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Welcome back to a new year! We are kick starting this year with a Journal Club blog because in doing some research for my own institution on PT services, I ran across an interesting article. We all understand the necessity of rehab services in the hospital. Many studies have documented the important benefits of early mobility provided by PT.

This study, however, looked at the frequency of PT services provided to determine essentially if there was a dose response on outcomes and length of stay. And low and behold, there is evidence that additional PT services have a dramatic impact on not only the health and outcome of the hospitalized patient but also on how long that patient stays in the hospital.

Additional PT Services Shorten Hospital Stays

The researchers in this particular study conducted a systematic review and metanalysis or available studies to uncover any evidence that PT can help decrease length of stay. They found that there is moderate evidence that additional PT services reduced subacute length of stay by about 3 days and some evidence that it can reduce acute length of stay by almost a day. The authors confirmed that PT services improve overall self care and ADL’s with no additional adverse events.

All in all, this study highlights that PT is valuable in acute and subacute PT care and that there is growing evidence that additional visits and services in those settings can not only improve health, self care tasks, and ADL’s prior to a patient's discharge but can also shorten their time window which will keep them less sedentary. I hope you find this study useful and helpful to your department or institution.

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

Christmas is here and it truly is the most wonderful time of the year. I recently took my family ice skating at the local park one evening and it was a wonderful time. The park was filled with Christmas lights, music, and of course an outdoor ice rink, which, yes, is unique for Georgia because it’s typically pretty warm over Christmas but this particular night was quite wintery. It was a quintessential holiday experience and it brought so much joy and happiness to me and my family as we made a Christmas memory together.

Similarly, but so much more so, this season brings much joy and thankfulness in my heart because of the dedicated time pondering the reality that God looked down from heaven in compassion and sent his son to this broken world to redeem it. He became one of us to free us from sin and sins death penalty. This season leads my heart to praise and worship our creator because he made a way of salvation through Emmanuel. God is actually with us!!  What. A. Joy!!! Reflect on these words from Spurgeon:

​“Look! Here is the subject of your joy. The God who made you, and against whom you have offended, has come down from heaven and taken upon himself your nature that he might save you. He has come in the fullness of his glory and the infinity of his mercy that he might redeem. Do you not welcome this news? Will not your hearts be thankful for this? Does this matchless love awaken no gratitude?...Oh I pray you adore the incarnate God and trust in him.”

I hope and pray you are filled with all joy this Christmas season as you worship God this and are filled with joy because of this great news!!

Jason

​***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

Another Thanksgiving is upon us and I am ready for the break from routine that it brings. I love this holiday because of its simplicity. Thanksgiving does not have the marketing or commercialization as other holidays like Halloween or Christmas, which may be why it seems to get lost in our current cultural moment. Instead, it is built around being with family and friends and orienting our hearts and attitudes in a positive direction. A direction of thankfulness. We should never lose sight of or skip this holiday. It is good for us to give thanks.
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We give thanks for many things during this holiday season, or at least we should. Many of the things we give thanks for are temporal things or provisional things. Ask any child or adult what they are thankful for and you will hear answers like, family, friends, shelter, toys, food, job, etc. This is right and good because every provision that we have is supplied by God, our Maker. Many Puritan prayers also reflect the thankfulness of the temporal things in life. Take this brief passage from a prayer of thankfulness in the book Valley of Vision:

​I bless thee for:
the body thou hast given me, for preserving its strength and vigor, for providing senses to enjoy delights, 
for the ease and freedom of my limbs, for hands, eyes, ears that do thy bidding;
for thy royal bounty providing my daily support,
for a full table and overflowing cup,
for appetite, taste, sweetness,
for social joys of relatives and friends,
for ability to serve others,

​And it continues on about tangible, practical things for which to be thankful. But I am especially thankful for something else this year. Something else that I read in Psalm 103 just the other day. It’s neat how sometimes when we read a passage, each time we read it something new jumps out at us. And for me, this happened specifically in vs 10. This time reading it, it gave me pause to be especially thankful during this season. Listen to what David writes:

“He does not deal with us according to our sins; nor repay us according to our iniquities.” Ps 103:10

Did you catch that? God does not deal with us according to our sins. He does not repay us according to what we actually deserve. Wow. If that statement doesn’t generate thankfulness and love for Jesus this season, then I don’t know what would! Bless the Lord because in his great love he sent Jesus to take the punishment for our sin that we deserved and gives us life everlasting if we repent and believe. Thinking about this truth will certainly stir a heart of gratitude and thankfulness.
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So, while we gather with family and friends and give thanks for all that we have been given, don’t forget to be thankful for the spiritual realities that we have as believers and for the unfathomable character qualities of our God. For by them, your soul is secure in Christ and you can be truly thankful. Maybe start by reading and re-reading Psalm 103!

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

It’s been a little while since “Journal Club” has featured an article for the hard working neuro therapists in the world, so I thought I would remedy that situation this month and post a neat little review article focused on stroke recovery.

This article takes a slightly different approach to return to activity. It does not focus on interventions and treatment options to return a patient to a desired level of function. It actually assesses the different environmental factors that contribute to resumption of a patient’s desired activities. And for that reason, I thought it was interesting.

Environmental Factors that Influence Resumption of Desired Activities in Patients Post Stroke

A systematic review of both qualitative and quantitative data was performed and analyzed and the researchers discovered some interesting factors. Some of the findings were somewhat obvious. For example, adaptive equipment and education were two big components to resuming desired activities. But there were also some factors that I hadn’t thought about before like transportation availability and easy to navigate environments. 

The researchers also looked at barriers to resumption of activities and identified an interesting factor: the negative attitudes and behaviors of others. I thought that was particularly eye-opening and a good challenge for us as PT’s to be encouraging and uplifting in our speech and actions. We may be the few people speaking life to help our stroke patients return to desired activities in a world that is much more negative and communicates annoyance and burden for those living post-stroke.

I hope this article helps you really treat the whole person when it comes to post stroke rehab and I hope it gives you some good non-treatment or intervention ideas to address with patients and their families.

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

I am very thankful to have Megan Mobley back on the blog today as she discusses how her faith impacts her work as a PT school professor. She recently detailed some of her PT work in a burn unit and now has been gracious enough to answer similar questions but in regards to her new position in the world of academia. I hope you find it insightful and encouraging!

1. Where did you work? Describe your work population.

I recently (July 2021) became an assistant professor in the physical therapy program at Augusta University. My main responsibility is teaching second year Doctor of PT students in the following areas of PT: hospital-based, critical care, wound management, scar management, and neurological rehabilitation (acute, inpatient rehab and outpatient). I am also involved in serving the department on the Admissions and Student Affairs committee, and I will eventually be involved in research projects.

2. What do you enjoy about working as a faculty member at a PT school?

I love teaching! Practicing PT in a very specific area led me to a lot of teaching opportunities (continuing education courses, guest lecturing at PT schools, and traveling to new burn centers around the US). I love the hunger for knowledge that the DPT students have as well as their excitement for a career in physical therapy!

3. What are some of the unique physical, emotional, or spiritual challenges of teaching in a PT program?

Academia is quite different than practicing in the hospital/clinic. Each of the faculty have their individual agenda and responsibilities for the day. We are all spread out in our own offices, and I miss the days of several therapists gathering around the PT office in the hospital to share lunch together or tell jokes while we documented at the end of the day. The OT department is upstairs compared to me co-treating with an OT in the hospital. Other professions are mainly available through email for collaboration versus sharing a therapy office with other professions. We team teach our courses (usually with 1-2 other faculty members), so that helps me not feel as isolated. I want the students to succeed, and I have not had formal training in how to teach, so that puts some emotional pressure on myself to make sure that I am delivering the content well. In a few years, I will most likely pursue a Doctor of Education degree (EdD).

4.  How does your faith impact your work and how you view your student/colleague interactions?

Being in this position is very humbling. PT school was a difficult time for me. It was the first time when I struggled in school and really had to fight for something that I wanted. It is quite humbling to be on the other side of the desk. I want to support the students as best as I can with their academic needs as well as their emotional needs. They are not just PT students – they have lives outside of school, which sometimes adds stress to an already stressful chapter of their lives. When a student has to retake a written or practical test, I want them to know that I want to use this opportunity to bring them up to speed on specific material that they had trouble grasping initially. I always try to ease their anxiety and stress level, and let them know that I am here to support them!  
 
I also do not take this opportunity for granted. The opportunities that I have had in my PT career to specialize in a very specific area of PT, and work for a hospital company with burn centers around the country, provided me with countless experiences and helped develop the skills that I need to teach these physical therapy students.

5. Briefly describe a story in which you really felt like you ministered to either a student or colleague patient and their family.

Since beginning last summer, I have had two students cry in my office. They were so stressed out about school and other personal factors that it led them to shed tears. I just sat and listened. I wanted to be sure that they felt heard and their feelings were validated. It is important that we see them as people with other responsibilities and relationships outside of this department. These interactions bring back memories of when I was a student, and my professor did the same for me. I am so thankful that the Lord led me here to be there for current PT students!

Megan

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

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In the world of Physical Therapy, like many other professions, education is a large component. We teach so many things to our patients. We teach them about movement mechanics, tissue healing, and pain science. We teach them anatomy, proper exercise form, the benefits of exercise, and many other facts for healthy living. The patient education component to our profession is, what I think, sets us apart from many other health care professions.

Many of the topics that we teach to our patients are complex and can be difficult to understand and we have to be sensitive to all types of ages and educational levels. So, how can we take many of these big concepts and make them more tangible? Enter analogies.

Analogies are a literary device in which a comparison is made between two things for the purpose of explanation and clarification. They are helpful in making more difficult or abstract ideas easier to understand. This is crucial to helping our patients understand their mechanical or physiological problems and without it, can leave the patient questioning if an intervention is necessary. When a patient truly understands the “why” well, compliance is certain to follow. 

So, what are some keys to creating good analogies? Here are two that I have thought about and learned from one of my colleagues who is really good and creating analogies for patient education.

Keep it simple. We don’t want to get too wordy because then the comparison can get lost. We want to share the comparison in a simple way with simple language that really highlights the comparison to bring better and more complete understanding.

Make it Relatable. This is where one of my colleagues really excels. He can convey his education concepts with the perfect analogy tailored to the patient. So, for example, it wouldn’t necessarily benefit an athlete to use the language of a welder. And likewise, we would want to try to explain a therapy concept using the characteristics of plumbing to a patient who is a plumber and not a pilot. And if you can’t come up with a career or work specific analogy, that’s OK. Just make sure that it is something generally relatable that most individuals would understand.

It’s also important to pick up analogies from your colleagues. I’ve incorporated many analogies that I have heard from others that resonate with patients. I think analogy sharing is an important part of clinic cohesion and that translates to patient experience. So, what are some of the analogies that you use when educating patients on certain topics? Let’s share!

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

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Not too long ago on a rainy Saturday, my kids were pacing around the house, bored trying to figure out something to do together since they couldn’t go outside to play. They were restless with energy to burn. Then one of them suggested the game hide and seek to the squealing delight of my 3 year old because she loves that game.

The countdown began and the sound of scurrying feet reverberated around the house as each child rushed to find the best possible hiding spot. For a few moments, there was actually silence in my house while the search began, which was refreshing. But then you could start to hear little giggles and chuckles as each child was found in their hiding spots and eventually a new round started.

As the game wore on and more rounds were played, the excitement of finding their siblings grew and grew to the point that in the last few rounds, there was raucous squealing and laughter of pure delight every single time one sibling was found. In the midst of all the noise and happiness of a classic game on a rainy day, I found myself reflecting on the situation I was observing. It reminded me so much of what Jesus tells us in his word speaking to Zaccheus.
 
“And Jesus said to him, ‘Today salvation has come to this house, since he also is a son of Abraham.’ For the Son of Man came to seek and to save the lost.” Luke 19:9-10

Much in the same way my kids were out searching for each other with joy and anticipation, we too, as followers of Christ with a disciple-making command should follow in Jesus’ footsteps and seek out the lost with joy and anticipation. We come into contact with so many people during the course of our day. Family members. Colleagues. Co-workers. Patients. And the list goes on. I needed that reminder from my kids. And maybe you need that reminder too - that we are to be seekers of the lost in order to bring them to Jesus and salvation.

But the other part of watching a rainy day Hide and Seek game unfold in my home was the utter excitement, joy, and laughter when one was found. It reminded me again of God’s word when Jesus is teaching his disciples.

“I tell you, there will be more joy in heaven over one sinner who repents than over ninety-nine righteous persons who need no repentance.” Luke 15:7

“Just so, I tell you, there is joy before the angels before the angels of God over one sinner who repents.” Luke 15:10

It is incredible to me that God could have used any means to bring lost souls to himself but He, in His wisdom, ordained me and you  to seek those who are lost, those who need to be found and brought to the light. And what a joy it is when salvation is granted. What a cool thought that we get a role in making all of heaven rejoice! So, who will you seek out in these days to bring to the father?

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

 Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

I am beyond thrilled today to have another friend and colleague back on the blog today in our "Faith at Work" series. Please welcome Megan Mobley to the discussion! She has graciously put together some thoughts and encouragements for us from her perspective of working as a PT in a burn unit. And if you want to get caught up with the series you can view previous therapists thoughts on these links: Neuro Rehab, Spinal Cord, Management, Ortho/Sports Rehab, Acute Care 1, Acute Care 2. Enjoy!

Where do you work? Describe the patient population in which you work.
 
Since graduating in 2010, I have been working as a PT at the regional burn center in Augusta, GA (Joseph M. Still Burn Center), which happens to be the largest in the USA. All of my patients have impaired skin, whether it be burn injuries or complicated wounds (necrotizing fasciitis, Stevens-Johnson syndrome, pyoderma gangrenosum, calciphylaxis). I am also involved in wound care in our outpatient clinic that involves scar management after burn injury, smaller non-healed burns, or less complicated wounds (venous, arterial, diabetic, pressure).

 What do you enjoy about working in that field of PT?
 
Never did I expect to go into wound care, but I have always loved the hospital setting. The burn center is such a special place. No one expects to get injured, and families are uprooted from around the southeast portion of our country (we have some international patients too), in order to come to Augusta, GA for treatment. I am able to walk along the patient and their family members during the most traumatic event of their lives.

What are some of the unique physical, emotional, or spiritual challenges of working in that field PT?
 
I touched on some of this above, but burns are an unexpected trauma. A loved one is recovering in the hospital, who may have been the breadwinner of the family, a father of 3 kids, and lives in a town 3 hours away from Augusta. Families take turns visiting. Some patients have no visitors. Many staff members are burned out from working in this setting, and treat it only as a job. It has to be so much more than that! Patients are in the hospital from just a few days to 6-12 months prior to their first admission home. Some patients never make it out of the hospital unfortunately. It can take a toll on you emotionally, but you have to stay focused on the long term of getting that patient as independent as possible and returning home. Your co-workers are a great support system. We work very closely together and support one another. In this setting, your co-workers truly are the only ones who understand your day. Patients are always in pain, but they are able to receive some pain medications, but therapy is never pain free here. I love educating the patient and their family on what their new normal may look like upon discharge home.

How does your faith impact your work and how you view your patient interactions?

Loving others above myself. Loving my patients and their family members even when they are unlovable. I can extend this love because Jesus first loved me. I try to be compassionate and put myself in the patient's or caregivers' shoes because this is their first experience going through a catastrophic burn injury (even though I have seen it countless times). I try to explain and educate them on healing timelines and what to expect during recovery. It is not an easy place to work, but I see it as a mission field. We have patients who tried to commit suicide but were given a second chance. I try to point those things out that the patient has a purpose and is still here for a reason.

Briefly describe a story in which you really felt like you ministered to a patient and their family.
 
There was a young couple that I worked with several years ago, and the woman was injured over 50% of her body including the most visual areas of the body: her face and hands. Her husband was at her side every day in the hospital, and their home was 3 hours away. He would participate in our therapy sessions, and he was always so engaged saying “She is my best friend. I will do anything for her.” It is a full time job for a caregiver when a patient with a large burn injury discharges home: lotion application and massage every 2 hours, donning compression garments and wearing them 23 hours/day, stretching, exercises. I was able to be there for this patient and her husband as they transitioned home after being in the hospital for several months with a burn injury that was not fully healed. I tried to educate and give them home exercise programs and other resources to help them prepare for managing everything at home. This particular couple ministered to me as well because their love and commitment were so strong to one another! Over the years, I have seen other spouses leave their partners after this type of injury because “this wasn’t the life I signed up for.”

Megan

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

Hello Everyone! Thank you for your patience with this blog. I mentioned a few months ago that my wife and I were having another baby girl and I was going to take pause. Well, now she is 3 moths old and we are enjoying having a little snuggly one in our house. I am finally feeling like I can get back to this platform a little bit, albeit slowly. So, I am excited to be back! And since I've been off for a little while, I thought I'd post a Journal Club from one of recent work discussions.

There are always many fun topics and research to discuss when talking about ACL rehab, recovery, and return to sport. We’ve even talked about some of the new research and ideas when it comes to ACL rehab on this platform. But one of the interesting aspects that often gets pushed to the back burner if you will is the psychology of return to sport after ACL injury and recovery.

In a previous Journal Club on this blog, we looked at a recent study involving the importance of looking at confidence and return to sport and provided an additional tool for you to use in your clinic to consider the mental state of your patient in reference to their rehab process and readiness to return to sport.

Similarly, a recent study came out looking at self reported fear and ACL recovery - specifically fear of activity after ACL and re-injury and this was the topic of our most recent residency journal club meeting.

ACL Reconstruction and Self-Reported Fear

The researchers found 40 patients who were cleared for return to sport and had them fill out the Tampa Scale of Kinesiophobia (TSK-11) along with other standard functional measures. Then these patients were tracked over a 12 month period to identify any subsequent ACL injury.
The results were interesting and lend credence to what we might have assumed. Essentially, the researchers found that, indeed, a higher score on the TSK-11 showed decreased activity levels of the year and increased risk of re-injury.
 
So, much like the functional measure we discussed previously on confidence, this study also validates the usage of a fear based outcome measure to help us better identify at risk patients for re-injury. We can subsequently use that information to help educate and tailor strength interventions to decrease the TSK score and improve that patient's activity level and ultimately quality of life.

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

I want to first of all thank all of you for the feedback over the past few years. It is encouraging to hear from y’all about the impact this blog and platform has had since its inception. It truly warms my heart and helps me to continue to write and build content. I really do love writing and publishing helpful content both here and postings on other social media platforms.

But sometimes life situations change and a pause is required in something you love doing to preserve the family/marriage/life/work balance. So, in order to prevent myself from getting overextended , I have an announcement to make.

I will be taking a few months off from writing and publishing blog content. Not because I am out of ideas or because I’ve lost interest but because of an exciting life event coming up: My wife and I will be having another baby girl in the next few weeks!!

We are thrilled to bring another child into our family but that will necessitate more dedicated time to my family for the time being. I will still continue to try to post brief quotes, verses, and other articles on the facebook page @ptsonmission. So you can continue to follow over there to stay connected.

I will also use this time to try to move current content onto different platforms like YouTube. And this will be a great time to hear from y’all too, so don’t hesitate to post or message me!

Thank you for understanding and if you are enjoying this platform please continue to share and spread the word. I will be back with y’all in a few months!

Jason

​***Check out the new book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***