APTA Michigan Lines is a blog to promote collaboration between professionals and students of the physical therapy profession in Michigan.

The goal is to create a space where individuals from many backgrounds can share knowledge and experiences with each other and the community.

We would love to hear from you about a topic you are passionate about. Posts are submitted by individuals and reviewed for posting. You can submit yours by emailing new blog items to contact@aptami.org


Member Spotlight: Priti George

At APTA Michigan Lines, we would like to take the opportunity to use our platform to celebrate our greatest asset: our APTA Michigan Members! We hope that this new endeavor will not only highlight our valuable members, but also inspire, engage, and connect us as a professional organization. This month, we would like to introduce you to Priti George, PT, DSc, Cert, MDT, COMT, Board-Certified Clinical Specialist in Orthopaedic Physical Therapy. Priti has been a practicing physical therapist since 1995. She completed her bachelor's from Nagpur University and Masters in Orthopaedic Physical therapy from All India Institute of Physical Medicine and Rehabilitation, Mumbai, India (AIIPMR). She earned her doctoral degree from Andrews University in Michigan and holds certification in Orthopaedic Manual Manipulative Therapy from the North American Institute of Orthopaedic Manual Therapy (NAIOMT). She is a certified McKenzie therapist, specializing in spinal movement dysfunctions. She currently works in an outpatient clinic for Henry Ford Health. At Henry Ford Health, in addition to treating patients, she also serves as the Chair of the Clinical Council and is a valued mentor to fellow clinicians. Priti recently was appointed by the ​Governor as a member of the Michigan Board of Physical Therapy. How…

Embracing Self-Care: One Nudge at a Time.

Embracing Self-Care: One Nudge at a Time. As we this year towards the home stretch of 2021, with many preparing for Holiday celebrations with filled with shopping, food, and family, there comes with this the inevitable business leading many into distress and leading to decisions that we come regret and come up with resolutions to combat in January.  In addition to this, covid-19 remains in the forefront of many people’s lives bringing with it illness, isolation, and bitterness that puts damper on our spirits and also is harmful to our health: physical, mentally, and even spiritually.  So, the first mention of embracing self-care is easy to disregard.  We all are I’m sure familiar with the self-talk, “I’m too busy for that” or “I’ll get to that sometime later.”  But maybe we should realize that this is when we need to address self-care the most.  I recently listened to a podcast from Jimmy McKay’s PT Pintcast titled: “Three Insights You Need From an FBI Hostage Negotiator” (December 02, 2021) that discussed how to engage clients about making behavior changes being asking “No” questions.  (“Would you be against…)  And I think it is applicable to self-care as my question to you the…

Recognizing Delirium, Dementia, and Depression

Could you recognize the signs and symptoms of delirium, as opposed to depression and dementia in your elderly patient? While all three can coexist simultaneously, the ability to differentiate can be difficult and is of great importance when working with older adults. Delirium in older adults is commonly undiagnosed, misunderstood, and responsible for unnecessary hospitalizations. It is estimated that delirium affects 14% to 56% of all hospitalized elderly patients. Each year in the US, at least 20% of the 12.5 million patients over the age of 65 experience some form of complication due to delirium.1 Delirium can be defined as a transient mental disorder causing a sudden and rapid change in cognition, lasting from a few hours or up to a few months. Clinical features of delirium include a reduced ability to focus on an external stimulus, inability to shift attention to a new external stimulus, and disorganized thinking which is manifested by rambling or incoherent speech.2 Symptoms of delirium can be classified as hyperactive, hypoactive, or a mixed combination of both. Common symptoms can include: a reduced awareness of their environment, decreased activity level, poor short-term memory, disorientation, difficulty speaking or understanding speech, anxiety, apathy, fear, aggression or anger,…

Vitamins and Supplements for 50+

It’s important as health care professionals and physical therapists that we do our best to ensure the general health and well being of our patients. As physical therapists we are specifically focused on encouraging our patients to stay active, no matter what age, in order to ensure our patients have a better quality of life. Aging is a normal part of life, however, our bodies sometimes need a little extra help to continue to stay healthy. That’s where dietary supplements like vitamins and minerals come in. As our bodies age we have different needs, so certain nutrients become more important than they were when we were younger. It’s important to talk about these with your patient, if it will help with their prognosis and healing.1 These supplements can be added to your diet to help your bones, muscles, nerves and cells stay healthy, as well as lower your risk of health problems like arthritis and osteoporosis.2 Supplements come in many forms such as pills, powders, capsules, gel capsules, extracts, tablets or liquids; these can be added to any foods or drinks.2 The patient's diet can be changed so they are getting a variety of healthy foods to help their body…

All Aboard the Gains Train: Why We Need to Stop Underprescribing Exercise in an Older Population

    Image from Functional Training for Older Clients. By Zac Martin, https://www.theptdc.com/functional-training-older-clients. In the physical therapy field, we’re no strangers to the benefits of regular physical activity and exercise to improve health outcomes, increase functional capacity, and create an overall better quality of life. This holds true for the older adult population, a growing demographic as we see Baby Boomers entering this next phase of life. Older adults represent a rapidly growing demographic of the population. The 2019 census indicated more than 54 million U.S. residents compared to 40.3 million reported in the 2010 census1. Participation in regular physical activity and exercise is proven to have substantial health benefits, delay physiological dysfunction associated with aging, and help prevent chronic disease2. Yet research suggests that only 22% of adults over the age of 65 years old meet the appropriate physical activity recommendations³. Furthermore, despite the known benefits of exercise, many clinicians remain hesitant to prescribe exercise to an older population4. This piece outlines the appropriate exercise parameters for this population, as well as how we can implement these recommendations to our patients in this demographic.   BENEFITS OF EXERCISE Healthy aging and maintenance of functional capacity require consistent physical activity…

Effectiveness and safety of HIIT for the geriatric patient

Importance of physical activity for the geriatric population According to the CDC, 54 million adults are over the age of 65 and that number is expected to increase to 71 million by 2030. Among the aging population comes a multitude of medical conditions and comorbidities that lead to disability and thus decreased function and independence. Physical activity is the common deterrent to combat the consequences of not only disease but a sedentary lifestyle that puts many older adults at risk for falls and increasing mortality.1 The challenge is encouraging older adults to participate in exercise and maintain an active lifestyle. A common barrier to exercise regardless of age is lack of time to engage in physical activity.2 Therefore, the ultimate goal as physical therapists and other healthcare and exercise providers is to determine the most effective, safe, and meaningful experience to benefit our geriatrics patients. What is HIIT? High Intensity Interval Training (HIIT) is a low volume exercise program characterized by vigorous intervals of physical activity at 80-95% of an individuals’ HRmax, interspersed by either passive or active recovery periods at low to moderate intensity. Completely customizable by activity, intensity, duration, and pattern of recovery, HIIT is a favorable choice…

Strike a Pose

Is getting your geriatric patients to participate in treatment sessions becoming a bit of a stretch? Do you feel like you are bending over backwards trying to come up with new programs for your geriatric patients? Yoga may be the solution to your problems since it has many physical and mental benefits for the geriatric population.     As your patients age, it is important to incorporate a variety of activities into their everyday routine to ensure overall health and fitness. Yoga is a great way to meet this recommendation because it provides a variety of benefits across many domains of physical fitness. Yoga is well-known for its intricate poses that promote flexibility and balance. These poses can be modified to the geriatric patients level of fitness and progress as the person improves. The poses often require single leg stance or positioning one’s center of mass outside of their base of support. Maintaining these poses for an extended amount of time works to challenge the patient’s vestibular system to improve the strength of stabilizing muscles. Gait improvements have also been seen in the geriatric population as a result of participating in a regular yoga program. Yoga helps to increase lower extremity…

Geriatric Patients “Move to the Beat of the Drum” with Cardio Drumming Classes

Cardio drumming has existed for centuries among cultures in Africa, known as djembe drumming, as a cultural tradition performed during rituals and celebrations.1 Over the years, it has gained popularity for its emotional and physical benefits. It has transitioned from being a ritualistic activity to a modern way to get active. Cardio drumming combines the use of an exercise ball, a platform to hold it, and drumsticks to create a unique workout. Cardio drumming classes are popping up more and more each year. Among the new found popularity, a cardio drumming company called POUND was founded in 2011.2 POUND offers an aerobic component alongside strength training and conditioning, but also offers yoga and pilates-inspired movements.2 The social aspect and inclusivity of cardio drumming programs can benefit geriatric patients by encouraging movement throughout the week. Although there are variations of this activity that exist worldwide, the goal is to provide an alternative option for working out that keeps individuals motivated while benefiting both physically and emotionally. There are many health benefits when it comes to exercise, especially in the geriatric population. As people become older it sometimes can be more difficult to engage in vigorous exercise. Common complications of aging include…

How to Prescribe Exercises to Your Older Patients with Chronic Conditions

How to Prescribe Exercises to Your Older Patients with Chronic Conditions   Do you feel intimidated by the thought of prescribing exercise recommendations to your geriatric patients with chronic conditions? If you don’t know where to begin, be sure to understand this: Any amount of exercise beats remaining sedentary. This holds true even when a patient’s health status interferes with attaining recommended goals.1 However, as healthcare professionals, we strive to provide effective, evidence-based treatment that is individualized to each patient’s needs. Frequent chronic conditions in the geriatric population such as arthritis, osteoporosis, and heart disease have specific exercise recommendations to improve physical function and symptom management. The risk of developing arthritis increases with age, and roughly 49.6% of people 65 years or older report being diagnosed with this condition.2 The goal of exercise for individuals with arthritis is to enhance function and decrease levels of pain to improve overall mobility.3 Both land and aquatic based physical activity can increase mobility, muscular strength, joint flexibility, and reduce pain in patients with hip or knee osteoarthritis.4, 5 Starting with aquatic based activities can have a therapeutic and pain minimizing effect through reducing joint loading. As mobility is improved and pain is reduced,…

Osteoporosis in older adults and its relationship with falls/fractures

Every second of every day, an older adult (65+) sustains a fall in the United States. In addition, falls are the leading cause of injury in this age group.¹ Osteoporosis is a condition that causes bones to become brittle, which may increase the risk of a fracture. Typically, older adults have various impairments such as vestibular disorders, vitamin D insufficiency, medications, postural hypotension, vision impairment, foot/ankle pathology, and trip hazards that increase the likelihood of falls.² This can be extremely problematic for older adults who have osteoporosis. The best intervention for falls is prevention. By routinely screening elderly patients and taking preventative measures, falls and secondary complications can be prevented as a whole. The prevalence of osteoporosis is a worldwide problem.5 Patients within the elderly population are more prone to having a reduction in bone density. Unfortunately, osteoporosis is on the rise within many countries. Researchers attribute this increase to elderly people living longer than before.5 It has been determined that a primary cause of bone density loss is through immobilization. When a patient is immobilized in a bed, they can lose just as much bone in a week as they would otherwise lose within a year.5 A way to…

Career, Interrupted: Tales From A Graduating PTA Class

  Career, Interrupted: Tales From A Graduating PTA Class 2020 was, to put it mildly, a challenging year for all of us. But it was especially challenging for those in the PT field who were least-equipped to cope with its effects: the graduating class of 2020. Many of these students-turned-PTAs still find themselves un- and under-employed even as the pandemic is (hopefully) nearing its end. It is the intention of this editorial to shine a light on the plight of the newest generation of PTAs, who entered the field at what was arguably its most difficult (though some would say “finest”) hour.  For the purposes of this editorial, I will be focusing on the experiences of graduates of Macomb Community College’s PTA program (of which the author is a member; go Class of 2020!). This is done partly in an attempt to limit the number of interviews necessary to write this article, since obtaining a core-sampling of the entire graduating class of the state of Michigan would be prohibitively difficult (especially for a beginning PTA who hasn’t made many professional contacts yet). It is also done out of entirely human self-interest: the young PTAs interviewed are the author’s friends, classmates,…

Not Every Doctor is a Physician

The term doctor originated in the early 14th century from the Latin word meaning “teacher.”  It referred to a group of theologians that had approval from the Roman Catholic Church to speak on religious matters and doctrines. Initially, the title was not associated with academics or health professionals. By the end of the 14th century, during the Renaissance, the term “doctor” was being applied to academics and medical practitioners.(3) The name “Doctor” is given to anybody who has received a doctoral level degree from a university. This includes, but is not limited to: Medical Doctor (MD) Doctor of Osteopathic Medicine (DO) Doctor of Philosophy (PhD) Doctor of Physical Therapy (DPT) Doctor of Dental Surgery (DDS) Doctor of Dental Medicine (DMD) Doctor of Optometry (OD) Doctor of Pharmacy (PharmD) Doctor of Podiatric Medicine (DPM) Doctor of Nursing Practice (DNP) Doctor of Occupational Therapy (DOT) Juris Doctor (JD) Doctor of Veterinary Medicine (DVM) Doctor of Chiropractic (DC)  The use of the title “doctor” for non-physician health professionals has been heavily debated. One should not use the title “doctor” if they are to be mistaken with a physician. This is especially important in hospital settings— if one is to use the title “doctor,”…

The Future of Physical Therapy

Change is inevitable. Everything must change. Change is the only constant. These commonly used expressions hold some truth, and in considering our profession’s evolution as we celebrate the Centennial, they have got me thinking about our collective future. What will physical therapy look like? What should it look like? What must it look like? There are three potentially very different answers to these questions. We only win if the answer to all three is the same. We only win when we do it together, as a unified association. We have some existential threats that will shape who and what we become, and we must deal with those threats successfully if we are to thrive. The ones I want to focus on here are value-based payment and diagnosis. I believe these two issues to be key drivers of many other related issues including the worsening student debt-to-income ratio, our lack of workforce diversity, our professional identity, and physical therapists being the providers of choice. Regarding value-based payment1, we are clearly not thriving on procedure-based, fee-for-service payment models. Payers are not offering substantial increases in payment, even if we demand it.  Gone are the days that we will be paid for the…

The Underrated Benefits of APTA Michigan Membership

The Underrated Benefits of APTA Michigan Membership I’d like to preface this article by saying that there is no single best reason for maintaining a professional membership in ATPA Michigan (APTA MI). Membership provides a list of benefits that is long and varies from person to person—and that’s okay! Today, however, I’d like to take a little time to recognize the membership benefits that I consider to be unsung heroes. The benefits, in my humble opinion, often go uncelebrated. The benefits that are typically overshadowed by some of the other, more tangible benefits our professional association provides. If there is one thing that I have learned in the past three years by volunteering for APTA Michigan’s Membership Committee, it is that each person measures the value of our professional association differently, and one person’s reason to be an APTA MI member may be completely different than another’s. In full disclosure, my data on this subject is purely anecdotal; however, often times when I ask individuals to discuss the aspects of their APTA MI Membership they find most valuable, the most common responses I hear are things like: 1. Access to content and resources. 3. APTA MI conferences and events. 4. Networking opportunities…

Covid-19: Shedding Light on Minority Accommodations

When the world took a turn with Covid-19, we were ready to think on our feet and adapt to our conditions in order to be successful. In PT programs across the nation, we saw adaptations such as reduced class size, hybrid learning, reduced lab hours, full PPE in labs, and limited lab partners in PT classes. Not only did we make rapid accommodations, we did so in a way where we remained confident that students were clinic ready. This resilience in the face of adversity is a testament to what we are capable of as a profession. Covid-19 is not the first situation in which this resilience has been warranted; however, it is perhaps the first situation where it was necessary. For various religious or cultural reasons, people have requested accommodations. Sadly, many have been treated as though their accommodations were impractical or a hindrance to learning. Today we might see those barriers as largely self-imposed. As an observant Muslim woman, I have firsthand experience with this. I requested religious accommodations in PT school, which included having a privacy screen and not having the men in my class work on me during lab. I made sure to be clear about these…

How Covid-19 Helped Us: How Covid-19 Gave Us the Opportunity to Live in an Ideal Acute Care Therapy World

In the world of an acute care therapist working in a large metropolitan hospital, we live day to day knowing that we will not be able to provide treatment to the number of patients who need our services because of high patient volumes.  We spend most of our time trying to figure out some sort of priority list that tells us which patients are going to make the cut for treatment.  New evaluations, patients returning home, patients who need rehab placement.  Who needs us the most?  It’s the question that physical therapists in acute care struggle with every day.  Did we help the right patient at the right time and were we the right provider?  Helping people to understand the role of the acute care therapist can also be a daunting task.  No, we aren’t just here to provide a discharge recommendation.  We aren’t just the resident lift team for the hospital either.  We are skilled professionals, experts in mobility and regaining function in the presence of disease, musculoskeletal impairments and critical illness.  We are here to help a patient regain their independence.  We are here to listen to what their goals and needs are so we can help them…

Into the Unknown

Into the Unknown If you started belting “Into the Unknown” like you are Idina Menzel (Elsa from Frozen) after reading the title, don’t worry you aren’t alone. While for Elsa, the song was in response to a mysterious voice beckoning her into the unknown, perhaps the events of 2020 are calling us and our profession to a similar journey of self-awareness and discovery. Has anyone ever asked you ‘where do you see yourself in 5 years?’ I think I am pretty safe to say that we have all been asked this question at least once, and that most of us NEVER envisioned 2020 going the way that it has. That being said, as I reflect upon the impact the COVID-19 pandemic and the Black Lives Matter movement had on this year’s APTA House of Delegates (HOD) meeting, I am reminded that we are a profession that has evolved and thrived on forging into the unknown. We address the necessities of our society by building upon our knowledge and skills, utilizing new technologies, pushing for educational advancement and by traversing into new clinical environments and specializations. Consider how far we have come over the past almost century. We have evolved from…

Importance of Civic Engagement for PTs and PTAs

Note:  APTA Michigan supports all candidates, regardless of political party affiliation, who are supportive of issues important to our profession and patients we serve. Many of you have heard me talk about the importance of civic engagement. I am currently running for State Representative in Michigan’s 60th House District and am in a competitive primary which takes place on August 4. While I highly encourage physical therapists and physical therapist assistants to consider running for office (we need more of us making decisions at all levels of government!), I wanted to discuss a few political options that can make a difference for our profession. First, NOW is the time to consider volunteering, donating, and helping with a campaign and candidate you believe in. Trust me, candidates will REMEMBER those volunteers who spent time making calls, texting, lit dropping, putting up yard signs and giving of their time to help the campaign. Of course, monetary donations are also needed, but there is nothing like volunteering to make an impression with a candidate and future lawmaker. Second, consider applying to serve on a city, county, or state advisory board. There are many – some to consider include Public Health boards, environmental boards,…

The Quiet Leader

The Golden Retriever                 A long time ago in some undergraduate psychology class I vaguely remember taking a personality survey designed to best match an animal to your personality characteristics. One look at the title above and you can guess what mine was. My qualities of dedication, focus, playfulness, and loyalty forever cemented my place as…well a dog apparently. In all seriousness though I should have realized these qualities for what they were at that time, a prediction of my future role as a clinician and a leader.                 There is a reason golden retrievers are one of the preferred breeds as leader dogs for those with vision impairments or disabilities. This breed is caring when needed, but also committed and focused to accomplish a particular task and ensure safety. Golden retrievers are loyal beyond all else and exhibit a playful yet modest demeanor that cements them as a quiet leader. I possessed these similar qualities years ago and somehow have refined them over the years to carry over into my personal clinical and leadership style. How do you refine qualities similar to a leader dog and employ them in the world of physical therapy you ask? Well, let me…

Riding the Pine

Riding the Pine Not familiar with the phrase? It is an expression in sports that refers to being on the bench…being on the sidelines and not having the chance to get in the game and contribute to the team’s effort. I have found myself thinking a lot lately about my days playing basketball in high school. Those who know me may be shocked to know that yes, indeed, I played varsity basketball in high school. At 5’8 ¾” first thing in the morning when my intervertebral discs have been hydrating all night, “basketball player” is not the first thing that comes to mind when you think of me. And by “play basketball”, I really mean lots of playing in practice. And even when I got to play during the last few minutes of those games when we were crushing the opposing team, I missed a lot of shots and had several turnovers. There was a reason I was a pine rider. So I got good at helping my teammates in practice to prepare for games and cheered them on, especially when the game was close or when we were losing. “Let’s go Blue!”  But I spent a lot of time…