Gaston Rehab Associates, Inc. Physical Therapy and Sports Performance

Celebrate with Gaston Rehab Associates: October is National Physical Therapy Month

In honor of National Physical Therapy month, Gaston Rehab Associates would like to thank all of our clients, family, and business friends and associates for all that you do for us and allow us to do for the community.

The American Physical Therapy Association has adopted the brand "Move Forward" for their national brand awareness campaign. This can have many different meanings depending on who you ask. For one, we as Doctors of Physical Therapy help people move. Move body parts, move the entire body, move towards their goals, and so on.

As a profession, we are moving forward in that we are moving from a technician status to a doctoring profession. With many states now having direct access, North Carolina included, to see a physical therapist without a referral from a physician, more people have access to the care they need than ever before. We as a profession are constantly moving forward in research, patient advocacy, policy and legislative changes, ethical practice standards and so much more.

We will not get so wrapped up in moving forward that we don't take time to appreciate what we have today, but it certainly puts us in the perspective to always continue on even among dark economic times, healthcare reform struggles, and the challenges that each of us face in every single day of our lives.

We are happy to have such wonderful support from our communities and can't thank you enough for all that you do for us. Happy National Physical Therapy month and we look forward to many more to come!

Strength Training for treatment of Osteoarthritis of the Knee

Lange et al. published their findings from a review of the current research in October 2008 in the Journal Arthritis Rhuematology. Their main goal was to assess the effectiveness of isolated resistance training on arthritis symptoms, physical performance, and psychological function in people with knee osteoarthritis.

After reviewing eighteen studies representing 2,832 subjects, they concluded resistance training improved muscle strength and self reported measures of pain and physical function in 50-75% of this cohort and 50-100% reported improvement in all but one performance-based physical function measures (walk time).

This is important news for individuals suffering from osteoarthritis of the knee who have been considering knee replacement and have not yet tried conservative treatment. Based on this review of the current research it would indicate that favorable results can be achieved from strengthening exercise without the inherent risk of surgery.

Physical Therapists are the experts in musculoskeletal function and movement. In the State of North Carolina referrals to physical therapy are not required by over 99% of insurance carriers (Medicare being the biggest exception) and wellness plans are now being covered by many insurers as well. If you or someone else you know is in pain don't delay! Get seen by your physical therapist and begin treatment today.

Corporate Owned Physical Therapy: Who Profits?

I recently saw an article on a new physical therapy company in Georgia called The Atlanta Falcons Physical Therapy Centers. What caught my eye was the fact that this center, all 3000 sq ft. of it, claims to offer all of the same services that I am sure are offered at other private practice physical therapy providers, "but at a higher quality."

I have to question the motivation to open such a center in the first place? The article reports:

[Atlanta Falcons Physical Therapy Centers is] A concept from AMB Group, LLC, the company that provides management and investment services to businesses owned by retired Home Depot co-founder and Falcons owner Arthur M. Blank, the centers are designed to bring professional-grade physical therapy and sports rehabilitation services to the masses.

Do the people in the Metro-Atlanta area profit or does the company? I find it hard to believe that a company the size of the AMB group, LLC would think that a 3000 sq ft facility would set the standard for care. Apparently they do though. According to Dan Gordon, AMB Group business development director:

Seeing first-hand the level of care provided to Falcons players year-round is what encouraged a leadership team from AMB Group to find a way to benefit the community-at-large with that unique and exclusive core competency. Together, the members conducted extensive research, analyzing the industry, consulting with medical practitioners and academic leaders and listening to what patients would want in a state-of-the-art physical therapy center. 

Gordon then goes on to add:

In addition, the facility’s cutting-edge rehabilitation and workout equipment is unlike anything found at a typical gym, with everything from advanced ultrasound instruments to the newest top-of-the-line fitness and strength machines being available for patients. Even massage tables with head cradles that promote comfort and relaxation have been specially selected.

Apparently Mr. Gordon didn't want the physical therapists actually doing the work, to have to be bothered and leave their patients to come do an interview.  Listing ultrasound instruments and head cradles on massage tables as value added features is rudimentary at best and certainly doesn't sound like "professional grade physical therapy."

When I did a quick search for physical therapists in Atlanta, GA and Gwinnett, GA it was actually very difficult to find anything of substance in that area. I know there are more practices, but maybe they are just not doing a good job of advertising on the internet. Either way, this looks more like an attempt at corporate branding for the Atlanta Falcons organization rather than any real attempt to do well for the community. Also why did they have to do all of the research, they claim to have done, if they already have the the great model of "the level of care provided to Falcons players year-round"?

My hope is that other NFL organizations do not think this is a great idea and start to try to reproduce this same type of branding initiative. Also maybe private practice owners in this area need to do a better job of marketing. If the public is seeing this kind of facility as "top notch" imagine what they would say when they actually find a facility that is "top notch" and is owned by a physical therapist.

Plantar Fasciitis: What does the Evidence Say?

In the latest edition of JOSPT a clinical guideline for Heel Pain-Plantar Fasciitis was introduced. What the guideline is useful for is not only determining what the evidence available says about the specific condition, in this case Plantar Fasciitis, but also providing grades to the available evidence. 

For plantar fasciitis, a painful condition on the rear bottom of the foot most often noticed with initial steps or after prolonged weight bearing, only two items were given a grade of "A" which means strong evidence to support their use. The first was outcome measures, which allows physical therapists to track function in clients that present with these symptoms. The other was orthotic devices. Of note was the fact that there is no evidence to support the wearing of foot orthotics for long term (1 year) to manage pain or improve function.

Those items receiving grades of "B" where moderate evidence is available to support their use were physical examination/diagnosis, iontophoresis (use of medication such as Dexamethasone 0.4% or Acetic Acid 5% driven through the skin barrier via electrical current),  night splints and stretching the bottom of the foot by grasping the toes and bending them upward while sitting.

Use of low-Dye taping, which is commonly used, showed only weak evidence for relief of pain and only when used for about 7-10 days. Also of note was that manual therapy including joint mobilizations and neural mobilization (attempting to stretch the nerves) showed only theoretical evidence to support their use.

Want to become a Physical Therapist?

The American Physical Therapy Association has a page on its website dedicated to promoting the profession in a positive light and based on the current shortage of therapists is also an attempt at gaining more interest in the profession. A new video highlights physical therapists performing their various job duties and shows aspects of the diverse profession we are in.

Functional Job Analysis: What does this mean?

How many times have you seen a job description that was so vague that even the human resources manager had no idea what the position really involved? Thankfully most hiring managers now have the sense to make their company's job descriptions more detailed.  But why is it then that we are still in the business of going on-site to large corporations performing detailed job analysis' and developing functional job descriptions?

One reason is that the functional job description should be viewed as a "fluid" document. It should always be evolving and should never be left in a book on a shelf in some office. As job duties, raw materials and /or finished products change so should the critical demands of the job description. For instance, say in a manufacturing plant a new client wants product made that is heavier than any other products previously made in the plant. This new increase in weight needs to be reflected in the critical demands of the job description. By having a web-based program which produces the job description from a template this is easily updated and can be as simple as just measuring the weight of the new product and then entering it into the computer.

Another reason is that many employers are now just realizing the benefit that a detailed job description can have in return to work after an injury. If the physician and or physical therapist are not sure what exactly it is the injured worker needs to be able to do to perform at 100% on the job, the worker could be either arbitrarily denied return to work or worse yet sent back to work too soon. When a job description documents how much weight needs to be lifted, the height at which it needs to be lifted and the number of repetitions need to be performed (amongst many other things), it lays out a blueprint for return to work and the health care provider can make an educated  decision about the return to work plan without ever even having to step foot on-site at the company.

And finally as physical therapists we have a unique set of skills that allows us the ability to measure and quantify physical demands of a job and then write up a job description that makes sense to not only the employer, but also to the other health care providers that may have to review the document if and when the time comes for an injured employee to return to work.

Functional job descriptions are not meant to be detailed manuals for the skilled performance of the job. "How to" training manuals should already be in existence and they differ in that a functional job description will have only those pieces of the job that require physical demands to be performed. 

WorkWell Systems focuses on improving workforce availability throughout the entire employment lifecycle-- by matching the workers' physical abilities to the work that needs to get done and keeping the worker at work. Gaston Rehab Associates is the only Charlotte Metro Area provider of the WorkWell Systems functional capacity evaluation (FCE), functional job analysis (FJA), and functional job description (FJD).

Physical Therapy Concierge Service Gaston County

During the month of April only, Gaston Rehab Associates, Inc. is offering the chance to become a member of our exclusive club at a significantly discounted rate. Our Concierge Program rewards individuals for taking care of themselves and at the discounted rate, which is only around for a limited time (offer expires 4/30/08), membership will virtually pay for itself in the first 3 months. It's like buying a one year membership and getting half a year FREE!

Services include appointment times before and after regular scheduled hours, medically based personal training (even if you don't need physical therapy services or it can be used after your completion of treatment), access to the therapists via E-mail and cell phone and more. In fact, we are so sure you will be more than just satisfied with your Concierge member status, that if for any reason within the first 30 days of signing up you are unhappy with your decision we will refund your money to you 100%. You have nothing to lose and everything to gain in our exclusive club.

This is physical therapy as you have never seen it before. Membership is limited so that we can provide the best possible service. Call (704) 864-4424 for more information or to sign up today. Hurry and call as this is a limited time offer.

Sports Medicine and Physical Therapy Statesville, NC

Sports Medicine in Statesville, NC will no longer be the same. How often do you hear companies say they offer sports medicine? Pretty regularly. But where are the sports in their sports medicine programs? Far fewer companies actually offer their services where the athletes train.

Gaston Rehab Associates, Inc. Physical Therapy and A Whole Lot More, is opening an office inside the soon to open KPAC facility at 2809 Amity Hill Rd Statesville, NC 28677. This brand new facility will offer gymnastics, cheerleading, dance, sports medicine physical therapy, strength and conditioning, and speed and agility programs.

This venture will mix state of the art medicine and conditioning with a national level training center for performing artists and gymnasts and will bring a new and exciting piece for additional sports training as well inside the 13,000 sq ft complex. Benefits will include the ability to treat discomfort on-site before it actually gets to the pain level that would prevent an athlete from practicing or worse yet competing. This facility will also provide the ability to prepare the athlete from a total perspective including skill training, strength training, and overall conditioning training all in one site.

For more information or questions call 704-864-4424 or E-mail us at info@gastonrehabassociates.com.

Be on the look out for class schedules and programs which will be launched by August 2008.

Medicare Fee Schedule Relief for PT

According to the PT Bulletin Online Feb. 22nd, 2008 edition

Physical therapists (PTs) and other providers would not face scheduled cuts to the Medicare physician fee schedule until December 31, 2009, under legislation recently introduced in the US House. HR 5445, introduced by Reps Tom Price (R-GA) and David Scott (D-GA), would delay for 18 months cuts in the conversion factor planned for July 1.

The delay is intended to give Congress more time to find a long-term solution to problems with the sustainable growth rate, which determines Medicare payments. Legislation signed by President Bush on December 29, 2007, delayed a scheduled 10.1% cut in the conversion factor for Medicare providers through June 30. More information on 2008 Medicare policies affecting PTs is available on the APTA website.

This is welcome news if it can only gain enough support in the House and then pass the Senate. This type of legislation introduced in an election year? I am still skeptical, but at least there is chance for some hope.

Squidoo

Check out my new page on Squidoo where I will help to educate the public about the profession of physical therapy. This is a cool new website that is taking off with the public. Buyer beware however, as with all things on the web a grain of salt must be used when taking information at face value on these sites. Do your homework and check the facts before you make judgements; good or bad.