Academy of Orthopaedic Physical Therapy

American Physical Therapy Association (APTA)

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30.31, Special Topics: optimizing recovery
abstracts and keywords

Current Trends in Nutrition and Supplementation with Relevance to the Physical Therapist

Abstract:

A patient’s nutritional status can impair or enhance physical therapy progress. Being overweight, undernourished, or having an underlying nutrition-related co-morbidity that is not well controlled will impede rehabilitation. Current diet trends may result in nutrient shortfalls that can delay recovery from injury, exacerbate inflammation, and jeopardize bone health. Supplements may be warranted to correct deficiencies, but may be misused or interfere with other medications. The physical therapist should work to establish a referral network of registered dietitians to work as a team to help patients optimize rehabilitation and health.

Keywords:​

nutrient requirements, injury, inflammation, supplementation

References:

Click here.

Let Me Sleep On It: Sleep for Healthy Aging, Rehabilitation, and Optimal Performance

Abstract:

CONTENT: This monograph discusses the effects of sleep and sleep restriction on quality of life, health, chronic disease, tissue healing, learning, and motor performance. Understanding sleep chronobiology is key in planning rehabilitation and human performance training programs to obtain optimal results. Physical therapists should incorporate sleep assessment as an important component of the medical screening and physical therapy evaluation. Selection and administration of the proper outcome measures will paint a complete picture of the patient and foster interdisciplinary collaboration among health care providers to promote optimal health. The monograph discusses the advantages and limitations of wearable technology in assessing sleep duration and quality. Finally, the eight pillars of good sleep and performance address a breadth of strategies for increasing sleep quality and improved health. CASE ANALYSES: Four diverse and intriguing cases are presented to illustrate the complex nature of holistic assessment and treatment of the subtle and not so subtle effects of sleep on the rehabilitation course in the orthopedic setting. The first case highlights the common presentation in complex care of an adolescent with prolonged recovery from post-concussion syndrome, the influence of the autonomic nervous system on recovery, and the role of the physical therapist in treating co-occurring and related conditions. The second case emphasizes the importance of screening for sleep apnea in the postoperative rehabilitation setting. The third case describes the importance of interprofessional collaboration between the physical therapist, primary care manager, and clinical pharmacist in postoperative pain management. The postoperative orthopedic patient presents with co-occurring conditions that should be considered by the physical therapist in planning a holistic treatment plan for sleep health, rehabilitation, and wellness. The final case describes the effect of neuroplasticity via autonomic regulation, biomechanical, and movement- based approaches to treating sleep and anxiety in chronic low back pain.

Keywords:​

circadian rhythm sleep-wake disorders, concussion, inflammation, insomnia, sleep

References:

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Blood Flow Restricted Exercise: Physical Therapy Patient Management Using Current Evidence

Abstract:

CONTENT: Blood flow restriction exercise, or BFR, has emerged in recent years as a physical therapy technique. It is used to provide an exercise stimulus to patients to restore muscular size and strength. Blood flow restriction involves the combination of exercise with the use of a device to restrict blood flow into the working limb, typically through a pressurized cuff. This monograph will provide the clinician with BFR foundational knowledge that will aid decision making, patient education, and application in the clinic. We will present current best evidence on mechanisms involved, safety, selecting pressures and loads, application via resistance and aerobic exercise, emerging techniques, and how to integrate BFR at various time points in the rehab continuum. CASE ANALYSES: Five cases are presented that highlight how clinicians may implement BFR in the clinical setting. Cases 1 and 2 highlights using BFR for a lower extremity injury in a geriatric and a pediatric patient with successful outcomes. Case 3 highlights the application for an upper extremity injury in the shoulder to help highlight the potential for proximal, above the cuff, improvements with BFR. Case 4 highlights the use of BFR and neuromuscular electrical stimulation to achieve an analgesic effect in a geriatric patient. Lastly, case 5 highlights programming high load training in conjunction with low-load BFR for a soft tissue injury.

Keywords:​

hypertrophy, low load exercise, vascular occlusion

References:

Click here.

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