Ask Us Anything About… Physical Therapy

>>Good afternoon,
and thank you for joining us for Ask Us Anything About Physical Therapy. I’m Barbara Schindo Imagine you go through
something that greatly changes your physical capabilities whether
it be a stroke, a surgery,
or a traumatic accident. How do you get your
body back to a new normal? That’s when providers
are going to work with you to treat your pain, restore function,
and get you back to a healthy lifestyle. I’m joined today by
Nancy Lokey who is a clinical case manager with the Department
of Physical Medicine and
Rehabilitation at Penn State Health. Nancy, thanks so much
for joining us.>>Thank you.>>Absolutely. So we say physical
therapy, but that’s really just one service
of the whole process of rehabilitating. A more encompassing
term is physical medicine and rehabilitation. Can you tell us what
that is?>>Sure can. Physical medicine
and rehabilitation is also known as physiatry or rehabilitation medicine,
and the doctor that does
this is called a physiatrist. A lot of times people
mistake them as psychiatrists or podiatrists
which is way, way, way different. A physical medicine
and rehab doctor, they specialize in the diagnosis, the treatment,
the management of conditions, illnesses, and
injuries that affect the brain, the spinal cord, the muscles, the bone, ligaments, tendons, and thereby altering somebody’s function or their ability to move. So a physiatrist’s focus is all about function and all about getting somebody back into their lifestyle maybe in a different
way, and the ultimate goal is to get them to their highest functional level, back home, in the community working, enjoying life.>>So, what sorts
— this is a very — this is going to be a very broad question so I think this might —
so what sorts of treatments and therapies
are used for people who suffer a stroke or have a surgery
or a traumatic injury?>>So, that is a very
broad one. It would all start out — it’s very individualized. So the physiatrist,,they work with a multi-disciplinary team
and on that team you would have a physical
therapist, an occupational therapist, a speech therapist, a recreational therapist, a music therapist,
a nurse psychologist, a dietician,
a vocational rehab. So really a lot of
people and depending on the needs of that person,
you would use that whole team to help. So after a surgery you might need physical therapy or you might need a brace or a wheelchair. You would have the physical therapist that would be helping you with strengthening and with mobility issues. You would have the occupational therapist that would help with learning how to redress in a different way or using adaptive
equipment and parenting, those kinds of things. So it’s really the therapeutic recreation specialist is going to help you get back into the community. Do outings that after the therapist have taught you all the tools that you need,
you will then go into the community with them
and practice that so that you get that chance to do it a dry run so to speak before you get home.>>So, there’s not necessarily one process for any one ailment? Anybody who have a surgery, who needs some type of rehabilitation,
that’s going to be individualized to them.>>Correct. There’s certain things that you would do maybe similarly
but each individual one would have
their own treatment plan depending on the team’s assessment.>>So could you describe how the rehabilitation process works? Take us through the process and how it impacts recovery for folks who have to go through
it.>>Sure. It’s huge. It stats from even before an injury. We can be in the recovery
process, and it goes on to lifetime. So it spans a huge amount of time of somebody’s life. So we call it pre-habilitation
and pre-habilitation, if you have maybe a scheduled surgery or amputation or you’re going to get a medication
like chemotherapy, we would be very instrumental
in helping you build up your core strength. We’d call in a physical therapist and the occupational therapist,
build up your core strength, build up your
strength, get you at your best ability so that you can go to the surgery and come out a step or two ahead.>>So sometimes this
happens before the treatment even happens.>>Yes. And then after an injury, you’re in
the acute care hospital, they bring us in, and we help to identify potential complications and treatment plans. Get them started early so that we can decrease that hospital time. We can decrease complications. We can decrease length
of stays, and then we also give that mode of —
what level of treatment is necessary? Do you need an acute
rehab, acute rehab? Okay, here we go. Acute rehab or outpatient
or home or a day program? All of those things. Do you need aqua therapy? The physiatrist is going to look at how this injury or disease has affected your function
and do you need help with learning how to dress
and learning how to drive, needing a wheelchair. All of those aspects.>>Okay. You are watching Ask Us
Anything About Physical Therapy with clinical case manager, Nancy Lokey. We welcome your questions
for Nancy if you are watching this live or if you’re watching this
on playback, if you have a question you
can just put it right in the comment field, and we will do our best to get an answer for you. And speaking of questions,
you had mentioned occupational therapy, physical therapy. So we had a question from Scott and Scott wants to know,
“What is the difference between those two?” Those are two terms you hear a lot when it comes to rehabilitating.>>It is, and they’re oftentimes confused. Yes. So, a physical therapist
generally focuses on lower body. They focus on mobility, strengthening, balance, those types of things,
as well as then an occupational therapist
will focus on activities of daily living. They’ll focus on your dressing skills. They also can work with balance and strengthening as well. They can work with you on parenting skills. They can work with you on meal prep, cognitive.>>More day to day. How you function on your day to day.>>Yes.>>Okay. Very helpful. I had been confused by those two terms as well, and I think we have another question that was submitted from Heather. She wants to know, “Why is it so important to have acute rehab after a stroke?”>>It is very important and there’s somewhat of a myth around that, I think, out there. But after a stroke, it’s really important that you go to acute rehab
so that you can maximize your function
and start that recovery process early so that you get the
therapist in there, physical therapy, occupational therapy, speech therapy. You may have swallowing issues, speech issues, and the longer you wait,
the more difficult it is for you to try to get
back what you have lost because of the stroke.>>That’s a really good point. You made a good point about the importance of that type of therapy. What about people with a more kind of minor pain? Like they haven’t had a major traumatic accident but maybe a sports injury or maybe,
I don’t know, they slept on their neck wrong or something and they are feeling — you know, you feel
like you can’t move your neck, and you have to move your whole body
or you hurt your ankle playing basketball. Do those people benefit from this type of rehabilitation? How do you know if you need it?>>Absolutely. I would say when in doubt, do it. So it’s funny you say that because I have a personal experience on that one. So in my job I use the computer a lot. So I was — I woke up and I literally could not move. I had electric feelings going down my neck. My daughter had to take me to the emergency room. I have been in rehab, physical medicine rehab for many, many years,
and I needed a physical therapist, and they
taught me how to do exercises to decrease that pain and that muscle tension. So yes, when in doubt, we can generally help any other discipline or anything
that affects your ability to move or function,
you need a physical medicine and rehab doctor to help guide the
way, guide the therapist in what modalities, and the collaboration
with the other teams is so, so important.>>So there are also
some folks who say go through a very traumatic injury
that drastically changes their capabilities. Like they may wind
up being a wheelchair user. What kinds of care is needed to help them function their best
and have a good quality of life?>>So, it takes a village, and that village is the rehab team. So we come in bright and early with the consult team in acute care. We get the therapist involved early to start that movement, that range of motion. We look at what adaptive equipment. The wheelchairs, a lot of people will just go online and just order a wheelchair. That’s so not the thing to do because a wheelchair is very important in your mobility,
in your shoulder — you end up with shoulder
overuse because of using a wheelchair, so if you don’t have the right one it could be detrimental
to you having a good quality of life and having less pain. All right, and the question was?>>It was, how do you — well, this could be for anybody who needs some type of physical rehabilitation. How do you, kind of, I guess, expectations set and help them make it a lifestyle change for a long-lasting type of therapy for physical rehabilitation?>>Okay. So, it is a mindset change. It’s a matter of bringing also in the nurse psychologist so that they can help
with the coping strategies and
understand, and it’s a process. People go through
the denial and all of that, and we’re cheerleaders. The whole team is cheerleaders, and each small step is a huge gain, and really they have
to get there and realize that life isn’t over. It’s just going to be done maybe in a different way and there’s no limitations. The only limitation is the limitation they place on themselves.>>Thank you. I think we also had a question from Rosemary on Instagram,
and let me make sure I am saying this right. What is the best exercise for a lumbar radiculopathy? I guess that means moving side to side? Moving side of hip to knee.>>Okay. So what I’d like to say there is it’s
a good idea to have the physiatrist in there to do an assessment to make sure that we are exactly,
we know what therapy is going
to be the best therapy. Having the physical therapist involved with that to give their point of view
as well and then they collaborate. There’s really no
cookie-cutter answer for everything. It’s really individualized
and it’s best to consult with a physical medicine and rehab doctor.>>Sure. That makes perfect sense. So it’s not like there’s one best exercise to do for that particular ailment,
but it’s finding a program with your team
to help you rehabilitate the best you can.>>Correct.>>And I note too
that, you personally, kind of, spearhead a lot of activities for folks
who have these big life changes and their
capabilities are drastically changed. What types of activities do you offer and do to kind of help them get back
into the best life they can have?>>We offer several things. We have multiple support
groups. So in those support groups we offer educational lectures
from our physicians and from community services. We also do a lot of community outreach where we’re doing airport outings
so that people can try to go through TSA, learn how to get on an airplane whether they have a sensory disability or a physical disability, we give them that opportunity to go
through security and see what it’s like. We also have adaptive
ski day where we collaborate with other community organizations so that people can try out the adaptive equipment and go snow-skiing. We do — this area is great for hunting so we coordinated with Cabela’s and a couple
of other organizations and had lots of vendors
for adaptive hunting and fishing and outdoors so that people know there’s things you can do. The big one that we do is my Rec Fest, and I absolutely — it’s near and dear to my heart because
it’s multi-faceted as far as its goals. We want to let people know that they can get out there. For health and wellness you need to exercise, and a lot of people with a physical disability whether it’s a psychological barrier or it’s a physical barrier or a financial barrier, they won’t get out there. Rec Fest gives them the opportunity to come out, try the adaptive equipment in a safe environment. So the adaptive things that we have is we did adaptive kayaking, adaptive scuba,
adaptive fencing, rugby, basketball. We had opportunities for those with autism. We had opportunities those with visual disabilities, hearing disabilities. We had adaptive dance, and we bring all the community resources
that we can find for all ages in one spot. So it’s kind of like one stop shop. We bring the local colleges in to teach the students early on about adaptive equipment
so that we can dispel the myth that those
with a disability don’t need to exercise or can’t have a good quality of life like anyone else.>>You are watching Ask Us Anything About Physical Therapy. I’m here with Nancy Lokey who is a clinical case manager in the Department of Physical Medicine and Rehabilitation at Penn State Health, and we have a question from Amy. “If I think I might need physical therapy, can I just call to get an appointment or should I reach out to my PCP,
reach out to my doctor first?”>>So, in order to go to physical therapy you need a doctor’s order. So the recommendation
you would need either your primary care physician can give you an order. The whole picture piece is you can call physical medicine and rehab,
get an evaluation by a physiatrist to
determine what modalities you may need, and then guide your physical therapy that way.>>Okay. So call your doctor first and get
a doctor recommendation on physical therapy. Again, we welcome your questions for Nancy. If you have a question whether you’re watching live or on playback, you can just put it in the comment field below this post and we
will do our best to get an answer for you. I just have one other thing I wanted to circle back on. You had mentioned doing kind of pre-treatment for somebody who’s going
through cancer treatment which is something
I did not realize that was a component of physical therapy or rehabilitation. So I think that there’s a lot that people don’t realize. Like even a very minor surgical procedure might require some rehabilitation. Is that right?>>Yes. And I don’t think
people understand that, and even other disciplines in the hospital. So this is a great opportunity for us to let people know
that physical medicine and rehab is out there. They can consult us. We’re glad to help,
and our physicians can look at how to get the person back into their home and into life with adaptive equipment or
different therapies that will help them with an increase in their quality.>>Well, thank you very much for joining us today. Again, we welcome your questions. Nancy, thank you so much for joining us.>>My pleasure.>>Thank you.

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