The Pulse

Diaphragmatic Breathing Exercise and Patterned Electrical Neuromuscular Stimulation (PENS)

Posted by ACP on Jun 18, 2020 10:18:20 AM

Diaphragmatic breathing helps individuals use their diaphragm correctly while breathing and enhances oxygen exchange (Cleveland Clinic, 2020). With age, stress, poor posture, and illness breathing changes and becomes shallow with increased reliance on accessory muscles. Implementing diaphragmatic breathing may help improve oxygen delivery throughout the body, use less effort and energy to breathe, and decrease overall oxygen demand.

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Topics: Clinical Tip, Cardiopulmonary

Improving Activation of Accessory Respiratory Muscles with NMES

Posted by ACP on May 26, 2020 10:09:12 PM

Primary respiratory muscles during normal quiet breathing include the diaphragm and external intercostals. Accessory muscles of respiration assist the primary muscles when the chest is not expanding or contracting effectively to meet ventilation demands. Increased age, stress, poor posture, COPD, pneumonia, and illness are conditions that negatively impact proper oxygen and carbon dioxide exchange in the lungs.

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Topics: Clinical Tip, Cardiopulmonary

Rehabilitation for Severe Deconditioning Using Advanced Technology and Electrical Stimulation

Posted by ACP on Apr 22, 2020 6:03:18 PM

Individuals who present with a compromised pulmonary system, are acutely ill, or hospitalized for extended periods may become deconditioned or develop hospital-acquired muscle weakness, among other deleterious effects. Even healthy individuals may become deconditioned and frail if they decrease their activity level due to social distancing and limiting time outside their room or home.

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Topics: Clinical Tip, Cardiopulmonary

Infection Control Procedures

Posted by ACP on Mar 18, 2020 11:13:37 AM

Infection control and patient safety are top priorities in healthcare. This document reviews low-level and intermediate-level infection control procedures for use with ACP technology to ensure the safety of healthcare providers and patients.

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Topics: Clinical Tip

Heart Failure Clinical Practice Guidelines Therapy Recommendations

Posted by ACP on Feb 24, 2020 5:54:24 PM

Approximately 6.5 million adults in the United States have heart failure. Heart failure (previously referred to as chronic heart failure or CHF) occurs when the heart cannot pump enough blood throughout the body to meet the requirements of other organs and muscles. This results in a wide variety of symptoms and functional impairments which may result in hospitalization, re-hospitalization, and death. In 2017, heart failure contributed to 1 in 8 deaths. (CDC, 2020)

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Topics: Clinical Tip, Cardiopulmonary

Virtual Reality in Rehabilitation

Posted by ACP on Jan 27, 2020 10:54:43 AM

Over the past several years, the body of evidence on the effectiveness of virtual reality (VR) in rehabilitation has significantly expanded. VR has been studied for a variety of diagnoses including stroke, Parkinson’s disease, multiple sclerosis, dementia, burns, pain, and total knee arthroplasty. VR helps enhance patient involvement and motivation while increasing the repetitions and duration of exercise. Benefits addressing ADL performance, balance, gait, pain, and cognition have been reported.

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Topics: Fall Prevention & Balance, Pain Management, Clinical Tip, Cardiopulmonary, Orthopedic, Neuro Rehab

Management of Tone with Biophysical Agents

Posted by ACP on Dec 3, 2019 2:02:00 PM

Hypertonia is defined as excessive muscle tone which leads to stiffness with movement or inability to move a joint and often occurs with neurological conditions such as upper motor neuron lesions (CP, CVA, TBI, SCI, MS) and basal ganglia disorders (PD, Huntington
disease, Dystonia). While the terms spasticity and hypertonia are often used interchangeably, spasticity is actually a subtype of hypertonia in which muscle tone is increased by the speed of joint movement. (NIH, 2019)

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Topics: Clinical Tip, Neuro Rehab

Reducing Contractures with Skilled Therapy Interventions

Posted by ACP on Oct 28, 2019 2:05:21 PM

Range of motion (ROM) deficits may affect an individual’s ability to move, care for themselves, or perform typical daily activities including self-feeding, walking, and dressing. Decreased ROM is a common deficit addressed regularly by rehab professionals in all settings. Contractures arise from shortened muscle or other joint structure restrictions, leading to reduction in mobility and deformity with resultant reduced function.
• Prevalence of contractures in nursing homes is estimated at 55% with significant functional and medical consequences. (Offenbächer, 2014)
• Patients who are immobilized for a prolonged period are at risk of developing joint contractures, which often affect functional outcomes. (Born, 2017)

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Topics: Clinical Tip, Orthopedic, Neuro Rehab

Core Set of Outcome Measures Across a Range of Populations

Posted by ACP on Aug 27, 2019 1:32:38 PM

The use of outcome measures has become the standard of care to objectively assess changes in function, quantify clinical observations, enhance interdisciplinary communication, and examine intervention effectiveness at the patient and practice levels. Inconsistent use of outcome measures remains an issue due to difficulty identifying the most suitable measures based on patient diagnosis, acuity of condition, or practice setting.

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Topics: Clinical Tip, Neuro Rehab

Defensible Documentation

Posted by ACP on Jul 24, 2019 12:55:21 PM

Per the American Physical Therapy Association’s (APTA) “Defensible Documentation Tips” resource¹, the top 10 payer complaints about documentation (reasons for denials) include:

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Topics: Clinical Tip

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