Y3S1W5: Walking Towards Health.

MSK continued with assessment and treatment strategies for the shoulder.  We were reminded about reactive and degenerative tendinopathy and introduced to GIRD (glenohumeral internal rotation deficit) often seen in throwers. In the grand-scheme of shoulder assessment we needed to assess the whole picture whereby "injuries start  with the big toe". In labs we applied Maitland and Mulligan manual techniques, strapping techniques and used exercise prescription to treat the shoulder. During the second lab, we all were given the task of presenting five exercises in small groups for specific muscles that were allocated to us. I presented exercises for the lower trap!

Thankfully, nobody's rolling any joints around here!!

There is a saying "If persons' with Parkinson's Disease saw a fire, they would be the first people out of the room", as they respond well to visual (and auditory cues) to initiate movement. In our neuro lecture we discussed rehabilitation strategies for persons with Parkinson's Disease. There were a few interesting ways in which we can teach them to manage gait, such as placing strips of tape on the ground for them to step over, displaying signs in their home suggesting when they should begin regulating their steps with verbal cues or to use mental imagery to pretend they're trying to squish spiders with their feet!! The second half of the lecture focused on strategies to improve upper limb function, especially in those who have little to no movement due to stroke or traumatic brain injury. There are many interventions, some of which are very clever such as using mirrors to trick the brain into activating the hand, and others are very innovative tools including using computers and motion technology to train the brain.

I had my first placement of 2015 on Monday morning at the School of Physiotherapy's Umove clinic. I got to work with a person with what seemed like a mild dyspraxia as well as what was possibly a homonymous hemianopia following a CVA. I had a bit of homework revising what each of these were, how they were diagnosed and how I could treat these conditions in following Umove clinics. I had three Umove clinics this week. During my other sessions I was able to work with a patient who had a brain tumour, multiple sclerosis and another stroke patient. Have you ever gone to the beach as a part of a school field trip and you were given a check-list for things to look for? e.g. a starfish, 2 different sea birds, a mollusk, etc.. Well, we have a checklist for neuro rehabilitation... basically, there are a list of conditions, assessments and interventions that we are aiming to check off as undergraduate students. Obviously, assessments and interventions won't be thrown randomly at clients just so we can tick them off, but where possible I will do my best to get a full house/bingo! With regards to interventions, the Umove clinic has a few interesting tools (see photo below). Did I mention that we get homework from placement too...?? I've got to give a presentation on apraxia on Monday. I've got two more weeks of neurological rehabilitation at the Umove clinic.

Umove's magic box that makes our hands appear on a screen!!

Students in my pathology lab group have picked up a trend, in our case studies, of patients dying. For most of the case studies, there is a reasonable amount of patient background given including the events pertaining to the pathology and other medical aspects. However, in almost all cases so far, the last sentence usually reads "despite treatment, he/she usually died from [an organ] failure". We get pretty excited when a person from a case study doesn't die... such as the girl who ate peanuts (despite knowing she was allergic to peanuts) and had an anaphylatic reaction.  Apparently, our case studies are of real, but historic, cases from Dunedin Public Hospital.

Our stethoscopes have arrived!! Woohoo!! Here is an unboxing of the stethoscope!

Tip for surviving physio: make good use of 'course reserve'! Books are usually quite expensive, so thankfully you can borrow them from the library! Course reserve is a small section where paper coordinators reserve books specifically for the course/paper. Obviously to borrow the book for a set period is free, which relieves your bank account and spears your bookshelf from creating your own home library of soon-to-be outdated books! (Books are usually updated every other year). Two books of interest for MSK are:

 However, this pocketbook for physio is super handy (& could be used to squish spiders!)... 

...you should consider buying this one for your back pocket!

In social events this week, second and third years had the one-off 'Physiotherapy City Tour' on Saturday starting at 3pm. "It's a historical tour [read pub-crawl] showcasing some of the finest bars, pubs, taverns and grills in Dunedin" ... that sums up the event very well. Students will start in North Dunedin and make their way over the afternoon toward South Dunedin. Now that's a lot of walking (and drinking)Transport will be provided to take students from the last pub to the stadium to watch the Highlanders versus Stormers rugby game!

Should I mention the cricket? Yes, of course (briefly)!! The Blackcaps (New Zealand's national cricket team) are facing off on against Australia for the Cricket World Cup on Sunday! We had an exciting match earlier in the week where we fended off South Africa for their place in the final. This was a big achievement in NZ sporting history. Fingers are crossed for the final!!!

On Thursday I popped over to the School of Physical Education, Sport and Exercise Sciences to participate in a research project undertaken by a School of Physiotherapy PhD student. The study had participants complete a few questionnaires, body measurements which included, blood pressure, lung capacity (electronic spirometry), and their fat and fat free mass calculated using a bioelectrical impedance machine (my data is below). The 'real' data however came from a 15min treadmill walking task. Participants had to wear a gas analysis machine during this task, which was linked up to the computer (photos below). A you would expect, it was a great experience and we received a $10 petrol voucher! The research, provided the hypothesis is supported by evidence, may change how exercise volume and intensity is prescribed! I won't give any more away than that - have a browse of the poster for more details!