Physiotherapist's: 2011

Monday, December 26, 2011

THE SEVEN LAWS OF SUCCESS(Cont)

The All-important Fourth Law
A person may have chosen his goal. Having it may have aroused tremendous ambition to
achieve it. He may have started out educating and training himself for its
accomplishment, and he may even have good health and still make little or no progress
toward its realization.
After all, success is accomplishment. It is DOING. They say any old dead fish can
float downstream, but it takes a live one to swim up. An inactive person will not
accomplish. Accomplishment is DOING.
Now comes an all-important law.
The fourth success-law, then, is DRIVE!
Half-hearted effort might carry one a little way toward his goal, but it will never get
him far enough to reach it.
You will always find that the executive head of any growing, successful organization
employs drive! He puts a constant prod on himself. He not only drives himself, he drives
those under him, else they might lag, let down and stagnate.
He may feel drowsy, and hate to awaken and get up in the morning. But he refuses to
give in to this impulse.
I remember the struggles I once had with this situation. It was during one of my “Idea-
Man” tours as a magazine editorial representative at age 22. I was having quite a struggle
with drowsiness. Yet I acquired the habit of sleepily answering the morning telephone
call and promptly going back to bed and to sleep. Then I bought a “Baby Ben” alarm
clock which I carried with me. But I found myself arising to turn off, then plunging back
into bed. I was too drowsy to realize what I was doing. I was not sufficiently awake to
employ willpower and force myself to stay up, get under the shower and become fully
awake and alert. It had become a habit.
I had to break the habit. I had to put a prod on myself. I needed an alarm clock that
couldn’t be turned off until I was sufficiently awake to get going for the day.
So one night at the Hotel Patton in Chattanooga, Tennessee, I called a bellboy to my
room. In those days the customary tip was a dime. A half dollar then had about the same
effect that a $20 bill would have today. I laid a silver half-dollar on the dresser.
“Do you see that half-dollar, son?” I asked.
“Yes Sir!” he answered eyes sparkling in anticipation.
After ascertaining that he would be still on duty at 6:30 next morning, I said,” If you
will pound on that door in the morning at 6:30, until I let you in, and then stay in this
room and prevent me from getting back into bed until I am dressed, then you may have
that half-dollar.”
I found those bell-boys would, for a half-dollar tip, even wrestle of fight with me to
prevent my crawling back into bed. Thus, I put a prod on myself that broke the morning
snooze habit and got me up and going!
Often workmen never rise above whatever job they may have because they have no
drive. They slow down, work slowly, poke around, sit down and rest as much as they can.
In other words, they must have a boss over them to drive them, or they would probably
starve. They would never become successful farmers -- for a farmer, to succeed, must get
up early and work late, and drive himself. That is one reason so many must work for
others. They cannot rely on themselves -- they must be driven by one of more energy and
purpose.
Without energy, drive, constant propulsion, a person need never expect to become
truly successful.

Thursday, December 15, 2011

THE SEVEN LAWS OF SUCCESS(Cont)

The Basic Third Law

The all-important law coming next in time order is GOOD HEALTH.
We are physical beings. The mind and the body form the most wonderful physical
mechanism we know. But man is made of matter. He is basically 16 elements of organic,
chemically functioning existence.
He lives by the breath of air -- which is the breath of LIFE itself. If the bellows we call
lungs do not keep inhaling and exhaling the oxygen-containing air, man won’t live to
achieve any goal. You are only one heartbeat away from death! As the lungs pump air in
and out, so the heart pumps blood through an intricate system of veins and arteries. These
must be supported by food and water.
And so man IS just what he eats. Some of the most famous physicians and surgeons
have said that 90% to 95% of all sickness and disease comes from faulty diet!
Most people are in utter ignorance of the fact that it does make a difference what we
eat! Most people, and the customs of society, have followed a regimen of eating whatever
tastes good to the palate.
Adults are babies grown up. Observe a nine-month-old baby. Everything that comes
into his hands goes to his mouth!
My youngest brother may not like to read this in print, but I remember when he was
about nine months old, and had managed to creep into the basement coal bin. We found
him trying to eat little chunks of coal -- his mouth and face well blackened!
You may laugh at babies trying to eat silver cups and chunks of coal. Or at people
who dip small mice into a sauce, and, holding them by their tails, dropping them as a
delicious delicacy into their mouths?
If you do, they will laugh back at you. They will tell you that mice eat clean grain and
clean foods, while you dip slimy, slithery oysters and other scavenger seafoods into
cocktail sauces, and consider them a delicacy!
You think adults have actually LEARNED any better than nine- month-old babies?
Go to your fancy grocer’s and you’ll find on his shelves canned eel and canned
rattlesnake.
WHY? As I said, humans know nothing at birth! We have to learn! But most of us do
not know that! And, again, what we don’t know, we don’t know that we don’t know! And
somehow, ever since babyhood, most humans seem to have grown up putting everything
into the mouth. Most have grown up eating just whatever seemed to taste good -- and
whatever they saw others eating. There has been little education or even study ah out
WHAT we ought -- or ought NOT -- to eat.
Most degenerative diseases are modern diseases -- penalties for eating foods that have
been demineralized in food factories -- usually an excess of starch, sugar (the
carbohydrates) and fats. Others are caused by a type of malnutrition -- lack of needed
minerals and vitamins in foods. Then people try to put the “vitamins” back into their
systems by buying pills at the drugstore!
A famous director of a “Physical Fitness” program, lecturing at Ambassador College,
reminded us that the medical profession has made great strides toward eliminating
communicable diseases, yet is having little success coping with the increase of the noncommunicable
diseases -- such as cancer, heart diseases, diabetes, kidney diseases. These
latter are affected by faulty diet.
Of course there are other laws of health -- sufficient sleep, exercise, plenty of fresh air,
cleanliness and proper elimination, right thinking, clean living.
Right now “jogging” has become the physical fitness fad. Even men in their late
forties read a book by a self professing “expert,” and suddenly are straining their hearts
running two miles every day. “More and more exercise!” cry the faddists.
Why do humans tend to go to extremes? Exercise is good -- it profits a little -- but like
most things, it can be carried past the law of diminishing returns. You can get an
overdose that can cause harm. We are prone to forget the admonition of TEMPERANCE
in all things.
What is the value of this excessive exertion in running two miles a day? It induces
blood circulation. It gets circulation even to the extremities. And that is good. Stimulating
blood circulation is important. But we can also DESTROY HEALTH by going to unwise
extremes. There is as much danger in over-doing exercise as in neglecting it.
Circulation can be induced without over-exertion or danger. I have never forgotten a
lecture I heard as a young man in the days of the Chautauqua. The lecturer had been
physical trainer to President Howard Taft. Immediately following the close of the Taft
administration, this physical trainer managed to secure a list of all -- or nearly all -- of the
centenarians in the United States. He personally visited every one. He asked to what they
attributed their long life. One never used tobacco, and gave that as the reason. But
another used tobacco all his life and still lived past a hundred years. One “tee-totaled” --
but another drank beer and brandy all his life. And so it went. When he had interviewed
them all, he analyzed his notes and was surprised to learn that ONLY ONE THING was
common to them all. Yet not one gave it credit for his long life. Every one had taken a
vigorous daily rub-down. Some with a bath towel, following a daily bath. Some with a
brush. But in one way or another, each had stimulated blood circulation even to the
extremities of toes and fingers by daily rubbing or massaging.
Many ask how I (now in my 84th year) keep up the energy, vigor and drive. I’m sure
there is more than one reason -- but I do not “jog” or go in for fads. I WALK -- the best
exercise for one of my age. But ever since I heard that lecture, perhaps 60 or more years
ago, I have taken a daily RUB-DOWN. Method? A generous-size bath towel, following a
daily shower. I try to get enough sleep. I watch elimination (very important). I try to be
careful about my diet. And I have a tremendous INCENTIVE -- a driving PURPOSE in
life, because I have learned what is life’s PURPOSE. That spurs to action! I have a
mission to accomplish that is more important than my life. There’s not much time left --
and it MUST and WILL BE ACCOMPLISHED! Besides all this I draw on a greater and
higher Power. I think that gives the answer.
The average person has never stopped to realize that it is not natural to be sick.
Sickness and disease come only from violation of nature’s laws of body and mind -- the
physical LAWS of health. Most people have not learned that there are any such laws!
They suppose that occasional illness or disease is natural in the course of life. Nothing
could be farther from the truth.
Sickness should not be taken for granted. Some authorities go so far as to say that we
do not catch a cold -- we eat our colds and fevers! They explain that a cold or fever is
merely the unnatural and rapid elimination of toxins and poisons stored up in the glands,
resulting from improper diet.
Now what about the great and the near-great of the world? They usually do not know
all there is to know about the laws of good, vigorous health with clear, alert minds. But,
compared to the average of the population, they know a great deal. They have, as a rule,
enjoyed, shall we say, comparatively good health!
As an example, the President of the United States always has a White House physician
who is constantly watchful over the President’s physical condition. A President is
virtually required to get in certain exercise. President Eisenhower played golf frequently.
President Kennedy took a daily swim. President Taft had a physical trainer who watched
the overweight President daily.
Yet, there are many things that even these important people do not know about the
causes of sickness, disease, debility.
One factor I think has worked universally in favor of such men. Mental attitude does
have considerable influence on physical condition. Most “successful” men -- as the world
evaluates success -- do think constructively, positively, in a mental attitude of confidence.
They do not allow themselves to think negatively or assume an attitude of fear, worry, or
discouragement. They do not allow themselves to get into uncontrolled moods of griping,
complaining. They enforce on themselves emotional balance. And, mindful of the
responsibilities on their shoulders, they probably put more restraint on dissipation than
most people.
Without health one is direly handicapped, if not totally cut off from achievement. The
fourth Law of Success is largely dependent on good health.

Monday, November 28, 2011

THE SEVEN LAWS OF SUCCESS(Continued)

The Vital Second Law
And so, if you are to arrive at SUCCESS in LIFE, you must first set the right goal, and
then comes the PREPARATION to achieve that goal.
So, the SECOND law of success, in time sequence, is EDUCATION, or
PREPARATION.
How can one expect to accomplish his purpose unless he acquires the know-how?
One thing we need to know about life -- and many do not -- is that humans do not
come equipped with instinct.
To this extent, the dumb animals have a certain advantage over us. They do not have
to learn. They never need weary their brains with book learning.
The newborn calf does not have to be taught how to walk. It starts immediately to get
up on its somewhat infirm and uncertain legs. It may fall down on the first or second
attempt, but in a matter of a few moments it stands, even if a little unsteady at first. It
does not require a year or two -- not even an hour or two -- the little calf starts walking in
a few minutes! It does not need to reason out any goals. It requires no textbooks, nor
teaching. It instinctively knows its goal -- dinner! And it knows, also instinctively, the
way. On its own four legs it proceeds immediately to the first meal!
I have repeated so many times: birds build nests -- by instinct. No one teaches them
how. Five generations of weaver birds, isolated from nests or nest-building materials,
never saw a nest. When nest- building materials were made accessible, the sixth
generation, without any instruction, proceeded to build nests! They were not crows’ nests
or eagles’ nests. They were the same kind of nests weaver birds have built since creation.
They had no minds to think out, imagine, design, and construct a different kind of nest.
Of course dogs, horses, elephants, dolphins, and some other animals can be taught and
trained to do certain tricks. But they cannot reason, imagine, think, plan, design and
construct new and different things. They do not acquire knowledge, perceive truth from
error, make decisions, and employ WILL to exercise self- discipline according to their
own reasoned wisdom and decisions. THEY CANNOT DEVELOP MORAL AND
SPIRITUAL CHARACTER.
But humans have it not quite so easy. Humans have to learn, or be taught. Humans
have to learn to walk, to talk, to eat or drink.
We don’t come to these basic accomplishments instinctively and immediately like the
dumb animals. It may take a little more time. It may come a little harder. But we can go
on to learn reading, writing, and “’rithmetic”!
Then we can go further, and learn to appreciate literature, music, art. We can learn to
think and reason to conceive a new idea, to plan, design, construct.
We can investigate, experiment, invent telescopes and learn something about outer
space and far-off planets, stars, and galaxies. We invent microscopes and learn about
infinitesimal particles of matter.
We learn about electricity, laws of physics and chemistry. We learn to use the wheel,
construct highways, and roll over ground faster than any animal. We learn to fly higher,
farther and faster than any bird. We learn how to take nature apart and make it work for
us.
But we have to LEARN -- to STUDY -- to be EDUCATED -- to be PREPARED for
what we propose to do.
One of the first things we need to learn is -- that we need to learn!
Once you have learned enough to CHOOSE A GOAL, the second step toward
successfully accomplishing that goal is to LEARN THE WAY -- to acquire the additional
education, training, experience, to give you the know-how to achieve your goal.
Most people fail to set any definite goals. Having no specific aims, they neglect the
specialized EDUCATION to make possible the attainment of their purpose.
Now all these men whose case histories I have recounted had goals. They had the
overall purpose of acquiring possessions, attaining status, and enjoying the passing
moments. As a means to this objective, they had the specialized goals of succeeding in
banking, industry, politics, acting, writing, or whatever. The all EDUCATED
THEMSELVES for their particular profession or calling.
They were broad enough to realize that education included not only book learning, but
personality development, leadership, experience, knowledge from contacts and
associations, and from observation.
Yet these “successful” people were not really successful. They not only chose an
overall goal that led them in the way of false values, they also failed to equip themselves
with the RIGHT education to make possible that REAL LASTING success -- fulfilling
the PURPOSE of life.
There is, then, a right and a false education.
These successful people were not lastingly successful. Their education failed to teach
them the TRUE VALUES. They chose goals that led them in the way of false values that
didn’t last.
The entire system of education in this world neglects to recapture the true values.
Even the scholarly educators themselves too often devote themselves to arduous years of
research into non- essential and useless channels.
The basic and most essential knowledge -- the true values, the meaning and purpose of
life, the WAY to peace, to happiness and abundant well-being -- these basics are never
taught. Because I was given to see this decadence in modern education -- to recognize
this tragic knowledge gap -- I was led to found a college that fills this need.
Right education must teach that all things are a matter of cause and effect -- that for
every result, whether good or evil, there is a cause. True education will teach the CAUSE
of this world’s evils -- of personal or collective troubles -- so that they may be avoided.
Also it must instruct in the CAUSE of the GOOD results, that we may know how to win
them instead of the troubles. Right education must not stop at teaching TO LIVE! It must
know, and teach, the PURPOSE of human life, and how to fulfill it.
Decadent education has spawned student revolt, which has, on occasion, plunged
many colleges and universities into states of violence and chaos!
It’s another significant tragedy of our time!
This world is disseminating false education that has come down to us from the
thinking, philosophizing, yet misguided pagans who lacked a knowledge of the true
values and purposes of life! The true history of education is an eye-opening story in
itself!

Wednesday, November 23, 2011

THE SEVEN LAWS OF SUCCESS

WHY are only the very few -- women as well as men -- successful in life?
Just what is success?
Here is the surprising answer to life’s most difficult problem, proving that NO
HUMAN NEED EVER BECOME A FAILURE!
All who have succeeded have followed these seven laws!
The only WAY to success is not a copyrighted formula being sold for a price. You
can’t buy it! The price is your own application to the seven existing laws.

The First Law
Certainly NOTHING in life is more important than to know: what is real success -- and
how to achieve it.
What, then, is the first law of success?
Before stating even the first law, let it be said that I am not considering here such
general principles of character as honesty, patience, loyalty, courtesy, dependability,
punctuality, etc., etc., etc., except as these are automatically included in the seven rules.
We may assume that one cannot become a real success without these principles of right
character.
But on the other hand, many are honest who have never practiced a single one of the
seven laws, specifically. Many may be loyal, have patience, extend courtesy, be punctual,
who are unsuccessful because they have not applied a single one of these seven definite,
specific rules. Even so, each of these laws covers a vast territory.
Here, then, is the first law of success:
FIX THE RIGHT GOAL!
Not just any goal. Most of the “successful” men I have mentioned had goals. They
drove themselves relentlessly to accomplishment. But making money, gaining STATUS
in the eyes of people, enjoying the passing pleasures of the five senses, has literally
strewn the pathway of history with fears, worries, heartaches, troubled consciences,
sorrows, frustrations, empty lives and death.
These things may be had and enjoyed along with true success. But they alone do not
bring success. The right goal includes something more.
In other words, the very first law of success is to be able to define success! Once you
have learned what success is, make that your goal in life.
Do you know that most people go on through life without any GOAL at all? In fact,
most people, as I’ve said before, do not know, and do not apply, a SINGLE ONE of the
seven laws of success!
Most people never think of having any PURPOSE in life. They are not going
anywhere, in particular.
If you have saved up money for a trip to Paris, or Rome, or London for your vacation
or holiday, you spend a lot of time in excited anticipation PLANNING your trip -- but
you DO have a definite DESTINATION -- and all plans are laid to take you to that
particular destination -- that GOAL. You know where you are planning to go. Otherwise,
how would you ever expect to arrive there?
As I said once before, most people have no aim -- they are merely the victims of
CIRCUMSTANCE. They never planned, purposefully, to be in the job or occupation in
which they find themselves today. They do not live where they do by CHOICE that is,
because they PLANNED it that way. They have merely been buffeted around by
CIRCUMSTANCE! They have allowed themselves to drift. They have made no effort to
master and control circumstances.
The first law of success, I repeat, is to fix the RIGHT goal. Not any goal. One could
set a goal in which he had little or no interests and drift into inaction. The right goal will
arouse ambition. Ambition is more than mere desire. It is desire plus incentive --
determination -- will to achieve the desire. The right goal will be so intensely desired it
will excite vigorous and determined effort. It will fire one with incentive.
There should be an overpowering PURPOSE to life. Few have ever known such
purpose. Down through centuries and millenniums thinkers and philosophers have
pondered, and sought in vain to learn whether life has a real purpose. Socrates, Plato,
Augustine among others, speculated and reasoned, yet the true meaning of life eluded
them. This deepest and most important question in life remained to them a mystery -- an
unsolvable enigma!
IF one could discover such an overall PURPOSE -- a definite purpose for which
humans were put on earth -- IF one could discover a human potential greater than mere
temporary existence, one would think that PURPOSE would be the goal that should
excite dynamic ambition!
But -- alas! Who has ever discovered such an objective as life’s aim?
Was there nothing greater to look forward to, for my two prominent banker friends?
Nothing greater than to enjoy fleeting status, only to be forgotten by those who succeeded
them? What is there, after all, to live for?
I repeat! The first law of real success is to have the right goal! The men I have
described, rated eminently successful in the world, all had goals. They applied diligently
all of the first six of the Success Laws. But failing the seventh, they misapplied the first.
Their success was fleeting.

Thursday, October 13, 2011

Physical Therapy Abbreviations

P-Z
P
_
p – after

P – poor (used in muscle testing)

P: - plan

P.A. – physician’s assistant

PA – posterior/anterior

para – paraplegia

pc – after meals

PCL – posterior cruciate ligament

PE – pulmonary embolus

PEEP – positive end expiratory pressure

per – by/through

PF – plantar flexion

p.o. – by mouth (per orem)

PERRLA – pupils equal, round, reactive to light and accommodation

P.H. – past history

p.m. – afternoon

PMH – past medical history

PNF – proprioceptive neuromuscular facilitation

PNI – peripheral nerve injury

POMR – problem-oriented medical record

pos. - positive

poss – possible

post. – posterior

post-op – after surgery

PRE – progressive resistive exercise

pre-op – before operation

Prep. – preparation

prn – whenever necessary

PROM – passive range of motion

PROME – passive range of motion exercise

PSIS – posterior superior iliac spine

PT – physical therapy/ therapist

PT – prothrombin time

Pt. or pt. – patient

PTA – prior to admission

PTA – physical therapist assistant

PTB – patellar tendon bearing

PVD – peripheral vascular disease

PWB – partial weight bearing

Q

q – every

qd – everyday

qh – ever hour

qid – four times a day

qn – every night

R

® - right

RA – rheumatoid arthritis

RBBB – right bundle branch block

R.D. – registered dietitian

Rehab – rehabilitation

reps. – repetitions

resp – respiratory, respirationRICE - rest, ice, compression, elevation
Z
RN – registered nurse

R/O or r/o – rule out

ROM – range of motion

ROME – range of motion exercises

ROS – review of systems

rot. – rotation

RR – respiratory rate

RROM – resistive range of motion

R.T. – respiratory therapist/therapy

Rx – prescription; therapy; intervention plan; treatment

S

_
s – without

SACH – solid ankle cushion heel

SBA – standby assist

SCI – spinal cord injury

SC jt. – sternoclavicular joint

SED – suberythemal dose

sig – directions for use; use as follows; let it be labeled

SI jt. – sacroiliac joint

SLE – systemic lupus erythematosus

SLP – speech-language pathologist

SLR – straight leg raise

SNF – skilled nursing facility

SOAP – subjective, objective, assessment, plan

SOB – shortness of breath

S/P – status post

S/Sx – signs and symptoms

stat. – immediately or at once

STG – short term goal

sup. – superior

Sx – symptoms

T

tab – tablet

TB – tuberculosis

TBI – traumatic brain injury

TENS or TNS – transcutaneous electrical nerve stimulator/ stimulation

THA – total hip arthroplasty

THR – total hip replacement

TIA – transient ischemic attack

tid – three times daily

TIW – three times per week

TKA – total knee arthroplasty

TKR – total knee replacement

TMJ – temporomandibular joint

TNR – tonic neck reflex

t.o. – telephone order

TPR – temperature, pulse and respiration

TTWB – toe touch weight bearing

TV – tidal volume

Tx – treatment

tx – traction

U

UA – urine analysis

UE – upper extremity

UMN – upper motor neuron

UMNL – upper motor neuron lesion

URI – upper respiratory infection

US - ultrasound

UTI – urinary tract infection

UV ultraviolet

V

VC – vital capacity

VC – verbal cues

VD – venereal disease

VO or v.o. – verbal orders

Vol. – volumev.s. – vital signs

W

w/c – wheel chair

W/cm2 – watts per centimeter square

WBC – white blood cell

WFL – within functional limits

wk. – week

WNL – within normal limits

wt. – weight

X

x – number of times performed (e.g. x3, x8, etc.)

Y

y/o or y.o. – years old

yr. – year

Physical Therapy Abbreviations

I-O

I&O – intake and output

IADL – instrumental activities of daily living

ICU – intensive care unit

IDDM – insulin dependent diabetes mellitus

IE – initial evaluation

IFC – interferential current

IM – intramuscular

imp. – impression

indep – independent

inf. – inferior

inv. - inversion

IR or int. rot. – internal rotation

IRDS – infant respiratory distress syndrome

IS – incentive spirometer, incentive spirometry

IV – intravenous

K

KAFO – knee ankle foot orthosis

kcal – kilocalories

KJ – knee jerk

KUB – kidney, ureter, bladder

L

L within a circle – left

Lat – lateral

LBBB – left bundle branch block

LBP – low back pain

LE – lower extremity

LOC – loss of consciousness, level of consciousness

LMN – lower motor neuron

LMNL – lower motor neuron lesion

LOS – length of stay

LP – lumbar puncture

LLQ – left lower quadrant

LQ – lower quadrant

LTG – long term goal

LUQ – left upper quadrant

M

MAP – mean arterial pressure

max. – maximal

MD – medical doctor, doctor of medicine

MED – minimal erythemal dose

Meds. – medications

MI – myocardial infarction

min – minimal

min. – minute

mm. - muscle

MMT – manual muscle test, manual muscle testing

mod. – moderate

MP – metacarpophalangeal

MRSA – methicilin resistant staphylococcus virus

MS – multiple sclerosis

MVA – motor vehicle accident

N

NDT – neurodevelopmental treatment

neg. – negative

NG or ng – nasogastric

N.H. – nursing home

NIDDM – non-insulin dependent diabetes mellitus

nn. – nerve

noc – night, at night

NPO or npo – nothing by mouth

NSR – normal sinus rhythm

NWB – non-weight bearing

O

O: - objective

OA – osteoarthritis

OB – obstetrics

OBS – organic brain syndrome

od – once daily

OOB – out of bed

O.P. – outpatient

O.R. – operating room

ORIF – open reduction, internal fixation

OT – occupational therapist/therapy

OTR – registered occupational therapist

Physical Therapy Abbreviations

A-H

A

@ – at

ā – before

A: – assessment

AAA – abdominal aortic aneurysm

AAROM – active assistive range of motion

Abd. or abd. – abduction

ABG – arterial blood gas

ABI – acquired brain injury

ac – before meals

AC – acromioclavicular

ACL – anterior cruciate ligament

ACTH – adrenocorticotropic hormone

Add. or add. – adduction

ADL’s or ADL – activities of daily living

ad lib – at discretion

adm – admission/admitted

AE – above elbow

afib – atrial fibrillation

AFO – ankle foot orthosis

AIDS – acquired immune deficiency syndrome

AIIS – anterior inferior iliac spine

AJ – ankle jerk

AK – above knee

AKA – above knee amputee, above knee amputation

ALS – amyotrophic lateral sclerosis

a.m. – morning

AMA – against medical advice

amb – ambulate, ambulates, ambulated, ambulatory, ambulation

ANS – autonomic nervous system

Ant. – anterior

AP – anterior-posterior

approx. – approximately (also "~" symbol can be used)

ARDS – adult respiratory distress syndrome

ARF – acute renal failure

AROM – active range of motion

ASA – aspirin

ASAP or asap – as soon as possible

ASCVD – arteriosclerotic cardiovascular disease

ASHD – arteriosclerotic heart disease

ASIS – anterior superior iliac spine

Assist. – assistive, assistance

A-V – arteriovenous

AVM – arteriovenous malformation

B

B/S – bedside

BE – below elbow

bed mob. – bed mobility
BID or bid – twice a day

bilat – bilateral (a B enclosed within a circle may also be used)

BK – below knee

BKA – below knee amputee, below knee amputation

BM – bowel movement

BOS – base of support

BP – blood pressure

bpm – beats per minute

BR – bedrest

BRP – bathroom privileges

BS – breath sounds/bowel sounds

BLE – both lower extremities

BUE – both upper extremities

BUN – blood urea nitrogen

C
_
c - with

C&S – culture and sensitivity

c/o – complains of

CA – cancer, carcinoma

CABG – coronary artery bypass graft

CAD – coronary artery disease

CAT – computerized axial tomography

CBC – complete blood count

C/C – chief complaint

cc. – cubic centimeter

cerv. - cervical

CF – cystic fibrosis

CHF – congestive heart failure

CHI – closed head injury

CKD – chronic kidney disease

cm. – centimeter

CMV – cytomegalovirus

CNS – central nervous system

CO – cardiac output

CO2 – carbon dioxide

Cont. or cont. – continue

COPD – chronic obstructive pulmonary disease

COTA – certified occupational therapist assistant

CP – cerebral palsy

CPAP – continuous positive airway pressure

CPR – cardiopulmonary resuscitation

CRF – chronic renal failure

CSF – cerebrospinal fluid

CV – cardiovascular

CVD – cardiovascular disease

CWI – crutch walking instructions

CXR – chest x-ray

Cysto – cystoscopic examination
D

D/C – discontinue, discontinued, discharge, discharged

dept. – department

DF - dorsiflexion

DIP – distal interphalangeal

DJD – degenerative joint disease

DM – diabetes mellitus

DNR – do not resuscitate

DO – doctor of osteopathy

DOB – date of birth

DOE – dyspnea on exertion

DTR – deep tendon reflex

DVT – deep vein thrombosis

Dx – diagnosis

E

ECF – extended care facility (In Physiology – extracellular fluid)

ECG/EKG – electrocardiogram, electrocardiograph

ED – emergency department

EEG – electroencephalogram, electroencephalograph

EENT – ear, eyes, nose, throat

EMG – electromyogram, electromyography, electromyography

ER or Ext. rot. – external rotation

E.R. – emergency room

eval. – evaluation

Ex. – exercise

ext. – extension

F

FBS – fasting blood sugar

FEV – forced expiratory volume

FH – family history

flex. – flexionFRC – functional residual capacity

FUO – fever unknown origin

FVC – forced vital capacity

FWB – full weight bearing

Fx., fx – fracture

G

GB – gall bladder

GCS – Glasgow coma scale

GI – gastrointestinal

GIT – gastrointestinal tract

GSW – gunshot wound

GYN – gynecology

H

H/A - headache

H&H, H/H – hematocrit and hemoglobin

Hct – hematocrit

HEENT – head, ear, eyes, nose, throat

Hemi. – hemiplegia, hemiparesis

HEP – home exercise program

Hgb – hemoglobin

HIV – human immunodeficiency virus

HKAFO – hip knee ankle foot orthosis

HNP – herniated nucleus pulposus

h/o – history of

HOB – head of bed

HR – heart rate

hr. - hour

hs – at bedtime

HTN or Htn – hypertension

Hx – history

Saturday, October 8, 2011

Physiotherapy Evaluation and Examination

Physiotherapy evaluation and examination is a very important process in physiotherapy practice. You become a detective of some sort. It becomes a skill that is sharpened as you see more people requiring physiotherapy evaluation and treatments.

Don't forget to introduce yourself first

Before getting any data from your client, you should always introduce yourself and make him or her comfortable talking to you. If possible, the area should be clear of distractions such as an open door where people are seen passing all the time. In addition, sitting in front of your client without any barrier (a table perhaps) between you and your client may be even better. This could probably make the person more comfortable talking to you.

History of Present Illness

In the history of present illness, or HPI, you will be asking questions that are related to the specific problem of your client. This may include asking:

What made you come here?
What did you feel? Please describe to me (Location/Intensity/Duration). What other symptoms did you feel? Please describe them.
What was your activity at the time your symptoms occurred? / What were you doing when your symptoms occurred?
What makes your symptoms worse? What makes it better?
What did you do about your symptoms? (Medications/Consultations and treatments provided including relevant lab works and results if available)
What other concerns do you have?

If your client's symptoms had been present in the past, ask why he or she decided to have a consultation today.

You might also want to make use of the mnemonics OLD CARTS, which stands for Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing and Severity. But, as you become skilled in clinical questioning (with client rapport of course!), questions that your supposed to ask will come in naturally.

Your Clinical Eye

Sometimes, you will know what your client's problem is as he or she enters the evaluation room before the actual evaluation and examination. This is your clinical eye working.

For example, your client is walking with exaggerated right hip and knee bending, lifting the foot to clear it off the ground while walking. Having your clinical eye working, you might expect that he has weakness or paralysis of his ankle dorsiflexors (muscles in front of the leg). Since you know that that may be the case with your client, you can now prepare your questions in your mind.

Past Medical History (PMHx)

Ask about previous medical conditions or other treatments that they are having for another health problem.

Family Medical History

Some conditions are inherited. Sometimes, health problems, such as heart disease or diabetes runs in their family, putting them at risk for the condition, as well.

Tests and Measurements

By doing physiotherapy tests and measurements during the initial encounter / initial evaluation, you will establish a baseline data, which will become your basis for possible change in your physiotherapy treatment plan.

Measurements that are essential in your physiotherapy documentation may include:

Blood pressure (BP), heart rate (HR), pulse rate (PR) and temperature (T^o)
Joint range of motion
Manual muscle tests (MMT) / Testing for baseline muscle strength
Other relevant measurements specific for your client's problem. For example, stump measurement for a patient who have had an amputation.

You may also need to perform orthopedic special tests to determine the actual structure affected. For example, the Lachman test, which can be used to test for anterior cruciate ligament injury or the McMurray test for meniscus injuries.

Setting Client / Patient Goals

Setting goals for physiotherapy rehabilitation should involve the person (your client). The goals should be realistic and achievable according to person's condition and problems. By making your client actively participating in setting goals, he or she will feel more comfortable and may be more motivated in achieving those goals, thus, resulting in better outcomes.

Plan of Treatment

Again, in formulating physiotherapy treatment plan, your client should always be involved. Besides, he or she is the most important person in the rehabilitation team. The treatment options to be followed should address the problems that you gathered from your examination and the goals set with your client.Your client should feel that you are putting great importance on what he or she thinks.

Always remember that rehabilitation is a collaboration between you and your client and the rest of the rehab team. Without motivation and active participation of the person (your client), the set goals may be hard to achieve.

Parts of the Physiotherapy SOAP Notes

Physiotherapy (PT) SOAP notes writing is an important part of physiotherapy practice. Following proper PT recording of every patient or client encounter should be practiced to avoid confusion or delays in reimbursements.

The physiotherapy SOAP notes, sometimes called daily notes or progress notes, is the documentation done for every patient physiotherapy visit following the comprehensive PT initial evaluation (IE). The daily SOAP notes will indicate whether a particular plan of care is benefiting the client or not or treatments need to be modified.
Every physiotherapy SOAP notes should include basic information such as the client's full name and identification number is included if applicable. The full name of the physiotherapist, proper designation, such as PT, DPT or MPT and signature should be included as well. The date of treatment or encountered should always be included.

Subjective

The subjective part of the SOAP note is where you write what your client has to say about his or her current condition. For example, "I can now bend my back to put on my socks and shoes following my treatment session yesterday."

It is better if the patient's subjective statement is more specific. For example, "The pain on my back has moved down to 3/10 from that of yesterday before my treatment."

Objective

The "objective" part includes all the measurements that you've obtained from your client. This include the vital signs (e.g. BP-blood pressure, T^o-temperature, HR-heart rate, and RR- respiratory rate), manual muscle testing measurements, joint range of motion measurements, etc.

The specific physiotherapy treatments are also included in the objective part of your SOAP note. The treatments provided should be specific enough so as another PT can provide treatment if the treating physiotherapist is out for the day. The treatment should include the specific weight, repetitions, intensity and duration whenever applicable.

Examples

Knee extension, full ROM, 10 reps, 3 sets with 5 lbs. ankle weight
HMP on bilateral lumbar area x 20 minutes

Assessment/Analysis

This is where the physiotherapist impression regarding patient's current situation since his or her last visit. This may also include the physiotherapist's perspective on whether a particular treatment will be continued or modified according to client's needs.

Example: "The patient tolerated the treatments well but patient needs frequent verbal cues from the physiotherapist to complete knee exercises at full range."

Plan

In the SOAP plan part, the physiotherapist writes the plans for the client's next physiotherapy visit. This may include the objectives, treatments, progression parameters, and precautions.

Tendonitis – Where Does Tendonitis Commonly Occur?

Tendonitis means that your tendon – a strong band of connective tissue connecting your muscle to your bone – is inflamed. Tendonitis can cause pain, swelling, and difficulty moving. This condition is also called tendinitis.

There are different types of tendonitis depending on the specific type of tendon affected.

Tendons Commonly Affected with Tendonitis

There are several places in your body where tendonitis can occur. The following are some of the major tendons in the body where tendon injury can happen:

Rotator cuff and biceps tendons in your shoulder ( Shoulder Tendonitis)
Forearm tendons near your elbow and wrist (e.g. Elbow Tendonitis, Wrist Tendonitis)
Tendons near or attached in your hip
Quadriceps tendon in front of your thigh, just above your kneecap
Patellar tendon, just below your kneecap
Hamstring tendons at the back of your thigh, near your knee joint
Achilles tendon, which is the largest tendon in your body, located at the back of your leg near your ankle joint (Achilles Tendonitis)

Often, tendonitis occurs as a result of overuse of the tendon or overstretching from a forceful or sudden movement.

Tendonitis – All About Tendonitis

Tendonitis occurs when any of your tendons becomes irritated and inflamed. A tendon is a strong band of tissue connecting your muscle to your bone. Tendonitis often results from overstretching or overuse/repetitive movements. Tendinitis is the other term for tendonitis.

What causes tendonitis?

Tendonitis can happen when your tendon is overstretched causing small or large tears in the tendon. In some cases, the tendon can be fully torn. The condition can be acute or chronic. Acute tendonitis can be due to a forceful movement, such as in pitching in baseball, sprinting, or sudden jumping in basketball or volleyball.

Chronic tendonitis is caused by repetitive movements putting stress on the tendon. Some sports at risk for the condition may include baseball, basketball, swimming, football, sprinting, long-jumping, heavy weight-lifters, and certain racket sports.

Repetitive activities at work can put a person at risk for developing tendonitis, as well. This may include carpenters, typists, and gardeners.

What are the symptoms of tendonitis?

The symptoms that you experience depend on what tendon is involved. However, the most common symptoms of tendonitis are pain, swelling, and difficulty moving. You may also experience bruising, a bluish discoloration of the skin overlying the injured area. Other symptoms may include tenderness, hearing a pop at the time of injury, and warmth or redness.

Treatments

What you can do

Immediately following your injury, you should

Rest and avoid certain movements that aggravate your symptoms
Apply ice on the injured area
Elevate your injured limb above the level of your heart

Taking anti-inflammatory medication may help relieve your pain and swelling.

Other Treatments

You may need other treatments for your tendonitis including

Ultrasound
Physiotherapy
Use of supportive brace or strap
Use of assistive device
Steroid injection

Your doctor may recommend surgery for a severe case of tendonitis only if your condition is not relieved with conservative means.

Physiotherapy for Tendonitis

Physiotherapy can help you manage your tendonitis symptoms and other associated problems. Tendonitis, sometimes called tendinitis, is an irritation or inflammation of any of the tendons in your body. Your tendons are strong bands of connective tissue that attach your muscles to your bones. Tendonitis can be caused by repetitive use or overstretching of the tendon causing it to become irritated and inflamed.
Physiotherapy for Tendonitis

Physiotherapy ultimately aims to improve your quality of life. The physiotherapy rehabilitation goals for tendonitis are

To relieve your symptoms
Maintain or improve your muscle strength
Maintain your overall fitness
Promote injury prevention
Safely return you to your original activities or sports

The kind of physiotherapy treatment that you will receive will depend on the specific type of tendonitis that you have; your symptoms and other related problems; whether you have had surgery or not; and your overall rehabilitation goals.

Physiotherapy Treatment Options for Tendonitis

Your physiotherapist may employ a combination of any of the following

Immobilization if necessary (e.g. splinting, bandaging, taping)
Cold therapy or cryotherapy (e.g. ice pack, ice massage)
Heat pack
Electrical stimulation / Iontophoresis
Ultrasound / Phonophoresis
Massage
Joint mobilization techniques
Physiotherapy exercises

Gentle range of motion (ROM) exercises
Flexibility / Stretching exercises
General conditioning exercises
Progressive strengthening exercises

Suggest brace if necessary
Recommend walking aid if needed
Gait/Walking/Assistive device training (for lower limb injury)
Ergonomic training
Patient education

Regarding the patient’s specific condition (type of tendonitis)
Precautions to observe
Suggest activity or work modification
Self-care of symptoms
Wound self-care / post-operative care (after surgery)
Injury prevention

Suggest work or sport-specific rehabilitation program

The physiotherapy treatment options mentioned above are general treatment interventions and should not be considered as treatment guideline for tendonitis. Only your personal physiotherapist can help you determine the appropriate treatment intervention best for your specific problems and goals. Your physiotherapist will gladly discuss with you about your specific plan of care.

Tuesday, October 4, 2011

Physiotherapy Books