Download Therapy Notes_March 2014 - Hillcrest Health Services

March 2014
Outpatient Specialty Rehabilitation
Mom was on to something when she told you to “Sit
up straight!” Poor posture can lead to many problems,
including breathing difficulties, discomfort and pain
around the head, neck and shoulders, and low back
pain, one of the most common consequences.
According to the National Institutes of Health,
approximately 12 million adults in the U.S. are
diagnosed with COPD, and 120,000 die from it each
year. It’s estimated an additional 12 million adults are
undiagnosed.1
Posture and sitting position, especially for those who
sit for extended periods of time, can affect lung
capacity.2
“Exercise can play an important role in improving
posture and strength, increasing one’s ability to breath
and allowing the muscles to work at optimum capacity,” said Jake Costello, DPT, Director, Hillcrest
Physical Therapy.
Rounded shoulders and an overly flexed spine
can restrict the expansion of the rib cage and reduce
the ability of the diaphragm to rise and fall. If the diaphragm can’t rise, it won’t be able to draw in as much
oxygen during inhalation.
“In this situation, our focus turns to correcting posture and working on strengthening the diaphragm,”
Costello said.
(continued on back
Therapist Spotlight Lymphedema Therapy
Kim Book, OTR/L, OTD, CLT
What type of therapy do you
specialize in at Hillcrest Physical Therapy?
I am the outpatient Lymphedema Specialist and
treat patients who have lymphedema, edema and/
or venous insufficiencies to help them manage the
fluid that their body is retaining. I also see patients
with low vision deficits (a personal interest of
mine after completing my professional rotation in
low vision at UNMC’s Low Vision House. It was
an enriching experience!)
How can occupational therapy assist with
lymphedema?
We start by educating the patient on lymphedema and why the body is not reabsorbing the
fluid. We can also provide manual lymph drainage
(MLD), which is a form of massage that allows the
fluid to be reabsorbed into the tissue/bloodstream
in a pattern that will not overload the system.
We also provide compression therapy, where a
patient would need to have his or her extremities
wrapped with compression garments to manage the
swelling/edema. The goal is to get the patient into a
compression garment that can be worn during the
day instead of the wraps.
Tell us more about your educational background:
I have worked at Hillcrest nearly five years and
graduated from the University of Nebraska at
Kearney in 2003 with degrees in Exercise Science
and Therapeutic Recreation. In 2008, I graduated
from Creighton University’s Doctorate of Occupational Therapy program, and I completed my
lymphedema training/certification through Norton
School of Lymphatic Therapy in December of 2011.
For more information about lymphedema therapy,
please call (402) 682-4210.
(Posture cont.)
In a pilot study published in Physiotherapy, regular
exercise was shown to improve respiratory muscle
strength and maximal voluntary ventilation in osteoporotic women.3
Additionally, a study published in the Journal of
Cardiopulmonary Rehabilitation concluded “respiratory
muscle endurance improved with exercise training,
contributing to increased exercise capacity, decreased
breathlessness, and decreased perception of breathlessness.”4
“Diaphragm strengthening is recommended for patients with less than normal vital capacity,” said
Costello. “When treating patients with poor posture
Outpatient Physical,
Occupational & Speech
Therapy
Certifications and Expertise
Aquatic Therapy • Hand Therapy • Geriatric
Therapy • Osteoporosis Management •
Lymphedema Management • Vital Stem®
Swallowing Therapy • Balance Therapy •
Total Joint Rehab • SaeboFlex Arm Training •
Back Pain/Spinal Rehab • Sports Therapy •
Stroke/Neurological Rehab • Women’s Health
Massage Therapy
and thus breathing problems, physical therapists are
able to train these patients in diaphragmatic breathing
techniques. Plus, we are trained to perform manual
resistance therapy to strengthen the intercostal muscles
leading to the patient’s ability to expand the ribcage
and improve ventilation.”
For more information on physical therapy treatments
to improve posture and diaphragm strength, go to
www.moveforwardpt.com or call (402) 682-4210.
References
1. National Institutes of Health: http://report.nih.gov/
nihfactsheets/ViewFactSheet.aspx?csid=77
2. Lin F, Parthasarathy S, Taylor SJ, Pucci D, Hendrix RW,
Makhsous M. Effect of different sitting postures on lung
capacity, expiratory flow, and lumbar lordosis. Arch Phys Med
Rehabil. 2006 Apr;87(4):504-9.
3. Ana C.M. Renno, Renata N. Granito, Patrícia Driusso, Dirceu Costa, Jorge Oishi. Physiotherapy. June 2005;91(2):113118, DOI: 10.1016/j.physio.2004.09.020)
4. McConnell, Timothy R. PhD; Mandak, Jeffrey S. MD;
Sykes, Jeffrey S. MD; Fesniak, Henry MD; Dasgupta, Himadri MD. Cardiac Rehabilitation Exercise Training for
Heart Failure Patients Improves Respiratory Muscle Endurance, Exercise Tolerance, Breathlessness, and Quality of
Life. Journal of Cardiopulmonary Rehabilitation. January/
February 2003;23(1):10-16
(402) 682-4210
hillcresthealth.com
1804 Hillcrest Dr.
Bellevue, NE 68005