Posts Tagged physical therapy
[APTA Blog] Confessions of a Tech-Challenged PT: Asking Searching Questions – And Getting Useful Answers
By Stephanie Miller, PT
But this thing is awesome.
And yet, the fact that PTNow is so awesome—that it contains so much information—can feel a little … overwhelming. I mean, where do you start? How do you start?
Here’s how I got my feet wet, and a few tips based on what I’ve learned along the way.
To begin with, I decided early on that I’d focus on small chunks, and get comfortable with bits and pieces at a time. I mean, anything new I learn today is more than I knew yesterday, right? Since I’d like to do a better job at searching articles, I thought ArticleSearch would be a good place to start. Seemed easy enough.
As heart failure is a common diagnosis in my practice area of home health, I decided to search on that topic. I began with the “basic search” option. The search window is what you’d expect: a box in which you can type in whatever search terms you’re looking for.
But then came the challenging part … all of the databases. ArticleSearch lets you choose which databases you want to use in your search, and although I vaguely recognized a few from grad school, I hated to admit that a lot of them were foreign to me. But where there’s a will, there’s a way! I was determined to understand the value of each and identify why I would select one over the other. Fortunately, the PTNow tutorial video helps to explain the differences.
The abstracts to the best articles are found using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, and SPORTDiscus. There are differences between them. Here’s a quick comparison, based on what I learned from the PTNow tutorial.
- Topics: nursing, allied health, general health
- Over 1,300 journals
- Evidence-based care sheets and quick lessons
ProQuest Nursing and Allied Health Source
- Topics: nursing, allied health, alternative and complementary medicine
- Journals, clinical training videos, evidence-based resources
- Over 1,000 full-text articles
- Over 15,000 full-text dissertations
ProQuest Health and Medical Complete
- Topics: clinical and biomedical, consumer health, health administration
- Over 1,500 publications; over 1,000 of them full-text
- Topics: sports and sports medicine, fitness, health, sport studies
- Full-text for 550 journals
Cochrane Database of Systematic Reviews
- Full-text articles, all systematic reviews
- Protocols and evidence-based data
- Updated regularly
- Investigations of the effects of interventions for prevention, treatment, and rehabilitation
If you’re looking for a specific kind of research resource, here’s what the tutorial suggests:
CINAHL Complete, Proquest Nursing and Allied Health Source, Proquest Health and Medical Complete, SPORTDiscus (be sure to select the “full-text only” option on the search page)
Cochrane Database of Systematic Reviews
Physical therapy-specific research
CINAHL Complete, Proquest Nursing and Allied Health Source, Proquest Health and Medical Complete
As for my own search …
After becoming more comfortable with the benefits of each database, I decided that the Cochrane database was the place I wanted to begin my investigation into the effects of exercise on patients with congestive heart failure. I clicked on the link, typed in “effects of exercise on patients with congestive heart failure” in the search bar, and chose the Cochrane database. In a few seconds I found articles on the beneficial effects of combined exercise training on early recovery, the effects of specific inspiratory muscle training on the sensation of dyspnea and exercise tolerance, the role resistance exercise training can play in improving heart function and physical fitness in stable patients with heart failure, and the effects of short-term exercise training and activity restriction on functional capacity in patients with severe chronic congestive heart failure, to name just a few. Wow.
Through this whole experience, I not only learned some of the details of how ArticleSearch works, I also got a better sense of how to get the most out of my searches. I suggest a few general tips:
- Take time to learn. Invest the time in learning each database and the benefits of using one over the other.
- More isn’t always better. Avoid searching every database. You can end up with so many potentially irrelevant options to review that it’s easy to get overwhelmed as you attempt to weed out the information you want. Choose only the search engines that can best target your specific topic, using the above information to guide your selection.
- Get help early on. If you start feeling confused, your time will be better spent if you take a break from your search and learn more about the resources you’re working with—trying and trying again when you don’t really understand the system can be frustrating and may result in you missing out on some valuable information. If you start to feel a little unsure of yourself, take a few minutes to check out the PTNow Video Tutorial and FAQ page. Have a more specific question? You can even access an actual PTNow librarian at ArticleSearch@apta.org.
If, like me, you sometimes wrestle with technology, you’ll understand this mixed bag I feel when I’m faced with something outside my technological comfort zone: I know technology can make my professional life easier, but I worry that the technology itself won’t be easy. I was happily mistaken with ArticleSearch. It was so easy!
How easy? Let me put it this way—I have a lot of reading to do.
Stephanie Miller is a staff development specialist with Celtic Healthcare.
[ARTICLE] Using Xbox kinect motion capture technology to improve clinical rehabilitation outcomes for balance and cardiovascular health in an individual with chronic TBI – Full Text
Motion capture virtual reality-based rehabilitation has become more common. However, therapists face challenges to the implementation of virtual reality (VR) in clinical settings. Use of motion capture technology such as the Xbox Kinect may provide a useful rehabilitation tool for the treatment of postural instability and cardiovascular deconditioning in individuals with chronic severe traumatic brain injury (TBI). The primary purpose of this study was to evaluate the effects of a Kinect-based VR intervention using commercially available motion capture games on balance outcomes for an individual with chronic TBI. The secondary purpose was to assess the feasibility of this intervention for eliciting cardiovascular adaptations.
A single system experimental design (n = 1) was utilized, which included baseline, intervention, and retention phases. Repeated measures were used to evaluate the effects of an 8-week supervised exercise intervention using two Xbox One Kinect games. Balance was characterized using the dynamic gait index (DGI), functional reach test (FRT), and Limits of Stability (LOS) test on the NeuroCom Balance Master. The LOS assesses end-point excursion (EPE), maximal excursion (MXE), and directional control (DCL) during weight-shifting tasks. Cardiovascular and activity measures were characterized by heart rate at the end of exercise (HRe), total gameplay time (TAT), and time spent in a therapeutic heart rate (TTR) during the Kinect intervention. Chi-square and ANOVA testing were used to analyze the data.
Dynamic balance, characterized by the DGI, increased during the intervention phase χ 2 (1, N = 12) = 12, p = .001. Static balance, characterized by the FRT showed no significant changes. The EPE increased during the intervention phase in the backward direction χ 2 (1, N = 12) = 5.6, p = .02, and notable improvements of DCL were demonstrated in all directions. HRe (F (2,174) = 29.65, p = < .001) and time in a TTR (F (2, 12) = 4.19, p = .04) decreased over the course of the intervention phase.
Use of a supervised Kinect-based program that incorporated commercial games improved dynamic balance for an individual post severe TBI. Additionally, moderate cardiovascular activity was achieved through motion capture gaming. Further studies appear warranted to determine the potential therapeutic utility of commercial VR games in this patient population.
Clinicaltrial.gov ID – NCT02889289
The last two decades demonstrated an exponential trend in the implementation of virtual reality (VR) in clinical settings . Researchers and clinicians alike are enticed by the potential of this technology to enhance neuroplasticity secondary to rehabilitation interventions. Currently, Nintendo Wii, Sony PlayStation, and Microsoft Xbox offer commercially developed semi-immersive VR platforms which are used for rehabilitation . Several studies report positive effects of these commercial technologies for improving balance, coordination and strength [3, 4, 5]. In 2010, Microsoft introduced a novel infrared camera that works on the Xbox platform called Kinect. The Kinect camera replaces hand held remote controls through the use of whole body motion capture technology.
Whole body motion capture VR allows a unique opportunity for individuals to experience a heightened sense of realism during task-specific therapeutic activities. However, clinicians need to be able to match a game’s components to an individual’s functional deficits. Seamon et al.  provided a clinical demonstration of how the Kinect platform can be used with Gentiles taxonomy for progressively challenging postural stability and influencing motor learning in a patient with progressive supranuclear palsy. Similarly, Levac et al.  developed a clinical framework titled, “Kinecting with Clinicians” (KWiC) to broadly address implementation barriers. The KWiC resource describes mini-games from Kinect Adventures on the Xbox 360 in order to provide a comprehensive document for clinicians to reference. Clinicians can use KWiC to base game selection and play on their client’s goals and the therapist’s plan of care for that individual.
In parallel with knowledge translation research, several studies found postural control improvements in multiple diagnostic groups including individuals with chronic stroke [8, 9, 10], Friedrich’s Ataxia , multiple sclerosis , Parkinson’s disease , and mild to moderate traumatic brain injury (TBI)  when using Kinect based rehabilitation. Additional research shows that exercising with the Kinect system can reach an appropriate intensity for cardiovascular adaptation. For example, Neves et al.  and Salonini et al.  reported increases in exercise heart rate and blood pressure in healthy individuals and children with cystic fibrosis while playing Kinect games. Similarly, Kafri et al.  reported the ability of individuals post-stroke to reach levels of light to moderate intensity using Kinect games.
Individuals with TBI are likely to have a peak aerobic capacity 65–74% to that of healthy control subjects . There is limited research on cardiovascular training after severe TBI . However, Bateman et al.  demonstrated that individuals with severe TBI can improve cardiovascular fitness during a 12-week program participants exercised at an intensity equal to 60–80% of their maximum heart rate 3 days per week. Commercial Xbox Kinect games, such as Just Dance 3, have been shown to improve cardiovascular outcomes for individuals with chronic stroke . However, there is a lack of research investigating the efficacy of motion capture VR on cardiovascular health for individuals with chronic severe TBI. Walker et al.  makes the recommendation for rehabilitation programs to go beyond independence in basic mobility and to develop treatment strategies to address high-level physical activities. The high rates of sedentary behavior in individuals across all severities of TBI could be attributed the lack of addressing these limitations in activity.
Postural instability is the second most frequent, self-reported limitation, 5 years post injury for individuals with severe TBI . It is unknown whether use of motion capture VR in individuals with severe, chronic TBI can address neuromotor impairments related to high-level activities such as maintaining postural control during walking. Similarly, there is a need to determine if training with VR motion capture can attain necessary intensity levels for inducing cardiovascular adaptation. Due to this knowledge gap and heterogencity of individuals post TBI, feasibility of investigatory interventions should be explored prior to examining effectiveness with randomized control trials. Single system experimental design (SSED) provides a higher level of rigor compared to case studies based on the ability to compare outcomes across phase conditions with the participant acting as their own control. The value of SSED within rehabilitation has been noted by other investigators [23, 24] making it an attractive design for practitioners aiming to gain insight into novel clinical interventions prior to large scale clinical trials. The purpose of this proof of concept and feasibility study was to evaluate the effectiveness of commercially available Xbox One Kinect games as a treatment modality for the rehabilitation of balance and cardiovascular fitness for a veteran with chronic severe TBI. Additionally, we provide herein a description of the Kinect games to assist providers with clinical implementation. […]
Continue —> Using Xbox kinect motion capture technology to improve clinical rehabilitation outcomes for balance and cardiovascular health in an individual with chronic TBI | Archives of Physiotherapy | Full Text
[ARTICLE] A neurocognitive approach for recovering upper extremity movement following subacute stroke: a randomized controlled pilot study – Full Text PDF
[Purpose] This study aims to describe a protocol based on neurocognitive therapeutic exercises and determine its feasibility and usefulness for upper extremity functionality when compared with a conventional protocol.
[Subjects and Methods] Eight subacute stroke patients were randomly assigned to a conventional (control group) or neurocognitive (experimental group) treatment protocol. Both lasted 30 minutes, 3 times a week for 10 weeks and assessments were blinded. Outcome measures included: Motor Evaluation Scale for Upper Extremity in Stroke Patients, Motricity Index, Revised Nottingham Sensory Assessment and Kinesthetic and Visual Imagery Questionnaire. Descriptive measures and nonparametric statistical tests were used for analysis.
[Results] The results indicate a more favorable clinical progression in the neurocognitive group regarding upper extremity functional capacity with achievement of the minimal detectable change. The functionality results are related with improvements on muscle strength and sensory discrimination (tactile and kinesthetic).
[Conclusion] Despite not showing significant group differences between pre and post-treatment, the neurocognitive approach could be a safe and useful strategy for recovering upper extremity movement following stroke, especially regarding affected hands, with better and longer lasting results. Although this work shows this protocol’s feasibility with the panel of scales proposed, larger studies are required to demonstrate its effectiveness.
[ARTICLE] The Efficacy of State of the Art Overground Gait Rehabilitation Robotics: A Bird’s Eye View – Full Text
To date, rehabilitation robotics has come a long way effectively aiding the rehabilitation process of the patients suffering from paraplegia or hemiplegia due to spinal cord injury (SCI) or stroke respectively, through partial or even full functional recovery of the affected limb. The increased therapeutic outcome primarily results from a combination of increased patient independence and as well as reduced physical burden on the therapist. Especially for the case of gait rehabilitation following SCI or stroke, the rehab robots have the potential to significantly increase the independence of the patient during the rehabilitation process without the patient’s safety being compromised. An intensive gait-oriented rehabilitation therapy is often effective irrespective of the type of rehabilitation paradigm. However, eventually overground gait training, in comparison with body-weight supported treadmill training (BWSTT), has the potential of higher therapeutic outcome due its associated biomechanics being very close to that of the natural gait. Recognizing the apparent superiority of the overground gait training paradigms, a through literature survey on all the major overground robotic gait rehabilitation approaches was carried out and is presented in this paper. The survey includes an in-depth comparative study amongst these robotic approaches in terms of gait rehabilitation efficacy.
The implementation of computer games in physical therapy is motivated by characteristics such as attractiveness, motivation, and engagement, but these do not guarantee the intended therapeutic effect of the interventions. Yet, these characteristics are important variables in physical therapy interventions because they involve reward-related dopaminergic systems in the brain that are known to facilitate learning through long-term potentiation of neural connections. In this perspective we propose a way to apply game design approaches to therapy development by “designing” therapy sessions in such a way as to trigger physical and cognitive behavioral patterns required for treatment and neurological recovery. We also advocate that improving game knowledge among therapists and improving communication between therapists and game designers may lead to a novel avenue in designing applied games with specific therapeutic input, thereby making gamification in therapy a realistic and promising future that may optimize clinical practice.
Physical Therapy Clinical Handbook For Ptas, Third Edition Is A Concise Clinical Guide Designed Specifically To Help Physical Therapist Assistant Students And Practitioners Easily Obtain Helpful Evidence-Based Information. This Succinct Handbook Covers The Evaluative As Well As The Interventional Aspect Of Physical Therapy And Offers Immediate Guidance Concerning Physical Therapy Data Collection And Interventions, Including Musculoskeletal, Neurologic, Cardiopulmonary, Integumentary, Geriatric, Pediatric, And Acute Care Interventions.
This Third Edition Reflects Updates Featured In The APTA’S Guide To Physical Therapist Practice 3.0, As Well As Contemporary Documentation Requirements And Best Practices. With Its User-Friendly Format That Includes Tabbed Sections For Easy Referencing And The Inclusion Of Clinical Pearls For The PTA, This Handbook Is A Valuable Resource For PTA Practitioners And Students Alike. KEY UPDATES: Expand Information On HIPAA And Bloodborne Pathogens Updated Infection Control Section New Information On Elder And Child Abuse Expanded Information About Documentation Inclusion Of EMR Inclusion Of Common Medication Wider Range Of Musculoskeletal Pathologies Wider Range Of Neurologic Interventions Expanded Section On Geriatric Disorders/Diseases Applicable Courses: Clinical Practicum Clinical Education Clinical Experience.
[ARTICLE] A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training – Full Text
Although motor learning theory has led to evidence-based practices, few trials have revealed the superiority of one theory-based therapy over another after stroke. Nor have improvements in skills been as clinically robust as one might hope. We review some possible explanations, then potential technology-enabled solutions.
Over the Internet, the type, quantity, and quality of practice and exercise in the home and community can be monitored remotely and feedback provided to optimize training frequency, intensity, and progression at home. A theory-driven foundation of synergistic interventions for walking, reaching and grasping, strengthening, and fitness could be provided by a bundle of home-based Rehabilitation Internet-of-Things (RIoT) devices.
A RIoT might include wearable, activity-recognition sensors and instrumented rehabilitation devices with radio transmission to a smartphone or tablet to continuously measure repetitions, speed, accuracy, forces, and temporal spatial features of movement. Using telerehabilitation resources, a therapist would interpret the data and provide behavioral training for self-management via goal setting and instruction to increase compliance and long-term carryover.
On top of this user-friendly, safe, and conceptually sound foundation to support more opportunity for practice, experimental interventions could be tested or additions and replacements made, perhaps drawing from virtual reality and gaming programs or robots. RIoT devices continuously measure the actual amount of quality practice; improvements and plateaus over time in strength, fitness, and skills; and activity and participation in home and community settings. Investigators may gain more control over some of the confounders of their trials and patients will have access to inexpensive therapies.
Neurologic rehabilitation has been testing a motor learning theory for the past quarter century that may be wearing thin in terms of leading to more robust evidence-based practices. The theory has become a mantra for the field that goes like this. Repetitive practice of increasingly challenging task-related activities assisted by a therapist in an adequate dose will lead to gains in motor skills, mostly restricted to what was trained, via mechanisms of activity-dependent induction of molecular, cellular, synaptic, and structural plasticity within spared neural ensembles and networks.
This theory has led to a range of evidence-based therapies, as well as to caricatures of the mantra (eg, a therapist says to patient, “Do those plasticity reps!”). A mantra can become too automatic, no longer apt to be reexamined as a testable theory. A recent Cochrane review of upper extremity stroke rehabilitation found “adequately powered, high-quality randomized clinical trials (RCTs) that confirmed the benefit of constraint-induced therapy paradigms, mental practice, mirror therapy, virtual reality paradigms, and a high dose of repetitive task practice.”1 The review also found positive RCT evidence for other practice protocols. However, they concluded, no one strategy was clearly better than another to improve functional use of the arm and hand. The ICARE trial2 for the upper extremity after stroke found that both a state-of-the-art Accelerated Skill Acquisition Program (motor learning plus motivational and psychological support strategy) compared to motor learning-based occupational therapy for 30 hours over 10 weeks led to a 70% increase in speed on the Wolf Motor Function Test, but so did usual care that averaged only 11 hours of formal but uncharacterized therapy. In this well-designed RCT, the investigators found no apparent effect of either the dose or content of therapy. Did dose and content really differ enough to reveal more than equivalence, or is the motor-learning mantra in need of repair?
Walking trials after stroke and spinal cord injury,3–8 such as robot-assisted stepping and body weight-supported treadmill training (BWSTT), were conceived as adhering to the task-oriented practice mantra. But they too have not improved outcomes more than conventional over-ground physical therapy. Indeed, the absolute gains in primary outcomes for moderate to severely impaired hemiplegic participants after BWSTT and other therapies have been in the range of only 0.12 to 0.22 m/s for fastest walking speed and 50 to 75 m for 6-minute walking distance after 12 to 36 training sessions over 4 to 12 weeks.3,9 These 15% to 25% increases are just as disappointing when comparing gains in those who start out at a speed of <0.4 m/s compared to >0.4 to 0.8 m/s.3
Has mantra-oriented training reached an unanticipated plateau due to inherent limitations? Clearly, if not enough residual sensorimotor neural substrate is available for training-induced adaptation or for behavioral compensation, more training may only fail. Perhaps, however, investigators need to reconsider the theoretical basis for the mantra, that is, whether they have been offering all of the necessary components of task-related practice, such as enough progressively difficult practice goals, the best context and environment for training, the behavioral training that motivates compliance and carryover of practice beyond the sessions of formal training, and blending in other physical activities such as strengthening and fitness exercise that also augment practice-related neural plasticity? These questions point to new directions for research….
Components of a Rehabilitation-Internet-of-Things: wireless chargers for sensors (1), ankle accelerometers with gyroscopes (2) and Android phone (3) to monitor walking and cycling, and a force sensor (4) in line with a stretch band (5) to monitor resistance exercises.
Any tool that can help people be more active and involved in their own rehabilitation is worthwhile. An increase in patient compliance can be achieved by making exercise programs easier to adhere to. Clear descriptions of how to perform exercises correctly is also critical to the success of any exercise program. Here is a list of software applications that allow physical therapists to create specific exercise programs for their patients. The list is not complete. If you know of a product that should be included or if you’d like to have your exercise prescription software reviewed, please let us know.
By Udrekeli [Public domain], via Wikimedia Commons
Arena Health Systems: Creators of Phys-X software
“Phys-X Advanced includes over 900 of the most often prescribed range of motion, stabilization and strengthening exercises (categories listed below) and includes Full Color Photographs for most exercises! Each exercise includes an illustration and specific easy to follow instructions that allow on-the-fly modification. The exercises can even be printed with Spanish instructions.”
BPM Rx: Exercise prescription for health and fitness professionals
“Whether you’re a personal trainer or physical therapist, exercise prescription is your life. BPM Rx is the ultimate PT Software that allows you to craft stunning exercise handouts that will inspire like never before! Try it out-the first week is free!”
BioEx Systems Inc.: Easy to use home exercise database
“Exercise, Fitness Assessment, Nutrition and Management software for Physical Therapists, Personal Trainers, Dietitians, Nutritionists and other professionals. Windows based software.”
Exercise Prescriber: Provide home exercises and information advice
“…an essential clinical tool for health professionals who routinely provide home exercises and information advice for their clients.”
Exercise Pro Live : Personalized Video and Printed Exercise Programs for Rehabilitation and Fitness
“…designed by physical therapists and other fitness professionals to provide video exercise programs with clear exercise instructions, proper exercise form and improved compliance and communication between health professionals and their clients.”
HEP2go.com: HEP for rehab pro’s
“For rehabilitation professionals such as physical therapists, occupational therapists, athletic trainers, etc. to create home exercise programs for patients and or clients.”
“Innovative Video + Web-based Platform = Better HEP Management & Better Patient Education
Mavenlive: Intelligent exercise prescription, customizable images, and documentation (free-trial available)
“Using Mavenlive will benefit you not only from a clinical standpoint, but it will help you improve relationships with your patients and your referral sources. Mavenlive clients tell us that physicians love getting professional correspondence. “
myclinicspace: High quality image and video exercises for patient rehabilitation
“myclinicspace is an online exercise prescription package for health professionals.”
MyPhysioRehab: A global community of therapists helping to speed your recovery (free-demo available)
“MyPhysioRehab allows you as a health professional to provide your patients with an injury profile and a rehabilitation programme to aid rapid recovery.”
PacPacs+: Online Rehabilitation Exercise and Client Management
“Manage your patient aftercare. Prescribe rehabilitation routines with multi-angle videos. Track consultation history and make notes for future sessions.”
Patient Care HEP: MedBridge
“Patient Care HEP is the fast, easy, comprehensive, and engaging home exercise program for rehabilitation professionals.”
Physiotec: Exercise and patient education database software
“Physiotec offers a health and fitness software with exercise programs for physiotherapy, rehabilitation and therapeutic exercises and distributes it across Canada, United-States (USA) and United-Kingdoms.”
PTX – PhysioTherapy eXercises: Create custom programs or choose ready made programs
“A free tool to create exercise programs for people with injuries and disabilities”
PhysioTools Software: Comprehensive and easy to use exercise software
“Exercise software for health and fitness professionals to print and email over 15,000 exercises for rehabilitation, physiotherapy, sports and education”
Physioview: Features professionally produced photographs, audio, video and text
“Physioview redefines the home exercise program from the fundamental to highly customized creation of rehabilitation exercise protocols. “
Physitrack: A mobile phone exclusively for practitioners
“Provides Physical Therapists with the ability to prescribe exercises, send messages to their patients”
The Rehab Lab: Online Exercise Prescription Software
“The Rehab Lab is an online exercise prescription software application that enables physiotherapists to create customised rehabilitation programmes for clients and patients.”
Simple Therapy: video exercise therapy that matches your needs, when and where you want it
“SimpleTherapy® offers more than 20 video-based exercise therapy programs designed by doctors.”
SimpleSet Pro: Advanced Exercise Prescription Software
“SimpleSet Pro is the ultimate online tool for professional exercise program design. With SimpleSet Pro you can create comprehensive exercise programs for your clients, and email or print them in minutes!”
SHAPES: Spatially and Human Aware Performance Evaluation System.
“SHAPES is an interactive, assistive technology (using the Microsoft Xbox Kinect) that enhances exercise routines.”
TheraVid: Connect. Discover. Recover.
“Use our expanding database of HD exercise videos and unique online interface to build better client relationships today. Free while in beta.”
WebExercises: Exercise Prescription Made Easy™
“WebExercises® will promote more frequent and proper form of all prescribed rehabilitation and corrective exercises – resulting in improved recovery and stronger happier patients and clients.”
wellpepper: gives your health a kick
“Wellpepper for iPad and iPhone enables healthcare professionals to prescribe physical therapy exercises and encourages people to complete exercises at home to help speed recovery”
When Physical Therapists document the progress of a patient, it’s common for abbreviations to be made within the notes. Rules vary depending on your facility, but it’s common to use physical therapy abbreviations such as NWB (non weight bearing) or AD (assistive device).
While the APTA does not endorse a standard set of physical therapy abbreviations (maybe it should…) you can find plenty of resources that share common words that are shortened by PTs. This list is not all inclusive or a ‘standard’ but it gives you an idea of what is commonly being used.
For student PT’s who are just starting in the clinic, it’s great to review this list in case you run into some language in the documentation that you’re not familiar seeing.
Common Physical Therapy Abbreviations
AAROM Active Assistive Range of Motion
AD assistive device
Amb. ambulate, ambulated
ACL anterior cruciate ligament
ADL’s activities of daily living
AFO ankle foot orthosis
AKA above knee amputee
ALS Amyotrophic Lateral Sclerosis
AROM active range of motion
As tol As tolerated
A/P Anterior Posterior
BAPS Biomechanical Ankle Platform System
bed mob. bed mobility
BKA below knee amputation
BID Twice a day
BIW bi-weekly, twice weekly
BOS Base of support
BP Blood pressure
bpm Beats per minute
CC Chief Complaint
CF Cystic Fibrosis
CGA Contact Guard Assist
CHF Congestive Heart Failure
CHI closed head injury
COTA certifi ed occupational therapy assistant
COPD Chronic Obstructive Pulmonary Disease
C/o Complains of
COG Center of gravity
CP coldpack, cerebral palsy
CPM Continuous passive motion
C/S cervical spine
CVA Cerebral Vascular Accident
CVD Cardio-Vascular Disease
CRPS Complex Regional Pain Syndrome
CP Cerebral Palsy
CTS Carpal Tunnel Syndrome
Cx. cancel, cancellation
dep., D dependent
DC discharge, discontinue
DDD Degenerative Disc Disease
DIP Distal Interphalangeal Joint
DJD Degenerative Joint Disease
DM Diabetes Mellitus
DMD Duchenne Muscular Dystrophy
DME durable medical equipment
DOB Date of birth
DOI Date of injury
DOS Date of surgery
DVT Deep Vein Thrombosis
Eval. evaluation eversion
ER Emergency Room
E-stim Electrical Stimulation
EOB Edge of bed
Ext. rot., ER external rotation
F, 3/5 fair (in reference to manual muscle testing)
FES Functional Electrical Stimulation
FCR Flexor Carpi Radialis
FCU Flexor Carpi Ulnaris
F/u Follow up
FWW Front wheeled walker
FWB full weight bearing
Gt. Trng. gait training
G, 4/5 good (in reference to manual muscle testing)
GMT gross muscle test
Hemi. hemiplegia, hemiparesis
HEP home exercise program
HHA home health aide
HKAFO hip knee ankle foot orthosis
HOB Head of bed
HP hot pack
HNP Herniated Nucleus Pulposus
HVGS high voltage galvanic stimulation
H/o History of
I , Indep independent
IDDM insuline dependent diabetes mellitus
IE initial evaluation
IFC interferential current
IMS intramuscular stimulation
Int. rot., IR internal rotation
ITB Ilio-tibial Band
KAFO Knee ankle foot orthosis
L , L, Lt. left
LAQ long arc quad (exercise.)
Lats Latissimus Dorsi
LBP low back pain
LB lower body
LBQC large base quad cane
LCL Lateral Collateral Ligament
LE lower extremity
LQ lower quadrant
LTG long term goal
L/S Lumbar Spine
MCL Medial Collateral Ligament
MCP Metacarpophalangeal Joint
MDL moderately limited
MENS microcurrent electrical nerve stimulator
MFR myofacial release
MI Myocardial Infarction
M/L Medial Lateral
MFR Myofascial Release
MHP Moist Hot Pack
MKL markedly limited
MMT manual muscle test
MNL minimally limited
MS Multiple Sclerosis
MSW medical social worker
MTP Metatarsophalangeal Joint
MVA Motor Vehicle Accident
N, .5/5 normal (re: muscle strength)
NAGS Natural Apophyseal Glides
NBQC Narrow Based Quad Cane
NCV nerve conduction velocity
NIDDM non-insulin dependent diabetes mellitus
N/T numbness and tingling or not tested
NF No Fault
NMR Neuromuscular re-education
NWB non-weight bearing
NS No Show
OOB Out of bed
OT occupational therapy/therapist
OTR registered occupational therapist
PD Parkinson’s Disease
P, 2/5 poor (re: muscle strength)
Pec Pectoral / Pectoralis
PCL Posterior Cruciate Ligament
PIP Proximal Interphalangeal Jt
PF plantar fl exion
PMH past medical history
PNF Proprioceptive Neuromuscular Facilitation
POC plan of care
P/A Posterior Anterior
PRE progressive resistive exercises
PRN As needed
PT physical therapy/therapist
PTA physical therapist assistant
P/u Push up
PVD Peripheral Vascular Disease
PWB partial weight bearing
QS Quadriceps Set
RA Rheumatoid Arthritis
R , R, rt right
RGO reciprocating gait orthosis
ROM Range of Motion
r/o Rule out
RSD Reflex Sympathetic Dystrophy
RTC Rotator Cuff
RTW Return to work
RW Rolling Walker
SAQ short arc quad (exercise)
SBA standby assist
SBQC small base quad cane
SCI spinal cord injury
SI, SIJ sacroiliac joint
SLP speech-language pathologist
SLR Straight Leg Raise
SNAGS Sustained Natural Apophyseal Glides
SOB Shortness of Breath
S/p Status post
SPC Single point cane
SPT student P.T.
SPTA student P.T.A.
ST speech therapy
STG short term goals
STM Soft Tissue Mobilization
Sup Supination or Superior
SW Standard Walker
T, 1/5 trace (re: muscle strength)
TA Therapeutic Activities
TBI Traumatic Brain Injury
TENS transcutaneous electrical nerve stimulator
THA total hip arthroplasty
THR total hip replacement
TIW three times per week
THA Total Hip Arthroplasty
THR Total Hip Replacement
Ther Ex Therapeutic Exercise
TIA Transient Ischemic Attack
TKA total knee arthroplasty
TKR total knee replacement
TLSO Thoracolumbosacal orthotic
TMJ Temporomandibular Joint
TTWB Toe Touch Weight Bearing
T/S Thoracic Spine
UB upper body
UBE Upper Body Ergometer
UE upper extremity
UQ upper quadrant
VC verbal cues
VIC Verbalized informed consent
W/cm2 watts per centimeter squared
WB weight bearing
WBQC Wide based quad cane
WBAT weight bearing as tolerated
WFL within functional limits
WNL within normal limits
y/o Years old
// Bars Parallel Bars
4WW Four wheeled walker
(3 dots in a triangle) therefore
Z, 0/5 zero (re: muscle strength)
< Less Than
1:1 One to one
‘ Foot or Feet
↑ Up, increased
↓ Down, decreased
↔ To and from
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The saying goes that “your left hand doesn’t know what your right hand is doing,” but actually, your left hand is paying more attention than you’d think. Researchers at Tel-Aviv University found that when people practiced finger movements with their right hand while watching their left hand on 3D virtual reality headsets, they could use their left hand more efficiently after the exercise. The work, appearing in Cell Reports, provides a new strategy to improve physical therapy for people with limited strength in their hands.
“We are tricking the brain,” says lead author Roy Mukamel, a professor of psychology at Tel Aviv University in Israel. “This entire experiment ended up being a nice demonstration about how to combine software engineering and neuroscience.”
After completing baseline tests to assess the initial motor skills of each hand, 53 participants strapped on virtual reality headsets, which showed simulated versions of their hands. During the first experiment, the participants completed a series of finger movements with their right hand while the screen showed their virtual left hand moving instead. Next, the participants put a motorized glove on their left hand, which moved their fingers to match the motions of the right hand. While this occurred, the headsets again showed their virtual left hand moving instead of their right.
After analyzing the results, the researchers discovered that the left hand’s performance significantly improved (i.e., had more precise movements in a faster amount of time) when the screen showed the left hand. But the most notable improvements occurred when the virtual reality screen showed the left hand moving while the motorized glove moved the right hand in reality.
The researchers also used fMRI to track which brain structures were activated during the experiments in 18 of the participants. The scientists noted that one section of the brain, called the superior parietal lobe, was activated in each person during training. They also discovered that the level of activity in this brain region was correlated to the level of improved performance in the left hand–the more activity, the better the left hand performed.
“Technologically these experiments were a big challenge,” says Mukamel. “We manipulated what people see and combined it with the passive movement of the hand to show that our hands can learn when they’re not moving under voluntary control.”
The researchers are optimistic that this research can be applied to patients in physical therapy programs who have lost the strength or control of their hands. “We need to show a way to obtain high-performance gains relative to other traditional types of therapies,” says Mukamel. “If we can train one hand without voluntarily moving it and still show significant improvements in the motor skills of that hand, then that’s the ideal.”
This work was supported through the Sagol School of Neuroscience and School of Psychological Sciences at Tel-Aviv University in Israel.
Article: Neural Network Underlying Intermanual Skill Transfer in Humans, Ossmy and Mukamel, Cell Reports, 10.1016/j.celrep.2016.11.009, published 13 December 2016.