PT Alberta Newsletter Spring 2011 | www.physiotherapyalberta.ca
What’s inside: New + returning members
1
Privilege of self-regulation
Professional development
10
2
The YOU Movement
11
President/Registrar’s message 3
Working together
12
Your license. Your responsibility 4
Member spotlights
13
Council news + election results 4
Media sightings
15
Practice advice
5
Finding Balance 2010 results
16
Good practice
6
University news
18
Research in focus
7
Leadership + Regulation
Physiotherapy Alberta College + Association *
New, Returning, Resigned, + Cancelled Members January 1, 2011 - April 30, 2011. Find a physiotherapist or verify registration at www.physiotherapyalberta.ca
Physiotherapy Alberta publishes PT Alberta to communicate policies, standards and other important matters to members. As all members are sent a copy, we therefore assume it has been read and understood. If you have any questions regarding the content within, please contact us.
Registrar: Dianne Millette Professional practice: Iain Muir Registration: Erin Howes Continuing competence: Audrey Lowe Communications: Mara Simmonds Complaints + conduct: Nancy Jette Chisholm Corporate services: Joyce Vogelgesang Council 2010/2011 President: Nancy Littke Vice-president: Greg Cutforth Secretary-treasurer: Grant Irwin Council members: Erica Bowen Grant Fedoruk, Gwen Harris Krishna Prasanna + Nicola Sadorra Public member: Vacant Student representative: Joey Mo, Matt Scott
New/Returning Megan Archibald Leonardo Barbieri Tracy Blake Heather Charette Jackie Davies Nathan Doerksen Melissa Hann Cecilia Luedemann Marinela Margarit Hayley Ng Vivian Overton Girish Padmanabhan Leanne Porteous Anjo Roelofs Bryce Rudland Rhonda Schmuland Melanie Short Leanne Simms Julie Stenner Jennifer Sullivan Jacquie Townsend Tammy Unteriner Doarnie Virag Anthony Willmot Brad Wilson Temporary license Lindsay Acheson Sarah Buddingh Sunjit Chhokar Kim Dao Nina Dumulot Caroline Gill Mac Kim Shinya Nakamoto Rajitha Venugopal
300, 10357 - 109 Street Edmonton, AB T5J 1N3 T: 780.438.0338 | 1.800.291.2782 F: 780.436.1908 www.physiotherapyalberta.ca
* Our legal name is the College of Physical Therapists of Alberta; however we do business as Physiotherapy Alberta.
Resigned Joan Ailsby Barbara Ashton Tamie Aubin Alice Babb Amy Bazzarelli Barbara Bentley Tracy-Lee Bourbeau Grant Bray Linda Buchynski Jody Cannam Marilyn Clark Mary Corns Krystyna Czengery Elisabeth Despres Shaela Doig Kevin Duff
Resigned Michael Dunne James Dunnett Catherine Eadie Heather Elliott Shauna Forbes Amanda Fraser Stephanie Gales Kim Grunling Darren Hagel Nicole Harder Crystal Hatcher Arne Heayn Nichole Henson Julie Hobern Anita Hoelzel Jennifer Hoff Allen Holman Elke Hottentot Suzanne Iafolla Holly Jenkins Chant Lynne Kane Tracy Kha Sung Kim Margaret Kirley Patricia Korpi Chantal Ladouceur Nancy Lambert Jennifer LaRoy Barbara Larson Bronwyn Lasair Janet Lester Karen Loone Charlene Luciak-Corea Diane Lyders Beverley MacLeod Fiona McDevitt Cheryl Menkema Sarah Meredith Padmaja Mukundan Sybil Murray Barbara Nagy Robert Najafee Lindsay Nichols Jessica Owen Gloria Palinkas Donald Patry Sarah Percy Jason Polk Shawna Lee Pound Eugenie Pranke Ramesh Purushothaman Stacey Reed Janet Roberts Helen Robertson Erika Rowden
Resigned Suzanne Rysak Kirsty Sanesh Trish Scott Margaret Senft Gailene Shaw Resigned Joanne Simonds Patricia Spady Fraser Sprigings Anne Symington Sarah Symmes Sharyn Van Damme Megan Waite Alice Walker Anna-Marie Weber Susan Withage Jeremy Woodfin Margaret Woytiuk Jennifer Zylstra Janet Roberts 1147149 Alberta Ltd. 1363990 Alberta Ltd. 1414046 Alberta Inc. 1510465 Alberta Ltd. 1545489 Alberta Inc. 422992 Alberta Ltd. Acadia Physical Therapy Ltd. Action Physical Therapy Clinic Ltd. Barb Ashton Physical Therapy Ltd. BodyTalk Physiotherapy Inc. Burnewood Physical Therapy Ltd. Castleridge Physiotherapy and Rehabilitation Corp. Corporate Sport Physiotherapy and Rehabilitation Corp. Enforme Physiotherapy Inc. Galipeau Physiotherapy Inc. Heritage Valley Physical Therapy Inc. Mount Pleasant Physiotherapy Ltd. Onside Sports Rehab Ltd. Royal Oak Sport Physiotherapy and Rehabilitation Corp. ...continued on page 2
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
1
Feature Editorial Physiotherapists in Canada are fortunate to be afforded the privilege of self-regulation. From time to time; however, we take this privilege for granted. As we come under new legislation (read on for the good news!) we challenge all Alberta physiotherapists to consider how they support the privilege of self-regulation.
Expectations
physiotherapists, part of your self-
The privileges and responsibilities that
regulation participation, is to read,
come with self-regulation are shared by
understand and comply with all
all members of the profession. Council
expectations as set out. Meeting these
and staff have a duty to govern in the
expectations is not an optional exercise,
public interest and develop, implement
they are not guidelines, position
and evaluate regulatory policy that impacts
statements or practice advice articles;
members by being thoughtful, evidence-
they are minimum obligatory requirements
informed, fair, and transparent.
for practicing physiotherapy in Alberta.
Physiotherapists have a duty to understand regulatory expectations and
We recently held an election. There were
participate in the self-regulatory process
no nominations from the largest region
including:
(Calgary). We need participation to continue to self-regulate as we have
yy Governing yourself + being aware
done for many years.
of your behaviour. yy Being committed to the profession as a whole. yy Respecting + contributing to the self-regulatory process.
Awareness A few years ago we conducted a member survey. The results were disturbing—over 50% of respondents said they’d never looked at our practice standards.
As a physiotherapist you have a role in actively participating in self-regulation
How is that possible? How can you
(e.g., on Council, committees, work
practice your profession if you don’t know
groups, other College projects/business,
what the standards, expectations and your
attending our AGM, voting for Council),
professional obligations are? What does
knowing/meeting your professional
that say about the profession and its
obligations, using practice standards and
commitment to patient care, safety, public
the code of ethics to guide your practice,
interest, and self-regulation?
New, Returning, Resigned, + Cancelled, Members ...continued from page 1 Resigned Sierra Physiotherapy Ltd. Stephanie Dumont Physiotherapy Ltd. Sunridge Physiotherapy Clinic Ltd. TriLife Corporation Ltd. Cancelled, non payment Melanie Ailey Andrea Barkman Sheela Behl Cara Berends Lori Biddulph-Deisroth Becky Burke Kristina Dooling Nalin Fernando Jodi Forster-Molstad Jolie Gale Kevin Gibson Antonio Grossi Amy Guidinger Nadine Hawkins Kyle Heppner Anna Hughton Flora Lee Darren Lonsdale JoEllen MacPhee Anthony Magnaye Jennifer McPhail Kyley Mohrenberger Oluseyi Olubowale Barbara Robinson Kelli Schiedel Gordon Schutz Sarah Shandera Christie Sorochuk Matthew Talpt Tina White Dynamic Physiotherapy Institute Inc
participating in key decisions, and never wavering from your commitment to
We encourage all physiotherapists to
quality of care. When done well, this
consider these comments and examine
serves not only your patients but also
your role in the self-regulatory process.
yourself, your profession and its
Do you know and meet your professional
reputation. These actions and awareness
and regulatory responsibilities? Do you
all contribute to maintaining the privilege
actively participate in the self-regulatory
of self-regulation.
process and do your part to ensure physiotherapy’s privilege of self-regulation
Participation
continues?
We recently released new standards of practice and code of ethics. For all
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
2
Leadership + Regulation
The Privilege of Self-Regulation
Leadership + Regulation
President + Registrar’s Message It’s here. Physiotherapists now under Alberta’s Health Professions Act On May 8, 2011, Alberta’s physiotherapy profession was proclaimed under the Health Professions Act (HPA). This event was a long time in the making and the result of much work and effort from various individuals to develop new regulations and other components to enable this transition.
Finally, the day has come! Proclamation was announced
For new members applying for registration, they will
by President Nancy Littke at the Annual General Meeting
be subject to the requirements of the HPA and Physical
and the new legislation came into effect on Sunday May
Therapist Profession Regulation as of May 9, 2011.
8, 2011. As Nancy said at the meeting “Thanks to those who have worked so hard to make this day come to pass:
New standards of practice and code of ethics are
staff, the many members of Council who debated difficult
approved and now in effect. They are posted on www.
policy issues, physiotherapists and other stakeholders
physiotherapyalberta.ca. Please familiarise yourself
who provided input over the years and to the Alberta
with them.
government for their assistance. It is an exciting time for the profession.”
HPA impact on Physiotherapy Alberta Physiotherapy Alberta will be impacted by procedural
The HPA consolidates Alberta’s self-regulating health
changes—some of which are already implemented as part
professions under one umbrella act with common
of our HPA preparation.
rules for self-governance. In addition to the HPA, each profession has a profession specific schedule and
Next steps and acknowledgements
regulation. You can find the Act and physical therapists
In the near future, Council will discuss additional
regulation online at www.qp.alberta.ca/570.cfm?frm_
details about HPA implementation. We will ensure all
isbn=9780779757053&search_by=link.
physiotherapists are kept up-to-date. Watch for HPA related information and communication via e-mail and in
How HPA will impact you
newsletters.
If you are currently licensed you will see limited change until you renew this fall. At that time, noticeable changes for physiotherapists will be: yy Renewal year changes from January 1 December 31 to October 1 - September 30.
Nancy Littke, PT Council president
Dianne Millette, PT Registrar
yy Liability insurance will be mandatory. yy Continuing competence requirements will be implemented in October 2011. yy Physiotherapists learning restricted activities (e.g., dry needling + spinal manipulation) will require supervision by physiotherapists authorized to perform the activity.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
3
Don’t practice without one
Council News
Leadership + Regulation
Your Practice Permit. Your responsibility.
Key highlights, discussions and decisions from Council’s March meeting + our AGM
As a professional, it’s your responsibility to ensure you’re appropriately registered to practice at all
Fee increase
times. This means completing all the registration
Members approved a membership fee increase of $96
and renewal documents, attesting to the fact that
(for active members) at the 2011 AGM on May 7. The
the information included is accurate and truthful and
increase will take affect October 1, 2011. The renewal
submitting the requisite documentation to the
fee in October will be $508.50 for physiotherapists who
College. These activities are not appropriate to assign
had an active permit as of January 1, 2011. This fee
to a partner, business manager or other third-party.
reflects both the increase and the fact members paid a 12-month fee last renewal but were granted a permit for
Consequences under HPA
nine months because the membership year was changed
Going forward, under HPA, practicing without a
in anticipation of our HPA transition.
practice permit is an offence that carries significant fines and is punishable by Alberta’s Attorney General.
Conduct committee appointment Council appointed Mara Shular to the Conduct
Consequences of practicing without a practice permit
Committee for a two-year term.
not only apply to the individual in question but also to any employer who knowingly employs someone not
Physiotherapy Alberta Councillors for 2011-2012
meeting registration requirements.
Council and Physiotherapy Alberta is pleased to introduce our newest Council members elected at
Check your status
our 2011 Annual General Meeting:
Checking your practice permit status can be done quickly and easily, online 24/7/365.
yy Tress Gibson (region 6 Capital) yy Candis Whittall (region 8 Peace)
Renewing members already have their log in ID and
yy Greg Cutforth (region 7 Aspen) - was re-elected
new applicants are provided one by email within a few business days of Physiotherapy Alberta receiving
Awards + financial support
their
Congratulations to the following award winners who
application. Because our member register is updated
were announced at the 2011 AGM:
in real time—data is processed as it’s entered so the register is always current.
yy Student Leadership Award - Sameera Chaudhary yy TD Insurance Meloche Monnex Physiotherapist
There is no excuse for practicing without a practice permit. Just don’t do it!
Scholarship - Jodi Boucher yy Member Presentation Fund - Alicia Olsen, Ashley Smith, Barb Clemes Unfortunately there were no nominations for the: yy Pinnacle Award of Distinction yy Award for Excellence in Innovation
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
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Professional Practice + Development
Practice Advice Questions & Answers (Q&As) Helping members apply legislation, standards and policies to real-life practice This column profiles some of the many member questions received by Physiotherapy Alberta’s practice advice department. Featuring examples of these questions in PT Alberta, and some related discussion, enables all members to benefit from the practice advice and information given.
Topic
While most physiotherapists think they won’t be subject
The value of good clinical record-keeping.
to a complaint or College proceeding, it stands to reason that over the lifetime of your career a complaint, concern
Question
or question may arise. Valid or not, complaints are always
Does Physiotherapy Alberta have any information to help
followed-up. Patient records are a key indicator of what
physiotherapists understand the importance of good clinical
happened during patient care and are often the starting
record-keeping? What are Physiotherapy Alberta’s expectations
point when examining a complaint, question or concern.
regarding record-keeping?
In the case of legal proceedings, charts are commonly presented. Good clinical record-keeping is good patient
Answer
care, good practice, a good competence indicator, and
All physiotherapists know good charting practices (including
good risk management.
specifics on assessment techniques, diagnosis and clinical impression and treatments) help you recall patient care
New standards
details and communicate that information to others (health
Physiotherapy Alberta has developed new standards of
professionals, payors, lawyers). Yet despite this recognition,
practice, Including standards on:
most physiotherapists consider clinical record-keeping one
yy Record-Keeping and Management - outlines general
of the more onerous and least valued parts of clinical practice
expectations for record-keeping and management
because it takes away from direct patient care.1
and record retention, disposal, storage, and security. yy Clinical, Financial + Equipment Maintenance Records -
Here are just some reasons why quality clinical record-
outlines the required elements for each record.
keeping is a critical component of professional practice: yy As chart review is increasingly used to evaluate a health professional’s competence, a positive association between charting and competence was found.2-4 yy Physician’s charting performance was found to be related to quality indicators for competence.5 yy When physiotherapist performance was assessed using various methods in the College of Physiotherapists of Ontario’s peer assessment program, it was recordkeeping performance that had the strongest influence on the ‘physiotherapist’s’ final competence level rating.3
These two are the most detailed of all the new standards and clearly outline your professional obligations. Physiotherapists are expected to review the new standards and assess if their record-keeping measures up. If changes are required, work with a colleague, manager or Physiotherapy Alberta’s practice advisor to ensure compliance. A records checklist is also available to help monitor record-keeping practices. As always, Physiotherapy Alberta’s practice advice service is here to help physiotherapists understand standards and other practice and regulatory related information.
1. Harman, K., et al., “I Think It, but Don’t Often Write It”: The Barriers to Charting in Private Practice. Physiotherapy Canada, 2009. 61(4). 2. Goulet, F., et al., Performance assessment. Family physicians in Montreal meet the mark! Can Fam Physician, 2002. 48: p. 1337-44. 3. Miller, P.A., M. Nayer, and K.W. Eva, Psychometric properties of a peer-assessment program to assess continuing competence in physical therapy. Phys Ther. 90(7): p. 1026-38.
4. Jennett, P. and L. Affleck, Chart Audit and Chart Stimulated Recall as Methods of Needs Assessment in Continuing Professional Health Education. The Journal of Continuing Education in the Health Professions, 1998. 18: p. 163-171.
5. Goulet, F., et al., Assessment of family physicians’ performance using patient charts: interrater reliability and concordance with chartstimulated recall interview. Eval Health Prof, 2007. 30(4): p. 376-92.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
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Professional Practice + Development
Good Practice Is this your definition of good physiotherapy practice? This column features case studies/scenarios to raise member awareness, encourage discussion and provide advice on topics + scenarios presented. Names and dates are changed or not supplied but the actual events are true. By using these studies as an education and communication tool, Physiotherapy Alberta helps promote prudent, professional, quality practice. Case studies presented are based on real situations. Situations that can shape and influence stakeholder perceptions of physiotherapy. Unfortunately, cases profiled here are often not isolated one off cases. It’s important to understand and remember your reputation and your profession’s is at stake in the choices you make.
Treating with no improvement and the
Discussion
professional perception created
The profession’s essential competency profile and
A physiotherapist assessed a patient (‘Deb’) who had
standards of practice expect more from physiotherapists
been treated for three months at another clinic following
than that described by Deb. Physiotherapists are
a car accident. When Deb’s funding ran out her doctor
expected to assesses, re-assess, modify treatment plans
authorised additional visits under a primary care
regularly and pay particular attention to evidence
certificate. Deb’s primary complaints were headaches,
supporting continued care when there is little/no
neck pain and radiating pain into the left arm and
improvement. To administer the same treatment over
forearm.
and over with no improvement is not in the patient’s best interest. Some may even suggest it’s an abuse of
Examination revealed limited neck range of motion (ROM)
the system.
but the neurological examination was normal except for minor bicep weakness. Deb’s lifestyle remains quite
Physiotherapists have a duty in these situations to
limited and she is unable to resume her regular exercise
consider:
regime. Deb said her previous treatment had been largely ROM neck and theraband shoulder exercises. She said her treatment never changed. Deb said she faithfully did the prescribed exercises which became increasingly painful. Then her arm symptoms worsened and she was unable to work. Deb said the physiotherapist was frustrated with the lack of improvement but didn’t change the approach or seek another opinion.
yy Brain storming with colleagues about difficult cases. yy Fostering a culture where ‘second opinions’ are simply part of standard care, free from financial and/or administrative barriers. yy Regularly re-assessing patients + adjusting treatment based on the re-assessments. yy Discharging patients who fail to progress.
The patient’s history concerned the new physiotherapist.
While difficult, it’s the ethical and professional
While not wanting to doubt a colleague, the new
choice and in the patient’s best interest.
physiotherapist was troubled that care continued for three months with no improvement. The concern was
What is the new physiotherapist’s obligation to deal
further increased because this patient’s situation was
with their colleague’s questionable practice? From
not unique—the new physiotherapist had come across
Physiotherapy Alberta’s perspective this is the heart of
this situation many times before.
self-regulation. Overlooking poor practice benefits no one, particularly the patient. Nor is it in the profession’s
What do you think? Is this good practice or not? How
interest to build a perception/reputation of poor service,
would you approach this? Are we ready to be respected
patient disregard, questionable use of health funds, and
as primary care practitioners, consultants, advanced
no evidence of outcomes.
practitioners? And if so, would Deb see us as such given her patient experience?
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
...continued on page 10
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Professional Practice + Development
Research in Focus To support and encourage evidence-based practice, Physiotherapy Alberta profiles current scientific research on diverse physiotherapy and health topics. Our goal is to showcase articles that will appeal to clinicians across practice areas and illustrate how the evidence applies to clinical practice. Let us know what you think. Send your comments and/or ideas on future topics to Iain Muir, Physiotherapy Alberta Professional Practice Director, at
[email protected].
Physical Therapy Management for Partial-thickness Rotator Cuff Tears By Judy C. Chepeha, MScPT, PhD (candidate), Assistant Professor, Department of Physical Therapy, University of Alberta
Rotator cuff (RC) tears are common in young, overhead
among participants undergoing PT (treatment components
athletes and individuals 65 years and older. The condition
not specified) and receiving oral medications. Function
manifests itself clinically in a variety of ways; however, most
(absolute difference, 11 on an 83-point scale) and time to
complaints include pain worsened with overhead activities,
maximum range of motion (ROM) (absolute difference, four
strength deficits and functional impairment. Physical
months) significantly improved in the injection, PT and oral
therapy (PT) is the usual course of treatment consisting of
medication group relative to the PT only group. The degree
rest, education, therapeutic exercise, and modalities.
of improvement in functional outcome scores varied
Surgical intervention is generally considered only after a
considerably in the uncontrolled studies and the strength of
failed course of appropriate, conservative treatment (≥
evidence was too low to make conclusions for any non-
three months).
operative intervention.
Despite PT being a mainstay of treatment, very little evidence
Operative vs. non-operative treatment – RC tears
exists to support its effectiveness in treating patients
The same systematic review identified five studies that
with RC tears. An even smaller proportion of this research
compared non-operative with operative treatments for RC
defines specific parameters and best delivery methods. The
tears. Four of these studies included either PT (treatment
following is an overview of evidence related to PT
components not specified), with or without the addition of
management of the patient with a partial-thickness RC tear.
steroid injections, oral medications, activity modification or manual therapy.3-6 One study examined the use of shock-wave
Non-operative treatment - RC tears
therapy.7 All study groups showed statistically significant
A recent review by Seida et al compared the benefits and
improvements regardless of the intervention. All but one
1
harms of non-operative and operative interventions on
study5 showed statistically significant differences in function
clinically important outcomes in adults with full- and
that favored operative repair. Similar to the non-operative
partial-thickness RC tears. Three controlled and seven
treatment studies, the evidence was too limited to draw
uncontrolled studies were found that examined non-
conclusions regarding comparative effectiveness.
operative interventions. Only one controlled study2 was specific to PT; a retrospective cohort study that compared
Non-operative treatment – shoulder pathology
rehabilitation focused on protecting the cuff through
The following section highlights research on the effectiveness
retraining of other muscles (deltoid, pectoralis major and
of therapeutic exercise, modalities and manual therapy on
latissimus dorsi) with no rehabilitation. Differences in
shoulder pathologies in general. The degree to which
function favoring rehabilitation were statistically and
generalizations about treatment effectiveness can be made
clinically significant (absolute difference, 26.9 points on a
across different shoulder conditions is unknown and requires
100-point scale). A second retrospective cohort study
further study.
3
compared steroid injections with no steroid injections
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
7
impingement.17,18 Manual therapy in addition to phonophoresis
patients with RC impingement. He identified 11 randomized
and exercise was found to abolish pain and restore ROM in a
controlled trials (RCTs) and despite several methodological
small case series of patients with impingement.19
concerns, concluded that exercise has statistically and clinically significant effects on reducing pain and improving
Method of PT delivery- RC tears
function in patients with impingement, but not on ROM or
Four RCTs have evaluated the method of administering PT to
strength. Kuhn also noted considerable variability and limited
patients following rotator cuff repair.20-23 All but one found
detail amongst reviewed exercise programs. Dewhurst9
comparable ROM, strength and functional outcomes in their
conducted a similar study to identify evidence-based exercises
respective study groups suggesting different delivery methods
for patients with RC impingement. Seven studies (four RCTs
of PT can be equally effective.
and three systematic reviews) were analyzed and exercises that had evidence for their use in RC impingement, from
The studies compared:
either an RCT and/or systematic review were collated and presented (serratus anterior strengthening, scapular control with lateral rotation, pectoralis minor/upper trapezius stretch, posterior capsule stretch, lateral and medial rotation/ abduction/flexion/extension/adduction strengthening). Two studies have investigated the effectiveness of acupuncture in treating rotator cuff (RC) tendinopathy. Both studies included RC tear, impingement syndrome and RC tendonitis in their study groups. One RCT10 found single point acupuncture with PT treatments significantly decreased pain, improved function and resulted in less pain medication compared with traditional PT treatment alone. The second, smaller study11 used six-nine acupuncture sites and reported no beneficial effects of acupuncture compared with PT alone. A large, blinded RCT12 revealed neither interferential or ultrasound was superior to exercise alone for patients with shoulder tendinitis. A subsequent RCT13 similarly found ultrasound no better than placebo when added to a PT regimen, although the cause of shoulder pain was undefined and the ultrasound dosage and exercise regimen were not standardized. No significant improvement was found when generalized shoulder pain was treated with low-energy laser therapy versus placebo laser.14 Ga-As low-energy laser combined with exercise was also reportedly no more effective in relieving night pain and improving function than exercise alone in patients with supraspinatus tendinitis.15 An uncontrolled RCT16 found high-intensity laser was superior to ultrasound; however, the change in two of the three outcome measures did not reach the accepted minimal clinically important difference. Several RCTs have supported the use of manual therapy in
1. Continuous passive motion to passive ROM home exercises.20 2. Standardized home exercises conveyed via videotape instructions to supervised PT sessions.21 3. Individualized, supervised PT treatments to standardized, unsupervised home exercises.22 The fourth study demonstrated that patients who received standardized physical therapy post RC repair, showed statistically significant improvement in function compared with those who received non-standardized treatment.23
Limitations & future challenges The state of evidence related to PT management of patients with partial-thickness RC tears is limited and of lowmoderate methodological quality. Reporting of specific treatment programs is inconsistent and often lacking in detail. Several studies label ‘physical therapy’ as an intervention with no description of treatment components, conjunctive therapies or delivery method. Very little research has examined the effect of PT treatments on partial-thickness RC tears specifically. Most studies combine partial- and full-thickness tears in study populations, despite evidence that large proportions of full-thickness RC tears require surgical repair. Conversely, some studies investigate a specific PT intervention (i.e., laser) but have applied it to a heterogeneous sample of patients with varying types of shoulder pathologies. The challenge for future researchers and clinicians is to carry out well-designed clinical trials using evidence-based, standardized PT treatment programs for patients with confirmed partial-thickness rotator cuff tears. ...continued on page 9
addition to NSAIDs, exercise or both to decrease pain, improve strength and range of motion in patients with RC
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
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Professional Practice + Development
Kuhn8 reviewed the role of therapeutic exercise in treating
Professional Practice + Development
Research in Focus ... continued from page 8
References 1. Seida, J.C., et al., Systematic Review: Nonoperative and
13. Ainsworth, R., et al., A prospective double blind placebo-
Operative Treatments for Rotator Cuff Tears. Ann Intern
controlled randomized trial of ultrasound in the phys-
Med, 2010. 153:p. 246-255.
iotherapy treatment of shoulder pain. Rheumatology,
2. Leroux, J.L., et al., Functional pattern of 115 rotator cuff tears. Eur J Phys Med Rehabil, 1993. (3): p. 242-247. 3. Vad, V.B., et al., Negative prognostic factors in managing massive rotator cuff tears. Clin J Sport Med, 2002. 12: p. 151-157. 4. Moosmayer, S., et al., Comparison between surgery and physiotherapy in the treatment of small and medium-
2007. 46: p. 815-820. 14. Bingol, U., et al., Low-power laser treatment for shoulder pain. Photomed Laser Surg, 2005. 23: p. 459-464. 15. Bal, A., et al., Low-level laser therapy in subacromial impingement syndrome. Photomed Laser Surgery, 2009. 27: p. 31-36. 16. Santamato, A., et al., Short-term effects of high-
sized tears of the rotator cuff: A randomized controlled
intensity laser therapy versus ultrasound therapy in
study of 103 patients with one-year follow-up. J Bone
the treatment of people with subacromial impingement
Joint Surg Br, 2010. 92: p. 83-91.
syndrome: a randomized clinical trial. Phys Ther, 2009.
5. Lunn, J.V., et al., A novel lesion of the infraspinatus characterized by musculotendinous disruption, edema
89: p. 643-652. 17. Bang, M., et al., Comparison of supervised exercise with
and late fatty infiltration. J Shoulder Elbow Surg, 2008.
and without manual physical therapy for patients with
17: p. 546-553.
shoulder impingement syndrome. J Orthop Sports Phys
6. Yamada, N., et al., Comparison of conservative and operative treatments of massive rotator cuff tears. Tokai J Exp Clin Med, 2000. 25: p. 151-163. 7. De Carli, A., et al., Reparable rotator cuff tears: surgery vs. shock wave therapy. J Orthopaed Traumatol, 2006. 7: S51. 8. Kuhn, J.E., Exercise in the treatment of rotator cuff impingement: A systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg, 2009. 18: p. 138-160. 9. Dewhurst, A., An exploration of evidence-based exercises for shoulder impingement syndrome. International Musculoskeletal Medicine, 2010. 32(3): p. 111-116. 10. Vas, J., et al., Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial. Rheumatology, 2008. 47: p. 887-893. 11. Razavi, M., et al., Effects of acupuncture and placebo TENS in addition to exercise in treatment of rotator cuff tendinitis. Clin Rehabil, 2004. 18: p. 872-878. 12. van der Heijden, G., et al., No effect of bipolar interferential electrotherapy and pulsed ultrasound for soft tissue shoulder disorders: a randomized controlled trial. Ann Rheum Disord, 1999. 58: p. 530-540.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
Ther, 2000. 30: p. 126-137. 18. Senbursa, G., et al., Comparison of conservative treatment with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther, 2000. 30: p. 126-137. 19. Pribicevic, M., et al., A multimodal treatment approach for the shoulder: a 4 patient case series. Chiropr Osteopathy, 2005. 13: p. 20. 20. Lastayo, P.C., et al., Continuous passive motion after repair of the rotator cuff. A prospective outcome study. J Bone Joint Surg Am, 1998. 80: p. 1002-1011. 21. Roddey, T.S., et al., A randomized controlled trial comparing 2 instructional approaches to home exercise instruction following arthroscopic full-thickness rotator cuff repair surgery. J Orthop Sports Phys Ther, 2002. 32: p. 548-559. 22. Hayes, K., et al., A randomized clinical trial evaluating the efficacy of physiotherapy treatment after fullthickness rotator cuff repair. Aust J Physiother, 2004. 50: p. 77-83. 23. Milroy, D.R., et al., Rotator cuff repair: the effect of a standardized post-operative physical therapy protocol versus a non-standardized post-operative protocol. J Orthop Sports Phys Ther, 2008. 38: p. A17-18.
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Helping members increase + enhance professional skills + knowledge
Good Practice
Webinars
Physiotherapists’ responsibility
With our spring webinars just behind us, we’re back at work planning more
It’s up to every physiotherapist to ensure
additions to our fall 2011 series and planning 2012 topics. Our confirmed
that the actions of a few don’t tarnish our
summer/fall 2011 lineup is:
profession in the public’s, funder’s and
...continued from page 6
government’s eyes. yy A guide to automobile insurance accident benefits in Alberta - Presented yy Talk to colleagues—don’t ignore
by Sandy Romanow, PhD, CIP, Rehabilitation Consultant, Peace Hills Insurance Company. This two-part series provides an in-depth under-
poor practice/patient care.
standing of automobile insurance accident benefits in Alberta. Part I
yy Offer (and take) constructive
focuses on Section B benefits, specifically the Diagnostic and Treatment
criticism both of which are critical
Protocols Regulation (DTPR) + Automobile Accident Insurance Benefits
to maintaining and improving
Regulation (AAIBR). Part II focuses on what physiotherapists need to
competence.
know about how treatment provided under Section B affects the
yy Contact Physiotherapy Alberta
outcome of third-party liability claims under section A and Minor Injury
and discuss it with the practice
Regulation (MIR).
advisor. Or in very serious cases,
Part 1 - June 2, 2011, 8 - 9 a.m. - Alberta Auto Insurance - Rehab-
register a complaint.
ilitation from an Insurance perspective - Section B (DTPR + AAIBR). Part II - June 9, 2011, 8 - 9 a.m. - How section B affects section A and MIR. What physiotherapists need to know.
What do you think? Contact us at
[email protected] to comment or respond to this scenario or
yy Optimizing rehabilitation using the AlterG treadmill - September 12, 2011, 8 - 9 a.m. - Bruce Stewart, PT, Fit Physiotherapy, Lethbridge. yy The effectiveness of interferential therapy in pain modulation October 19, 2011, 8 - 9 a.m. – Jorge Fuentes, PhD Candidate, University of Alberta.
forward a suggestion on future topics.
are made available online within five days of the live broadcast.
Health Provider + Patient Sleep + Dementia Resources
Online modules
By 2030, over one million Canadians are
Remember if you miss a webinar date - All live webinars are recorded and
Two online modules will be launched this fall: Ethics 101 and Infection, Prevention and Control for Physiotherapists. These will be followed by an Occupational Health and Safety module in January 2012. All modules were designed for easy online access, enabling you to complete
expected to have some form of dementia, many of whom will also experience significant sleep disruption.
at your own pace from any computer.
Researchers in the University of Alberta’s
Alberta Rehab 2011
recently completed a structured review of
We are gearing up for Alberta’s collaborative rehabilitation conference on November 4-5. Information on registration, hotels, conference program streams, and key note speakers
Department of Occupational Therapy evidence for non-pharmacological sleep interventions. They’ve now launched a knowledge translation website with down-
is now available online at www.buksa.com/albertarehab.
loadable evidence-based sleep resources for
Upcoming professional development (PD) events
for caregivers and patients. Find the site at
Remember to regularly check Physiotherapy Alberta’s online PD events
health providers and education brochures (www.sleep-dementia-resources.ualberta.ca).
section. As upcoming professional development activities and events become available they are posted at www.physiotherapyalberta.ca/physiotherapists.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
10
Professional Practice + Development
Professional Development Program
Communication + Marketing
The YOU Movement Consumer advertising and marketing campaign
Physiotherapy Alberta has launched a consumer marketing
Other activities
campaign to promote that physiotherapy is a proven care
In addition to our ad campaign, we have also been working
health option that can be accessed directly. Our target
on:
market (i.e., who we are speaking to primarily) is women aged 35-55—‘Dr. Mom,’ the health decision makers and key
yy Member marketing materials which were launched on
health influencers.
May 2 to help celebrate National Physiotherapy Month. These professionally designed materials are available to
Our creative platform
members at no cost. They include:
‘The YOU Movement’ is the over arching creative platform
–– Downloadable, customizable marketing and
for all our marketing material. The creative focuses on the
condition sheets.
individual and illustrates positive results. It can be general
–– Professionally printed brochure and poster.
(you) or personalized (Ingrid, Dianne, Sandra) and can
–– Promotional You Move Me DVD that promotes
portray lifestyle or seasonal activities.
physiotherapists as movement specialists for multiple conditions in various practice settings.
Our ads The advertising campaign began
Use these materials now and year round to
March 21 and runs until early
communicate and promote physiotherapy as an
July. All ads (see examples to
important consumer health care option. Visit www.
the right) carry our key ‘no
physiotherapyalberta.ca/physiotherapists for more
referral needed’ message and
information or to download the customizable material.
Physiotherapy Alberta’s web
To order the printed brochures and posters, or a DVD,
address—except the online ads.
email us at
[email protected].
They have visual ‘find out more’ link directly to our website. The
yy
print ads carry the direction (‘call to action’) to see a
Public and media relations plans are being developed and a list of spokespeople is being created.
physiotherapist when pain or discomfort gets in the way. Ad timing, placement and rotation is designed to generate the most impact with our target audience. You’ll see us in: yy Magazine inserts in May (Best
the support Proud to ent. em ov m YOU
Health, Canadian Living, Chatelaine).
how erts on are exp moving. herapists it from d physiot at stops use a License and wh herapists and y moves physiot maximize your bod cialists, restore, ent spe . you vem p your life As mo to hel rest of approach for the hands-on vement your mo g. vin maintain mo g. Keep Get movin
yy Online ads April - June (on
Canadian Parents, Chatelaine,
g. Keep
in Get Mov
Flair, LouLou, Today’s Parent, Hello!, Good Housekeeping, RedBook, Quick
ialists. ement Spec The Mov
ialists. ement Spec The Mov
& Simple websites).
.ca pyalberta iothera . w.phys near you Visit ww therapist a physio to find
Moving.
rta.ca
erapyalbe
hysioth
www.p
yy Newspapers April - June (Calgary Herald, Edmonton Journal, Fort McMurray Today, Grande Prairie Daily Herald, Lethbridge Herald, Medicine Hat News, Red Deer Advocate).
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
11
Working together
Marketing success happens when marketing, advertising
efforts (e.g., advice, tools and resources like the member
and branding components come together to create
marketing tools recently launched).
Advertising can paint an appealing picture. But if the product/service
”
a consistent and complete package.
‘being sold’ isn’t re-enforced or doesn’t live up to the campaign’s promise or consumer’s basic expectations, your marketing becomes ineffective. Your brand
Your brand is only as good as your customer’s last experience.
Now it’s up to you Despite mass media and advertising, the most credible, memorable, meaningful ‘marketing and branding’ occurs during
”
image and reputation suffers and
Communication + Marketing
to build and promote the profession + its brand
the patient’s experience (appointment booking, treatment, waiting room, billing, follow-up, etc). Because physiotherapists embody physiotherapy,
you are the face of physiotherapy. You are
consumers can develop negative
the brand. You are where the ‘rubber hits the
perceptions about you and your product/service. Perceptions are very important. They are people’s reality
road.’ It’s your actions that form, reinforce and impact
and they directly influence purchasing decisions and
the profession’s brand. As such, you are best positioned
referrals. Negative perceptions once formed are hard,
to:
sometimes impossible to reverse. yy Present, re-enforce + promote your profession
Marketing happens everywhere
to patients, the public, physicians, other health
Marketing and brand promotion is more than advertising.
providers, insurers, and others.
They occur at/with each and every contact (or touch point) someone has with you, your practice setting, your staff/co-workers, your profession, etc. To build a strong, successful brand all touch points must support, re-enforce and live up to patient expectations. If not, patients, potential patients, potential referrers, and others become dissatisfied and disinterested.
Physiotherapy Alberta’s role Our role is to establish an over arching brand and platform for physiotherapy and implement a mass market level campaign to promote Alberta physiotherapists and educate Albertans that: yy Physiotherapists are trained to treat many health conditions/issues. yy Physiotherapists are the provider of choice for movement issues (The Movement Specialists). yy Physiotherapy is an accessible consumer/patient driven health option. yy No referral is required. Our role also includes seeking out various opportunities to reach and educate our target audience en masse (e.g., magazine articles, strategic sponsorships) and support Alberta physiotherapists in their practice and marketing
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
yy Increase physiotherapy’s visibility in your respective community and workplace. yy Ensure Albertans receive the best care possible in your practice setting. Ensure their experience meets their expectations. Ask patients about their experience and how you can better meet their needs.
Your challenge yy Reflect on how you represent and promote yourself and your profession. yy Identify your touch points. Ensure each reflects you/your profession in a professional, credible and clear manner (e.g., does the audience get the information + service they need/want at each point). yy Be familiar with The YOU Movement campaign. Let Physiotherapy Alberta know if a patient mentions the campaign (e.g., seeing an ad). yy Use the member marketing material. yy Identify how you can be the brand. How you can support, incorporate, promote the campaign in your practice and community. yy Let us know what you do and what works for you so we can share with other members.
12
Communication + Marketing
Member spotlight Putting YOU, the physiotherapist in ‘The YOU Movement’ Physiotherapists are their own best and most credible marketing tool because they are the face of physiotherapy. Each physiotherapist is critical to the profession’s collective promotion, image and reputation. Whenever you interface with others (patients, public, other health professions, insurers) it’s a prime opportunity to represent, market and promote your profession, its value and benefits. Perceptions created during these ‘touch points’ reflect on both you and the profession. So what are your touch points? Think about all the opportunities—meeting other health professionals, booking patient appointments, ensuring your waiting room is welcoming and informative, or communicating with an insurer. To help highlight the importance of touch points to physiotherapy marketing and promotion, we’ve decided to profile two members, one from public practice and one from private practice. While the setting may differ, the importance and principles of representing, promoting and communicating physiotherapy’s value and expertise doesn’t.
Member profile #1- Private practice setting Siobhan Duggan, PT, The Downtown Sports Clinics (Bow Valley Square), Calgary Questions 1. What are some of your brand touch points? There are many including: yy Satisfied patients + word of mouth referrals. yy Crossing paths/speaking with current, potential + past patients in various situations including social
yy I personally follow-up with patients after discharge to check on their status + allow time for questions. yy I encourage further contact with me if needed and encourage their return if they experience other problems.
situations like restaurants, fund raising events, at my fitness club, etc. yy Exhibiting at corporate health fairs + sporting events. yy Keeping our website current. yy Verbal + written communications with other health professionals (physicians, fitness trainers, dietitians). yy Attending education events and building relationships with other health professionals.
3. What do you consider to be your most important marketing tool/brand touch point? Why? Staying current with new information and research, self-confidence and an ability to give clear explanations are my keys to fostering patient trust. My delivery has always been quality versus quantity. I am totally patient-focused from personally greeting them right through the assessment, treatment, education, and exercise program.
2. How do you use these touch points to educate patients, potential patients, other health professions, etc?
4. While all touch points are important, how critical is the
I take great pride in my profession and always introduce
‘patient experience’ to patient perception of your clinic,
myself as a physiotherapist not a ‘physio.’ Knowing I am
yourself and other physiotherapists.
a primary care provider and being confident in my skills
It’s of the utmost importance, especially the first
and knowledge paves the way for me to invite questions
appointment as it leaves the greatest impression. Our
and give advice on musculoskeletal issues in any
clinic promotes excellent customer service delivery
environment.
among all our staff, to help ensure positive patient
yy I always carry business cards and respond quickly when contacted by potential new patients or other health professionals. yy My name tag identifies me + my work place. I wear it
experience and satisfaction, and hopefully a return for further treatment when needed. A satisfied patient speaks well of their whole experience. Our number one referral source is word of mouth and it is a statistic we are very proud of.
at work and whenever/wherever I represent the clinic.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
13
share my knowledge base with others. In so doing, I help
Karen Hurtubise, PT, Alberta Children’s Hospital, Calgary
highlight the significant and vast expertise PTs have and
Questions 1. What are some of your brand touch points?
Every moment, everyday is a potential touch point—
walking through hospital halls, scheduling appointments, seeing patients, interacting with colleagues in an interprofessional clinic, sending a letter/report to a referral source, volunteering at an event. All are opportunities to make an impression about physiotherapists (PTs) and physiotherapy.
2. How do you use these touch points to educate patients, potential patients, other health professions, etc? I use them as building blocks—to educate. First I build rapport and establish a relationship. Then exchange knowledge and communicate my role as a PT, our training and knowledge base. For example:
• When calling parents to schedule an appointment, I explain who referred them and describe myself and specialty area. I ask about their concerns and changes they’ve observed since their referral. Then explain what the physiotherapy assessment will involve.
• While performing an assessment, I explain what I’m doing and why. Then share my findings with the patient relating it back to their concerns and what I can do for them.
• Working with children, I’ve learned that showing genuine interest in them and engaging them really impacts the trust and rapport with the parents.
• I’ve also found that honest and straight forward responses, even to tough questions, and respecting
help create further understanding of our role and our profession’s image and credibility.
3. What do you consider to be your most important marketing tool/brand touch point? Why? The first impression! Followed closely by non-verbal communication. As health providers most of our daily work relies on communication—and 93% of communication is non-verbal. Studies show that in faceto-face encounters body language (appearance, body position and movement, facial expression and eye contact) plays a key role in creating first impressions. So I think the visual we present (what we wear, facial expression), how we carry ourselves (e.g. posture, movement), and the interest we show in people is a crucial marketing opportunity/tool; that same interest in the individual can also come across on the phone via tone of voice and appropriate pauses. Email and written communication are more challenging so I tend to resort to a more formal approach.
4. While all touch points are important, how critical is the ‘patient experience’ to patient perception of your clinic, yourself and other physiotherapists. As seen in my previous answers, I’m a strong believer the ‘office’ experience is vital and a distinctive opportunity to: yy Create rapport + foster patient-therapist relationships. yy Showcase our broad skills base and extensive and specialized knowledge. yy Mitigate, if required, factors that influence the patient experience.
follow-up time lines really helps the patient/provider relationship and the impression patients and others
As a public sector health professional I see and treat the ‘in
have of our profession.
office/patient experience’ as a make or break situation. This first impression establishes the patient’s perspective and
I’m always looking for knowledge exchange opportunities.
opinion about me (as a physiotherapist and health provider)
Answering or translating medical language for patients/
and my profession. In these times of fiscal restraint and
parents, presenting observations on a case I’ve been asked
political turmoil, it is critical to create supporters and
to consult on, seeking advice/expertise from other
advocates for our profession. Every patient, parent, family
professions, sharing/reviewing an article and applying it
member, other health provider, and hospital administrator I
to a case with my team, or sharing tips on running injury
interact with is an opportunity to promote physiotherapy
prevention with my running group. All are opportunities to
and its many contributions, role and value.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
14
Communication + Marketing
Member profile #2 - Public practice setting
Physiotherapy + physiotherapists In the media
Recent sightings yy Pelvic pain. What is it and how to get help –
about teaching the finalists muscle strengthening and
advertorial in a special women’s health supplement
stretching so they can continue and hopefully win the
in IMPACT magazine’s May/June issue. The topic
challenge.
profiles a common issue for IMPACT’s readers (35-44 year old
What it
is and
for many silent enemyas a mild can be a It can strike ndly affects women. that profou family, do severe pain care for your bladder, steady and sleep, ache or move, sit, pain can also affect ist intermittent ability to work, therap life. Pelvic your a physio has and enjoy with help from your life, Pelvic pain activities, e n. But available. joint and muscl everyday is relief sexual functio ent nical bowel and health, there lead to mecha ent or alignm can in pelvic can ms l movem trained n proble All of which e in the norma s. functio many cause by a chang women, pain and caused many resolved. problems girdle. For cause is in the pelvic after the initial long continue ks when or buttoc one leg Pain? Pelvic of your pelvis or standing on women ack have front/b in bed, Do you . Often, , moving pain in the or doctor , or a If you feel stairs, sitting physiotherapist ne related a climbing a, hormo consult walking, dressing) pain, sciatic (e.g. when pain is low back the are told ted nerve. ageD 18-40 d Women trapped/irrita Pain for starts in the secon of all Pelvic ncy – often up to 50% and tyPes of common pain during pregna rtum. It affects stability postpa pelvis losesing overactive Pelvic girdle can continue when the and becom trimester rs and occurs responds by to pelvic floor mothe floor expectant Often the pelvic then lead which can alignment. stability — is an under restore intercourse) to try and has many dysfunction. pain during/after of women, that muscle muscle (pelvic pelvic floor up to 20% hormonal, Dyspareunia om, affecting al, tologic sympt reported ing derma s includ a. root cause and birth traum dysfunction, therapists n. ncy. Physio on and functio it during pregna available helP is is treatable, even assess your situati and symptoms, d fully diagnosis Pelvic pain ment followe health will ds on the e assess in pelvic and ent depen trained and muscl c treatm symptoms posture your specifi ete reunia, relieve While a compl ques to like dyspa and involves usually y and techni pain conditions, therapist l therap by manua Some pelvic en you, your physio function. betwe improve oration e collab will requir . doctor your visit raPist pelvic pain e area select Physiothe ist who treats finD a under practic al physiotherap a.ca and To find a gical, perine visit herapyalbert ical/gynecolo resources www.physiot health, urologinformation and women’s . tal. For more www.nva.org or postna in.org and Physical www.pelvicpa of CURA for 17 director and clinic health issues lives. therapist g pelvic and PT, physio has been treatin l of their bodies Wood, ton, Mary contro in Edmon take back Therapies women helping years and
in Pelvic Pa
yy University of Alberta creates first Canadian
communicates that pelvic pain is
research chair dedicated to the rehabilitation of injured soldiers and veterans - the Edmonton
common and can profoundly affect
Journal announced the University’s Canadian
female - our consumer target). It
a woman’s life. But because the
Military and Veteran’s Chair of Clinical Rehabilitation.
issue isn’t well known or widely
The research chair is expected to make important
talked about it can create fear
developments in the care provided to Canadian
in those who experience it.
soldiers who have suffered combat-related injuries.
Physiotherapy Alberta wanted
The chair will provide academic leadership to drive
to raise awareness of the
innovations and make new discoveries that will
e
T & sPor HealTH
in Pelvic Pa get help how to
FeaTur
WoMen’s
aDverTising
Communication + Marketing
Media Sightings
d by TS ions cause ists HERAPIS therap health condit PHYSIOT diagnosis and treat body moves physio the of life. s, ALBERTA who asses standing of how ty and quality providers under n, mobili al functio advanced health care regulated issues. With an in optimal physic ists are al mainta lber ta.ca Physiotherapdisability, or medicmaximize and e, iothe rapya injury, aging, patients restor www.phys help
issue and let readers know that
change and improve clinical practices and the health
physiotherapists trained in pelvic health can help.
of Canadian Forces personnel and veterans. The new
The advertorial was developed in collaboration with
chair is expected to work closely with provincial
Mary Wood (an Edmonton physiotherapist who’s
healthcare facilities, and the new Canadian Institute
practice focuses on pelvic health).
for Military and Veteran Health Research Network and the U.S. Department of Veterans Affairs.
yy Gain insights from your pain - Edmonton Journal highlighted ‘what you don’t know about exercise can
yy 3D gait analysis puts physiotherapists a step ahead
hurt you.’ Featured on the front page of the Arts
- the Edmonton Journal article pro-
+ Life section, the article profiled physiotherapist
filed a new gait analysis machine at
Kelly Spence. Kelly explained many of his patients
the Glen Sather Clinic and the health
have been injured while exercising—often because
professionals using the equipment,
they exercised the wrong way or at a higher
like physiotherapist Blair Shular. The
intensity, frequency or duration than their bodies
article details how runners can
could handle. He advises people not to wait if
benefit from the new tool by seeing a
they get injured because it could worsen if not
precise, high-quality 3-D image/video
addressed right away—that the longer it’s left the
that pinpoints/measures their gait in millimetre
harder it is to resolve. Kelly also highlighted that
accuracy. The machine can also asses how much and
physiotherapists develop individual injury prevention
how fast their ankles and knees twist and bend.
exercise programs/approaches.
Similar machines have been available in Edmonton
Runners' reha
b
makes strides 3-D analysis of athletes' gait puts physios a step ahead Physiotherapists at the University of Alberta unveiled chine Monday that will provide a new running high-quality 3-D marunners for the images to Edmonton first time. The new gait analysis the Glen Sather machine was installed Sports at time Monday morning. Medical Clinic last week and tested for the first It creates a precise three angles, and video of a runner’s measures exactly gait from how much and ankles and knees how fast a runner’s twist and bend. “It’s millimetre accuracy,” said Reed Ferber, a University of Calgary’s researcher from Running Injury machine and helped Clinic, who developed the install and test the it here. “We could an hour, optimally ,” said Blair Shular, do one patient in Machines similar a physical therapist to this have been available in biomecha at the U of A. labs for at least Alexa Hassen 15 years, and are nical research uses the used at the Glenrose Sather Sports Medical 3-D gait analysis system Monday Hospital. But this Clinic at the Running is the first time Rehabilitation Injury Clinic in the University any runner can and get access of Alberta Glen phone up the clinic to such a precise diagnosis. Most $180,000, said automatically to lab Ferber. But the versions cost about Ferber’s lab in system he developed Calgary. That A session at the partners reams gives him and of data on many Sather clinic will costs only $20,000. his research specific knee or cost a runner about covered under data than each other problems, most medical plans, could collect on $200 but should far more their own. be Ferber said. News of the new machine is starting Alexa Hassen, Roppelt said “it to the first person sounds like something spread through Edmonton. to use the machine, Brian years ago playing price point, it might I’d hurt her ankle fastball. The ankle be out of my reach.” be very interested in, but at five that her ever since Heights School seemed to heal, The Grade 6 teacher and sometimes runs but six it has times at bothered Patricia gets so sore a week. He’s had massage it. Hassen video to analyze a coach use slow-moti his stride before, assumed she needed she needs to stop running and and that helped. on ankle, but when ed inserts for his to strengthen muscles The coach recommen she climbed onto shoes in her the treadmill Monday, showed that her only captures problems to help a painful Achilles tendon. dankle Ferber’s report But the video that can be seen inward too quickly. worked just fine. It was her would be more with the naked knee that collapsed detailed. That means instead eye, he said. This needs to strengthen of working on her ankle, she her hamstrings and the muscles He would be interested in her butt. in preventive training, “That’s a typical pair of track spikes he said, picking patient for us,” at up a new said Ferber. “They’re lot of times it’s it before it becomes the Running Room. “Absolute complicated and ly. I’d rather deal just frustrated. a problem. Otherwise there’s a lot of A with would have thought Hassen said she you just end up factors involved.” thinks runners about strengthen wasting time.” Who in Edmonton might ankle? But that’s chance to know ing the hamstring be skeptical, but what’s really causing the weak link in to treat a sore the her chain, Ferber installed machines a chronic injury said. is tantalizing. in five private He previously clinics, and has researchers using “There are a lot partnerships with of frustrated runners his McGill University machines in Brazil, New Zealand pain,” said Hassen, out there who have chronic injury . Each time one and at Montreal’ 24, who is also of a kinesiologist ates informatio know how much or s at the n for the physiothe those machines is used, it generconfidence they would have coming clinic. “I don’t rapist and sends but I’m sure they a copy of the data would in (to get treatment) that kind of knowledg be absolutely blown away , coming out of e.” it getting
before (in biomechanical research labs and the yy Finalists aching to ease their soreness - article
Glenrose Rehabilitation Hospital), but this is the first
accompanied the Edmonton Journal’s Gain Insights
time Edmonton runners can get such a precise
article. Piece promotes a 12-week health challenge
diagnosis at the Glen Sather Clinic.
contest sponsored by The Journal and Edmonton YMCA. Edmonton physiotherapist Kelly Spence is
Tell us if you spot physiotherapy in the media
again profiled. He’s been working with the
If you see or participate in physiotherapy-related media
challenge’s three finalists, helping with muscle
stories, articles or appearances, tell us and we will share
soreness and previous unresolved injuries that are
it here. Reach us at communications@
affecting their workout progress. He also talks
physiotherapyalberta.ca.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
15
Finding Balance 2010
Finding Balance is a public health campaign that educates
Global Edmonton also ran a segment with a physiotherapist
Alberta seniors on the importance of preventing falls. The
talking about falls prevention on its morning news show.
campaign’s three key messages are:
Still more work required 1. Watch your step
Despite the campaign, there’s still much work to be done.
2. Keep active – exercise for strength and balance
While there is high awareness of falls, 61% of Alberta seniors say they want to learn more about preventing falls
3. Check you medications
and only 37% believe other Alberta seniors know enough about it.
Everyday physiotherapists treat seniors with fall related injuries and see the consequences of these falls on the individuals and their families. The importance of preventing falls from happening in the first place, prompted
10% suggested using mobility aids. Clearly there’s an
2010 Campaign. As an added bonus, our brand and ‘The
opportunity for physiotherapists to provide seniors and
Movement Specialists’ tagline was broadly communicated
their families with the education needed and desired.
Watch Your Step ! Wherever you
yy Physiotherapy Alberta logo on promotional
are
materials, Finding Balance website and all
How YOU can help prevent falls yy Champion falls prevention. Make falls prevention
TV + print media materials. yy A ‘Talk to Your Physiotherapist’ message
seniors suggested watching your step, 16% suggested exercising, 13% suggested being careful in the house, and
Physiotherapy Alberta to sponsor the Finding Balance
through:
In terms of key prevention tips and messages, 39% of
Talk to your phys
iotherapist
on 20,000 campaign flyers.
2010 campaign results Last year’s campaign was the most successful to date. Highlights include: yy 669,700 flyers/posters were distributed to Alberta pharmacies, libraries, hospitals, and seniors facilities. yy 552 TV ads on Global TV (Calgary + Edmonton). yy Print ads in 36 different weekly newspapers, total circulation of 550,350. yy 73% increase in traffic to Finding Balance website. yy 17 print media stories—5 featuring physiotherapists! yy Campaign messaging translated into 12 different
materials available in your clinic or facility. yy Visit the Finding Balance website at www.findingbalancealberta.ca. The site provides great educational materials and practitioner resources. yy Encourage families to talk to their parents, grandparents and other senior family members about falls. Safety Superheroes has resources designed to get children to talk to their grandparents visit www.safetysuperheroes.com. yy Conduct a talk at a local senior’s centre, social club or recreation centre. yy Promote exercise classes that focus on balance, strength and mobility. yy Host a local event for the 2011 Finding Balance Campaign (November 1-30, 2011).
languages.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
16
Communication + Marketing
Campaign analysis + results
Communication + Marketing
Physiotherapy Alberta Email Communications Physiotherapy Alberta often communicates important and time sensitive information electronically. To ensure you receive email notices from Physiotherapy Alberta make sure you add
[email protected] to your address book and/or safe senders list. Doing so will help keep you in the loop and prevent important updates being filtered to your junk mail folder. If you have trouble receiving Physiotherapy Alberta email messages at work, consider changing your work email in your member profile to your home email.
Research Study
Clinical Decision Making of Physical Therapy Graduates. Physiotherapists Required By Patricia (Trish) Manns, PT, PhD Researchers at the University of Alberta are looking for 35 physiotherapists who graduated between 1996-2000 or 2004 - 2007 to participate in a research study considering how physiotherapists make clinical decisions, what resources they use and how clinical experience influences clinical decision making. For more information or to volunteer contact Dr. Trish Manns at ptgrads@rehabmed. ualberta.ca or 780.492.7274.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
17
Department of Physical Therapy
Feedback from both applicants and interviewers was
The current University of Alberta (U of A) Augustana
overwhelming positive about the process. Applicants
MScPT pilot in Camrose has been well received. So
appreciated the opportunity to present their suitability
well that the government has provided additional
for the profession and interviewers found the process to
funding for at least three more sub-cohorts in Camrose
be valuable in assessing applicant communication skills.
University News
More Funding for MScPT Program Satellites
and two sub-cohorts at a new Calgary MScPT satellite. The additional students will increase the total MScPT cohort size to approximately 100 students by fall 2012. The U of A Faculty of Rehab Medicine is working closely with the University of Calgary to secure classroom and
Meet Dr. Linda Woodhouse the new Dr. David Magee Endowed Chair in Musculoskeletal Research By Laurie Wang
lab space and to ensure the U of A MScPT students in
A leading research clinician, originally
Calgary will have access to adjunct student services
from Montreal who cheers for—brace
(library, campus facilities, etc). However, all MScPT
yourself—the Toronto Maple Leafs. Meet Dr.
students irrespective of their location of study will be
Linda Woodhouse, the new Dr. David Magee
enrolled in the U of A MScPT program. Local (Camrose
Endowed Chair in Musculoskeletal Research.
and Calgary) staff to coordinate the satellite operations, assist with teaching and optimize clinical placements
Last summer, the Faculty of Rehabilitation Medicine
will be hired in the next few months. Watch the PT
announced its first endowed research chair named for
Department website for position postings!
one of the world’s foremost physical therapists Dr. David Magee, an internationally recognized physical
A full evaluation of the pilot project has begun. Many
therapist, author, associate dean and professor at the
educators, not just in physical therapy, are keen to see
Faculty. The Endowed Chair will have a direct impact
how the technology used in the MScPT program can
on patients because of its focus on maximizing physical
change the traditional classroom.
therapy care by finding improved methods of clinical assessment for arthritis, injury prevention and sports
Multiple Mini Interviews: A Positive Addition to the MScPT Admissions Process On Saturday April 30, 164 MScPT applicants were interviewed using the Multiple Mini Interview (MMI) format. Similar to an objective structured clinical exam (OSCE) or practical exam each individual applicant met with seven separate interviewers, one after the other and answered a different question at each station. Developed at McMaster University, the MMI is designed to evaluate important variables not clearly expressed by an applicant’s grade point average alone, for example interpersonal skills, integrity and/or professionalism. MMI questions typically pose a predicament, present an ethical situation or inquire as to an applicant’s knowledge of a health related topic. Applicants are encouraged to ‘think aloud’ and discuss how they would
injury and low-back pain treatment. Dr. Linda Woodhouse, who will join the faculty on June 1, is a leading research-clinician from the School of Rehabilitation Medicine at McMaster University, the Departments of Orthopaedics and Rehabilitation at Hamilton Health Sciences, and the Department of Surgery at Sunnybrook and Women’s Health Sciences Centre. Dr. Woodhouse has made significant contributions to the development and evaluation of inter-professional models of care for patients accessing hip and knee surgery. She has also developed innovative clinical programs for patients with osteoarthritis, osteoporosis and cancer survivors who receive conservative treatments in the community.
react in the posed situation.
PT Alberta - Spring 2011 | www.physiotherapyalberta.ca
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The Movement Specialists.
Canadian publications mail #40063092
Return undeliverable Canadian addresses to: Physiotherapy Alberta 300, 10357 - 109 Street Edmonton, AB T5J 1N3
Please read carefully This supplement to the PT Alberta Newsletter is dedicated to Health Professions Act (HPA) changes that most significantly impact member’s registration, renewal, competence requirements, and reporting.
Membership year The membership year is now October 1 to September 30. Practice permits (i.e., licenses) must be renewed before October 1, 2011 for the period October 1, 2011 to September 30, 2012. Online renewal will be available the beginning of August. You will receive an email notice from Physiotherapy Alberta when the system is ready for you to renew online.
Liability insurance If you are a regulated member on the general 1 or provisional 2 register, you must hold individual professional liability insurance in the amount of $5 million per occurrence/patient and a $5 million minimum for the policy year. Coverage must extend to all activities related to your practice of physiotherapy, e.g., clinical practice, teaching physiotherapy, volunteering at a sporting event. When renewing your practice permit, you must provide the insurance provider’s name and policy number.
Practice permit fee The 2012 practice permit fee for the period October 1, 2011 to September 30, 2012 is $646.00. However, fees to be paid for the 2012 renewal year will vary depending upon the legislation in place when you paid your last fee. If you are currently registered and hold an active license under the Physical Therapy Profession Act and wish to renew your practice permit for 2012, the fee is $508.50. This fee takes into consideration fees already paid for the 2011 renewal year. If you are currently registered and hold an active license under the Physical Therapy Profession Act and plan to retire between October 1, 2011 and December 31, 2011 you may renew your practice permit until December 31, 2011 without additional fees. This fee takes into consideration fees already paid for the 2011 renewal year. If you are currently registered under the Health Professions Act (anyone who registered after May 8, 2011) and wish to renew your practice permit for 2012, the fee is $646.00. This takes into account that fees paid to date only cover the period to September 30, 2011.
Penalty for late renewal Renewals submitted after September 15 will be charged a $100.00 penalty for late renewal.
Inactive registration category Under the HPA, the inactive category is discontinued. If you currently have an inactive license under the Physical Therapy Profession Act, you have three options: 1.
1 2
Renew your practice permit as a regulated member on the general register if you meet the current registration requirements.
General register – formerly active license Provisional register – formerly temporary license as a Registered Practitioner
2.
Cancel your registration. Prior to returning to practice in Alberta, you may apply for reinstatement of registration and must meet the registration requirements at that time.
3.
Apply for registration on the non-regulated alumni 3 register. Prior to returning to practice in Alberta, you may apply for reinstatement of registration as a regulated member and must meet the registration requirements at that time.
Practice hours The practice hour requirement remains 1200 hours of physiotherapy practice during the preceding five years; however, the reporting period changes to October 1 – September 30 to align with the membership year. For this transitional year only, members will report practice hours for nine months only (January 1 to September 30). The hours required are pro-rated to 900 hours.
Restricted activities Members on the general register learning to use dry needles or perform spinal manipulation may do so only with the consent of and under the supervision of a physiotherapist who is authorized to perform the activity. The supervising physiotherapist must be on site or present when the activity is being performed and able to observe, promptly intervene to stop or change the actions of the supervised practitioner if required.
Continuing competence program Participation in the continuing competence program is mandatory for members on the general register. Two components of the program will be phased in as follows: 1.
Jurisprudence module: an evaluation of your understanding and application of legislation, practice standards and the code of ethics. ● All members on the general register (with the exception of volunteers from the pilot) must complete the online jurisprudence module between November 1, 2011 and April 30, 2012 ● Members will receive their official notice in October along with instructions for access, completion and timelines ● A user guide, frequently asked questions document and sample questions are available now on Physiotherapy Alberta’s website in the physiotherapists section/continuing competence
2.
Competence portfolio: competence development including self-assessment and reflection leading to identifying and implementing a learning plan. ● All members on the general register must complete their self-assessment between April 2012 and 2012 renewal ● Members will receive their official notice in March 2012 along with instructions, forms and timelines
Reporting changes to information The HPA requires regulated members to report changes to the following information within 30 days of a change occurring:
● ● ● ● ● ● ●
full legal name home and business mailing addresses employer information (e.g., name, location where services are delivered) employment status, areas of practice and job title or position description restricted activities performed degrees and other qualifications registration with another college that provides health services
Login to your online account through Physiotherapy Alberta’s website to report changes as they occur throughout the year.
3
Alumni register – formerly retired member category