Physical Therapy clinicians are not only therapists, they are educators. A big part of being a physical therapist is answering patient’s questions and educating them on anatomy, the proper way to perform an exercise, how to walk and transfer safely, and what to expect going into surgery.

One-on-one educational session with a physical therapist

A recent study looked at the benefit of having a one-on-one educational session with a physical therapist prior to having a total joint replacement surgery. A researcher split 126 patients into two groups: one group had a group class prior to having surgery, the second group had an additional one-on-one session with a physical therapist. “Significantly more patients who attended the extra one-on-one counseling session with the physical therapist before surgery indicated that they were better prepared to leave the hospital after surgery and were, overall, more satisfied with the preoperative education they received,” Dr. Joshi stated.

Additionally, the patients who received the one-on-one session had required fewer PT sessions in the hospital and met discharge criteria (walking up/down stairs and transferring out of bed) faster.

What this indicates is that patients benefit from a one-on-one educational session with a physical therapist prior to joint replacement.

Improve overall satisfaction

Patients, therefore, may consider having a pre-surgical appointment with a physical therapist to improve their overall satisfaction and outcomes following a total joint replacement

Source: http://www.news-medical.net/news/20160222/Patients-benefit-from-one-on-one-counseling-session-prior-to-knee-or-hip-replacement-surgery.aspx

Seeing a physical therapist first for low back pain decreases overall out of pocket costs, opioid use, and less ER visits.

Study from the University of Washington and George Washington University

A study split patients into three groups. The first group saw a physical therapist first “PT first” group. A second group was “PT later” group, as they saw another provider initially, but eventually had physical therapy.  The last group was “No PT” as they never had physical therapy.

This study found that the group that saw “PT first” for low back pain had lower costs for care vs the “PT later” and “No PT” groups (this includes what they are paying out of pocket). The “PT first” group also had lower costs with emergency room visits, imaging, and opioid use.

Physical Therapy reduces prescription medication use

What this means is that seeing a physical therapist can not only reduce your pain and use for prescription medication, it also costs you less! Since Oregon has direct access for physical therapists (by law, you do not need a physician referral to see a physical therapist), patients should be using this route directly for treatment of their low back pain. Call Nick Rinard Physical Therapy today and schedule your pain away! 503-244-6232

Source:

http://www.apta.org/PTinMotion/News/2016/2/29/PTFirstDirectAccessLBP/

At Nick Rinard Physical Therapy a lot of patients come to see us with knee pain and/or knee arthritis, both before and after various knee surgeries, including total knee replacement surgeries.

Since 2010, knee replacements have been the most performed surgery on people over 45 years of age. Knee replacements are performed at the rate of 700,000 per year. Because of this increasing rate, the efficacy of pain relief and improvement of function should be investigated.

100 patients with knee arthritis

A researcher, Soren Thorgaard Skou, has done just that. In his study, he looked at 100 patients with knee arthritis and assigned them to a surgical group or non-surgical group (which received physical therapy, medication and diet education). After one year, 85% percent of the surgical group had significant improvements in pain vs 68% of the physical therapy group. The surgical group and larger gains in their ability to climb stairs and walk. However, the study also showed that the surgical group is at greater risk for complications that the physical therapy group is not. The surgical group is more likely to have blood clots or a manipulation (another procedure performed by the surgeon to increase range of motion). The surgical group had more adverse side effects vs the physical therapy group (24 vs. 6).

Physical therapy is effective

Physical therapy is effective and should be considered a viable option before jumping to surgery. If the first knee replacement can be delayed, this can decrease the necessity for a second surgery (current replacements last 10-15 years).  We urge our patients to remember that we are always here for you before or after surgery.  Nick Rinard Physical Therapy is a phone call away 503-244-6232 !

1/3rd of knee replacements are unnecessary

This, taken into consideration with the study that came out last summer that found nearly 1/3rd of knee replacements are unnecessary, should be considered when deciding to have a knee replacement or a trial of physical therapy to determine effectiveness.

Sources:

http://health.usnews.com/health-news/articles/2015/10/21/knee-replacement-brings-less-pain-better-function
Dr. Skou’s report (N Engl J Med. 2015 373;17:1668-9)

Nick came across this article about shoulder pain and MDT approach to treatment that we use at Nick Rinard Physical Therapy clinic.  He thought it would be informational for our audience.

Excerpt

Case Report

Rapid resolution of chronic shoulder pain classified as derangement using the McKenzie method: a case series Maria Corazon Aytona1 , Karlene Dudley2 1 Southeastern Regional Medical Center, Lumberton, NC, USA, McKenzie Institute, NY, USA, 2 Southeastern Regional Medical Center, Lumberton, NC, USA The McKenzie method, also known as Mechanical Diagnosis and Therapy (MDT), is primarily recognized as an evaluation and treatment method for the spine. However, McKenzie suggested that this method could also be applied to the extremities. Derangement is an MDT classification defined as an anatomical disturbance in the normal resting position of the joint, and McKenzie proposed that repeated movements could be applied to reduce internal joint displacement and rapidly reduce derangement symptoms. However, the current literature on MDT application to shoulder disorders is limited. Here, we present a case series involving four patients with chronic shoulder pain from a duration of 2–18 months classified as derangement and treated using MDT principles. Each patient underwent mechanical assessment and was treated with repeated movements based on their directional preference. All patients demonstrated rapid and clinically significant improvement in baseline measures and the disabilities of the arm, shoulder, and hand (QuickDASH) scores from an average of 38% at initial evaluation to 5% at discharge within 3–5 visits. Our findings suggest that MDT may be an effective treatment approach for shoulder pain.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3822320/pdf/jmt-21-04-207.pdf