Friday, February 10, 2017

Week 1

Hello all and welcome back to my blog!

This week I started interning at my on-site location, Center for Athletic Performance and Physical Therapy. While my first day meant filling out paper work regarding patient confidentiality and interaction limitation, I was extremely excited to begin observing appointments to learn more about doctor-patient interaction. One of the most important things I learned about this site in particular are the different areas. The "inside" is made up of treatment tables, where patients can receive ice/heat packs, stretch, or get isolated muscular massages. On the other side, the "outside" is structured more like a gym, with work out equipment throughout for patients to go through their rehabilitative exercises. However, starting next week the inside/outside split will be a downstairs/upstairs division, since the entire facility will be moving location to a larger building! Luckily the staff and patients will remain the same and I will be able to continue my research.

Another interesting division is within the staff. The physical therapists are those with their doctorates and primarily work with patients "inside", performing fire cupping massages, kinesio tape wrapping, and other restorative treatments. The PT techs are either physical therapy school or undergrad students, who guide patients through their exercise programs "outside" or other stretches "inside". As an intern, I'm able to move between the two areas, primarily reading charts and observing regimens during down time "outside" and helping with laundry "inside" during busier hours.


For each week, my on-site adviser asked that I have a question to guide my research. The first week brought a more general question: what level of independency do the patients take with their exercise programs? After watching several outside exercise programs, I noticed that several patients ask the PT tech to explain each exercise and watch their form. However, others who have had more appointments only require the occasional check-in to confirm the number of repetitions or weight amount their therapist wants for them. Some patients ask to do their hardest exercises first and finish with the easier ones, showing that there is a certain flexibility. One of the common requirements for almost all of the knee and hip patients is the "alter g" which is an anti-gravity treadmill to reduce pain upon movement and leaves you looking a little like this:



So far, other than the alter g, there seems to be some similarities between the majority of knee/hip exercise regimens such as squats, lunges, and other quadricep stretches. The specialization seems to occur both within the "outside" workouts and the "inside" treatments, and depending on the patient's fatigue or pain level, certain parts of the program may be skipped or new steps may be added.

I can't wait to see what else I will be able to discover about how the regimens are created and how the doctor-patient interactions are unique for each injury, especially in the new building! Stay tuned for more observations on the physical therapy field and dog gifs next week.

21 comments:

  1. Hi Carla! What an incredible opportunity! I can't believe you get to look at patient charts and observe actual patient, PT interaction. Have you noticed any correlation between patient age and their motivation to work independently? or maybe a correlation between the type of PT program and patient independence?
    I can't wait to see what happens next week.

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    1. Hi Mrs. Bailey! What I've noticed is that a lot of the high school-aged patients try to be a little bit more independent with their regimens whereas some of the older patients prefer the techs to lead them through their work outs a little more. Also, those patients with less exercises or those who have been doing their regimens for a while are more independent.

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  2. Is there anything that surprised you about the ways doctors and patients interacted, anything that you found unexpected? I'm sure it depends on the people, but it would be interesting to know if you saw any general trends.

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    1. Hey Nicole. For a lot of the patients who have been going to PT longer, there seems to be more comfort with and trust in the techs. Obviously this is something that happens often with more time spent with a person, but the relationships become more friendly, which is interesting to see in a rehabilitative environment.

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  3. Looking into patients charts and observing generally in all the different area seems like an amazing opportunity. I was wondering if the majority of the patients were more comfortable exercising independently or with a fellow doctor. I am sure this cannot be calculated by numbers, but just generally from what you observed were there any trends?. Was there anything specific that you observed that changed the way you had originally thought about this project? Can't wait to see what is coming up next.

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    1. Hi Sara. I think a lot of the comfort depends on the person, and whether or not they're more confident in what their regimen is and which exercises they are doing. However, even for the more independent patients, since the tech is there supervising and checking in, each patient is held accountable. Since starting the project, seeing just how friendly and familiar the interactions with the patients are really surprised me! I think it's incredible that physical therapy is a practice that is so beneficial for rehabilitation but isn't a painful and arduous task.

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  4. This is definetely an interesting research! I was wondering if you could go into a little more detail about the inside and outside facilities. It would be really cool if you could write the similarites and the differences between the two. Furthermore, I think it would be nice if you could find out which facility is more effective in general. I would love to continue reading this reseach!

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    1. Since the patients receive treatment in both the inside and outside facilities, I don't necessarily think one is more effective than another. The inside involves icing, massaging, and other stretching while the outside is more of the work-out, with machines and equipment out to be used.

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  5. This is very interesting! On the "inside," are the treatment tables for specific stretches or are they for a different purpose? Do people who are older have a more difficult time with the exercises or does everyone have roughly the same difficulty? I'm excited to learn more!

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    1. Hi Nikita. The treatment tables are primarily used for the patients to receive ice or a massage, however the patients can utilize them for whichever stretch they need. I think for the older patients, there is definitely a higher level of difficulty, even if the weight and repetitions are lowered for them.

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  6. Helping out in the Center for Athletic Performance and Physical Therapy seems like such a rewarding experience. Do you get to interact with the patients and help them with their regimens? After reading the charts, do you give any of the PT techs any input? Also, does the larger building open up more opportunities in your research? Looking forward to seeing the progress. Cute gifs :)

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    1. Hey Lekha. Since I'm not as well versed in kinesiology and anatomy as the PT techs, I'm mostly asking questions about the specific exercises and why they are being utilized. However, I am able to tell the patients which exercises they will be doing and explain the movements if they are unsure. With the larger building, I may be able to see more patients!

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  7. Hey Carla!

    Other than exercises, do patients have the chance to be involved in recreational activities, such as sports? Also, are there any requirements to be admitted for treatment, or is it open to anyone?

    I hope your research is successful, and I'll be keeping an eye out for your next post!

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    1. Hi Sachin. Many of the patients who come in are athletes recovering from sports injuries. While some of them have very severe injuries, the majority are still able to practice their sport. As for who can have the treatment, I'm not totally sure, but I will definitely ask!

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  8. Hi Carla! I enjoyed reading about your experience on-site and thought that the exercise activities, especially the alter g, were interesting. From what you've seen, what would you say was the most popular exercise there? I can't wait to hear more about the physical therapy process and decision-making next week!

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    1. Hey Anthony. Especially for the knee and hip injuries I'm researching, I think the more used exercises are squats and other lunge-type work-outs. I'm definitely looking at which are used across the board and which are applied to specific patients.

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  9. Hello Carla! I loved reading about your experience. I am personally very fascinated with medicine; however, as a dancer I am interested in this field a lot. I was very interested in your observations. What are some of the most popular exercises? And the effectiveness of these exercises? I can't wait to hear more about your journey!

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    1. Hi Siena! For knee and hip injuries, a lot of the patients do squats, lunges, and other exercises with leg mobility. As for the effectiveness, I'm not sure so I'll have to keep observing.

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  10. Hello Carla! You said that next week, this program will be moving to a different building and that consequently the split between the "inside" and "outside" will be "upstairs" and "downstairs." Would that put a strain on patients who need to go from one place to another or would it be another exercise option? I'm really curious to see how the transition will impact patient experience.

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    1. Hi Vijay! After seeing the new building, I realized that the upstairs is actually additional "outside" space and the downstairs has the same split of inside/outside. I definitely didn't think about the patients with limited mobility, but CAP obviously did :)

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  11. Wow, Carla! It sounds like your first week on-site was super cool and interesting! I'm sure it's different for everyone, but I was wondering, in general how frequently and for how long do patients typically do their rehabilitative exercises? By the way I loved the dog gifs.

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