and fill the gaps between brick and mortar doctor visits”. Patients can now use these devices to communicate with their doctors effortlessly and access health information with the click of a button. We need doctors and therapists to take the next step in implementing these devices. As the article states, “amidst the ongoing controversy and debate surrounding health care reform, it’s become more and more evident that we’ll need to allow the consumer to take power over their own health and connect them to their provider through a dynamic, fast, safe and personal medium”. These “dynamic, fast, safe and personal mediums” are the smartphones and tablets that, according to Morgan Stanley, are within arm’s reach of 91% of smartphone users 24/7. Now that’s access.
FORCE Therapeutics attended last month’s mHealth Summit in Washington DC. The Summit was a three day conference that brought together leaders from many different organizations across the mHealth sector including government, the private sector, industry, academia, providers, and not for profit organizations to work together to advance the use of wireless technology to improve health outcomes both in the US and abroad. During our time at the conference we had the opportunity to share how FORCE is transforming the physical therapy delivery system through the FORCE TherEx online platform and our soon to be released mobile app. We also met many other digital health care start ups with great ideas for improving health and health care accessibility through the use of mobile devices.
There were a number of keynote speakers in attendance, including Health and Human Services Secretary Kathleen Sebelius. Also in attendance was Paul Jacobs, CEO of Qualcomm, who shared his perspective on the future of mobile health in the health care industry. He predicted that mobile devices will play a significant role in the future of health care delivery, estimating that by 2020 160 million Americans will be treated remotely via mobile devices. This is great news for both the suppliers and creators of such technology as well as the patients and end users who will receive the benefits of mobile health.
FORCE is already engaged in the mhealth revolution with the release of our mobile app which will be available on the iTunes and Android app markets this month. The FORCE app is a consumer app that will provide individuals the ability to sort through video exercises by type and region to find an exercise for their particular rehabilitation need. The FORCE app will reach those who may not have access to physical therapy, or for those who are not currently using the FORCE TherEx on-line platform and are in need of video exercises to enhance their physical therapy experience. According to Paul Jacobs: “individuals are ready to stay healthy”, and with the introduction of our mobile app, consumers will have 24/7 access to quality of life improving video exercises.
Measurement is the cornerstone of evaluation. In Healthcare, objective metrics help us assess treatment protocols and relative outcomes. From this process we establish standards that serve as guidelines to help us recognize shortfalls in a procedure and make necessary changes. Measurement guides our decision-making and provides benchmarks for optimal outcomes.
Performance measures give providers a way to assess themselves as well as their patients. In a recent article entitled The ABCs of Measurement, the National Quality Forum (NQF) discusses the use of performance measures in evaluating optimal care and how they can improve quality and safety for patients (1). The NQF offers guidelines, derived from providers and patients, that health professionals should incorporate into their care regimens. This allows for a standardized, yet comprehensive review of the system and incorporates every endpoint of care. “Measures light the way, showing where systems are breaking down and where they are succeeding to help patients get and stay well” (1).
Further, measurement drives improvement, informs consumers and influences payment (1). Measures drive improvement through review of processes and adjustment of care. One example of this can be seen in physical therapy practices, ongoing measurement of a patient’s strength, range of motion and functional ability allow a physical therapist to evaluate effectiveness of treatment being applied and make necessary adjustments to subsequent treatment. Measures educate consumers, allowing them to better understand their condition, assess the quality of care being provided make informed decisions. Finally, measures also allow payors to accurately and fairly evaluate caregivers and patient progress.
What are the key components of measurement? Communication and monitoring. A continuous feedback loop where patients and providers can actively engage ensures improvement in quality of care. This also allows patients to report errors and potential mishaps in their care. For example, North Shore-Long Island Jewish Hospital uses performance measures of patient care and public reporting of results (1). A database has been created to track all patient feedback, which is then used to prioritize improvement initiatives. Communication ensures that patients “get better and stay better.” A rural hospital in northern California’s Humboldt County has significantly improved outcomes through new models of patient monitoring. The hospital discovered, through measurement, that patients needed “more follow up: more education, more explicit linking back to primary care, and more help managing their chronic conditions” (1).
Clinics leverage technology to become better informed. The NQF endorses wider use of electronic health records (EHRs) suggesting that, “EHRs will also make measurement and performance data available on a real-time basis, making healthcare much more responsive to patient needs.”
So how do we apply health care measurement in physical therapy? What tools do we have at our disposal to document patient performance and drive better care? Best practices dictate that we start the rehabilitation process by gathering baseline data against a set of standardized objective scales i.e. strength, range of motion and balance. Ongoing tracking of these metrics keep therapists and patients focused on specific, measurable goals. Engaging the patient in this process will allow providers to constantly re-evaluate care and make necessary adjustments. Available technology like the FORCE TherEx platform facilitates a continuous feedback loop between patient and provider. The NQF has made it a priority to endorse the use of performance measures to improve the healthcare system and it is imperative that we apply these standards the arena of physical therapy; “Measures can best succeed when they are backed by all involved in healthcare, reported to the public, and used for continuous improvement.”
In the wellness arena, measurement devices and applications like ‘fitbit’ and ‘runkeeper’ have demonstrated traction with consumers. It seems that people manage what they measure, in which case, including patients in monitoring their physical progress should improve their participation in rehab programs and their resultant outcomes.
Resources
1. Robert Wood Johnson Foundation (RWJF). 2010 . The ABCs of Measurement, National Quality Forum, www.qualityforum.org/Measuring_Performance/ABCs_of_Measurement.aspx.
Patellofemoral Pain Syndrome (PFPS) is one of the most common conditions physical therapist’s encounter and yet one of the most challenging to treat. Hip weakness, quadricep weakness, and poor flexibility are just some of the factors that can contribute to PFPS, not to mention sub-par footwear, sport technique, joint arthrokinematics and/or foot abnormalities. Flexibilty exercises for psoas, quadricep, hamstrings, and gastroc-soleus are staple protocol when treating PFPS, however when it comes to strengthening, what is the most effective approach for the early stages of rehabilitation? Is there a difference between an early stage quadricep versus hip musculature strengthening approach?
A recent study published in Journal of Orthopedic and Sports Physical Therapy studied the effects of isolated hip strengthening compared to isolated quadricep strengthening prior to initiating a functional weight-bearing strengthening program in women with PFPS. This study included exclusively females due to their epidemiologically higher incidence of PFPS. The study was a randomized clinical trial where 33 women were randomly assigned to either a hip strengthening group or a quadricep strengthening group. The hip group performed exclusively hip abduction and external rotation strengthening for 4 weeks while the quadricep group performed only quadricep strengthening exercises for 4 week. At 4 weeks, both groups initiated a weight-bearing strengthening program.
Treatment was as follows: both groups performed stretching of the quadriceps, hamstrings, and triceps surae (3 times for 30 seconds each) throughout the 8-week program in addition to their respective strengthening programs (hip vs. quadricep).
Measures taken at baseline and at 8 weeks:
Strength
Pain (Visual Analog Scale)
Step-down Test
Lower Extremely Functional Scale (LEFS).
Hip group exercises (weeks 0-4):
Standing hip abduction
Sidelying combination hip abduction and external rotation (clams)
The results of this study found that both groups experienced an overall increase in strength and improved function over the 8-week period, however, the hip group had a significant decrease in pain during the first 4 weeks of treatment whereas as the quadricep group reported no change in pain. The results of this study suggests that isolated hip strengthening in the early stages of treating patients with PFPS may be the more clinically efficient way of reducing pain and increasing function.
Click on the video below to see the correct technique for performing sidelying combination hip abduction and external rotation (clams). For videos of all other exercises mentioned in this post, please visit the FORCE Therapeutics online store.
Reference
1. Dolak, K. et. al. Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females With Patellofemoral Pain Syndrome: A Randomized Clinical Trial. J Ortho Sports Phys Ther 2011; 41(8): 560-571.
Tejal Ramaiya is National Client Representative at Force Therapeutics. Force Therapeutics provides a web and mobile application that extends physical therapy patient care beyond the office visit. The application provides physical therapists with clinically tested platform to manage patients, track compliance and effortlessly assign exercise videos. Tejal owns a private practice in NJ where she uses the Force Therapeutics platform to prescribe video based exercise programs to her patients. Please visit www.forcetherex.com for more information.
FORCE Therapeutics attended the Private Practice Section Conference (PPS) 2012 at the Wynn Las Vegas last week. We are excited to share what we learned with our readers! The next few posts will be dedicated to our synopsis of the underlying PPS themes and some of the new cutting edge innovations we discovered there.
Measurement is the cornerstone of evaluation. In Healthcare, objective metrics help us assess treatment protocols and relative outcomes. From this process we establish standards that serve as guidelines to help us recognize shortfalls in a procedure and make necessary changes. Measurement guides our decision-making and provides benchmarks for optimal outcomes.
