Saturday, December 12, 2009

Physical Therapy... en Espanol!

Check out this video made by Bradley Health Science student, Melissa Buness. Melissa is bound for a professional DPT program next year. She created this video articulating the benefits of physical therapy in Spanish as part of an undergraduate Independent Study project in the Health Science Major.

Friday, October 30, 2009

Physical Therapy in the Dominican Republic

You may have seen an article written in PT Priority by Heather Hall, BU DPT '11, about a trip to the Dominican Republic in March of 2009, or perhaps you read her blog while she was there. Recently another physical therapy team from Bradley returned to San Juan de la Maguana. I had the pleasure of accompanying Dr. Dawn Hall, PT, PhD, Abigail Walk, BU DPT '10 and Dorothy Fernandez, BU DPT '10, along with several others on an adventure to a city 3 hours from Santo Domingo and near the Haitian border during our Fall Break.

Everyday we examined patients in San Juan at a rehab facility associated with a local hospital. This clinic provides physical therapy to patients in the area, however in most cases the people cannot afford the 'luxury' of these services. The need for physical therapy appears to be the same as in the United States. By my best estimate, San Juan proper is about 130,000 people, and the rehab facility is the only one between San Juan and Santo Domingo (about a three hour drive.) It would be like having one PT clinic within 200 miles...only the drive to get there would much more interesting with partially paved roads and intermittent livestock crossings.) Diagnoses included SCI, CVA, BKA and patients with numerous neuromusculoskeletal issues, including many complaints of mechanical neck and LBP. In addition we saw a number of patients with diagnoses we probably just wouldn't have the opportunity to manage in the United States. For example a man with neurofibromatosis had a 40# tumor removed from his leg. Had the tumor not been removed, the man would have undergone an amputation, and my perception is prosthetic limbs in this part of the Dominican Republic are not readily available to all. Another patient had significant scarring on his chest and axillary region from a burn he received as a child. As a direct result of this, he has had limited function in his right upper extremity for the majority of his life. Because of the widespread access we have to quality health care here in our own country, conditions like these would be addressed much earlier in a patient's life and long before mechanical problems developed. Dorothy, Dawn and Abigail were involved in pre and post-op management and assisted in both surgeries. In just a week's time they were able to make a pretty significant difference in the lives of these patients.
Another cool thing on this trip was simply the opportunity to examine new patients, re-examine current ones and to teach health care providers another approach to patient management. During our short stay the physical therapy team addressed the needs of more than 70 patients, and the surgical team performed 37 surgeries. Also while we were there the entire Mission Awareness Team delivered over 1600 pounds of food!
On our last night we had dinner with those who had played a key role in making our trip a success. They graciously thanked us for our service, but I assure you, the pleasure was ours. We are looking forward to returning and future opportunities in both teaching and patient care. Our next trip is scheduled for late February, early March. We would love to have you join us! Please feel free to email me for additional details:

Tuesday, September 15, 2009

Saving a Life to Change a Life

"Life changes when your child's doctor tells you your daughter won't walk, or use her right hand and will always need assistance for daily tasks. You begin a journey to find ways to allow your child to live as independently and normal as possible. You learn that there are barriers that you hadn't anticipated and become passionate to find solutions to remove as many obstacles as possible. PAWS Giving Independence has given our family hope for our daughter's future independence.
Since Naomi can't use her right hand, a simple task like removing her coat becomes possible with the help of Sasha, her service dog. Holding a door open to let her wheelchair pass through is also a task that Sasha is training to do for Naomi. Picking up dropped items like a cell phone, remote control, wallet or keys is probably our most used task for Sasha. The assistance is empowering for Naomi because she isn't always calling upon other people or feeling as though she is interrupting the activities of others to come to her rescue. Above all, Sasha has bridged a social gap between Naomi and non disabled people in the community and in social settings. Everywhere Naomi goes with Sasha, people are drawn to make conversation.
I didn't realize how substantial the social barrier was for our daughter until she recently started beaming about how popular she feels when Sasha is with her."


The Bradley Physical Therapy Department was instrumental in helping three Bradley students start a non-profit organization in September 2008. Michelle Kosner, Brandi Arnold and Eric Swanson came to the physical therapy department looking for help to build the philanthropic association known as Paws Giving Independence. Paws Giving Independence rescues dogs from animal shelters, trains them to become service dogs for children and adults with disabilities, and places them free of charge to the families. Their motto is "Saving a Life to Change a Life".

The purpose of PGI is to train service dogs to physically assist people with various disabilities. Dogs complete simple tasks for their owners such as picking up dropped items, turning on lights or opening a door. These tasks would be difficult or impossible for these individuals without assistance. PGI's ultimate goal is to provide support to encourage independence for the dogs' owners. In addition, the dogs can help to bridge a social gap between those with a disability and those without, providing a small connection between the disabled and non disabled communities.

When Amy, a 24 year old woman with quadriplegia, received a dog, she commented that prior to this people would first see her wheelchair and now they see her dog. She notes people are always stopping to talk with her about her companion and to ask questions. She states she felt as though no one ever acknowledged or engaged her in public before this.

Obtaining a Service Dog
Similar organizations may charge between $10,000 and $15,000 per dog. However, PGI is different because it places its dogs free of charge. PGI's service dogs benefit individuals with spinal cord injury, muscular dystrophy, arthritis, developmental delays, cerebral palsy, balance problems, and more.
PGI offers two types of dogs: service dogs and companion dogs. Service dogs have been specially trained to assist a disabled person with certain daily tasks such as picking up an object from the floor. The service dog has access into all public settings. In-home companion dogs are given to children who may suffer from anxiety or depression or someone with autism or Down's syndrome. The dogs give a sense of constant companionship. However companion dogs are not certified to work in a public setting.

Since trained dogs are given to their owners free of charge, PGI is run exclusively from donations and endowments. Each dog has various expenses such as adoption fees, vaccinations, medications for heartworm, grooming, vests and patches, leashes, collars, insurance, and food. PGI is a 501 (C) (3) corporation and all donations are tax deductible.
Training Process
Most dogs come to PGI as rescues from local shelters. PGI contacts the shelters to see if they have any dogs that would potentially make good service dogs. The rescued dogs are then placed in a foster home for six months to one year before they are formally placed with an individual. During this time, foster families are required to attend class once a week with their foster dog to teach the dog basic obedience commands it will need to later assist someone with a disability. New skills are practiced during class and are to be reinforced and practiced in the foster home. Foster families must also commit to training them on how to behave in a home. Once the dog passes the public access test, the family will then be given permission to take the animal in restaurants, stores, movie theaters, and more to complete the final training process.
By the end of the training process, dogs are able to open/close a door, turn on/off a light, carry a backpack, pick up a dropped item, brace for transfers, retrieve a telephone, pull a wheelchair, assist with dressing/undressing, and ultimately provide independence and support.

Other Information

You can learn more about Paws Giving Independence NFP or donate at their website:

Follow Us On Facebook!

Written by:
Michelle Kosner, Founder, Paws Giving Independence and 1st Year DPT Student
Victoria Gestner, Senior student, PR, Bradley University

Monday, August 31, 2009

Should PTs Screen for Eating Disorders?

Upon reading an article regarding the physical stress theory, I couldn't help but think about how important understanding basic science is. I remember so many times throughout undergrad thinking "how is this even important?"However, it comes down to the fact that basic science is essential, and we need to remind ourselves when we are working in the clinics of the 'basics' when considering the source of our patients' problems.

In this article on physical stress theory, I was drawn to a section regarding how physiological factors influence the ability of our tissues to adapt to physical stress. This authors covered medication, age, pathologies, and obesity, yet much to my surprise they failed to mention the other extreme: low weight as a result of disordered eating.

A 2008 study by Barrack et al reports that there is an association with increased dietary restraint and low bone mineral density. This study included 93 female cross country runners ranging from age 13-18. Cross country runners cause moderate to high stress on their bones daily (regularly,) and the addition of dietary restrictions could potentially lead to injuries and decreased ability of the tissue to handle that stress.

My point being that there is a significant amount to consider regarding basic sciences when treating patients like these. For example, Gonzalez et al. mentions that people with low weight/eating disorders commonly have an abnormal variation in electrolytes, low blood sugar, and decreased calcium due to these dietary restrictions. Well, we all know when we take the time to consider our basic sciences that our muscles require ATP(comes from things that increase our blood sugars) to contract and relax. Low electrolytes can lead to an alteration in the sodium potassium ion channels. Lastly, calcium has a direct effect on muscular contraction considering its interaction with the sarcoplasmic reticulum, trasverse T-tubules, troponin, and tropomyosin. Aside from muscles, calcium is also a key component to the bones.

Presumably, this can be overwhelming to keep into perspective at times, but when we are managing patients in the clinic it is important to decipher the hints they are throwing at us. Caloric restriction and disordered eating ARE problems that can go undiagnosed. If left unchecked for long enough they can be damaging to the musculoskeletal, integumentary, cardiopulmonary, and neuromuscular systems. For example, a person who is restricting his or her caloric intake is picking and choosing certain foods with little thought about which nutrients he is going to get that day. A weight paranoid person is going to cut out calories however she can. Dairy products can be high in fat and calories and therefore neglected all together. Patients may forego drinking calcium rich milk when they know they can drink water with zero calories. If we consider basic science, isn't it possible that this lack of calcium from dairy products will affect bone regeneration and muscular function in the musculoskeletal system? How then will this patient's tissue respond to the stress of a work out?

When we look at the integumentary system, we know that a basic component of skin is protein. Therefore when our patients are restricting sources of protein is it reasonable to think this would have a negative effect on wound healing? Prolonged nutrient deprivation can also have serious effects on the cardiovascular system. A common problem that occurs with eating disorders is bradycardia. Long term disordered eating can also lead to cardiac failure. What if we push our patients to get better and their heart cannot handle the extra strain? The neurological system is affected at an even deeper level. Commonly, depression is associated with eating disorders. Depression alters the flow of chemicals within the brain. Most of us have seen the pharmaceutical television commercials which state, "depression hurts". Additionally, many times there is a lack of energy which can lend itself to inactivity and lead to muscular atrophy. Depression can also be a part of a vicious cycle which causes a person to not eat.

I am not sure that I would say that eating more or less than normal is unhealthier than the other. If taken to the extremes both are extremely unhealthy and create a new category of stresses put upon the tissues in each of the systems. The key is good nutrition and the input of proper physical stress. I think my main point of all of this is that regardless if your patient is young, old, eating too much, eating too little, on medications etc. it is important that physical therapists get 'back to the basics.' Rehabilitation is still dependent upon minute factors such as these. So here's my question: If we are what we eat or what we do not eat… shouldn't we be screening for eating disorders in our patients? How do we know if we are inputting the proper amount of physical stress? Are we even looking and considering how a patient's personal nutritional situation impacts the results of their therapy? How can we truly help our patients if we do not know for sure... if we are not asking the questions? It's food for thought!

Stormie Prather, SPT

1st Year DPT student

Thursday, August 27, 2009

Welcome to BU DPT

A famous line from Gone with the Wind came to my mind when I was invited to write the inaugural posting for this BU DPT Blog. With apologies to Prissy, the house servant, and Scarlett O’Hara, “I don’t know nothin’ about birthin' no blogs, Miss Scarett!” Well, that is not entirely true in that I do have a blog of my own that I started on my trip to Copenhagen, Denmark a few years ago. The last time I made a post to it was in December, 2008! I’m afraid it has died a premature death. Let us hope for more frequent communication here.

This blog represents continuing evolution in the development of the Doctor of Physical Therapy program at Bradley University. In the words of the BU DPT blog creator, BU DPT faculty member Ms. Cheryl Sparks, “My hope is the blog will also serve to educate and elevate the profession as a whole and will identify an online presence for Bradley PT in the field of orthopaedics.” “Topics not directly related to ortho could include current events, issues, and growing pains we are experiencing in the profession. My perception is students spend a fair amount of on YouTube, Facebook, and Twitter that they really gravitate towards this type of learning environment. Therefore, my hope is this blog will stimulate active online learning, help to foster healthy debate with the use of the evidence and educate many within our profession.” These are lofty aspirations indeed--ones that are worthy of our pursuit. With that in mind, I’d like to post my first question here in hopes of learning more about using blogs as a learning tool: Students ( and current PT professionals), Do you spend “a fair amount of” time on YouTube, Facebook, Twitter, and other social networking sites or is this estimation grossly exaggerated? What do you think of the idea of this medium (online social networking) as a learning environment? Is it effective or are we co-opting a leisure time activity in the name of teaching and learning? Do you come online to learn in a social network setting? If you all would be so kind as to respond to my query by identifying yourself as a PT student, current PT, and/or both along with an estimation of how much time you spend, on average, each week on social networking sites for fun. I would also be interested in how much time you think you are “forced” online to social networking sites in the name of learning? Also feel free to comment on the notion that blogs and social sites such as Facebook, Twitter, etc. are effective learning laboratories.
We are looking forward to the exchange of some useful information on this blog as well as robust and healthy debate. I would like to say thank you to Cheryl Sparks for inviting me to write this inaugural post and for invigorating our department with energy and enthusiasm. Let the fun begin.