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	Featured Article UNLICENSED THERAPISTS WORKING IN FEDERAL FACILITIES HEALTH & FITNESS QUICK-TAKES READERS' FORUM T'AI CHI DETAILED COURSE DESCRIPTION

UNLICENSED THERAPISTS WORKING IN FEDERAL FACILITIES

DID YOU KNOW? Federal agencies like the Department of Veterans Affairs (VA), for example, can decide whether therapists working in their hospital facilities need to be licensed and meet the minimum education and training required by the State. The VA currently utilizes Physical Therapy Assistants who are unlicensed and who received all of their education and training for the position while working on the job. According to Ann Tyminski (TYMINSKA@dhmh.state.md.us), Executive Director of the Board of Physical Therapy Examiners of Maryland, "the VA facility is a Federal facility and not subject to State laws." As such, "The State would not have any opinion as to how the PTA practiced within the VA facility." This holds true for all standards set by the State, including licensing, minimum levels of education, supervision by a Physical Therapist, standards for documentation, etc. Ms. Tyminski cautions that unlicensed therapists working in Federal facilities "may not 'moonlight' as PTAs in Maryland outside of a Federal facility". Sources within the VA state that all newly advertised positions will be open only to licensed therapists. However, unlicensed therapists who currently are working in VA facilities will have their jobs protected as "grandfathered" positions. It is unknown what the policies are at other Federal facilities regarding Standards of Practice for therapists. All Federal facilities are free to develop their own standards without regard to the policies set forth by the State licensing boards. It is believed, however, that most facilities will try to uphold standards that are commonly accepted by the State boards.

HEALTH & FITNESS QUICK-TAKES

Regular Yoga practice may improve pulmonary function according to an abstract presented at APTA's CSM 2004 in Nashville, TN. The authors of the case study found a 9% increase in vital capacity after a 10-week, 6 day/week program involving 5 yoga poses (asanas) and two yoga breathing exercises (pranayama). Other positive indicators included increased thoracic expansion and flexibility, suggesting that a moderately intensive yoga program could help those with compromised pulmonary reserve. EDITOR'S NOTE: THESE NEXT TWO SUBMISSIONS COULD NOT BE PUBLISHED IN APRIL (even if we had published an April issue); YOU WOULD HAVE THOUGHT THAT WE MADE THEM UP AS AN APRIL FOOLS PRANK. WE ARE QUOTING THESE TONGUE-IN- CHEEK ARTICLES DIRECTLY FROM THE WACKY FOLKS AT THE BRITISH MEDICAL JOURNAL. BE COMFORTED IN THE KNOWLEDGE THAT YOUR PHYSICIAN/SURGEON DOES INDEED HAVE A SENSE OF HUMOR, AND CAN BE VERY ENTERTAINING. "Facial transplantation should not be performed until more research is done on the procedure and the risks that go with it" caution "an expert group of surgeons" from the Royal College of Surgeons of England as reported in the November 22, 2003 BMJ. The surgeons' concerns about the procedure, which is also called "composite tissue allotransplantation", reportedly are as follows: 1. Excessive media harrassment of the world's first such patient and the patient's family. 2. Possible psychological impact of the surgery. 3. Long-term effects of immunosuppression. 4. The ethics of facial transplantation. 5. Surgeons' inability to obtain acceptable and valid consent from patients because the procedure remains highly experimental. 6. The probability of intense "suffering of those patients who might be tempted by the prospect of facial transplantation". There is an apalling lack of randomised controlled trials (RCT's) studying the effectiveness of parachute use as an intervention "in preventing major trauma related to gravitational challenge", according to two writers at the BMJ. The authors reportedly attempted to perform a meta-analysis of RCT's showing the effects of using a parachute during a free fall. The Oak Tree PT editors can only quote BMJ's "Introduction" and "Conclusions" word-for- word", and encourage our readers to go to the BMJ website and read the whole article, along with the invited responses. Inroduction The parachute is used in recreational, voluntary sector, and military settings to reduce the risk of orthopaedic, head, and soft tissue injury after gravitational challenge, typically in the context of jumping from an aircraft. The perception that parachutes are a successful intervention is based largely on anecdotal evidence. Observational data have shown that their use is associated with morbitity and mortality, due to both failure of the intervention and iatrogenic complications. In addition, "natural history" studies of free fall indicate that failure to take or deploy a parachute does not inevitably result in an adverse outcome." Conclusions "As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine hace criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute." HEALTH AWARENESS IN MAY FOR LINKS TO MORE INFORMATION ABOUT ANY OF THE FOLLOWING OBSERVANCES, GO TO THE NATIONAL HEALTH INFORMATION CENTER WEBSITE. Asthma and Allergy Awareness Month Better Hearing and Speech Month Better Sleep Month Clean Air Month Correct Posture Month Healthy Vision Month Hepatitis Awareness Month Lyme Disease Awareness Month Mental Health Month National Arthritis Month and Annual Arthritis Walk National Bike Month National Digestive Diseases Awareness Month National High Blood Pressure Education Month National Neurofibromatosis Month National Osteoporosis Awareness and Prevention Month National Physical Fitness and Sports Month National Sight-Saving Month: Ultraviolet Awareness Month National Stroke Awareness Month National Teen Pregnancy Prevention Month National Trauma Awareness Month Older Americans Month Skin Cancer Awareness Month Tuberous Sclerosis Awareness Month 2 - 8 Brain Tumor Action Week 2 - 8 Children's Mental Health Week 2 - 8 National Mental Health Counseling Week 2 - 8 North American Occupational Safety and Health Week 3 Melanoma Monday 4 Childhood Depression Awareness Day 5 National Anxiety Disorders Screening Day 8 Cornelia de Lange Syndrome (CdLS) Awareness Day 9 - 15 National Women's Health Week 10 - 16 Food Allergy Awareness Week 10 - 16 National Stuttering Awareness Week 10 National Women's Check-up Day 11 - 17 National Alcohol-and Other Drug-Related Birth Defects Week 12 International Chronic Fatigue Syndrome Awareness Day 16 - 22 National Emergency Medical Services Week 16 - 22 National Running and Fitness Week 18 HIV Vaccine Awareness Day 23 - 29 Older Americans' Mental Health Week 24 - 31 Buckle Up America! Week 24 National Schizophrenia Awareness Day 25 National Missing Children's Day 26 National Senior Health and Fitness Day 31 World "No Tobacco" Day

READERS' FORUM

This spot features answers to questions and/or news of interest from our readers. Send your physical therapy-related questions, comments, and current therapy/health topics we can share to: pt@oaktreept.com. If we answer your question in this column, we will send you an Oak Tree PT ergonomic pen. Please be sure to include your mailing address, to be used strictly for mailing the pen only, and no other purpose. I will also be happy to publish in this Readers' Forum any original, relevant, well-written articles submitted by readers. Just forward your material to: pt@oaktreept.com. **Editor's note: This month we feature news from Katie Glaser-LeClere, MSPT, owner of Safe Home Pediatric Physical Therapy, LLC. PHYSICAL THERAPIST OFFERS FREE EQUIPMENT FOR CHILDREN WITH DISABILITIES Safe Home Pediatric Physical Therapy has launched the Adaptive Equipment Exchange program to locate free loaner durable medical equipment for children who have physical disabilities. The program is designed to provide interim solutions for families of disabled children so that the children can receive continuity of care while long- term arrangements are made. The Adaptive Equipment Exchange obtains items through public and private sources, and is constantly seeking contributions of unused equipment. For more information, or to donate to the Adaptive Equipment Exchange, please contact: Katie Glaser-LeClere, MSPT Safe Home Pediatric Physical Therapy, LLC (301) 807-9955 voice (443) 247-0690 fax therapy@safeh omept.com Safe Home Pediatric Physical Therapy Katie has also published a directory of regional special needs summer camps on her website. The directory includes more than 50 camps in the Mid-Atlantic region that embrace and accommodate children with mild to severe disabilities. These programs typically offer experienced professional support, low staff-to-camper ratio, and wheelchair accessibility. They often include activities that teach children to manage their disabilities and network with peers. Some programs are free to those who qualify, and many offer "camperships". The directory is available online at www.sa fehomept.com/camps.php. Katie Glaser-LeClere is a Physical Therapist and founder of Safe Home Pediatric Physical Therapy, providing PT to children and adolescents in the home and community. Safe Home's service areas include Frederick, Montgomery, Carroll, and Howard Counties in Maryland. Outpatient sites are located in Rockville and Frederick, and insurance is accepted.

T'AI CHI DETAILED COURSE DESCRIPTION

WHAT THE STUDENTS SAY ABOUT THE SEMINAR: "Good practical work" Eric Chamberlain, Science Teacher -- Manchester, NH, "The instructor was delightfully enthusiastic about topic & stuck to it" Mary Ann Smith, O.T.R./L -- Manchester, NH "Jon excellent one-on-one correcting movement" Trudy Goldstein, PT -- Boston, MA "Speaker made excellent application & reference to Geriatric population" Maraen Fisher, O.T.R./L -- Burlington, MA "Excellent instruction & good amount of material" Patrick McDonagh, PT -- Brockton, MA "Content of course was excellent & helpful for Home Care population" Helen Estes, R.P.T. -- Brockton, MA "Instructor great. Overall very interesting, informative & fair. Thank you :-)" Heather Bernier, PT -- Bristol, RI "Instructor was excellent -- course/content interesting & valuable" Ellen Tragar, PT -- Bristol, RI "Very enjoyable -- I liked the labs -- practical hands-on approach -- made me want to find out more on this subject for myself" Mona Kelleher, O.T.R./L -- Bristol, RI RECENT E- MAIL: "Hi Jon, I've already begun to use some of the concepts with a few of my patients. They seem to have a little difficulty with it at first, like the LE isometrics in sitting, but with some perserverence, it clicks. Really cool stuff! I'm also using it with my Mom, she needs a knee replacement and if adapted to non WBing it works very well. Thanks for the video, can't wait to share it with the PT's in the office." Nancy Montgomery, PT -- Groton, MA Improving Balance and Decreasing Fall Risk Using T'ai Chi A groundbreaking one-day seminar for Therapists and other Professionals working with patients who are at risk for falls According to the most recent statistics from the Center for Disease Control (CDC), falls are the primary reason for accidental deaths, the 5th leading cause of death for Americans age 65 and older. In that age group, 30 percent of community dwelling elders and 50 percent of nursing home residents fall each year. The research literature supports T'ai Chi as the best balance exercise for elderly people at risk for falls. This interactive seminar will provide you with all the tools and skills you will need to begin a T'ai Chi balance program as soon as you return to the clinic. You will also learn creative techniques for engaging patients who are withdrawn and reluctant to participate in other forms of therapy. After practicing each exercise during this one-day seminar, you will leave with a clear understanding of how to progress your patients through the sequence of T'ai Chi exercises toward higher function with decreased fall risk. Finally, you will learn how to include T'ai Chi in the multidisciplinary Care Plan, and how to document the therapy sessions for maximum reimbursement from Medicare Parts A and B and all other types of insurance plans. This course is designed to be participatory and fun, and after initiating the program in your own clinical setting, you will be pleasantly surprised to find your patients looking forward to their next T'ai Chi session with you. What You Will Learn · Understand how Eastern and Western approaches to balance differ · Learn postural corrections that have an immediate effect on balance · Use kinesthetic imagery to improve cognitive, emotional and physical function · Demonstrate movement strategies that maintain balance control · Practice T'ai Chi exercises in sitting and standing that strengthen lower extremity and postural control muscles, increase range of motion and improve balance · The three common mistakes in stance that decrease balance and reaction times · Reprogramming neuromuscular responses using kinesthetic imagery · The tan tien: The key to controlled and centered movement · Tailoring the T'ai Chi exercise progressions to individual patient needs · Incorporating T'ai Chi in the Care Plan and documentation for reimbursement Who Should Attend · Physical Therapists · Occupational Therapists · Recreation Therapists · Nurses · Restorative Team members · Physicians · Clinical Managers · Educators · Administrators · Athletic Trainers · Anyone involved in the care of someone who has issues with decreased balance About the Speaker Jon Ruttenberg holds a Masters Degree in Physical Therapy from Boston University, and he is a Certified Ergonomic Assessment Specialist. He has trained patients in T'ai Chi principles while working as a Physical Therapist in a variety of settings, including nursing homes, retirement communities, hospitals, sports medicine clinics, outpatient clinics and occupational medicine. Mr. Ruttenberg has taught therapists and other health care professionals how to design T'ai Chi balance programs in seminars sponsored by various health care facilities and by ADVANCE Magazine. He is the owner of Oak Tree PT, which is a private practice specializing in orthopedics, balance and ergonomic assessment and consulting for various industries. Mr. Ruttenberg is a speaker with experience, energy and enthusiasm for one of the most practical and exciting seminars you will attend this year.