Better Balance means Better Life!

Let's talk balance. I deal with balance on a daily basis, whether it be teaching my patients balance, working on my own balance, or helping my kids learn to balance. Balance is an important part of life and independence. It’s the body’s ability to maintain equilibrium and keep the body upright. Many studies show the link to core stability, balance, and independence. Better balance also leads to an overall decreased fear of falling and increased confidence. 

The body has three different systems that work together to maintain a person’s balance. Balance training should include components of each of these systems. 

• The Vestibular System refers to the organs of the inner ear. It is composed of the utricle, saccule and semicircular canals. These organs help in identifying vertical, linear, and rotational movements. When one is off, a person can experience symptoms of vertigo, or a spinning dizziness. 
• The Visual System refers to the eyes. It’s how we see and perceive the world, which helps a person figure out their orientation in space compared to other objects. 
• The Sensory System includes not only the sense of touch, but the ability feel movements. The body has sensory receptors in the skin, joints and muscles, which detect the sensation of pressure or stretch, allowing the body to respond accordingly. When a person reaches forward, and moves their body onto their toes, the toes pick up the stretch and pressure, and help the person identify how far she can safely lean without falling. 

Balance training should be included in any regular exercise program, but is especially important in the geriatric and neuro populations. Proper balance training can decrease fall risk, increase independence, and improve quality of life. Balance can be improved in anyone, at any time, with appropriate training. Part of balance training includes putting the body in uncomfortable positions to feel a loss of balance to learn boundaries and recovery techniques. Balance training should be done in safe, open locations, with supervision and assist as needed. As with any exercise program, please consult a medical professional prior to starting a balance program.

Many things can lead to balance impairments, such as any injury to the nerves or neuro system (brain or spinal cord), sensory loss from diabetes or injury, orthopedic injuries to joints, general aging, inactivity or weakness. Indications of impaired balance may include stumbling frequently, a general sense of feeling “off”, using furniture or people for support, a fear of falling, or actual falls.

neuroPT can help you or your loved ones start and develop a personalized balance program. Please contact me for details at patricia@azneuropt.com

References

1. http://vestibular.org/understanding-vestibular-disorder/human-balance-system 
2. Gbiri, C.A., Shittu, A. (2014). Effects of a six-weeks balance training on balance performance and functional independence in hemiparetic stroke survivors. Indian Journal of Physiotherapy&Occupational Therapy, 8(4). 123-127.
3. Halvarsson, A., Dohrn, I., Stahle, A. (2015). Taking balance training for older adults one step further: the rationale for and a description of a proven balance training programme. Clinical Rehabilitation, 29(5). 417-425.
4. Kahle, N., Tevald, M.A. (2014). Core muscle strengthening’s improvement of balance performance in community-dwelling older adults: A pilot study. Journal of Aging and Physical Activity, 22. 65-73. 

Pool Therapy

Greetings to my fellow followers!

As summer is quickly approaching, and the temperatures are rising, I want to remind everyone to stay safe, hydrated and sunscreened! I also wanted to talk about aquatic therapy as part of your rehab process. neuroPT is proud to announce that pool therapy is now available. It can be done in your own personal pool, or I am contracted with a state of the art facility, which includes warm pool temperatures, multiple lifts in/out of the pool and life guards on duty. 

Pool therapy is typically done in a warmer temperature, which allows for muscle relaxation, increased peripheral blood flow, and pain relief. No worries, though, if you want to do it in your own pool, at a normal pool temperature. There are still so many more benefits! Just surrounding yourself in water is beneficial for the constant resistance it provides, the added proprioceptive feedback, stimulation and body awareness. The buoyancy of water also provides a body weighted support effect, reducing your body weight by up to 90% when submerged up to the neck. Decreasing your body weight provides an easier environment to initiate stepping and walking, and can also decrease pain if you’re suffering from any orthopedic injuries. 

Pool therapy has so many great advantages that have been well researched through the years. You can do a quick google search and see for yourself. I love pool therapy for the added psychological benefit of doing something new and different and returning some “normalcy” to life. As long as you take the appropriate precautions, pool therapy can be an invaluable addition to your rehab program.

Contact me for any further information or to start your own aquatic therapy program!

My first Patient

What a year it’s been…and it’s only February! My poor grandparents (well Grandparents in law, but I dropped the “in law” a long time ago!) both fell last month. Grandma was diagnosed with a lumbar spine fracture and Grandpa fractured his long leg bone- the femur. Both are going to be okay- luckily broken bones heal!! It just takes time, patience and a lot of hard work to get the right medications, treatment and care. My take home messages from helping my grandparents after their fall? The healthcare system should NOT be that hard to navigate, every patient should have a strong advocate, and don’t work with Family!

Both my grandparents were taken to the ER after their fall. Grandpa was admitted and prepped for surgery and Grandma was kept in the ER while awaiting imaging results. This post will focus on what I learned from being on the other side, helping Grandma. Thanks to cell phones, no one memorizes phone numbers anymore. Neither Grandma or Grandpa could remember any numbers to call, so it was awhile before we even heard the news that they were in the hospital, in a state away from us. Being so far away is scary and stressful, and you just feel helpless. 

I spent a lot of time on the phone that night, with family and Grandma’s nurse. I tried desperately to convince the nurse that he could not possibly discharge my 83 year old Grandma that night to an empty home, pulling out the big terms of “fall risk”, “high risk readmission”, “unsafe discharge plan”…oh yah, I know the lingo from working in the hospital. I was able to get them to hold her over night, purely for a physical therapy evaluation. The next morning, my mother in law and I left super early in hopes of getting to the hospital before Grandma was discharged. When we got there, by 10:00 in the morning, we found Grandma, discharged, sitting in a wheelchair next to Grandpa’s bed, in incredible pain and an ill fitting brace. Her discharge instructions were essentially non existent. She had received inadequate pain medication and absolutely NO training on how, when or why to wear her brace. She had no instruction or contact numbers for questions and no doctor’s names to schedule her follow up appointments. And the physical therapy eval that she was held for over night? Cancelled! 

Needless to say, I was stunned. The medical system that I encourage my patients to trust on a daily basis had failed me and my grandma. And she didn’t even know! That’s the thing I don’t get. If you’re not in the field, don’t know the lingo, how do you even know what you don’t know or what you should know? I don’t blame Grandma by any means…I blame the medical system. We’re supposed to educate and advocate for our patients. Where was the education? All Grandma was told, at 1:00 in the morning, was “here, where this super uncomfortable brace to heal your back”. Her impression was it needed to be on 24/7. She had no idea how to manipulate the brace or how to care for herself in the new confines of being braced. 

The next few days were busy with trying to get Grandma comfortable and get our questions answered. I was all over the hospital, from trying to talk with the case managers and nurses that treated her, to medical records to try to find the answers myself. Between my persistent mom-in-law and I, we were able to get Grandma into a neurosurgeon the next day. This was our hail Mary- the turning point in her early recovery. We dragged poor Grandma up and in the car and to a hospital 20 minutes away to be squeezed in during this gentleman’s lunch break. The PA we saw was just as sweet and wonderful as could be. He finally listened (what a concept!), got Grandma the right pain medication and a new, better fitting brace. He also explained her exact injury in a way she could understand, including showing her the CT scan images. After this point, Grandma was on the road to recovery. It’s amazing what a few good muscle relaxers and pain meds can do for you! 

The next morning, Grandma was moving better. We were able to simulate an entire morning routine for her, problem solving how to dress and bathe while staying safe and protecting her back. I always knew I had an inner OT in me! This is something that should be done with home therapy, but that was another problem in itself to schedule. When they finally did make it out, almost a week later, Grandma was able to show off her skills and everything I had been able to teach her.

Overall, I’m incredibly frustrated by the medical system. It should NOT be that hard to get answers to your medical questions, get appropriate and effective medication and braces. I have a new appreciation and respect for my patients and their family who have to maneuver through the system. If you don’t know what you don’t know, then your only option is to trust what the discharging medical team says. And if they do a poor job on education, then what?

Here’s my message to you all…don’t be afraid to express your concerns of safety, pain or lack of understanding of the medical plan. If you don’t know who to ask to get your questions answered, ask everyone who comes into your room. Ask every healthcare provider you see. Eventually, you will get one who will help. I know on a daily basis, I go above and beyond for my patients, even if it’s outside “my job”. The fact is, I treat each patient I have as if they were my personal family member. Being sick, injured and in pain sucks. There’s no other way to say it. It just sucks. Let the people who want to and who can help you help. I’m sure you would do the same thing for them if the situation were reversed.

That First Step

Sometimes it's hard to take the first step. Today I took mine...I started a company that specializes in helping people along their rehab journey. Let me help you take your first step!