Exercise is a staple in physical therapy treatment, yet it is often underdosed. By does, I am referring to the frequency, duration, and intensity. Many physical therapy studies that incorporate exercise fall into the underdosed category as well. To have a better understanding of the power of exercise and appropriate application, we need to pull from the exercise physiology and strength and conditioning community.
While we treat pain, and exercise can help with pain, we also need to address power, strength, hypertophy, and endurance. The latter two are sometimes achieved in the clinic, but strength and power are often neglected.
Below are a handful of articles that can be used as foundational pieces for clinical practice. This is clearly not meant to be comprehensive. Instead, my goal is to use them to showcase the breadth of designing exercise programs in the clinic. Programming and measuing intensity is not exclusive to the sports and performance world. To obtain the best outcomes, and to treat exercise as medicne, we must pay attention to the details and apply more than a flow sheet.
I am not a registered dietician and I am not here to give nutrition advice. If you want to know what I eat, I am happy to let you know along with my reasonings. When treating patients, nurtition can be addressed in two ways.
The first is to provide direct intervention through developing dietary strategies and providing patient education. Depending on your state practice act, that may not be an option. Even if it is, tread lightly if you lack the necessary background in nutrition education.
The second is to adjust your plan of care based on the patient's nutrition status. This can, and should, be applied in all patient cases. What you patient eats affects how they will respond to exercise and how their body will heal. Through motivational interviewing, I attempt to gather at least a rough idea of a patients diet on day one. You only know what to do with this information if you develop some foundational nutrition knowledge.
As nutrition is a vast subject, I will not attempt to curate a representative collection of articles. Instead, I have added a few on the impact nutrition can have on patient presentations.
One of the fastest ways for a patient to torpedo their plan of care is insufficient sleep. Bear in mind, we don't all require the same duration of sleep. Some people operate at full capacity on a mere six hours while other struggle with anything less than eight. Much of the benefit lies in the quality and the consistency.
We receive little to no education on sleep in physical therapy school. Other healthcare professional receive equally poor education on the topic in school. This leads to a gross udner-educaiton and neglect within healthcare. While sleep education has gained popularity in mass media over the past 5 years, and more clinicians are recognizing the importance of it, few patients receive adequate education.
One of the main reasons is lack of clinician education and understanding. Another is the priority of topics to discuss in the clinic. The research below provides a strong overview of why sleep should be high on your priority list and part of every plan of care.