Y3S2W6: Hokey Pokey

"You do the Hokey Pokey and you turn yourself around, that's what it's all about"

...and you thought I was going to talk about Hokey Pokey ice cream, right?!

On Wednesday we gave our group presentations. My group presented a community exercise and education programme for peripheral vascular disease to the class. This was a topic I knew a lot about (having covered it in a presentation in my BPhEd degree) so I was able to cover exercise prescription and management without much preparation or any cue cards. The exercise component included a choreographed 'Hokey Pokey' in which the audience (and assessor) joined in ... good fun! 

Other groups, with other topics, pulled out equally interactive and informative presentations... and put the hard work in as not to rely on cue cards!! The asthma group presentation had us breathing through straws then playing games like 'tag' - mainly because there is a high incidence of asthma in school aged persons... check out 'Jump Jam' on youtube to see how primary children can integrate dance and exercise. The COPD presentation was targeted to the elderly, so naturally we sat in a giant circle and done a chair aerobic warm-up, then kick many small Swiss-balls around the group circle. This was followed by exercising our upper limbs in the same way with balloons. The diabetes outreach team invited to the local Marae looked to incorporate Maori culture, and had choreographed a couple of upbeat songs for an aerobic exercise session; "Shake it off - Taylor Swift", and "Jump - Van Halen". I heard that another lab group on diabetes introduced themselves with a Mihi. The cardiac rehabilitation group had a focus on transitioning patients from a phase II to phase III programme. Many groups gave out 'home-made' information brochures. All the groups had a slightly different interaction between presenters which made it very entertaining - some gave a patient interview demo whilst others treated the audience as the targeted audience that we were suppose to be.

Integrated Studies focused on connective tissue conditions like fibromyalgia, rheumatoid arthritis, ankylosing spondylosis and gout. In the first lab, we were given the diagnostic criteria, practised evaluating xrays, and physical assessments of these conditions (n.b. xrays won't pick up on fibromyalgia... obviously). It also required us to think how we would adapt our MSK consultation for a patient with osteoarthritis and/or rheumatoid arthritis going in for a full hip replacement in two days time! For the second lab, we had a middle aged person come in so our year group could interview them and find out about how ankylosing spondylosis was diagnosed and what it is like living with it (they have ankylosing spondylosis). It was mentioned that their first port of call was a physio, and that physio didn't pick up on the condition (and neither did the chiropractor whom they saw after a year of non-improving symptoms)... rather it was an osteopath that referred the patient for an xray. I'm not sure whether Osteos refer most people for xrays, but I'm pleased the condition was diagnosed so it could be appropriately treated! Ankylosing spondylosis is a disabling condition, and when medically treated can put the patient back to near 100% functional, pain-free living!

Required readings are usually articles or book chapters that we are REQUIRED to read (they are usually associated with a lecture or lab)... it is expected that we know the content in these texts. Anyway, reading these is usually a mundane task. Occasionally we will be required to read an article that strikes us as interesting or enjoyable to read. One article (that may have been last weeks required reading... don't stress, we'll have a one week break soon for catching up) that was strikingly good to read was: 

'Pryor, J. A. (1999). Physiotherapy for airway clearance in adults. European Respiratory Journal, 14, 1418-1424'

Confession: I don't usually read articles from beginning (intro) to end (conclusion) - usually it's the abstract followed by the discussion that I read first... followed by whatever section in a jumbled order has the info I'm looking for. This probably isn't good practice - but it's proven to be time efficient. However, this text gave a historical background on physiotherapy / respiratory therapy in the introduction, something that struck my attention before I had a chance to skim-scroll-down (a.k.a "eyeing up") the document. So this is one of the few articles I have read from start to finish (from intro to conclusion). Here is a brief bullet-pointed outline of the origins / development of documented respiratory therapy adapted from Pryor (1999).

• An Assyrian text instructed that a condition characterised by 'fits of hissing coughs, murmuring wind-pipes, and phlegm' be treated by 'braying together roses and mustard in purified oil, then drop some on patients tongue and blow some into his nose'... then "he shall drink several times beer of the finest quality; thus he will recover".
• 1898: The 'intermittent' then (1901) 'continuous' postural [drainage] method was described for bronchiectasis.
• 1915: Soldiers with lung injuries were given 'exercise' and taught forced expiratory techniques.
• 1953: Vibration and percussion techniques were added to postural methods.
• Post-1960s new technologies emerged from around the world, and have been adapted by others since.
• Belgium's 'Autogenic Drainage'
• New Zealand's 'Active Cycle of Breathing Techniques'
• Denmark's 'Positive Expiratory Pressure'
• Switzerland's 'Flutter'
• USA's 'Incentive Spirometry' & "frog breathing / Glossopharyngeal Breathing"

"We've got to die of something, eventually". On Thursday morning we had a lecture from a cardiothoracic surgeon working at Dunedin Hospital. Although there was very little relevance to physiotherapy, we got a good history about the development of surgeons, the problem solving and chaos they were faced with. Apparently Henry VIII empowered barbers 'barber-surgeons' (yes, the people that shave man's face and cut hair) to perform surgeries... mainly because they had sharp knives/blades. Historically, problem solving was related to sterilisation, keeping the lungs inflated, anaesthetic, and there was a belief for some time that if you touched the heart it would go in to fibrillation (it would have been very hard to operate on the heart without touching it!!). The surgeon described their role (general procedures for various conditions and materials i.e. heart valves) when repairing the plumbing or heart components. 

On Saturday we had the Physio Ball. There were a couple of pre-ball gatherings, with good food and great company. It was raining, but that didn't put a damper on the evening!

The ball itself was set at Dunedin's iconic railway station. There was a lot of work put into setting up the ball room to make it look Grecian (big thank you to the ball committee). The ball had everything: food & drink, live artists, DJ, lights, cameras, dancing. Photo-wise there was a photography guy who stayed around the dance floor, and a dedicated Grecian scene group photo area - with props n' all!