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So, you think you can walk? #AcutePT

All you do is walk people! Are you going to walk Mrs. Smith? Are you getting Mr. Johnson up? You don’t have to think in acute care!

In my opinion, the role of the physical therapist in acute care hospitals has some of the most profound & robust reasoning and logic. In addition, clinical research evidence continues to illustrate the positive benefit of physical therapists within acute hospitals for individuals who have had total joint replacements to the most critically ill individuals in intensive care units. The Physical Therapy Journal special issue on Rehabilitation for People with Critical Illness inspired me to discuss acute care practice in more depth. Despite the complex, fast paced environment and short lengths of stay, physical therapists continue demonstrate value in regards to patient outcomes, hospital throughput and flow, and risk reduction. The acute care environment is bursting with opportunity for physical therapists to enact meaningful change through innovative practice models and health care changing research.

Yet, the above are common statements and questions the acute care physical therapist must routinely face. Unfortunately, the skills, knowledge, role, and contribution of the acute physical therapist is misunderstood not just by other healthcare professionals within and outside the hospital environment. Equally as important, is the misunderstanding of physical therapist colleagues who practice in other settings.

In the editorial Acute Care Physical Therapist Practice: It’s Come a Long Way physical therapy journal editor Dr. Rebecca Craik, PT, PhD, FAPTA comments:

“Should Physical Therapists Practice in Acute Care Settings?” That was the 2007 topic for the Rothstein Debate, an annual event held at APTA’s conference and exhibition and established to honor PTJ’s esteemed Emeritus Editor in Chief Jules M. Rothstein (1945–2005).

 Dianne Jewell, PT, PhD, FAPTA, was moderator. Anthony Delitto, PT, PhD, FAPTA, and Charles Magistro, PT, FAPTA, argued for and against the need for physical therapists in the acute care setting. On one side, the physical therapist was characterized as a sophisticated decision maker with a breadth of knowledge that spanned medicine and physiology; on the other side, the physical therapist was characterized as just another clinical staffer who “dragged” patients down the hall.

The session was filled to capacity with approximately 300 people; the tension was palpable, the debaters articulate—but tempers were kept in check. The debate was declared a draw. I still recall my surprise that day at learning about the paucity of research on acute care practice:

1. The clinical decision-making process touted as complex by the “pro” team had not been described in the literature.

2. Responsive outcome measures had not been agreed upon.

3. Clinical trials had not been conducted to compare different interventions in that setting.

4. Cost-effectiveness had not been examined.

Today, in my opinion, I feel asking whether physical therapists belong in acute care shows a gross misunderstanding for the history and future of the physical therapy profession generally and the role of the acute care practioner specifically. Where is the recognition and assessment of the logic, rationale, and research behind acute care practice? My hope is that this debate topic was purposefully chosen to expose physical therapists to the acute care practice environment. Dr. Craik contends it inspired action. Acute care research and investigations since that debate have grown tremendously in both number and quality.

What are the physical therapist’s roles in acute care?

The obvious role of the physical therapist is to examine and evaluate a patient within the International Classification of Functioning, Disability, and Health (ICF Framework) to determine current and future need for rehabilitation, appropriate discharge location, equipment needs, and current functional level. Specific impairments of body structures and function, activity limitations, and participation limitations can be identified. Physical therapists can then also prescribe mobility and movement recommendations which I like to term “movement medicine.” This conceptualization of acute care practice, while accurate, is overly simplistic. For many, this is where their understanding and conceptualization of #acutePT ends.  In fact, it only represents a minute fraction of the effect and role of PT.

Beyond Function…

The profound effect that physical therapists can have in the acute care environment extends far beyond function and mobility. When analyzing the acute care practice environment from the outside many often ask if specific physical therapy interventions are effective from a functional, patient outcomes standpoint. While valid, this narrow scope does not fully encompass acute care practice.

The role and effect of the physical therapist’s presence, input, and treatment (generally and intervention content specifically) needs to be analyzed from multiple perspectives. Various metrics need to be assessed. Outcomes from multiple levels of the care and delivery process from the individual patient to the specific unit to the hospital to the entirety of the healthcare system need to be analyzed. This includes not only function and functional improvement, but current and future costs of an episode of care. No doubt, patient performance and function including future functional status and time to accomplishment of functional milestones are vitally important. But, length of stay, readmission rate, proper/safe discharge location, and reduction of medical complications are all important outcomes to patients, hospitals, and the healthcare system.

Physical therapist’s presence, guidance, and treatment can actually reduce the risk of adverse medical events including pneumonia, blood clots, readmissions, and longer lengths of stay. They may have an impact on hospital costs, future medical costs, overall healthcare costs and morbidity. These are important outcomes metrics. Taking a function only approach to acute care physical therapist practice and research may be detrimental. For example, a study may show that the functional outcome of a patient population treated by a physical therapist resulted in minimal improvements in function at hospital discharge. But, what if the same study illustrated that the treatment drastically lowered the incidence of pneumonia. Is that an outcome of interest to patients, physicians, hospitals, and health care administrators? A retrospective study illustrated physical therapists make accurate and appropriate discharge recommendations. More interestingly, when actual discharge location did not match the therapist recommendation the odds of readmission were 2.9 times higher than when the actual discharge matched therapist recommendation.

Physical therapists act not only as treating clinicians, but valued consultants (or a consulting service) in the acute care hospital. In a qualitative study of acute care practice the authors discuss acute care physical therapist practice in the evolving healthcare and hospital environment

According to the Centers for Disease Control and Prevention’s National Center for Health Statistics, the number of hospital days of care for patients of all ages was 226 million in 1970 compared with only 166 million in 2006. Similarly, the average length of stay was 7.8 days in 1970 and 4.8 days in 2006. Today’s hospital environment is one where patients are admitted for procedures, invasive medical management, and surgical interventions while longer-term healing, recovery, and rehabilitation occur elsewhere.

As a result, questions have been raised regarding the relevance of physical therapist intervention and management, commonly associated with the more lengthy rehabilitation phase of care, being delivered in such a fast-paced setting. The responses of the physical therapists interviewed in the study by Masley and colleagues suggest something else is occurring. The themes of this article and previous studies regarding the role of the physical therapist seem to demonstrate that physical therapists have evolved to becoming valued professional consultants who provide a unique, essential perspective, rendering them integral contributors to the acute care team. Today’s physical therapists specialize in evaluating and managing the patient’s functional mobility needs and, within that scope, serve as both consultants and effective transitional care providers.

Communication and Advocacy

Inter-professional communication is an ongoing necessity within the acute care hospital. Physical therapists are routinely interfacing with nurses, physicians, case managers, social workers, and other hospital staff. Acute care physical therapists are positioned to find and fight for allies outside the physical therapy profession. Emergency medicine and critical care physicians are recognizing the skills, expertise, and contribution of physical therapists. From coast to coast, they are advocating for physical therapists within and outside hospital walls resulting in development of innovative clinical programs and lines of research. Physical therapists are routinely a part of trans-disciplinary programs to improve patient care and outcomes. Through their physical location within a hospital setting, acute care physical therapists can leverage knowledge, skills, and expertise to promote and advocate for the entire profession of physical therapy.

Where’s the evidence?!?!

Recently, on twitter, a #DPTstudent tweeted that acute care had the least amount of supporting research. One of the reasons for this perception, I believe, is that much of the evidence supporting physical therapist practice in acute care is published in non-physical therapy specific journals such as Critical Care Medicine, Chest, and the Archives of Physical Medicine & Rehab. For example, Critical Care Medicine published an entire supplemental issue on Intensive Care Unit-Acquired Weakness (ICU-AW). But, the Journal of Acute Care Physical Therapy and Cardiopulmonary Physical Therapy Journal are still fantastic resources (by jennifer). As I outline in the Leveraging Technology Series post Selection of Content, we must read outside of the physical therapy specific literature. So far, I have discussed some of the rationale, which is vital, but what has research illustrated?

Total Joint Replacement
A study investigated the effect of immediate postoperative physical therapy on length of stay for total joint arthroplasty patients illustrating that “Isolated PT intervention on POD 0 shortened hospital LOS, regardless of the intervention performed.” A study published way back in 1993 illustrated that receiving weekend treatment by a physical therapist correlated with decreased length of stay following joint arthroplasty.

Emergency Department
I have written before about the emergence of physical therapists in the emergency department. Preliminary data illustrates potentially improved patient satisfaction with care and shorter wait times when physical therapists are present in the ED. In addition, physicians practicing in emergency medicine have recognized the expertise and contribution of physical therapists in a variety of conditions including painful problems, musculoskeletal conditions, dizziness, and overall mobility/safety/discharge determination. An article in PTJ discussed the development of this novice practice venue.

Intensive Care Units
“Intensive Care Units cater to patients with the most serious injuries and illnesses, most of which are life-threatening and need constant, close monitoring and support from specialist equipment and medication in order to maintain normal bodily functions.”

Early mobility and physical therapy has been shown to be not only safe, but feasible in the individuals who require mechanical ventilation. A randomized control trial investigating early physical therapy and occupational therapy in critically ill mechanically ventilated patients concluded that not only was early physical therapy treatment safe and well tolerated early on in a critical illness course, but resulted in better short term functional outcomes and less delirium. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project  demonstrated with “hospital administrative data…that across all MICU patients, there was a decrease in intensive care unit and hospital length of stay by 2.1 (95% confidence interval: 0.4-3.8) and 3.1 (0.3-5.9) days, respectively, and a 20% increase in MICU admissions compared with the same period in the prior year” And earlier this year, a systematic review on early mobility in the intensive care unit was published.

Response Dependent Progression

Back to some of the original questions. Well, so what? All you are doing is helping people get up and walk around. Can’t a nurse assistant do that? In a study of mobilization level in a surgical intensive care unit it was found that physical therapists mobilize their patients to a higher level than nurses.  And, sometimes sitting ain’t easy. What appears simple procedurally often involves complex knowledge and decision making. A gentle manual technique may require a complex reasoning process and constant assessment of patient response. Similarly, in acute care the decision to sit up, stand, transfer, or ambulate requires the integration of physical therapy specific principles with knowledge of medical conditions, medical management, pharmacology, and pathophysiology. Mobility and therapy progression (within and between session) is based upon the principle of response dependent progression which necessitates integrating the previous knowledge with the patient’s current presentation/functional status while constantly monitoring physiologic status (vital signs), patient performance, and patient feedback (fatigue, shortness of breath, and other symptoms). The acute care physical therapist must assess and integrate complex information from various sources. Much of this information is dynamic in nature requiring constant integration and re-assessment…

So, you think you can walk?

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New vision & role for the physical therapist in athlete management #sportsPT

The following post was written by Paul Mitalski. Paul is not a physical therapist, but has vision for the where the profession of physical therapy can go in the realm of sports and athletics. The introduction was written by Matt Sremba, PT, DPT. Matt is a physical therapist. He is passionate about the profession of physical therapy and critically thinking about what we are doing, why we are doing it, and how we can do it better. Matt introduced me to Paul, and the three of us have discussed specifically the physical therapists role in athletics. What are your thoughts?

Introduction

The evolution of the physical therapy profession is something that has always intrigued me. It is continually looking for new models of growth, practice, and education as seen in the recent progression towards the year long clinical model, the Innovation Summit by the APTA, and of course many discussions by passionate PTs on twitter and blogs like this to name a few. While spending the day at Dr. Christopher Powers’ Movement Performance Institute, I had the chance to meet with Paul Mitalski.

Since that time, Paul and I have discussed many areas of Physical Therapy and I believe he brings an interesting angle to these topics as he is not a PT, however has worked closely with them for many years.  We look forward to discussing his innovative model and vision for the role of physical therapists in the management of athletes which can be wagered on 홈카지노.

Matt Sremba PT, DPT
@MattSremba

Background

Before I present a snippet of my vision of the future of performance training and wellness (PTW) and the role I believe physical therapists should embrace, I will briefly describe how I got here. In short, I am the CEO of Conatus Athletics and I am not a physical therapist.  I am a computer programmer/software engineer/consultant by trade and mathematician. I led the development of three unique entities; the first and only complete mathematical model of the kinematics/kinetics of basketball, the first general methodology for performance training based on engineering principles, and a complete hierarchical “System” to implement the previously mentioned methodology. The last entity, the “System”, will be the primary focus of this blog post and I will discuss  the unique role of a Physical Therapist. My “System” is now a new business venture. My company, Conatus Athletics, is an education company and a training company. I lease space at the Movement Performance Institute in Los Angeles CA. and currently train professional athletes, however, our priority is developing and delivering  curricula based on science, engineering, and our system. My training “System” wasn’t intended to be a business nor was it created with the input of the sports performance world or fitness industry. I developed it in the late 1990s to prevent injuries in basketball and it is based upon mathematics, science, engineering, with refinement and guidance from physical therapists.

The Conatus Athletics System was designed to be a complete systematic process for managing all aspects of an athletes training and rehabilitation with clearly defined roles and responsibilities for all individuals. The role of the Physical Therapist in the Conatus Athletics System is unique. Here are some of the components, which help define the role of our therapists in our “System”.

COMPONENT 1. Therapists manage and oversee ALL therapy and training as well as related care extenders

We believe in a hierarchical model in which a MD and PT are peers and collaborate at the top of extender clinicians made up of PT’s, strength coaches, ATC’s, interns and residents to oversee and treat athletes. The MD and the PT both act as attendings as in a hospital setting, and must oversee all other clinicians. PT’s must contribute to the performance training program and must be present for all training including court, field, weight room, etc. This role is necessary due to our belief that athletes are NEVER “healthy” and always have musculoskeletal issues and require real time feedback during performance training. PT’s oversee the training regimen but do not execute it. Extenders are used for that role. The role of the Therapist in observing training regimens is to diagnose potential problems or future injuries and monitor return to activity.

COMPONENT 2. Therapists “Own” Musculoskeletal Problems

Physical Therapists are in charge of all musculoskeletal Problems and must establish treatment plans while altering training to allow continued performance training. We expect true collaboration between exercise physiologists, MDs, and strength coaches, and engineers. Although we believe in performance improvement, the health of the athlete is the highest priority. Therefore our conclusion is the Physical Therapist must “own” the training regimen.  This component also defines relationship/collaboration with Physicians in the training environment. In short, the therapists own the diagnosis of Musculoskeletal Disorders. MD and therapist must consistently communicate because some pathology requires both skill sets. The MD is not trained to “prescribe” a treatment plan (rehab) or manage the performance training. At the same time PTs should not try to be MDs and prescribe medications, etc. either. PT’s focus on mechanical problems.

Therapist Roles

1. Final approval of all Performance Training
2. “Veto” power over individual units in training regimen
3. Adjust individual units (exercises), add and replace units (exercises)
4. Defend his/her decisions to other professionals with rational explanations
5. Insure  team members are also to be able to defend the decisions related to training

Constant mentoring and explanations from the therapist is required…Team members WILL question the decisions made by the therapist. The culture is one of skepticism and constructive criticism. The therapist must take ownership and responsibility for management.

“Owning” a problem or issue is a part of Leadership training (google it). I have yet to meet non military trained therapist who understand this leadership topic. I suspect there are many natural leaders among the therapist ranks and I look forward to recruiting them into my happy company : ) I still feel this is a missing aspect of therapy curriculum. It is non negotiable in my System.

I would like to summarize.  I concluded that physical therapists should manage and lead performance training.  I am completely dismayed that physical therapists do not seem to want this role.   My system requires therapists to lead, manage, collaborate with other professionals (MD, Scientists, Engineers), defend their decisions, accept criticism, and  collaborate with other therapists for diagnosis and treatment. At the same time I hear therapists tell me they want these responsibilities, they resist embracing them and the sometimes difficult steps necessary to raising the standards in their profession.

Are there physical therapists out there who want this role?
Are physical therapists ready for this role?
Are the physical therapy curricula preparing students for this role?
Are you interested in the challenging steps necessary to make this system become the standard?

Paul Mitalski
Paul is the CEO of Conatus Athletics.  He has a B.S. in Mathematics, a M.S. in Computer Science, and is currently pursuing a M.S. in Engineering with a concentration in Biomedical Engineering.  He worked as a consultant for over 10 years and now is an entrepreneur focused on promoting Mathematics, Science, and Engineering in performance training and therapy.

Matt Sremba PT, DPT
Matt is a graduate of University of Colorado Doctor of Physical Therapy program in 2009. His clinical experience is in orthopedics/private practice and in the neuro rehabilitation hospital setting. His current interests include sports, orthopaedics, and manual therapy. He currently practices in Orange, CA where he is also trying to surf some waves.

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STUDENT MENTORSHIP- #DPTSTUDENT TOPIC FOR WEDNESDAY, DECEMBER 12, 2012

Does your DPT program have an organized mentorship/buddy program? How has this helped you? Are you a mentor to someone in a class below you? What do you do help them and motivate them?

If your school does not have a formal mentorship program organized- did you adopt a mentor from the class above you? Would you want your school to start a mentorship program? Let’s talk about it! 9pm EST this Wed, December 12th.

PT school is a strange place and I as a 1st year student I am thrilled to have a second year giving me the inside scoop on classes, teachers, and the way things work around here.

 

CHAT UPDATE

Click here for analytics and transcript.

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How to Survive Finals – #DPTstudent topic for Wednesday, December 5, 2012

Topic: How to Survive Finals!

It’s that time in the semester again where you can’t seem to drink enough coffee, you quiz yourself in your sleep, and you don’t think that there is any way for this much information to be absorbed in your brain. It’s finals time! This Wednesday we will be discussing how we make it through finals. What are your tricks to staying sane? What kind of study breaks do you take? Are you an up-all-night studier or early-bird studier?

Use this twitter chat as a nice study break to learn some new ideas from other DPT students on how to survive finals. Talk to you all this Wednesday at 9pm EST! #DPTStudent

User’s Guide to Twitter:

APTA’s Social Media team put this excellent quick guide to how to get the basics of Twitter down. Check it out!

http://www.youtube.com/watch?v=GCqBeZLnmNM

CHAT UPDATE

Click here for this chat’s analytics and transcript.

 

About Lauren Riley:

Lauren is a first year DPT student at Regis University in Denver, CO. She’s helping to coordinate the #DPTstudent tweetchat with others, and is a new PTThink Tank contributor! She attended American University in Washington, DC for her undergraduate degree where she majored in accounting and statistics. After a severe knee injury and a change of heart, Lauren decided to change careers. Outside of PT school, Lauren enjoys whipping up new recipes, hiking and triathlons. You can find her on Twitter at @LaurenrSPT.
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#DPTStudent Tweetchat Analytics

The inaugural #DPTStudent tweetchat took place this past Wednesday, Nov 28.

It was a huge success! How do you measure success? With these analytics of course, taken from the hour that the chat occurred:

66 twitter accounts participated

Most of these accounts were that of PT students of course, but we also saw PT faculty and PT programs participating.

486 tweets issued

This new hashtag stacks up well compared with other established PT hashtags, as illustrated by this fancy chart (note: the number on the chart is > 486 because this chart shows total tweets for the entire day):

 389 tweets per hour, 7.36 tweets per participant

We expect to see these numbers jump once the word gets out about the tweetchat. A figure of 7.36 tweets per participant indicates that although there was a small group, they were all very engaged with one another.

155,083 impressions made

“Impressions” is a metric for how many impressions a healthcare hashtag has made in users’ tweet streams. Symplur computes total impressions by taking the number of tweets per participant and multiplying it with the number of followers that participant currently has. This is done for all participants in this time period and then finally the numbers are added up.

 The influencers

Being atop the mentions column means your tweets were interesting enough for others to respond back to you, the tweets column explains itself, the impressions column shows the heavy hitters whose tweets were viewed by the massive number of followers they have.

The transcript

The topic of the first DPTStudent tweetchat was “Why PT?”. It was a great discussion, one that we suggest you relive by looking at the chat transcript.:

#DPTStudent – Healthcare Social Media Transcript

Conclusions

Tweetchats are a great forum to connect users with a common interest. #DPTStudent is bringing PT students from across the country together the exchange thoughts and ideas in a meaningful way. This is just another example of the power the PT profession can leverage by using emerging media. Let’s keep an eye on this and see how big it can get.

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#PhysicalTherapy Hashtag Project

#Hashtags are a robust means of tracking or tagging information on Twitter. They help you manage the fire hose-like nature of the constant stream of information on Twitter. Conferences, tweet-chats, and general topics of discussion all benefit from the use of hashtags. Combined Sections Meeting (CSM) of the American Physical Therapy Association, the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT), and the Private Practice Section of the APTA all have hashtags surrounding their conferences. The conference acronym is usually followed by the year. For example, #CSM2013, #AAOMPT13 (No AAOMPT conference this year because of IFOMPT Conference), and #PPS2012. Functionally, hashtags  group tweets by keywords. For those not familiar check out Twitter’s help page what are hashtags? or the wikipedia page hashtag.

Personally, I have leveraged hashtags to follow and contribute to discussion surrounding conferences (CSM and AAOMPT for example). I  unfortunately was not able to attend #AAOMPT11 or #IFOMPT12. But I did learn, discuss, and contribute via the conference hashtags. The # creates potential for discussion and collaboration on a topic, course, conference, or issue. Unable to attend a conference or event? Participate virtually! Busy during the time of a tweet chat? No problem, you can search the hashtag later to read, respond, and continue the conversation. Wondering what individuals are saying on a particular topic? Search that hashtag. Storify even lets you create and save conversations or stories based on certain parameters.

Outside the PT Sphere

@HealtSocMed claims #HCSM (Healthcare Communications and Social Media) forumlated in January of 2009 was the first global healthcare tweet chat. Other non physical therapy specific hashtags or tweet chats include #SocialOrtho, #SportsSafety, #mHealth, and #MedEd.

Physical Therapy Hashtags

Established physical therapy hashtags include #physicaltherapy, #physicaltherapist, and #physioPT. Kendra Gagnon PT, PhD (@KendraPedPT) who has guest blogged here on PTTT, utilizes hashtags in entry level DPT education. Her students tweeted #WhyIchosePT to communicate their reasons for pursuing the profession of physical therapy. Her class used #PTprof throughout the semester. On her blog, Kendra discusses social media communication as a part of the curriculum in a Professional Interactions course.

In some cases hashtags are utilized both as a tweetchat and to track discussion on a particular topic. #SolvePT is an example with weekly tweet chats on Tuesdays from 9-10PM Eastern Standard Time as well as ongoing discussion related to issues pertinent to the physical therapy profession. @SnippetPhysTher (Selena Horner, PT, GCS) discusses the emergence of the hashtag and the tweet chat. The #SolvePT hashtag continues to be an interesting conversation regarding physical therapy.

Call to Action

I propose a #physicaltherapy hashtag project. As a physical therapy community lets discuss specific hashtags for practice areas, topics, and ideas. I recently began using #AcutePT to tag some tweets containing evidence and rationale for the physical therapist’s vital role in the acute care environment. The Healthcare Hashtag Project has curated content and hashtags relating to health care topics, specific tweet-chats, conferences, and even diseases!

Below are my proposed hashtags for the physical therapy profession in addition to what we currently utilize. What did I miss? Should we change the wording? Let’s get started…

Practice Areas: #AcutePT #CardioPulmPT #GeriatricPT #ManualTherapy #NeuroPT #OrthoPT #PainPT #PedsPT #SportsPT #WomensPT

#PTscience for research, evidence based practice, and critical thinking relating to physical therapy.

#PTAdvoc for physical therapy advocacy and legislative issues.

#bizPT for business and private practice topics.

#PTtech for information relating to technology and the physical therapist.

#DPTEd for topics relating to physical therapy education and educators, including clinical education.

Hashtags for education and student topics could include #PTedu or #PTschool. Rumor has it that #DPTstudent will emerge as a hash tag topic and potential chat spear headed some of the student leaders in social media. You know @MattDeBole is at the center of that! Also check out @LaurenSPT as well.

And last, but certainly not least, #PTHero for inspiration and greatness within our vital profession.

@Dr_Ridge_DPT

 

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Thought of the Week: Help.

As everyone is aware, Superstorm Sandy has wrecked things. Especially, my home state of New Jersey. Many of my friends and family are still without power. My cousin was particularly hard hit as his home in Ortley Beach, NJ was completely devastated. He’s the “Joe” featured in this video and pictured above. Authorities tell him he will not be able to return to his home for 7 months at the earliest. Devastation.

Please click on either of the two links and donate funds to help this stricken land.

American Red Cross Disaster Relief Fund

 

 

NJ Hurricane Sandy Relief Fund
 

 

 

I’m sure my family and friends will be thankful for your generosity.

ERIC

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Do you MOOC?

In a recent article in the NY Times entitle, “The Year of the MOOC,” writer Laura Pappano describes an exciting, ongoing disruption in education. MOOCs, or Massive Open Online Courses, are quickly becoming the next big thing. I’ve taken or am taking several of these and I very much enjoy the learning process. The ability to engorge your mind with such high-quality content is unmatched. However, don’t think this is simply sitting back and getting fed information. These courses, usually mirrors of the on-campus versions of the courses, can be a lot of work!

There are obvious implications for healthcare within this framework. In fact, the University of Texas System recently joined up as a main partner with EdX, a collaborative including Harvard, University of California Berkley, and MIT. In their press release on the matter, the UT office spoke directly to the idea of including health-based offerings on the EdX platform.

The UT System brings a large and diverse student body to the edX family. Its six health institutions offer a unique opportunity to provide groundbreaking health and medical courses via edX in the near future. The UT System also brings special expertise in analytics – assessing student learning, online course design and creating interactive learning environments.

Within the next year, expect to see MOOCs being offered with options to pay for credits. Within the next few years, expect to see a wholly different educational environment that what we have today. University education is set to undergo a rapid evolution. Here’s to hoping this evolution occurs consistent with the traditionally high standards that have always existed, and here’s to hoping physical therapists can find a way to educate more than just future PT’s using such tools. It’s a clear opportunity for worldwide advocacy.

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Can Assumed Postures Help Chronic Pain?

I’m teaching a freshman seminar course this year at Texas State. It’s about introducing students to the university as well as the college learning environment and culture. I was prepping them for some interview and presentation assignments and stumbled across a fine TED Talk by Amy Cuddy about the importance of body language.

The information in this is fascinating. Basically, you can see significant, measurable changes in hormones simply by maintaining a posture for as little as two minutes. It doesn’t seem to matter if you actually feel powerful or weak, but if you hold the power poses, you increase testosterone and decrease cortisol. It also seems that subjects are better able to cope with stress and have superior results in job interviews following this 2-minute posture hold.

If the simple act of assuming a posture can alter the brain, I wonder if having patients in chronic pain can see a similar benefit. Power poses before therapy might just help take that edge off and allow more pain-free motion during a therapy session. Of course, this is just me postulating, but I wonder… Testosterone might not have an obvious connection to pain, but cortisol and resultant stress levels certainly could. Perhaps testosterone could somehow enhance self-efficacy, which is important for function in the face of chronic pain. Visit sites like indacloud to explore a wide variety of cbd products that may help alleviate pain from various health conditions and injuries.