PTA SIG Roundtable at Fall Conference and November Video Conference to Feature Discussions on New RCs Adopted at House of Delegates

During APTA’s House of Delegates in June, two RCs passed that affect PTAs. RC 14 allows a PTA to directly supervise a PTA student and RC 3 opens the door for PTs to dictate physical therapy care to health care practitioners other than PTAs. There is still much to be decided regarding the details of RC 3, so keep your ears open. The PTWA PTA SIG has scheduled two meetings to discuss the details of these decisions. The first will take place at PTWA Fall Conference at the Greater Tacoma Convention & Trade Center during the SIG Roundtable Discussions on Saturday, October 29 from 7:30 to 8:30 a.m. Breakfast is included for conference registrants and may be purchased on site for non-registrants. The second will be another statewide video conference on November 2, 2011. Future announcements will be made but both meetings will require PTA SIG membership, which costs $10 for APTA members, $20 for nonmembers.

Lisa McCann, PTA
PTWA PTA Student Liaison to the Board of Directors

Contact sigs@ptwa.org if you have any questions.

Gersh Presents Poster at World Congress

PTWA Eastern Washington At-Large Director Meryl Gersh, PT, PhD, presented her special-interest poster, “Patient Empowerment Through Collaborative Education: Implementing Public Education Programs Concurrently with Professional Conferences,” at the World Confederation of Physical Therapy’s annual congress, World Physical Therapy 2011, in June in Amsterdam, Netherlands. The poster described the origination, organization and implementation of the consumer education programs offered by PTWA at spring conferences and last year by APTA at its national conference. The research topic came out of Gersh’s doctoral work and dissertation, the topic of which was professionalism in physical therapy from the patients’ perspective.

At the congress, Gersh was involved in a new poster discussion format. This format brought together six speakers and a panel leader. Each speaker briefly presented the highlights of their poster. Participants were given time to visit each of the speakers at their posters, then reconvene as a group to ask questions of the panelists.

Following the poster-discussion session a member of the WCPT executive board told Gersh that she liked the concept of consumer education concurrent with a professional meeting and that she planned to bring the idea forward to the conference committee planning WCPT 2015 inSingapore. “If they adopt it, I hope to assist with the organization of such an activity at the next WCPT meeting,” Gersh said. In an email, Gersh added, “It’s going viral!”

University of Puget Sound Researchers Garner International Award

Researchers from the University of Puget Sound received an award for outstanding research presentation from the International Acupuncture Association of Physical Therapists (IAAPT) given at World Physical Therapy 2011 held inAmsterdam,Netherlands, June 20-23. From among the 1,800 studies presented at this international meeting, 28 received awards for excellence in categories of global geographic region, research special interest and clinical area. Three studies from theUnited Statesreceived research awards. Judging was based on a combined assessment of abstract and presentation quality.

The study, “Relationship of body awareness to the influence of respiratory-based therapeutic relaxation on electromyographic activity of the upper trapezius,” was presented by Roger Allen, PT, PhD, professor in the physical therapy and neuroscience programs at UPS. It was conducted in collaboration with UPS DPT students Kelsey Wallin, DPT, Tonya Bennett, DPT, Brittany Hodgeson, SPT, and Ali Heartman, an undergraduate intern from the UPS neuroscience program.

The research project began as an investigation into the potential efficacy of respiratory-based relaxation maneuvers to decrease maladaptive neurogenic hypertonicity.

Early results were disappointing. Therapeutic relaxation exercises that have been promoted in the literature for a long time, were not demonstrating an ability to attenuate muscle activity under controlled conditions. The initial study, undertaken by Allen, Wallin, Bennett and Hodgeson, found no significant effects of the relaxation techniques on muscle tone.

As part of her internship in the new neuroscience program at UPS, Heartman worked with the research group as an assistant while also studying psychometric instruments for assessing an individual’s level of body awareness. This coincidental convergence of interest uncovered an unexpected finding. Based on Heartman’s interest in body awareness, participants in the study filled out Cynthia Price’s Scale of Body Connection. Participants’ electromyographic responses to the relaxation techniques were then re-evaluated taking their measured level of body awareness into account. This revealed that individuals with relatively high body awareness scores derived significant muscle tone reduction from the relaxation training compared to controls, whereas participants with low body awareness experience little or no muscle tone differences.

The findings suggest that an individual’s body awareness may be a predictive factor in his or her response to some physical therapy interventions. It will be interesting in the future to see if body awareness influences other types of PT treatment responses, or if an individual’s body awareness may be enhanced to maximize the effectiveness of other interventions aimed at physical restoration.

At last year’s PTWA Fall Conference in Tacoma; Wallin, Bennett and Hodgeson presented the initial study as a poster and Heartman presented a poster on the potential physical therapy applications of assessing body awareness, both under Allen’s direction. The study presented at World PT 2011 brought these two bodies of work together for the first time.

This represents a new and exciting direction for collaboration at UPS. Collaborations between UPS physical therapy faculty and DPT students have produced a great deal of meaningful research over the past decade. Now in its fourth year, the neuroscience undergraduate offering is an interdisciplinary blend of faculty from biology, psychology, exercise science, mathematics and philosophy, with the occupational and physical therapy students and faculty.. A physical icon of this interdisciplinary cooperation is the new Weyerhaeuser Center for Health Sciences building. Beginning fall 2011 this new facility will be the home of the UPS physical therapy, occupational therapy and neuroscience programs, along with the biology and psychology departments. The study linking body awareness to treatment responses impacting muscle activity is one of the first to formally draw entities of the neuroscience program together. It has taken the work of a group of DPT students and an undergraduate neuroscience intern all the way to presentation at the World Physical Therapy Congress and an international research award.

In addition to this study, Allen presented “Pain distribution quantification using enhanced ‘rule-of-nines’: reliability and correlations with intensity, sensory, affective, and functional pain measures,” conducted with second-year DPT students Willa Sorbie, Kristina Fugere, Chris Soterakopoulos, Ariel Oksendahl, and UPS assistant professor of physical therapy Dr. Julia Looper, PT, MSPT, PhD.

Roger Allen, PT, PhD
Professor, University ofPuget Sound

APTA Oncology Section Offers Course on Breast Cancer

The APTA Oncology Section will host “Breast Cancer Rehabilitation,” presented by Barbara E. Nicholson, PT, MSPT, CLT-LANA, October 1-2, 2011 at Kadlec Medical Center, Richland, Wash. The course is open to PTs, PTAs, OTs and OTAs who are interested in working with patients who have breast cancer or are already working with this population because of shoulder dysfunction.

Attendees will receive 1.6 CEUs, 16 contact hours, for attendance. Registration closes Sept. 9, 2011 and costs $475 for section members, $525 for other APTA members and $600 for nonmembers.

Here are some thoughts from Nicholson on how PTs can help improve the lives of breast cancer survivors.

Physical Therapists Help Improve the Lives of Breast Cancer Survivors

Barbara E. Nicholson, PT, MSPT, CLT-LANA

There are 2.6 million breast cancer survivors in the United States.[1] These courageous women are mothers, friends, sisters, wives, partners, daughters and grandmothers.  They will see surgeons, oncologists, radiation oncologists, nurses, social workers, integrative medicine physicians and physical therapists. The side effects of breast cancer treatment can create functional and physical impairments that can keep these women from doing activities that bring joy to their lives. It can be the mother who does not have the strength to lift her child, the athlete who wants to return to her sport or the woman who needs her arm strength to return to work. As PTs we can assist in decreasing the side effects of cancer treatment that can lead to frozen shoulder, pain, upper extremity weakness and lymphedema.

Axillary web syndrome can occur one to eight weeks after the surgical removal of axillary lymph nodes for breast cancer staging.[2] This disorder is characterized by fibrous bands or cords that originate in the axilla and may extend to the wrist or palm. Cording is palpable when the shoulder is in 90 degrees of abduction. 2 These cords have been found to consist of sclerosed lymphatic vessels and veins. Women with axillary web syndrome will complain of pain or they may have difficulty lifting their hand above their head. Shoulder range of motion will be most limited in abduction. In physical therapy treatment we can educate them on the benign nature of this process, teach gentle shoulder and trunk exercise and perform myofascial release techniques to decrease cording. This treatment can help decrease painful guarding that may lead to frozen shoulder.

Six to twelve months after breast cancer surgery 50 percent of women report shoulder range of motion restrictions.[3] Breast reconstruction can also contribute to limited shoulder range of motion. Expanders or implants placed under the pectoralis muscle can cause an anterior pull of the scapula, changing the scapulo-humeral rhythm and creating impingement.

Radiation treatment can cause fibrosis in the pectoral muscles increasing tension over the expander or implant. These physical changes can be reduced with rotator cuff and postural muscle strengthening, stretching, joint mobilization and myofascial release techniques.

Breast cancer related lymphedema may occur after the removal of axillary lymph nodes. The reported incidence of this lymphedema ranges from 7 to 47 percent.[4]   Risk factors depend on the number of axillary lymph nodes removed, radiation treatment, infection and body mass index. Lymphedema may affect the upper extremity, trunk and breast. It can cause achiness, decreased shoulder motion, weakness, difficulty wearing clothes and self-esteem issues. Recent research is beginning to show that early treatment of lymphedema can decrease the progression of this chronic condition and allow the patient improved function and mobility.4

Working with women with breast cancer is an extremely rewarding experience for both the practitioner and the patient. Physical therapy plays an important role in improving the quality of lives of women who are healing from breast cancer. Our techniques greatly improve shoulder range of motion, strength, tissue mobility and decrease lymphedema, allowing patients to gain trust in their ability to heal and strengthen their bodies again. If you are interested in learning more about working with breast cancer survivors, the Oncology Section of the American Physical Therapy Association is offering a course in Richland, Wash. October 1-2, 2011. For more information and to register please visit www.oncologypt.org.


[1] SEER Cancer Statistics Review Bethesda , MD: Nation Cancer Institue,  http://seer.cancer.gov/statfacts/html/breast.html#survival

[2] Moskovitz A, Anderson B, Yeung R, Byrd D, Lawton  T, Moe R.: Axillary web syndrome after axillary dissection. Amer J Surg 2001; 181: 434-439

3 Thomas- MacLean RL, Hack T, Kwan W, Towers A, Miedema B, Tilley A.: Arm Morbidity and Disability After Breast Cancer:  New Directions for Care.  Journal Club.  Oncology Nursing Forum 2008; VOL 35, No 1:65-71

4 Stout-Gergich N, Pfalzer L, McGarvey C, Springer B, Gerber L, Soballe  P: Preoperative Assesment Enables the Early Diagnosis and Successful Treatment of Lymphedema.  Cancer 2008; VOL 112, No 12.

Advocacy Opportunities for 5th District Constituents

We are still looking to gain Rep. Cathy McMorris Rodger’s cosponsorship on our national PT priority legislation. Here are two opportunities to put APTA’s legislation priorities in front of her in the next couple of weeks.

McMorris Rodgers will host a “Coffee with Cathy” public event at the Port of Walla Walla Conference Room, 310 A. St. Walla Walla Thursday, August 25. Local citizens will be able to speak directly with the Congresswoman and express their opinions on key issues affecting our community and our nation — including jobs, government spending, health care, energy, and national security.

McMorris Rodgers will also host a public town hall at Lincoln Center, 1316 N. Lincoln, Spokane August 31.

Position papers are available for download and print at apta.org/advocacy

Questions? Contact PTWA Federal Affairs Liaison Sharon McCallum sharonemc@comcast.net.

Advocacy Opportunity for 8th District Constituents

Congressman Dave Reichert invites constituents to Puyallup for a breakfast with special guest Senator John Boozman (R-AR) Saturday, August 27 at 8: 30 a.m. at the Elks Lodge314 27th Street Northeast, Puyallup. Cost is: $35 per person or $325 for a table.

 Consider attending this event. Bring along the position papers for our priority bills available to download and print at www.apta.org/advocacy. Approach the representative or staff before or after the event. Hand them the position papers and let them know you will be in touch!

The bills currently of concern to the physical therapy profession are:

HR 1546/S829 -The Medicare Access to Rehabilitation Services Act.
HR 1426/S 975 “The Physical Therapist – Student Loan Repayment Eligibility Act of 2011 HR 531 Access to Frontline Health Care Act.
HR 469-The Protecting Student Athletes from Concussions Act

To attend, Please R.S.V.P to Keith Schipper at 425-455-3283 or kschipper@davereichertforcongress.com.

Sharon McCallum, PT, DPT
PTWA Federal Affairs Liaison

Rep. Adam Smith Holding Town Hall Meeting Aug. 25

Rep. Adam Smith invites 9th District constituents to a budget town hall meeting Aug. 25 at 7 p.m. Consider attending this meeting. Bring along the position papers for our priority bills available to download and print at www.apta.org/advocacy. Approach the representative or staff before or after the meeting. Hand them the Position papers and let them know you will be in touch!

The bills currently of concern to the physical therapy profession are:

HR 1546/S829 -The Medicare Access to Rehabilitation Services Act.
HR 1426/S 975 “The Physical Therapist – Student Loan Repayment Eligibility Act of 2011 HR 531 Access to Frontline Health Care Act.
HR 469-The Protecting Student Athletes from Concussions Act

What: Town Hall discussion on the national budget, debt reduction, and economic recovery
When: 7 p.m., August 25th, 2011
Where: Burien City Council Chambers
400 SW 152nd St., in Burien Town Square
Council Chambers are on ground floor of City Hall/Library building.
Space is limited and attendees are encouraged to RSVP, please call 253-593-6600 or email rsvpsmith@mail.house.gov.

Sharon McCallum, PT, DPT
PTWA Federal Affairs Liaison

Invite Legislators for a Clinic Visits

You may have seen PTWA Lobbyist Melissa Johnson’s article in the June PTWA Connections about arranging a clinic visit with your legislators. Here are some additional thoughts from PTWA Legistlative Committee Chair Robin, Schoenfeld, PT, OMT:

While the legislative session is over, the PTWA Legislative Committee would like to keep activity going in the home districts. Hosting legislators in clinics and work settings is a great way to inform them of who PTs are and what we do. This year we are calling on manual therapists in particular to make these contacts, given the continued efforts to pass PTWA’s spinal manipulation legislation. Two years ago, I was happy to have Rep. Reuven Carlyle, of the 36th District, at the MTI Physical Therapy Clinic in Magnolia. It was great to have him see the clinic and talk to him about manual therapy.

Over the next few months we should take advantage of the chance to get to know our legislators away from their busy office settings by inviting them for clinic visits. This affords us the opportunity to really explain who we are as constituents and PTs. The Legislative Committee and PTWA Lobbyist Melissa Johnson can help make the appointments and prepare you for your clinic visit.

Please let us know if you already had these visits planned by emailing the Legislative Committee at legislative@ptwa.org.  Thank you for your commitment to the ongoing legislative efforts, including that of lifting the ban on spinal manipulation.

Robin Schoenfeld, PT, OMT

 

 

Overwhelming Outpouring of Support for Shoes4Kids at House of Delegates

Shoes4Kids, which provides new socks and athletic shoes to low-income children, collected more than 1,100 pairs of new shoes and 4,000 pairs of new socks that PTs and PTAs distributed to low-income children in the Washington, D.C. community in conjunction the APTA House of Delegates in June 2011. House officers spread the word about Shoes4Kids by promoting it on the HOD message boards and kept shoes on the stage and around the podium.

The 20-member Washington delegation contributed more than 20 pairs of shoes and socks to the cause, according to Cathleen Tarro, PTWA PTA caucus rep, who has organized Washington delegation participation for the last two years. “This project is wonderful because we are showing our caring and compassion through our actions,” Tarro said. “As all the PTs and PTAs descend upon all of these cities for conventions, what better way to make our presence known than by giving back to the community through our caring nature?”

Brad Thuringer, PTA, of the South Dakota chapter, started Shoes4Kids about six years ago because he saw an opportunity for PTs and PTAs gathering at APTA’s national events, like House of Delegates, to go out into the community and provide a service while promoting physical fitness and wellness. The first year, he collected 55 pairs of shoes. Last year, at 2010 House of Delegates, S4K distributed 1,000 pairs of shoes in Boston, Thuringer said. He was touched by the continued outpouring of support for the project at 2011 House of Delegates. “With the economy, I feel like I’m asking people to give when they can’t afford to give,” he said. “Seeing the overwhelming response made my heart feel quite full.”

Having a pair of shoes that fits is an ongoing thing when it comes to children, he said. His own experience as a father had him heading to the shoe store every three to six months for bigger shoes for his children. He also noted that children might not tell their parents if their shoes didn’t fit correctly or hurt their feet, especially if purchasing shoes would be a financial burden to the family. But ill-fitting shoes could deter them from physical activity.

“I felt like this was one way we could make sure that kids have a good-fitting pair of shoes on and to allow them to actually enjoy their young little lives,” Thuringer said.

If you are interested in participating in the program, you can send new shoes and new socks (please, no gently used items) or checks payable to Shoes4Kids to:

Brad Thuringer, PTA
Instructor, ACCE
Physical Therapist Assistant Program
Lake Area Technical Institute
230 11th St NE
PO Box 730
Watertown, SD 57201

Wanted: School-based PTs for Research Study

PTWA member Sally Westcott McCoy, PT, PhD, and her colleagues received a grant from the US Department of Education Institution for Educational Sciences for a multi-site observational study called “Relationship of Student Outcomes to School-Based Physical Therapy Services,” which began July 1, 2011.

“The purpose is twofold: one is to be able to describe what physical therapists are actually doing in school-based settings and the other one is to look at the relationship of what they’re doing to the outcomes of the children that they’re serving,” Westcott McCoy said. “I think it’s a really exciting study and, as far as we know, nobody else has done this.”

The study will include 120 randomly-selected PTs from sites across the country, like Kentucky, Oklahoma, Philadelphia, and the Pacific Northwest, treating students with disabilities from kindergarten through the sixth grade. The actual observations will take place during the 2012-13 school year. Westcott McCoy is currently seeking school-based PTs in Pacific Northwest school districts with at least three PTs on staff who will be working in that district during the 2012-13 academic year. Participants will receive online training and CEU for their efforts.

For more information, email Sally Westcott McCoy at westcs@u.washington.edu.