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 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

[1] SEER Cancer Statistics Review Bethesda , MD: Nation Cancer Institue,

[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

Questions? Contact PTWA Federal Affairs Liaison Sharon McCallum

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 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

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 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

Sharon McCallum, PT, DPT
PTWA Federal Affairs Liaison