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Evidence Based Practice
Don’t Be Afraid of Early Mobilization in Acute Brain Injury
February 20, 2018 by Mary Beth Osborne, PT, DPT, NCS
This article was originally written for Medbridge and is shared here with permission. People who suffer brain injuries require extensive medical care to preserve vital organ functions and prevent secondary injury. Physical therapists are in a unique position to positively influence the ultimate outcome for these individuals by simply providing early mobilization. Two studies provide support for early...
Evidence Based Practice
Evidence Update: Adding Resistance to BWSTT
November 27, 2017 by Elena Noble, MPT
Although integrated into pediatric clinical practice for the last decade, body weight supported treadmill training (BWSTT) continues to be an area of research interest and an evolving intervention. We can see this reflected in a recent study examining effective motor learning strategies for treadmill training. For children with disabilities, the treadmill is a safe place where they can organize their...
Evidence Based Practice
Evidence Update: Dynamic Gait Training for Child with SCI
October 17, 2017 by Elena Noble, MPT
Because good clinical evidence on the benefits of gait training is so scarce, we celebrate every contribution we find. Here’s one that specifically explores the effect of dynamic gait training on a child with a spinal cord injury. After sustaining a complete T10 spinal cord injury (SCI) at 23 months old, this child began a walking program six months later. She initially started with a posterior...
Evidence Based Practice
Improving Gait in Chronic TBI with Motor Learning Strategies
July 25, 2017 by Elena Noble, MPT
Long-term disability is a frequent sequel of traumatic brain injury (TBI) and takes the form of persisting motor impairments that impact walking and autonomous movement. So to improve environmental negotiation and basic care skills, independent gait is an essential therapy goal for TBI patients. Literature shows that the best time for independent gait recovery occurs within the first few...
Evidence Based Practice
Evidence Update: Rehab Gait Training with BWS
June 27, 2017 by Elena Noble, MPT
Gait rehabilitation uses both body weight supported treadmill training and over-ground training to help a client reach their maximum walking potential. With no established clinical indications, choosing between the approaches is a research-based and experience-based decision which factors in the nature of a client’s injury, timing and scope of intervention and projected outcomes. Here are two recent...
Evidence Based Practice
Evidence Update: Task-Specific Gait Training Improves Gait Speed
January 05, 2017 by Elena Noble, MPT
Improving gait parameters is a primary goal of therapy intervention. One of these parameters is gait speed because we know there is a link between how fast we walk and how well we interact with our surroundings. (Just notice how frustrated your aging parents become as their gait slows them down.) Simply put, refining gait through therapy ultimately improves speed and boosts quality of life. There are a...
Evidence Based Practice
Evidence Update: Quicker Recovery with Early Movement
July 13, 2015 by Elena Noble, MPT
A recent study at Cleveland Clinic, a leading rehabilitation provider, found that patients participating in early mobility routines after neurological injury recovered quicker and went home earlier than those receiving standard care. NPR recently ran an excellent segment on this study providing good detail and anecdotes from the researchers illustrating how early mobilization is improving the...
Evidence Based Practice
Evidence Update: Safe Patient Handling
June 03, 2014 by Elena Noble, MPT
As therapists working in acute care and rehab well know, safe patient handling (SPH) is becoming a widely accepted discipline. Advocating the use of lifts and additional equipment for patient transfers and gait training routines, the safe patient handling movement seeks to eliminate all unnecessary manual handling of patients. This is because statistics have clearly shown that work-related musculoskeletal...
Evidence Based Practice
Three Principles of Neural Plasticity to Apply in Your Rehabilitation Practice
December 03, 2013 by Gilbert Thomson, PT
There has been a great deal of interest in recent years in the study of plasticity in the nervous system. Plasticity simply means the capacity of the central nervous system to adapt and change. Changes in the structure and function of the nervous system accompany improvements in motor skills that happen with learning and with rehabilitation after neurological damage. Although much of the work on neural...
Evidence Based Practice
Evidence Update: Early Mobility in the ICU
March 26, 2013 by Elena Noble, MPT
Since introducing our XL Pacer, TRAM, and E-Pacer we have been introduced to a growing body of clinicians who are active in early mobility, a practice that is becoming increasingly accepted and implemented in ICUs across the country. There is growing evidence showing that the provision of early ambulation support to critically ill and injured patients results in more favorable recovery outcomes as...