PT Pintcast - Physical Therapy

What Every Physical Therapist Should Know About Vestibular Rehab

Danielle Tate and Abbie Ross are both vestibular physical therapists at Balancing Act Rehab providing vestibular telehealth treatment and hosts of the podcast “Talk Dizzy To Me”, the basics you need to know but also the complexities of vestibular rehab. Danielle created Vestibular Today to provide evidenced-based vestibular resources for patients and professionals.

Abbie started a vestibular therapy company via telehealth to treat patients all over the country , increasing access to care, and providing treatment she believes patients deserve.

Danielle and Abbie talk through the prevalence of vestibular dysfunction and conditions commonly seen in the clinic or telehealth (BPPV, vestibular migraine, post-concussion, balance dysfunction). 

They discuss research related to treatment for this population that extends beyond treating using the Epley maneuver. The guests emphasize that our inner ear is made up of 3 canals and each should be checked with testing. 

If interested in how you can add vestibular therapy into your practice, check our Vestibular Today which provides research, resources, and education for the treating therapist. 

Listen to Abbie and Danielle on Talk Dizzy to Me Podcast. 

PARTING SHOT

59:13 “Get into vestibular therapy. Just get into it. Get comfortable with it.” - Danielle Tate

59:40 “Persevere because you will not know everything in the vestibular world.” - Abbie Ross

2021 Foundation Donor Reception We're really excited to host our annual donor reception virtually this year with such a great group of PT researchers. Tamara Keeny, PT, PhD, DPT, CCS Rich Severin, PT, DPT, PhD (c), CCS Jason Falvey, DPT, PhD Douglas Haladay, PT, DPT, PhD, CSCS RSVP today (it's free!) and join us on Feb. 10 at 6pm EST!SHOW LESS

Leslie Bonci is a registered dietitian and sports nutrition consultant to the Kansas City Chiefs, lecturer for the DPT program at the University of Pittsburgh, founder of her blog Active Eating Advice, and co-founder of a sport nutrition consulting group called Performance 365.

Leslie begins with emphasising nutrition does have a role in PT’s scope of practice as we help prepare our patients for recovery. PT’s can improve PT outcomes by integrating nutrition therapy. 

Integrating rehabilitation nutrition, Leslie recommends to ask these questions to your patients to learn about their diet habits: When? What? How much? 

As society has found ways to learn from diet trends, nutrition myths were established which may not meet end health and nutritions goals. Leslie identifies what foods do not cause extra inflammation, what foods do help, and why food should be part of the healing plate to recover from injury. 

In the future, physical therapists and registered dietitians should increase collaboration to optimize nutrition therapy for patients.

Check out Leslie teaching on Medbridge with new released nutrition courses! 

PARTING SHOT46:05 “Food is what unites us. It should not divide us.” - Leslie Bonci 

Danielle Pittaluga is a physical therapist and contractor for a Special Warfare unit and embedded in the Tactical Air Control Party Unit of the United States Air Force at Fort Bragg/Pope Army Airfield. She is also a nutrition Coach and recently started her own blog called Fit 4 the Fight educating on topics such as performance, recovery, nutrition, and rehab. 

Danielle discusses the different types of military jobs and settings for physical therapists and the perks that come with this position that are not typically seen in the civilian world - lack of working with insurance, increased autonomy, treated as specialist, order imaging, and order certain types of medication. 

As a nutrition coach, Danielle has become an educator on performance, nutrition, and rehab for any individual to conquer their own fight. She remains active on her website by writing blogs and having a presence on social media platforms to spread her insight on human performance and optimization. 

PARTING SHOT

26:58 “Don’t give up if you know what you want if you have a dream or a goal.” - Danielle Pittaluga

Brett Neilson is a physical therapist and full time educator with Evidence in Motion and is completing his Doctor of Science in Physical Therapy (DScPT) at Bellin College with a research focus on sleep health and pain. Katie Siengsukon is an associate professor in the Physical Therapy and Rehabilitation Science Department and Director of the Sleep, Health and Wellness Lab at the University of Kansas Medical Center. 

They discuss strategies and sleep hygiene interventions to incorporate sleep health into practice and why this is essential for physical therapists to discuss sleep health with their clients. 

The experts have pro and con viewpoints on using wearable technology for sleep. Pros include discussing sleep, behavior change, and use as a tool to improve sleep. Cons include accurate results/data, may increase anxiety from results, and patients interested in the data collected. 

In physical therapy research, there is a limited amount published on patient’s beliefs related to sleep if seeking therapy services for a musculoskeletal condition. 

According to the APTA, the House of Delegates’ position on sleep health states “supports collaboration to promote education, research, and practice between physical therapists and sleep medicine professionals to enhance the health and well-being of society.” This motion was proposed by the Washington and Kansas delegates. 

Check out Katie’s article in PTJ “Sleep Health Promotion: Practical Information for Physical Therapists.” 

PARTING SHOT

54:32 Recognize the role of the physical therapist that we can play in improving sleep health for our patients in the community.” - Brett Neilson

55:02 “If you are not sure where to start or have those conversations, there are a lot of great resources. Start having the conversation. That is the very best and the very first step,” - Katie Siengsukon 

Kylie Ahern is an award-winning science publisher and launched COSMOS Magazine, an Australian science magazine. She is also the CEO of STEM Matters, publisher and Editor in Chief of The Brilliant, and Board member of the Australian Center of Robotic Vision. 

She launched The Brilliant to showcase our global leaders in STEM communication and engagement. These people however do not follow the traditional public relations handbook. 

Universities perform science and research yet have a difficult time communicating this to the world. She emphasizes every university should have a publishing strategy to support the current science and research as 99% of STEM organizations continue to PR compared to building an audience. 

Kylie recommends Lumen5 Video Maker which will turn your content into a visually engaging explainer and attract your target audience. 

Pro tip to improve your science communication: 

* What is your business objective? * Who is your audience? * What do they need to know?

PARTING SHOT

56:09 “Challenge in the next year for one of you to have really cracked this and be a destination point around physical therapy.” - Kylie Ahern

Joe Reinke is the CEO and founder of Fitbux which helps professionals, like physical therapists, strategize, conquer and ultimately save money on their student loan repayment. 

Justin Berry is a physical therapist who recently wrote a research report in JOPTE called “a national survey of accrued student loan debt by doctor of physical therapy students.”

Mike Makher is a physical therapist who has an interest in finance after receiving his BS in Economics and finding it essential to study the banking and financial industries. 

Joe discusses President Biden’s executive order to extend the payment pause and 0% interest on federal student loans. This means that direct loan borrowers do not have to make a loan payment and interest will not be accrued until September 2021.

Through Justin’s survey, he found shocking statistics to the student loan borrower:

* The average student loan debt at time of graduation was around $103,000 (public) and over $138,000 (private)* 75% of student loan participants would not meet a 10 year repayment guideline* 21% of participants would not meet 25 year fixed or graduated repayment guidelines 

As a physical therapist with a background in finance, Mike got tactical into what students and therapists should know about their student loans, strategies to pay down their loans, and minimize their student loan debt. 

PARTING SHOT

49:10 “Don’t refinance. Try to save your money. Be smart. Be careful.” - Mike Makher 

Shelby Miller is a second year DPT student who posed the question on Twitter “How do you respond to a patient who tells you they are ready to die?” Megan Eldridge, Sharon Gorman, Talia Pollok, and Julie Skzrat, all physical therapists who work and/or teach in the acute care setting, responded by providing assistance and insight to Shelby on this topic. 

Shelby shared her experience and how she responded to this patient and question. Shelby is a second year PT student who was finishing her first full time clinical rotation in an acute care setting. 

Megan had a similar situation as a physical therapist new to the acute care setting. When Shelby posted the tweet, Megan wanted to provide her shared experience. Megan suggests looking into hospital's protocols for these situations and looking at it from a multidisciplinary standpoint.

Sharon put her professor hat on as she teaches this topic at Samuel Merritt University. She recommended screening and referring for depression using the patient health questionnaire (PHQ-2, PHQ-9).

Talia and Julie emphasized for therapists to be prepared for these conversations and they will occur in any setting. Talia discussed the importance of maintaining resilience of therapists in these situations to prevent burn out. She believes physical therapists do play a role in end of life care. 

With extensive work in cardiopulmonary physical therapy, Julie encouraged all therapists to increase their understanding of positive intensive care syndrome to understand a patient's experience post-COVID. 

Other resources provided by the experts include:

* The Geriatric Depression Scale* An Indepth Look at Palliative Care* Deathoverdinner.org* Vital Talk Resources 

PARTING SHOT

50:36 “Sometimes the bravest and most important thing you can do is just show up.” - Talia Pollok

50:49 “For you, today is ordinary but for you patient and their family, it is extraordinary. So be patient.” - Julie Skrzat

51:11 “Remember to always listen to your patients.” - Megan Eldridge 

51:31 “Speak the truth, even if your voice shakes.” - Sharon Gorman 

52:06 “Just because we are physical therapists doesn't mean we just treat the physical. We also treat the emotional.” - Shelby Miller 

Katie Butzu is an occupational therapist and assistive technology mentor for the Bay Arenac ISD (intermediate school district), Michigan Chapter Leader in Makers Making Change and currently collaborating with Makey Makey to use their tool as assistive technology. 

Makey makey is an easy to use invention kit that combines everyday objects with the internet. Katie’s youtube channel Creative Makers demonstrates how to use your everyday object with Makey Makey for rehab purposes. 

Working in the pediatric setting, Katie found 3D printing as a tool to improve patient outcomes. In Makers Making Change, Katie is a creator of 3D printing to build assistive devices for individuals with disabilities. 

PT Pintcast and The Onco PT are holding the first Virtual Oncology Physical Therapy Summit. Register here today. 

PARTING SHOT

49:40 “When you think it is impossible, it’s possible.” - Katie Butzo 

Lisa VanHoose is a physical therapist, researcher, educator, and equity warrior in the front lines addressing health disparities. She is founder of the Ujima Institute which is an inclusive space to improve health and wellness and raise the voices of Black communities. 

The Ujima Institute created three villages with support and a focus on female healthcare providers, individuals in underserved/non-served communities, and community based research. 

The Ujima Institute Toolkit is available for resources and guidance on anti-racism discussion and personal growth. 

100 multidisciplinary healthcare professionals, patients, and caregivers collaborated to create the Black Rehabilitation Manifesto with a purpose to express the needs of the black rehabilitation community. 

Lisa and Mica Mitchell, PT, lead together Mindful Mondays to provide mindfulness and discussion for rehabilitation students and clinicians. See future dates by following the Ujima Institute on Twitter.

PARTING SHOT

1:01:30 “Health disparities matter especially for our front liners working in the middle of COVID. We have to commit to health disparities...Do what you can within your village.” - Lisa VanHoose  

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QUOTES

12:56 “I love listening to everyone’s commentary comparing the policing from January to the summer. That’s everyday in America.” - Lisa VanHoose 

16:34 “When you look around in a room and you keep saying that someone should do something about that. Then that someone is probably you.” - Lisa VanHoose 

18:09 My role as a human is to use that privilege to help elevate somebody else because you can’t be in all the lanes of traffic.” - Lisa VanHoose 

18:20 “A leader does not create more followers. A leader creates more leaders.” - Jimmy 

26:40 “COVID is just a manifestation of all these injustices that we’ve not addressed.” - Lisa VanHoose 

33:42 “How do we insert ourselves into places that maybe we don’t belong because that is where you make change.” - Jimmy  

AUDIOGRAM 

6:59-7:54 I grabbed on to it because that was how I was raised… with the ujima institute we’re really focused on health and wellness in black communities 

11:30-12:10 Our congressional leaders were othered…. January 6th was definitely a wake up call 

30:56- 31:40 In my mind I see the ujima institute as a guide…. A big part of that conversation is provider bias

32:34-33:12 You can’t talk about transforming society if we don’t double down….who is the APTA of urban planners