Week 10

Hello everyone, and welcome to the final post! With the project wrapping up and the presentation nearing, I can't help but feel like the end is a little bittersweet. I was in Pittsburgh the past week looking at a school, and was even able to talk to a professor about my project! Being able to explain my research was amazing (almost as amazing as the buildings on campus).

Since I wasn't on site at CAP, I did research regarding the average timelines of physical therapy patients with specific knee and hip injuries. I found the Mayo procedure details for ACL reconstruction and hip arthroplasty (replacement), which explain what causes the injury, what's expected from the surgery, and the steps to be taken post-operatively. Additionally, I looked at some discussion boards where physicians from different practices share their own "timelines" for recovery. Almost always the process is divided into different phases, where the times vary per surgeon. Here's a general recovery timeline provided by the Game Ready company:

Similar to this week-based timeline, many physicians break the recovery into phases from I up to VI. What I found is that for ACL reconstruction it takes 24 weeks on average until full recovery. For hip replacement it is 36 weeks and knee replacement it's 9 weeks. LCL reconstruction is 28 weeks until recovery, while the time is only 5 weeks for LCL sprains. For IT band injuries not requiring surgery, the recovery time is 6 weeks.

Additionally, for non-surgically repaired injuries the average number of days per week spent in physical therapy to fall in those recovery times is 2 days. However, for surgically repaired injuries, patients are in physical therapy on average 3 times a week until full recovery.

This quantitative research helped me to wrap up my project and finish up my presentation. I've been so happy to have been working in the "real world" the past ten weeks, researching kinesiology and physical therapy, and hunting down the perfect dog gifs. My on-site mentor, Dr. Jeschien, and all the other physical therapists and techs were beyond welcoming and always open to my questions regarding the field, and I am so thankful I was able to complete my project with them.

To really wrap up this blog and my project, here's a string of dog gifs! Thanks for reading and following my research. :)

Week 9

Hello again!

The end of my research is near, and that means there's only a limited number of dog gifs left. But don't be sad- here's a dog gif to begin this post!

My question this week: what are all the different types of patients who come in to CAP? By this I mean what are the different reasons/injuries which motivate patients to come in for physical therapy. The majority of patients who come in are geriatric patients who want to reduce day-to-day pain or athletes trying to get back to playing.

I noticed that there are four basic categories of patients, the two aforementioned, pre-operative patients, and patients who suffer non-sports related pain. The geriatric patients tend to come in for arthritis, knee-replacements, and other age caused pain. Their number of appointments are usually longer, since they don't have time pressure to return to a previous performance capability. On the other hand, the athletes who come in for rehab do need to return to their original, pre-injury state to participate in their sport. Most of the athletes have tears in ligaments such as the ACL, Achilles, or LCL, all central to knee and ankle function. There are also less serious sports injuries treated such as soft-tissue sprains and tendinitis or other tightness in the IT band or general knee/hip area.

The pre-operative patients may also be in the geriatric/athlete category, but they are in physical therapy for preventative measures before their surgery rather than reparative. The common knee/hip surgeries that warrant pre-operative therapy are knee or hip replacements and ligament repairs. As for patients who are neither geriatric nor sports-based, the injuries treated range from general joint pain or knee/hip tightness to sprains caused from simple accidents that are outside of sports.

All these different types of patients come in for a range of time until recovery/improvement and for various times per week and hours per appointment. Next week those are the numbers I will be looking at to finish my research. See you then!

Week 8

Hello everyone!

This week was especially exciting. On Tuesday somebody brought the perfect number of bagels so everyone working the morning shift could have one, and on Thursday one of the patients brought mini cupcakes for one of the therapists and her "helpers" (aka whoever saw the box and was hungry) to enjoy. Other than the free food, I was able to interact with the patients a lot and learn more about the field.

I had a pretty simple research question: what exactly happens during a patient's first injury evaluation?

I wasn't as confused as this dog, but I wasn't 100% sure about what happened during these appointments. Luckily, I was able to sit in on my one of my site advisor's knee evals!

The patient is a dancer, who had previously been in physical therapy for Osgood-Schlatter's disease, a common, growth-related knee injury. However, this time the patient's pain was in the other knee, and came about after landing from a jump. The sharp pain was located in the back of the knee and flared during activities such as walking up the stairs. To start, Dr. Jeschien asked the patient to do a squat, but they could only bend slightly at the knee before there was discomfort and pain. After asking questions about the current and previous injuries, he asked the patient to walk back and forth (and back and forth and back and forth) in order to make observations about their gait, which is simply just how they walk. Dr. Jeschien noticed that the patient was bringing their knee in and kicking their foot out with every step, a sign of weakness in the quadriceps muscles. After making these observations, he then measured the patient's strength in both knees by bending and stretching the legs and asking the patient to resist when he pushed against either leg. This all seemed pretty straight forward as I sat in, so I sat in and watched everything, even making mental notes of my own about the patients injury.

However, as the eval went along, Dr. Jeschien was taking notes about each measurement he was taking, which would later help him to create the exercise regimen the patient would follow. Most of the notes were numbers on a scale of 1-5 or 1-10 or plus/minus signs to dictate ability, flexibility, and overall strength. By the end of the about 20 minute eval, Dr. Jeschien wrote up a short "starter" program including 4 exercises that the patient would go through that day and continue to do at home and an ice and electrical stimulation period at the end of the rehab. By the time the patient comes for a second appointment, Dr. Jeschien will write more exercises into the routine based on what he saw during the eval and any new information the patient comes back with.

This week was definitely helpful for my research on both knee injuries and how the individual rehab programs are created. See you next week!