The Pulse

Proper trunk positioning is an essential component of optimal aerobic capacity training. Poor positioning of the head, neck, shoulders, trunk, and pelvis during aerobic exercise may compromise an individual’s ability to reach optimal functional outcomes.

Patient Information: Female, Age 85

Diagnosis: Fractured ribs / CHF / Generalized weakness

History: This woman was hospitalized after falling and fracturing seven ribs. During her
hospitalization, she began having complications from chronic heart failure which resulted in an
extended stay of almost a month. By the time she was discharged from the hospital, her function had declined as a result of generalized weakness and pain in her low back and upper shoulders. She was referred to therapy to recover her function, treat her pain, and improve her activities of daily living.

Patient Information: Female, Age 72

Diagnosis: Multiple Sclerosis / Chronic Left Leg Pain / Fibromyalgia

History: This woman, a long-term skilled nursing facility resident, was referred to therapy due to an increase in chronic left leg pain and decreased safety with functional mobility. Prior to this decline she was independent with transfers and walking.

Increasing emphasis on the value of care over the volume of care provides opportunity to incorporate different therapy delivery modes. Therapy delivered in a group format offers benefits over traditional one-on-one therapy that include increased socialization, independence with exercise, and improved transference of learning.

Patient Information: Female, Age 86

Diagnosis: Right Shoulder Fracture / Shoulder Pain

History: This woman fell at her home in an assisted living facility, resulting in a fracture of her
right shoulder. She was evaluated and treated in the emergency room and returned home with an immobilizer to limit the movement of her shoulder. After six weeks of right shoulder immobilization, she was referred to outpatient therapy. Prior to her fall she lived in an assisted living facility and was independent with dressing, eating, and bathing.

Gersten’s 1955 article on the effect of ultrasound on tendon extensibility began six decades of continuous published research, which has demonstrated the tried and true benefits of ultrasound. ¹ These benefits include pain reduction, a high degree of patient comfort and acceptability, increased cellular microcirculation, relaxation of trigger points and improved collagen extensibility. All of these physiological benefits are dependent on proper dosage and application technique. Ultrasound can provide both mechanical and thermal effects. An effective, skilled ultrasound treatment requires the use of high-quality ultrasound equipment, evidence-based patient-specific parameters, the appropriate treatment area, proper transducer movement speed, and optimal incorporation of the treatment with other therapy procedures.

Patient Information: Male, Age 86

Diagnosis: Stroke / Oropharyngeal Dysphagia / Dysarthria

History: This gentleman was admitted to a skilled nursing facility for rehabilitation services due to oropharyngeal dysphagia (difficulty swallowing) and difficulty managing saliva after hospitalization due to a stroke. He was only consuming 0-25% of his meals. Prior to his stroke, he lived at home with family, worked two days a week, and ate a regular diet.

Patient Information: Male, Age 72

Diagnosis: Spinal Stenosis / Muscle Weakness / Low Back Pain

History: This gentleman went to the emergency room (ER) due to increased pain from spinal stenosis. He received pain medication and was sent home. He fell and returned to the ER and was referred to a skilled nursing facility due to his inability to bear weight on his right leg, walk, or return home. Previously he lived independently in a single story home with three steps at the entry.