Post Rehab Challenge

Here is an interesting case study you might like to figure out. You receive a post rehab referral from a local rheumatologist. The client is a 48 year old female with a history of rheumatoid arthritis and two recent motor vehicle accidents (the last accident was 5 months ago) with subsequent cervical injury. She completed a course of chiropractic care to manage the cervical pain. She no longer has cervical pain and she full cervical ROM but she complains of right shoulder pain. The shoulder pain occurs with overhead activity and movements across the midline of the body. She also has pain at rest along the lateral aspect of the right shoulder in the area of the deltoid. Her x-rays after the second accident show no fracture. The shoulder pain seems to occur with cervical right side-bending and right rotation. X-ray and MRI of the right shoulder show are unremarkable. What cervical nerve root innervates the lateral aspect of the shoulder? How does right cervical sidebending/rotation effect the client's shoulder pain? Please email your responses to this case study to DrMike@postrehab.com.

Dr Mike

Selling Post Rehab Fitness Using the Assessment

For medical exercise specialist and corrective exercise specialists selling personal training and post rehab sessions is becoming more challenging in this economic environment. I interviewed a former student, good friend and very successful post rehab professional, David Gilks, MES, MEPD of Nanaimo, BC. David shared his strategies for selling personal training and post rehab sessions using the post rehab assessment. Click the link below to listen in our this interview. I guarantee it will change your concept on the use of the post rehab assessment as a sales tool.

Dr Mike

My Post Rehab Story - Here's how the Medical Exercise Specialist certification started!

Hi, I am Dr Mike and in 1994 we offered the first post rehab certification for fitness professionals, the Medical Exercise Specialist workshop and certification. I am asked frequently how it started. So I would like to share this story. Please click the video link below to learn how the MES and our other post rehab certifications began more than 14 years ago. For more information on our certifications visit us at www.postrehab.com.

Post Rehab Tip 7 - The Components of Function

Medical Exercise Specialists and Post Rehab Conditioning Specialist are bombarded with information on "functional training" programs. It's important to understand the components of function and how exercise will impact on the overall functional capacity of the post rehab client. Functional improvement is the most important aspect of rehabilitation. The components to function include:

If any or all of the components of function improve with exercise, then the client's overall functional capacity will improve. Remember, its all about "function" with the post rehab client. Click the link below to listen to this post rehab tip.

Dr Mike

The post rehab fitnesss/medical exercise approach....do you have a system?

Managing the post rehab client requires a systematic approach to assessment and exercise program design. The first step is understanding the related clinical anatomy and pathology of the client's condition. The next step is understanding what NOT to do with regard to exercise for the client. Once you understand what not to do now you must determine the key areas that must be assessed to determine the client's exercise capacity and function. After you have completed the client assessment now you may proceed with establishing an exercise program. Each post rehab client must be approached using this step-by-step systematic approach.

1. Understand the related clinical anatomy and pathology.
2. Based on the client's condition what exercises and/or activities are contraindicated.
3. Determine the key assessment techniques, based on the client's condition, you must utilize to assess the client.
4. Develop a safe and effective post rehab exercise program based on your assessment findings.
   

If you can establish a systematic approach to developing the post rehab program, you will increase your clients success levels as well as establish yourself as the post rehab expert in your community. We use this same approach in our PREPS - Post Rehab Exercise Protocols. Visit www.PREPS-Protocols.com for more information and to download a sample protocol.


Dr Mike

Post Rehab Product Spotlight - TubeTrak

The TubeTrak is a great new post rehab product developed by Fran Scheel, MS, MES. The TubeTrak is a great tool you may use to provide rubber tubing resistance for several regions of the body. I tried the TubeTrak with a few clients and it's easy to use and provides a simple means of giving resistance in functional movement patterns for a wide range of joints and conditions. If you have a small studio and you need a way of providing resistance with rubber tubing, TubeTrak might be your answer. Go to www.tubetrakstation.com for more info.

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