Ready to Get Involved? How to Get Started

As an SPT and even as a new graduate in the workforce, I always felt that advocacy for my profession was important but was too busy orienting myself to my new profession to even consider being involved on a bigger level. As I developed in my career, I felt called to do more.

AmandaScharen 8-2017

Amanda Scharen

Three years into my career, there was a student physical therapist at my clinic who was heavily involved in the APTA. She quickly became one of my mentors in encouraging my involvement in the APTA and asked if I would like to apply with her to be part of a new task force. The task force was addressing an issue that I was interested in, so I decided to apply. A few weeks later, I was disappointed to find out that I had not been selected for the task force due to lack of advocacy experience. I was frustrated – how could I possibly get experience if experience was a prerequisite for getting involved?

I decided to start attending my local PT Pub Nights to network with other like-minded professionals. It was a great way to connect with other professionals in the physical therapy community, and I enjoyed getting a taste of the bigger picture within my profession. After about six months of regularly attending Pub Nights, the organizer told me that she was moving to Boston. When I asked who would be organizing the Seattle events going forward, she said no one had volunteered. Seeing this as an opportunity to take on a leadership role in the local PT community, I asked if I could be the event organizer.

My first PT Pub Night was so much fun and ended up hosting almost 50 attendees. I got to know so many people who were involved in PTWA through these events. Eventually I was approached by Jim Shepherd from the Nominating Committee asking if I would like to run for the House of Delegates. I was elected, which I attribute to how much time I spent building relationships with local PTs at the Pub Night events. As a delegate, I met many esteemed PTs from across the state and found it easier to get involved in committees, meetings and events as my professional network expanded.

For someone who is struggling with where to start, I would recommend starting with something where the only requirement is simply to show up and have an interest. There are PT Pub Nights in Seattle, Tacoma and Spokane. Most metro areas have regular district meetings that anyone can attend. If you are interested in a specific topic or issue, consider joining a special interest group (SIG) or committee. These groups and committees are listed on the PTWA website and are open for members to join. Finally, consider attending Legislative Impact Day. This is a great way to not only connect with other PTs but also to your representatives in Olympia.

Recently, I was elected to Nominating Committee. I am so excited for this opportunity to hopefully seek out people who, like me as a younger professional, want to get involved but don’t know where to start. I hope to show our PT community the benefits of membership and the opportunities both big and small to get involved and make a difference in our wonderful profession.

Amanda Scharen
Nominating Committee member
Delegate to the APTA House of Delegates

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Get Inspired and Lead by Example during the Special Olympics 2018 USA Games in Seattle

@2018USAGames. #RiseWithUs #2018USAGames

The Special Olympics oath: (McCallum, 2008)
Let me win,
but if I cannot win
let me be brave
in the attempt

Last summer, I had the opportunity to join physical therapists, physical therapist assistants, students and a few other members of the community who volunteered for a FUNfitness screening program in Everett during last year’s Special Olympics of Washington (SOWA) Summer Games. FUNfitness is part of the Special Olympics Healthy Athletes initiative to assess flexibility, strength, balance and aerobic fitness of the athletes. Introduced in 1997, FUNfitness is a fitness screening event that is part of the Healthy Athletes program and that was developed in collaboration with the APTA.

Lagging healthcare for those with intellectual disabilities culminated in this program of health education and prevention. Despite a mistaken belief that people with intellectual disabilities receive the same or better healthcare than others, they typically receive sub-standard care or virtually no health care at all. (Special Olympics Organization Health). In 2008, the global adult obesity rate was 12 percent compared to 30.9 percent for adults with intellectual disabilities. (Sunders M, 2008). Healthy Athletes has the world’s largest database of health data for people with intellectual disabilities.

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During the Healthy Athletes screenings, Special Olympics athletes receive dental, vision, hearing, foot and general health screenings and receive recommendations for improvement after each screening. Physicians and healthcare professionals provide the screening services at tournaments at no cost to Special Olympics athletes. Special Olympics has set a goal of having 100 locations recognized as Healthy Communities by 2020. (Special Olympics Organization Health).

The Special Olympics movement was born out of the work of Eunice Kennedy Shriver, a constant champion for those with intellectual disabilities. Today, the mission of Special Olympics Washington (SOWA) is “Special Olympics Washington BUILDS Communities and LEADS in Wellness through Sports and Inclusion. (SOWA website, 2017).

As a veteran orthopedic manual physical therapist I was confident that I could help somewhere, but this new adventure brought a little nervous excitement. I had no idea what I was expected to do and I was not sure what the athletes would expect from me. Special Olympics was something I learned about when I was a child. This early education left me with the impression that I would be working solely with an athletic, pediatric population with intellectual disabilities. Wrong. Well partially wrong. The athletes with intellectual disabilities span from individuals age 8 and upward into adulthood.

Under the direction of Natasja Ysambart, PT, DPT, SOWA Clinical Director, and Vicki Tilley, PT, GCS, Special Olympics consultant and trainer, volunteers were oriented to the FUNfitness screening stations: flexibility, functional strength, balance and aerobic capacity. While we waited for the athletes to finish competitions the Summer Games volunteers talked and learned from one another, particularly from the current UW student. We had fun running through the tests and it was nice to speak to a group that works with pediatric patient populations and those who rehabilitate patients with varied neurologic conditions. We also had a brother and sister team of high school volunteers, incredibly helpful as our extra hands.

The athletes that night shined – in their medals, in their dress attire (many of them stopped for screenings on their way to a big dance) and in their smiles. Once the process got rolling, it really became busy. Having so many athletes come for screening and education is inspirational. Earlier we ate alongside the athletes in their cafeteria dining room. One realizes quickly how much more can be done to educate and empower this population. At-risk populations are enabled to thrive with instruction and improvement of their awareness.

While we scrambled through the testing, I noticed that the athletes who received dental tools from the Special Smiles dentists were especially careful about saving their packages and educational materials as they worked through our busy screening stations. Behavioral change can occur when you educate and provide tools to those who want to improve their quality of life. The athletes were learning a great deal from what we tested and discussed that night. And likewise, I was learning from them.

During our testing I met a woman who was a fabulous athlete as proved during her fitness screening. She was also proud but competitive with her fiancé. She introduced the FUNfitness team to her fiancé, showing off her physical fitness while supporting his work on balance for his long-term health. After all, he is part of her future life.

Another athlete moved me during an educational discussion about stretching and her home exercise program compliance. She was not particularly fond of flexibility exercises. She told me about becoming a leader for the Special Olympic athletes.  After some discussion we concluded that her role as a leader in the athletic community meant that she needed to be a strong example for others. This piece was inspiring and motivational to both of us; we all have to lead by example.

The athletes and volunteers that I met that day were truly motivating. Everyone was excited about their sports performance, the dance that was being held that night and their future.

The Special Olympics USA Games will take place in Seattle from July 1-6, 2018. Hundreds of volunteer providers will be needed to offer screenings for thousands of athletes who will come from around the country to compete. Visit our web page to find more information and for links to sign up to provide screenings or to sign up for other volunteer opportunities.

http://ptwa.org/misc/special-olympics-usa-games-2018

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Robin Schoenfeld
PTWA Vice President

 

Help Observe National Physical Therapy Month

The heat of summer made one last push as we moved into “school season.” Hard to think it will be fall very soon!

NPTMLogoColor 2017I would ask that you consider some sort of observation of National Physical Therapy Month (NPTM) in October. The American Physical Therapy Association (APTA) recently posted resources for your 2017 planning.  National Physical Therapy Month resources may be found at http://www.apta.org/NPTM/ . Plan to share your observations with us (PTWA) and our national association (APTA).

This form of professional advocacy is critical. We must tell the public who we are and what we do. Tell the public why you are the reason to #ChoosePT. Let them know of your education and scope of practice. You make differences in people’s lives…as long as they know who you are. Not everyone knows who you are and what you do as a professional. Take the opportunity to leverage your voice to the public during NPTM.

#ChoosePT

Sig_Erik-Moen_First-Name-Only

Erik Moen PT
PTWA President

Rich Content and Networking at CSM

Combined Sections Meeting (CSM) 2017
San Antonio, TX

Washingtonians flocked to San Antonio to attend the most-attended CSM in APTA history. Can  you believe there was 14,000 PT, PTA, respective students and exhibitors there? That is a lot of PTs. Why do they go? Excellent programming that addresses their needs specific to their practice interest, a huge exhibit hall, alumni, section and industry receptions, excellent keynote/featured speakers and plenty of networking with friends and peers from around the country. Our great state of Washington was well represented in leadership, presentation, industry and social aspects.

Also featured are state and federal affairs updates. This is where we are updated on processes with the definition of dry needling in the states practice of physical therapy, license compact initiatives, concussion management and continued work to repeal the therapy cap.

Discussion took place regarding the incorporation of the new evaluation codes. Continued work and practice with their use in billing will be critical. The new evaluation codes have far more complexity then our previous 97001 and 97002. Physical therapists can do their part by reliably following the code criteria to clearly define their clients as low, moderate or high complexity. The resultant data will help to better understand physical therapy practice and our interventions. The APTA has numerous resources on its website.  http://www.apta.org/PaymentReform/NewEvalReevalCPTCodes/. APTA was recognized nationally for their efforts in association education regarding the new evaluation codes.  Our Arizona friend Helene Fearon accepted the award on behalf of the APTA.

Want to get involved? I strongly believe that return on your association membership comes through your active membership. APTA does have volunteer opportunities for committees and task forces. http://www.apta.org/VolunteerGroups/.  The March 1st deadline is quickly approaching.

As this is a blog, I will conclude my summary comments. It is safe to say that the entire coverage of a meeting like CSM cannot be fully covered in the length of a blog. CSM certainly is an exciting, material rich meeting. CSM is the meeting for you if you are thinking of attending a national meeting for the first time. See you in New Orleans next February!

Erik Moen_EditedErik Moen
PTWA President

The Skinny on Sarcopenia

One definition of sarcopenia by Santilli et al1, states: Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength and it is strictly correlated with physical disability, poor quality of life and death. Risk factors for sarcopenia include age, gender and level of physical activity.

To diagnosis sarcopenia three of the following need to be present:

  • HR >84 bpm at rest
  • Orthostasis: a decrease in systolic 20 bpm or diastolic 10 bpm within three minutes of standing compared to sitting or supine
  • Muscle weakness: a general 3/5, no specific muscle group
  • Impaired mobility: need assistive device, need assist with bed mobility, difficulty with transfers
  • Heart rate increases 10-20 bpm with verbal exam
kele-murdin

Kele Murdin

As PTs we should be drooling at this. All of these are WELL within our scope to treat and VERY treatable! Treatment of deconditioning typically targets activity HR 20 beats greater than resting (light load). And remember to educate your patients to be patient as recondition takes two times longer than deconditioning.

Ikezoe2 found that older adults need knee extension force of 45 percent of their body weight and sit to stand of 5.6 times in 30 seconds to retain their ability to walk independently.

There is a wealth of research to support the benefits of low intensity strength programs that improve knee extension strength and functional mobility in frail older adults. Westoff3 demonstrated significant strength increases using these parameters: one to three sets of four to eight reps, with one minute rest, using TheraBand and using criteria that when they can perform three sets with good form to increase load.

Sarcopenia cost over 18 billion dollars in healthcare costs per year.  We as PTs have the power to impact that and significantly improve the quality of life of our older adults! What a great job we have!!

Kele Murdin, PT
Geriatric Certified Specialist
Geriatric Training Certification
Certified Exercise Expert for Aging Adults

References:
1) Santilli V, Bernetti A, Mangone M, and Paolone M. Clinical Definition of Sarcopenia. Clin Cases Miner Bone Metabv. 11(3); Sept-Dec 2015. Published online 2014 Dec 10.
2) Ikezoe, et. al, Muscle Strength and Muscle Endurance Required for Independent Walking in the Elderly. Journal of Physical Therapy Science. 9(1):19-22. January 1997. DOR 10.1589/jpts9.19
3) Westhoff M, Stemmerik L, Boshuizen H. Effects of a Low-Intensity Strength-Training Program on Knee-Extensor Strength and Functional Ability of Frail Older People. Journal of aging and physical activity. 8(4):325-342. October 200. DOI: 10.1123/japa.8.4.325

 

We Are Moving

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Jim Rivard

Vision statements are typically born of small groups with big passion. Brainstorming, discussing, wrestling, and finally writing a statement of direction for the future – a vision. A vision statement is something not yet achieved, not a description of what is already. A vision may never be achieved, but defines the work and energy of the organization moving forward.

In 2013, the APTA adopted a new vision: Transforming society by optimizing movement to improve the human experience. The APTA as an organization, and physical therapy as a profession, has much work ahead to achieve this ambitious vision. I have had the pleasure and pain of spending time in different groups and task forces pounding out strategic plans and visions. Often the hard work of these small groups is lost in translation when attempting to have the larger body adopt the vision and move toward steps of implementation. The APTA is putting equal energy behind their new vision, with the most recent being The Movement System Summit held near the home office December 8-10, 2017.

 

The Movement System Summit involved 100 therapists stuffed in a room for three days in a collaborative discussion and debate as to the implementation of The Human Movement System as a primary tenet toward achieving the APTA’s vision statement. A safe and open environment of discussion, debate and dissention was established and maintained throughout the meeting, allowing all voices, thoughts and opinions to be heard. As president of the American Academy of Orthopaedic Manual Physical Therapists, I was invited to attend this summit. This is not to establish my credentials, but more to exemplify the inclusiveness of the group, having representation from within and outside of the APTA. Every corner of the profession was represented, including several students. The diversity in brain function—listening, critical thinking, communication—across the room was remarkable. Regardless of where you place yourself in the diverse landscape of physical therapy, you had fair representation. That said, having 100 physical therapists agree on anything related to the profession is unrealistic. Thankfully, lunch had been previously decided upon and was not open to debate.

So, what exactly is the Movement System? The definition is a moving target (pun intended). Currently it stands as follows: The movement system is the term used to represent the collection of systems (cardiovascular, pulmonary, endocrine, integumentary, nervous and musculoskeletal) that interacts to move the body or its component parts. The overall intention is to brand physical therapists as movement specialists that are the go-to profession for addressing the Movement System. We are the profession with a unique set of skills to define and own this area within the healthcare system. If we cannot define our advanced clinical skill set to the consumer and medical profession, we risk being replaced by a less expensive, lower-quality product to address movement and performance.

If you were mentally challenged by the naming of a “new system” that encompasses these other systems, then include yourself in minority group of participants (including myself) that pushed to remove the word system but continue with the concept. But semantics aside, bringing all branches of physical therapy together with a common language for defining, describing and evaluating movement is a worthy goal. For example, an imaginary line between orthopedic and neurologically trained PTs would be replaced with a common training and language to define basic movement. Those participating at the summit attempted to create a basic short list of movements, regardless of specialty, that all therapists could assess and describe. A branding shift toward movement specialists would place the focus on our ability to evaluate and restore these movements across a wide variety of clinical presentations. Movement could then be assessed by an annual visit to a physical therapist, much as with an annual dental exam, to identify movement impairments and potential interventions. The preventative approach could go a long way toward “Transforming society by optimizing movement to improve the human experience.”

The summit’s objectives:

  1. Describe the history and development of the term “movement system” as the identity
  2. principle with the APTA’s new vision. (You can read more on the APTA’s website at: Movement System).
  3. Develop a common understanding of the definition of the movement system and the role of physical therapy in the movement system.
  4. Identify the potential benefits of integrating the movement system in physical therapy education, research and practice.
  5. Discuss the movement system as it relates to both ICF language and the patient‐client management model in the Guide to Physical Therapist Practice.
  6. Begin to identify essential activities that should be included in the patient/client examination for assessment of movement performance and the criteria for how to measure these.
  7. Agree upon criteria for adopting or promoting movement system diagnostic labels.
  8. Describe the implications of using movement system diagnostic labels, including selection of treatment options, communication with other professionals, clinical documentation, reimbursement, education and research.
  9. Develop an action plan for the integration of the movement system into practice, education, research. This document will be a recommendation to the APTA Board of Directors.

Further discussions revolved around the need for movement system diagnoses. A collaborative lecture between physical therapists and an orthopedic surgeon colleague established a much easier consensus on removing terms such as shoulder impingement from the list of diagnoses we use, as they are inaccurate, often describe nothing and are often too vague to directly assist in establishing an intervention. The need to establish a movement diagnosis instead, that better describes the impairments leading to the symptoms of an impingement, did cause more spontaneous movements of heads nodding up and down. What replaced this nodding with cervical paralysis and reflexive oral expulsion was the intention of replacing all pathoanatomical descriptions for diagnosis with movement-based diagnosis. As the gloves came off, and the once cordial discourse was replaced by factions of dissention, the challenge of the broader strokes of this fundamental shift in the branding of our profession became more apparent. The diagnosis of shoulder impingement, having many causes, does little to establish a frame of thinking for intervention. Likewise, cerebral palsy as a diagnosis provides nothing in the clinical frame for which a clinician can make decisions for intervention. The insertion of classification schemes has attempted to address this clinical conundrum. One of the many arguments for maintaining the pathoanatomical description is that physical therapy has a long history of specific intervention to address specific tissue pathology. Influencing collagen repair, bone density and healing, as well as cartilage lubrication, has a long history in physical therapy. The arguments at the summit to maintain both the movement and pathoanatomical diagnoses then moved to which one would be first. As you re-read this paragraph, and your head begins to ache, it may occur to you how we create movement-based diagnoses and intervention when there is only pain, or normal walking for only short distance, or the patient presents with a wound. The last day of the summit did not ignore these issues but dug in, attempting to lay out a working plan to address them all.

The analogy for the Movement Summit was moving from sea level to summiting a mountain. It was obvious after three days that we had gained some altitude but there is much more to address to make it over the hill with this movement systems concept. We only scratched the surface on professional interaction between disciplines, organization and countries. Billing, coding and reimbursement would also need to see a significant overhaul.

If you have made it this far in reading you have demonstrated the grit required to be engaged in this process. The APTA has provided all the details and progress on this issue on their website, and is asking for comments, input and energy. The APTA is not some outside body, it is made up of all of us. We are the APTA. The leadership of the APTA is leading, and should be commended for thinking boldly. We have an opportunity here to better define who we are and what we do, finding better ways to message and deliver this to both colleagues and clients. Regardless of how you currently feel about this issue, acceptance is the key; this is happening. If all participants in the summit were honest, they would admit entering with a little bias on the issue. Maybe there was even a little confirmation bias in how some of us prepared for the summit. But all participants left with a broader understanding of the issues we face and how they affect all corners of the profession, not just within our own bubble.

You can elect to sit as we Move Forward, but we are stronger with all voices. Move with us.

Jim Rivard, PT

Doctor of Manual Therapy
Orthopedic Clinical Specialist
Fellow of the American Academy of Orthopaedic Manual Physical Therapy
AAOMPT President

State of the Association 2016

I would like to start by thanking you for your professional membership and your commitment to professionalism. Your commitment to professionalism matters; it does make a difference.

PTWA has had an eventful year. Many hands have helped with “the lift.”

Our Accomplishments
We’re #3! Each year APTA ranks states in the United States regarding which is the best Erik Moen_Editedstate in which to practice physical therapy. We are on the rise from last year’s ranking of 11.

We had a record number of conference registrants in Tacoma this year. Our conference had diverse educational offerings with excellent speakers. This year’s conference featured a new Student Conclave. APTA President Sharon Dunn kicked off the Student Conclave festivities. It was a thrill for the students. Studies show that engaged students and new professionals stay engaged in professional associations. We felt a Student Conclave was well worth our professional investment. Ten of the students were “sponsored” to attend the Friday night WPT-PAC party.

This is the first full year after the rule-making for spinal manipulation was finalized for PTs in the state of Washington. This has been a long and drawn out task. Your prolonged commitment to the process paid off.

This was the first year that the PTA had a full vote in elections and at our state conference. No more half votes to count.

We have had many of our members/leaders representing us at APTA meetings including the federal and state legislative forums, the membership conference and the house of delegates. These volunteer efforts on your behalf have been invaluable to ensure Washington is up to date with national trends and initiatives. You benefit from this as a member of PTWA.

You should also know that your PTWA leaders are highly respected on the national scene.  They are task force members, committee members, directors, invited speakers and much more.  Their knowledge and skills are at the front of the APTA.

PTWA has held numerous district meetings and webinars. These meetings and webinars have included CEUs for sports/ortho, pediatrics and admin. This is a membership benefit for your continuing education efforts.

We have had numerous meetings with state and federal legislators on your behalf. These have included a recent King County District Town Hall meeting with multiple legislators, a fundraiser for Representative Eileen Cody hosted by Sound PT, attendance at fundraisers for Governor Inslee, Congressman Heck, Senator Becker and the new Democrats (multiple federal legislators). These behind the scenes work benefits you by making legislative relationships that benefit the profession of physical therapy.

Our Unexpected News
We received news from the Department of Health (DOH) regarding the Sunrise Review of dry needling. It was not positive. PTWA and members have sent in rebuttals to the draft summary.  It should go without saying that tireless and voluminous work has gone into this effort. Stay tuned and be prepared to engage when the time is right. You can become involved. Join our Legislative Committee and Dry Needling Task Force for future work regarding this issue.

Our Goals
It wouldn’t be physical therapy without having goals.

We as a state association need to regrow our financial reserves. We will be evaluating opportunities to increase our non-dues revenue and membership.

New evaluation codes go into effect January 1, 2017. APTA will keep you up to date with code implications and their appropriate use in your practices.

Payment:  if we don’t get paid, we can’t run businesses. We will continue working toward legislative initiatives and collaboration with third party payers. We want to ensure that our patients can have access to the care they need and that we as professionals are compensated fairly for our evidence-based interventions.

We will be pursuing the licensure compact legislation in this upcoming legislative session. Our neighbors in Oregon were the first state in our nation to pass this legislation. We hope to join them as early adopters. This benefits our state as early adopters will be part of the rule making process right from the beginning.

We are committed to our school-based physical therapists. We are supporting legislation to ensure they are compensated fairly for their years of service. This will help ensure our children in state-funded schools will get the care they need to successfully navigate their education experience.

PTWA will petition the DOH to add PTs to the Health Professional Conditional Scholarship Program (RCW 28B.115). This program encourages health care professionals to serve in shortage areas. This is currently offered to medical students but we will work to make this available for PT students too. This is a non-legislative process that can be requested through the DOH. This idea came from a recent discussion with a state senator.

We encouraged you to participate in National Physical Therapy Month and PT Day of Service. PTWA hosted the exhibition of falls prevention exercise programs at our recent conference as a means of providing members with some ideas to promote #healthyaging and #ChoosePT. Please share your PT Day of Service and PT month activities with PTWA. We would like to feature and celebrate your efforts.

PTWA will provide suicide assessment training this coming spring 2017. Suicide assessment training is now part of your license requirement.

I would like to recognize the excellent efforts with regards to our PTWA staff. They are excellent, creative, resourceful and incredibly hard working.  Please meet them and thank them for their work.

We thank you for your membership and your commitments toward being excellent health care professionals in the state of Washington and beyond.
Sig_Erik-Moen_First-Name-Only
Erik Moen PT
PTWA President