Didactic Education

Keep Stepping

#21111 PTA Therapeutic Exercise

For the past two semesters, our class participated in Keep Stepping. This program helps reintegrate older adults into their social, work, and home environments through group and individualized physical therapy. Each of us were assigned a client to work with over an 8- week period. The sessions consisted mostly of group exercise with time at the end to educate our clients and give them home exercises based on individual need. This fulfills competencies #4, #8, and #9. 

The patient I worked with first semester had low back pain, forward head posture, and limited knee mobility. The exercises my partner and I chose for her included transverse abdominis activation, mini squats and lunges, and chin tucks to correct her posture and improve core stability and strength. It was hard, because she didn't want to be here and wasn't doing her exercises. Because of my inexperience, I also didn't feel confident that I could handle the situation. We had to work outside the box and figure out how to keep her interested. She mentioned that she had started aqua therapy classes and was interested in low protein foods, so we gave her some information on the benefits of aqua therapy and low protein foods, in addition to management of back pain, fulfilling competency #7. She found out she really liked aqua therapy and it improved her pain. We encouraged her to keep doing aqua therapy and find other things she liked, such as playing with her grandkids, with in pain tolerance. Overall, it was a good first experience, and I feel that it prepared me well for the second semester and my clinical experiences thus far. I have attached my Keep Stepping write up as well as the articles I gave my client. 

Musculoskeletal practical: THA

#81175 PTA Principles of Musculoskeletal Rehabilitation 

On the second practical, I drew scenario #3, involving an 83- year old female that had an anterior right hip replacement 1 month ago.  Her functional limitations included decreased strength, balance, and trouble with gait, transfers, and stair climbing. She is WBAT and uses a front wheeled walker. Her goal was to start driving again so that she could participate in community events. 

I first assessed her pain, which increased with walking.  My main intervention was observing her gait and making sure she was following hip precautions. With all hip replacements, it is important to make sure that they don't turn on their weak side to protect the stitches and weak tissues. My home exercise program included counter squats, making sure that she didn't go beyond 90 degrees. Other interventions I chose was the application of heat and core strengthening.

On my second clinical rotation, I treated many hip replacements at different stages. By one month out, many were already using canes. This is something else I could have trained this patient on. Using and strengthening the involved hip as tolerated within precautions is important after surgery.