Assessing function in seniors.....which method do you use?

I recently received a call from an experienced MES with specialization in aquatic fitness. She was interested in the incorporation of functional movement patterns into her aquatic fitness classes for seniors. As we discussed which movements might work best for general senior fitness population I asked if she included an individual functional assessment during the intake process for new aquatic participants. She reported her facility did not because there were no functional assessments she found that were short and easy to perform. She needed a quick assessment that could easily be performed poolside and would take no more than 10 minutes. I immediately recommended the Functional Status Index (FSI).

The FSI is more subjective than objective but it does give you an overall view of the client's functional status in a brief easy to use format. The FSI should take no more than 10-15 minutes to perform. If the assessment you provide is free, as in the case of this young lady, then the FSI is the best choice because of its ease of use. Remember, if we assess function at the start of the program, we must reassess function at no more than 30 day intervals to determine if your program is truly achieving the increase in function capacity we want. You may download a copy of the functional status index by clicking the link below.

Functional Status Index

We review the step-by-step procedure for administering the FSI along with eight other functional assessment scales in our Current Topics in Post Rehab DVD series. The other functional assessments reviewed on the Current Topics DVD include the Harris Hip Scale (commonly used with total hop replacements), Lysholm's Scale (knee pathologies), the Ankle Foot Scale (ankle and foot pathologies), the Tinetti Gait and Balance Scale (balance dysfunction), the Shoulder Strength Scale (shoulder pathologies), and the Oswestry Scales for the lumbar and cervical spines (spinal pathologies). The Current Topics in Post Rehab 2005 DVD is part of our MES and Essentials of Post Rehab Fitness DVD workshops. For info on the MES or Essentials DVD workshops, please click on the link below.

There many functional assessment tools available but we here at AAHFRP have identified the nine we feel are most useful and easy to use for fitness professionals. I recommend you incorporate a functional assessment tool into your post rehab assessment.

Dr Mike

Should I use soap?

SOAP notes are used in clinical settings to document the treatment, progress and recommendations for future management of the patient. Utilization of the SOAP format is usually thought of in a clinical setting. I don't recommend the soap format for the post rehab professional. I do recommend the use of narrative and/or form-based progress reporting format. We developed a session log to document the activities and the outcome of a post rehab session . Our post rehab progress report form allows PRP's to report client progress on a one-page sheet while noting changes in strength, rom/flexibilty, endurance, balance and function. Look for our upcoming podcast on writing post rehab assessment and progress reports.

Dr Mike

Congratulations to our New Medical Exercise Specialists and Post Rehab Conditioning Specialists

We would like to congratulate our new Medical Exercise Specialists (MES) and Post Rehab Conditioning Specialists (PRCS). These individuals recently passed either the MES or PRCS exam. Again, congratulations and best wishes building your post rehab practices.

1. Lisha Perini, MES - San Luis Obispo, CA
2. J.R. Smith, MES - Somerset, KY
3. John Johnson, PTA, PRCS - Petaluma, CA
4. Alana Yates, MES - Tulsa, OK
5. Marsha B. Pogue, MES - Tulsa, OK
6. Michon Wynn, MES - Tulsa, OK
7. Neil Hodgson, MES - Tulsa, OK
8. Eric G. Nieusma, MES - Fort Lauderdale, FL
9. Michael Marasigan, MES - New York, NY
10. Angel Perez, MES - Westwood, NJ
11. Albert R. Ferrara, MES - New Providence, NJ
12. Jill Foster, MES - Burke, VA
    
13. Steve S. Page, MES - Corona Del Mar, CA
    
14. Julia Derek, MES - New York, NY
15. Steve Beattie, MES - Toronto, ON
    
16. Jeanne M. Douthit, MES - Tulsa, OK
    
17. Vinisha V. Shah, MES - Toronto, ON
18. Adele Tevlin, MES - Toronto, ON
19. Stewart Knorr, PRCS - Riverside, CA
20. Ronald Holley, PRCS - Washington, DC
21. Kristin Fisher, MES - Washington, DC
22. Leslie Lawrence, MES - Edmonton, AB
23. Lesley Bates, PRCS - Comox, BC
    
24. Sally Whibley, PRCS - Errington, BC
25. Jeffrey F. Collingwood, MES - Salisbury, CT
26. Joan Collingwood, RN, MES - Salisbury, CT
27. Karen Church, MES - Salisbury, CT
    
28. Juliana DeFriese, PRCS - Concord, CA
    
29. Sheryl Oeftering, PRCS - Keyport, NNY
    
30. Michael Fitch, MES - Miami Beach, FL
    
31. Hayley Ridgway, PRCS - Cheshire, England
    
32. Jim Keizer, MES Miami Beach, FL
    
33. Elizabeth Blanton, RN, MES - Valdese, NC
    
34. L. Reine Vilim, MES - New York, NY
    
35. Paul McKinney, MES - Victoria, BC
    
36. Jacquelyn M. Campbell, PRCS - Fort Washington, MD
    
37. Nicholas Luciano, MES - Bel Air, MD
    
38. Jon Rainey, PRCS - Victoria, BC
    
39. Kaly William Robinson, PRCS - Victoria, BC
    
40. Thomas Acheson, PRCS - Victoria, BC
    
41. Aisha Ellis, MES - Toronto, ON
    
42. Derrick Whelan, MES - Toronto, ON
43. Michelle Hosty, MES - Toronto, ON
44. Levi Sampson, PRCS - Victoria, BC
    
45. Kari Putnam, PRCS - Austin, TX
    
46. Austin Barbisch, PRCS - Austin, TX
    
47. Kimberly Lawrence, PRCS - Dublin, CA
    
48. McAllister Dodds, PRCS - Lafayette, CA
    
49. Lori Anne Thompson, MES - Belleville, ON
    
50. Courtney Gregory, PRCS - Arnold, MD
    

How does a Medical Exercise Specialist Build Credibility?

Credibility seems the one thing post rehab professionals are consistantly searching for but in all the wrong places. I think our Medical Exercise Specialist workshop and certification is the best on the planet. The MES workshop is thorough and gives you all the tools and knowledge you need to succeed. But just having the MES won't give you instant credibility. Credibility is built from the ground up by working with a large number of medically-based clients with wide range of conditions over a long period. During that period you demonstrate the ability to manage and progress these clients effectively and you communicate this information to medical professionals and insurance carriers in a clear and concise manner. Again, this is over a long period.

I built credibility as a physical therapist not because I had a PT degree or a license. It was built over a long period treating a wide range of patients and working closely with their physicians and other medical professionals. If you think credibility comes in a certification, weekend workshop, an exercise technique or website, you are sorely mistaken. If you can look back at a large number of your clients and unequivocally say you have managed them well and 80% reached their goals.....YOU HAVE CREDIBILITY!!! The MES certification will give you more knowledge and skills to reach more medical professionals and clients. The MES certification can not make your credible if you have no foundation.

Please let us hear your comments on building credibility by recording your thoughts at 214-615-6505 x9985. We appreciate hearing from you. Click the link below to listen to my comments on building credibility.


Dr Mike

Do you have the "8 Habits of Highly Effective Post Rehab Professionals"?

As I travel North America teaching our Medical Exercise Specialist and Advanced Essentials of Post Rehab Fitness workshops, I have noticed the highly successful Post Rehab Professionals (PRP’s) demonstrate eight habits that guarantee their success. We will discuss each of these 8 habits and explain the impact each has on a post rehab practice. Successful PRP’s are able to develop safe and effective post rehab programs for a wide range of medical conditions, establish long-term referral relationships with medical professionals, and receive insurance reimbursement for post rehab services. If you embrace these habits, I guarantee you too will grow a profitable and successful post rehab practice. The 8 Habits of highly successful post rehab professionals include:

1. Define
2. Present
3. Report
4. Follow-Up
5. Assess
6. Progress
7. Motivate
8. Educate

PRPs define their scope of practice and role in a clear and concise statement in their brochures, marketing materials and presentations. Defining your scope of practice and clearly outlining your menu of services allows you to position yourself as the expert in the rehab spectrum, rather than relying on someone else who lacks a true understanding of your background and education. This could result in an inaccurate definition that will negatively impact the destiny of your practice. Providing a definition of post rehab fitness will further reinforce your scope of practice and prevent any misunderstanding or misconceptions regarding your role as a PRP.

To read more about the 8 Habits, please click the image below to download the podcast and full version of this posting.

Post Rehab Tip #6 - Utilization of Heart Rate Monitors

Use heart rate monitors with ALL clients. Even clients with musculoskeletal disorders should use heart rate monitors. Many clients do not exercise at the appropriate intensity levels. Working in the target zones ensures the improvement of cardiovascular efficiency and the avoidance of extremely high exercise intensity. Though heart rate monitors may not work for clients on certain medications, primarily beta-blockers, the majority of clients will benefit from their utilization. Listen to this post rehab tip by clicking on the link below.

Dr Mike

Member Spotlight - Debbie Pickersgill, MS

Our post rehab member in the spotlight is Debbie Pickersgill, MS of Queensland, Australia. Debbie is the manager of a unique program at the University of Queensland titled "AgeFit". Debbie attended our Medical Exercise Specialist workshop and certification in Fort Lauderdale in March 2008. AgeFit is a unique supervised exercise program designed to meet the needs of seniors with medical disorders. The program serves more than 100 senior participants with neurological, cardiovascular and musculoskeletal disorders. Please take a few moments to learn about AgeFit and to meet Debbie. Click the title "Member Spotlight" to access our website to listen to the interview.

Post Rehab Tip #5 - Wolfe's Law

Wolfe’s Law is the very basis of post rehab and strength training. Wolfe postulated that if we stress connective tissue it will become stronger. Strengthen training actually makes bone, muscle, tendons, ligaments, muscle and even cartilage stronger. Even connective tissue has limits. This limit is known as the "physiologic threshold". The physiologic limit or threshold is the amount of force the tissue may absorb before damage occurs. Tissue damage occurs when the force exceeds the limit. Sprains, strains and ruptures are examples of exceeding the physiologic limit or threshold. Wolfe's Law is fundamental in understanding the injury process and post rehab program progression guidelines. Click the link below to listen to this post rehab tip.


Dr Mike