Download Summer 2016 - Oakland Physical Therapy

Health, Wellness, & Fitness
Quarterly
Summer 2016
An Update on Exercises for Osteoarthritis of the Knee
Frank Kava, PT, MS, DPT, OCS, OMPT
Osteoarthritis of the knee affects more than 9 million people in the United States. Without an absolute
cure for osteoarthritis, the outcomes of current conservative medical and physical therapy management is to
decrease pain, improve function and improve and enhance quality of life. In some cases effective treatment may
prevent or delay the need for joint replacement. This update will highlight the latest research
developments emphasizing the benefits of exercise and physical therapy in the management of osteoarthritis of
the knee. Exercise for treatment of osteoarthritis of the knee is recommended as an effective treatment by all of
the current clinical practice guidelines of the American College of Rheumatology,
the Osteoarthritis Research Society International, National Institute for Health and
Care Equality and the American Academy of Orthopedic Surgeons.
The recommendations for exercise as effective treatment for osteoarthritis
of the knee are based on several recent clinical trails and systematic reviews mostly
comparing exercise with no exercise and have concluded that exercise improves
function and decreases pain compared to not exercising. One of the systematic
reviews confirmed that the benefits of exercise were comparable to conservative
drug treatments with fewer side effects.
The type and duration of exercise included in the studies varied widely but
included a combination of strengthening exercise, range of motion and aerobic
exercise. Greater pain reduction and functional improvement have been seen with quadriceps specific
exercises. Positive outcomes were attained with approaches combining exercises to increase muscle strength,
flexibility and aerobic capacity. Significant benefits can be attained from both high and low intensity exercise
from individually supervised, group or home based exercise programs. Similar benefits have been seen with
aquatic exercise programs. The most effective dosage of exercise is uncertain based on current studies. Greater
benefits were attained from exercise programs performed at least three times per week compared to those
performed less than two times per week regardless of exercise intensity or
duration of each exercise session.
Exercise stimulates the development and strength of the cartilage,
bones and muscles and improves the lubrication and nutrition to the joints.
Exercise also improves the shock absorbing capacity of the cartilage.
Osteoarthritis is a degenerative condition of thinning of the joint articular
cartilage with subsequent joint inflammation and thickening of the
ligaments and fibrous tissue around the joint. The most sensitive component
is the cartilage. Excessive mechanical forces applied to the cartilage and underlying bone over time plays an
important role in the development of the degeneration of the cartilage in
osteoarthritis. In healthy adults the phases of cartilage destruction are
balanced by phases of cartilage reconstruction. With osteoarthritis there is an
imbalance with more deconstruction than reconstruction. Controlled repetitive
movement with moderate exercise stimulates the reconstruction phase and may
repair some of the cartilage thickness deficits. The stimulation of the joint with
exercise is related to variations in articular pressure which increases of the
synovial fluid circulation of nutrients in the joint.
Manual physical therapy and exercise increases the range of motion and
strength thereby improving function. Patient involvement is critical in maintaining
the improvement that the therapist can achieve. Patients are instructed in
self-stretching exercises that can be performed by the patient at home. Specific strengthening exercises are used
to improve the stability of the knee and increase the strength of muscles of the lower extremity.
Our physical therapists follow similar treatment protocols used in
the current published studies in the treatment of osteoarthritis. We have
also demonstrated the same degree of effectiveness and success in
treating osteoarthritic patients with manual physical therapy and exercise.
The ultimate benefit is that exercise can improve the quality of life
by minimizing pain and maximizing strength and flexibility and improve
the ability to perform more functional occupational and recreational
activities.
Upcoming Events at Oakland Physical Therapy
Tuesday August 9, 2016 at 6 p.m.
An Update on Exercises for Osteoarthritis of the Knee
The objectives of our upcoming community education program are:
 Identify the physiological benefits of exercise for osteoarthritis.
 Explain the advantages and importance of flexibility, aerobic conditioning and strengthening exercises.
 Demonstrate the correct performance of appropriate exercises.
 Identify the proper progression and precautions for each type of exercise.
Please call (248) 380-3550 or email [email protected] to register!
Team Fox in the D will host their inaugural fundraising Gala to benefit The
Michael J. Fox Foundation on Saturday, September 10th, 2016 at the Westin Book
Cadillac in Detroit. This tremendous event is being organized by our long time
patient Donna Rajkovic. Guest speakers will discuss the most current research and
treatment and will include Dr. Kristie Kava. The evening will include cocktails, a
delicious meal and dancing. For more information, check out the Team Fox
fundraising page at http://www2.michaeljfox.org/goto/teamfoxintheD or call 248-231-3343.
Staying Fit Through The Hot Summer Months May Be Easier Than
You Think!
Linda Erickson, MS, PT, OMPT
Many residents of Michigan seek opportunities to be outdoors during the glorious days of summer.
Combining the yearning to spend time outside with the desire to participate in regular exercise provides a
number of palatable options. Many fitness buffs continue with their year round pursuits which might include
jogging or biking. Others may choose to engage in more seasonal activities such as golf, tennis, or roller blading
and water-related activities such as swimming, kayaking, canoeing, paddle-boarding, and water skiing. No
matter where your interests may lie, exercising during the summer months require some additional planning
and consideration.
First of all if you have not participated in your chosen activity for a while, be sure to warm your muscles
and perform gentle stretches prior to beginning. Make sure your shoes and clothing fit well and that your
equipment is safe and in good repair.
If it is hot and humid, you will need additional fluids to replace those lost while sweating during activity.
To prevent overheating with vigorous activity, consider exercising early in the morning or later in the evening.
What if you do not like to “exercise”? All summer fitness pursuits do not require athletic process and can
still accomplish a goal or provide
Daily Activity
Given Time Period Calories Burned
some relaxation and fun. An article in Mowing the Lawn
8 minutes
52 calories
Pushing
a
Stroller
20
minutes
59 calories
the Huffington Post in 2013 listed a
Playing Catch with the dog 15 minutes
50 calories
series of activities that burned
15 minutes
51 calories
approximately 50 calories in a given Fishing
Playing Croquet
20 minutes
57 calories
time period. See chart on the right.
Grilling on the Barbeque 19 minutes
50 calories
Water sports are also fun and
healthy ways to exercise. Water sports enthusiasts were able to burn approximately 50 calories in 12 minutes
while paddle-boarding, treading water, or performing water aerobics. Similarly, kayaking for 10 minutes burns
59 calories. However, being that it is summer, why not take advantage of your local pool? Along with lap
swimming, aquatic exercise also has many benefits. According to Julie Mulcahy, PT, MPT, writing for an
American Physical Therapy website, submersion in waist to chest deep water makes the body more buoyant and
reduces stress on joints, cartilage and ligaments patients with musculoskeletal problems find that this weight
reduction allows them to move more freely and assists with range of motion exercises. Being in the pool is also
safer if you have a minor balance problem, reducing the risk of falls and injuries. Weight-bearing exercises such
as marching, side-stepping, side-kicks, lunges and single leg balance can all be components of a water exercise
program.
Water also acts as resistance which helps to strengthen muscles. Water gloves with webbing, kick
boards, inflatable balls and Styrofoam weights provide a variety of tools for water exercise. The speed of your
movements can determine resistance. Slow movements create less resistance than quick movements. Pool
exercises can also help to improve flexibility, balance, agility and strength while providing a safe exercise
medium.
As you can see there are many opportunities to stay fit during the summer months. Simply pick your
favorite (or must do) activities and get moving!
26850 Providence Parkway
Phone: (248)380-3550 Fax: (248)380-1620
Suite 365
E-mail: [email protected]
Novi, MI 48374
www.oaklandphysicaltherapy.com
Our Therapists:
Frank Kava, PT, MS, DPT, OCS, OMPT
Kristie Kava, PT, MS, DScPT, OMPT
Linda Erickson, PT, MS, OMPT
Kristen Decker, DPT, OMPT
Cathy Jamrog, MPT
Elizabeth Burkel, DPT, OMPT
News and Updates
Dr. Kristie Kava recently presented at the 2016 International
Performing Arts Medical Association Symposium in New York City.
This event combined the fields of performing arts medicine, sports
medicine, and medical education to address artists and performers
with injury issues. Dr. Kava’s presentations included the topic of
therapeutic exercise for musicians injuries and a case study
presentation of an injured violinist.
Dr. Kristen Decker recently completed a 2 year graduate certificate program in orthopedic manual
Physical therapy (OMPT) at Oakland University. This program offers advanced courses in theoretical and
clinical training, emphasizing manual therapy techniques. By completing this program, Kristen has
advanced her manual therapy skills, which will allow her to provide Oakland Physical Therapy patients
with greater care. Physical therapists on staff have advanced training and are certified in orthopedic
manual physical therapy, a process that requires years of experience and academic and clinical education
beyond the doctorate degree level.