PT-1533007 EA DB Altimate Medical.indd 1 7/21/15 9:22 AM · s I write this, the USA beach...

PT-1533007 EA DB Altimate Medicalindd 1 72115 922 AM

wwwadvancewebcompt

ON THE WEB

SALARY SURVEY INFOGRAPHIC

THE GENDER DIVIDEOur annual PT salary survey unearthed some revealing data disparities

PATIENT HANDOUT

WHAT IS DRY NEEDLINGMore patients are inquiring about this mysterious pain-relief technique

TRENDING TOPICS

TREATING THE WORLDrsquoS TOP ATHLETESThe Olympic Games bring together thousands of volunteer healthcare professionals

NEW BLOGGER

SHIFTING REHAB PARADIGMSMeet Viktoriya Friedman a rehab manager in New York who will challenge your thinking

ANNUAL CONTEST

PRACTICE OF THE YEAR 2016Itrsquos time to submit your entry for this esteemed honor Donrsquot delay

PLUS Daily News Watch multimedia offerings webinars and much more

VOL 27 | NO 10 | AUGUST 15 2016

ADVANCE FOR PHYSICAL THERAPY amp REHAB MEDICINE

Coming Next IssueThe growth of the performing arts industry is highlighting the need for dance medicine programs to keep these athletes free from injury Meet the physical therapists tasked with helping professional dancers do what they love

FEATURED ARTICLES

COVER STORY

15 First Steps to RecoveryGait support systems are the standard in other countries mdash why not here

18 Welcome to the Wellness Business

Why ldquoindustrial specialistsrdquo are really ldquowellness providersrdquo Part 2 of a series

21 Room With a Water ViewOne private practice is redefining the delivery of aquatic therapy

24 An Uncomfortable SubjectPelvic floor dysfunction is a troublesome side effect of many cancer treatments

ADVANCE for Physical Therapy amp Rehab Medicinereg is published 15 times a year by Merion Matters 2900 Horizon Drive King of Prussia PA 19406-2651 ADVANCE was established March 1990 as a national newsmagazine Its purpose is to provide in-depth coverage of news and employment opportunities to therapists in the nation Subscriptions are free to all PTs PTAs and senior students as well as to national PT schools amp health care facilities employing PTs

Postmaster send address changes to ADVANCE for Physical Therapy amp Rehab Medicinereg Merion Matters Circulation 2900 Horizon Drive King of Prussia PA 19406-2651 Contents are not to be reproduced or reprinted without permission of publisher copy2015 Merion Matters

Our company publishes magazines and websites for audiologists laboratory administrators health executives health information professionals medical laboratory professionals respiratory care and sleep medicine profession-als nurses occupational therapy practitioners nurse practitioners and physician assistants physical therapy and rehabilitation professionals and speech-language pathologists

Advertising Policy All advertisements sent to Merion Matters for publication must comply with all applicable laws and regulations Recruitment ads that discriminate against applicants based on sex age race religion marital status or any other protected class will not be accepted for publication The appearance of advertisements in ADVANCE Newsmagazines is not an endorsement of the advertiser or its products or services Merion Matters does not investigate the claims made by advertisers and is not responsible for their claims ADVANCE is a member of the National Association for Health Care Recruitment

4 Ad Index

5 Editorial

6 Sports Medicine Focus Treating Soccer Injury

9 Management Focus Building a Staff

11 Geriatric Journal Honoring Mary McMillan

26 Where We Work Pivot Physical Therapy

27 Education Opportunities

31 Classified Employment Opportunities

DEPARTMENTS amp COLUMNS

CONTENTS

Find us on

wwwadvancewebcompt August 15 2016 ADVANCE for Physical Therapy amp Rehab Medicine 3

SILVER-LEVEL PARTNER IN RESEARCH

Bump Set Spike

Professional beach volleyball is a high-octane sport fraught with potential dangers(Photo by Kyle Kielinski)

12

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SUPPORT THE COMPANIES THAT SUPPORT YOUR PROFESSIONThe companies listed below support the physical therapy profession by placing advertisements in ADVANCE for Physical Therapy amp Rehab Medicine Their support keeps our publication coming to you free of charge Please contact these advertisers or visit their Web sites to learn more about their products or services

ADVERTISER INDEXLog on to wwwadvancewebcompt Our searchable online Resource Directory allows you to receive detailed

information about the companies and products listed below as well as submit requests for free info

ADVERTISER WEB PG

4 ADVANCE for Physical Therapy amp Rehab Medicine August 15 2016 wwwadvancewebcompt

Pull out your phone and go to AdvanceHealthcareJobscom

With our mobile job board you can use every little break to search for something new

The next time yoursquore waiting in line or stuck on a long ride head to AdvanceHealthcareJobscom and turn those frustrating moments into fruitful ones A quick convenient job search will not only help you pass the time but it could also lead to an amazing new opportunity

Donrsquot let your day come to a standstill Keep moving onward and upward by seeing what new openings have been added to our job board since you last looked

Find Healthcare Jobs and Advance

Your Career

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Radius

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s I write this the USA beach volleyball tandem of Kerri Walsh Jennings and April Ross have just edged out Switzerland in a nail-biting three-set match on Copacabana

Beach in Rio advancing them to the Round of 16Beach volleyball is a high-energy sport fraught with physical dan-

gers as yoursquoll learn in this issuersquos cover story Walsh Jennings has dis-located her shoulder twice and has undergone five shoulder surgeries

Toward the end of the third set in the Aug 10 match Switzerlandrsquos Isabelle Forrer dove for a ball and slammed onto the packed sand her head whipping downward and hyperextending her neck In visible pain Forrer took a five-minute injury timeout and returned to play but Team USA gutted out the victory in the remaining rallies

Following the match Forrerrsquos teammate told the media that Forrer felt dizzy and would need to see her physiotherapist

Traumatic injuries sustained at the elite levels of Olympic sport demand the proficiency of physical therapists who are plying their trade on the world stage and raising the profile of the profession

Jeremy Crow PT DPT SCS CSCS director of clinical education at Manhattan-based SPEAR Physical Therapy was chosen as a med-ical volunteer for the Olympic Games in Rio ldquoItrsquos a much different experience than what you see on television and what you read about in the newsrdquo Crow said via WhatsApp ldquoI look forward to sharing my story with my colleagues and the media during my visit and upon my returnrdquo

You can follow Crowrsquos journey on Instagram and Twitter at jeremybcrow n

By JONATHAN BASSETT EDITOR ADVANCE

Editorial Let the Games Begin

ACUTE CARE AND INPATIENT REHABBarbara Garrett PT NCSClinical SpecialistKessler Institute for RehabilitationWest Orange NJ

BUSINESS AND PRIVATE PRACTICEMichael Nula DPTOwner and FounderElite Physical TherapyWarwick RI

EDUCATION AND PTA ISSUESClaudia Medeiros PT MS Lic Ac GCSAcademic Coordinator of Clinical EducationPhysical Therapist Assistant ProgramKeiser UniversityMiami FL

LEGAL AND REGULATORY AFFAIRSFranklin Rooks Jr MBA PT EsqCo-founder PRO Physical TherapyPrincipal Jacobson amp Rooks LLCPhiladelphia PA

NEUROLOGYMike Studer PT MHS NCS CEEAA CWTPresident Northwest Rehabilitation AssociatesSalem OR

ORTHOPEDICSJared Vagy PT DPT OCS CSCSAdjunct Instructor of Clinical Physical TherapyUniversity of Southern CaliforniaLos Angeles CA

PHYSIATRY AND PMampRDavid Cifu MDChairman and Herman J Flax MD ProfessorDepartment of PMampRVirginia Commonwealth UniversityRichmond VA

SPORTS MEDICINE amp ATHLETIC TRAININGMarje Albohm MS ATCDirector Ossur Academy Ossur AmericasPast President NATAMt Pleasant SC

EDITORIAL ADVISORY BOARD

Is produced by Merion Matters celebrating 30 years of excellence in healthcare publishing


PRESIDENTAnn Wiest Kielinski

GENERAL MANAGER WM ldquoWoodyrdquo Kielinski

EDITORIALEditorial Director Michelle Perron

mperronadvancewebcom Editor Jonathan Bassett

jbassettadvancewebcomEditorial Assistants

Dillon Stickledstickleadvancewebcom

Katherine Bortzkbortzadvancewebcom

Special Projects Editor Brian W Ferriebferrieadvancewebcom

Web Director Jennifer Montonejmontoneadvancewebcom

DESIGN Design Director Walt Saylor

Production Manager Cheryl A Drotar Mac Tech Manager amp Production

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MARKETINGMarketing Director Maria Senior

Events Marketing Manager Laura SmithMarketing Manager Jessaley Stercula

ADMINISTRATION Senior Recruiter Ellen Spiegel

Director of Sales AdministrationMike Connor

MEDIA amp MARKETING OPPORTUNITIES

DISPLAY ADVERTISINGNational Corporations Sales Manager Rachel Laird rlairdadvancewebcom

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HEALTHCARE FACILITY ADVERTISING

Group Sales ManagersAmy Sherlock asherlockadvancewebcom

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SPORTS MEDICINE FOCUS


hen Watford Football Club earned a spot in the English Premier League (EPL) 15 months ago itrsquos safe to say that the stakes

were raised to a level that I couldnrsquot have imagined Along with this came the pressure one would expect when you have been elevated to the very highest level of play

Promotion to the EPL is no simple task It is the most competitive (and watched) football league in the world Qualifying for a spot in the EPL is very different from many professional sports in that a team truly does have to ldquoqualifyrdquo If a teamrsquos performance diminishes they can be relegated out of the league to make room for a better team from the league below

As you can imagine once you arrive on the big stage and the spotlights are on itrsquos ldquogame timerdquo and the goal is to have everyone performing at their best Itrsquos hard to describe the pride that pulses through the club and fuels everyone in the organization to perform at the highest level in every way

Itrsquos especially evident within our medical program We are doing all we can to incorporate the most effective evaluation and treatment methods

Itrsquos About The 1At this high level of game-play itrsquos about the 1 The finest of margins can make a difference Getting that extra 1 of performance or the extra 1 of recovery can make a difference between winning and losing Getting these players on the pitch even one day sooner could tilt the scales in our favor at the most crucial time

Medically we created the right infrastructure to accomplish these marginal but essential improvements Itrsquos my job to decide whatrsquos going to be most beneficial for the team and the individual players We strive for the best outcomes but the solutions also have to be cost-effective We treat injuries when they happen but we also have a substantial injury prevention strategy to keep our players well mdash and having the right programs and technologies to prevent injury is important to us

Sifting through the noise can be difficult I vividly remember the day we were promoted to EPL I instantly received a battery of e-mails from companies trying to sell me all kinds of things I began looking at research and decided to evaluate a few modalities We are pretty much practicing 24-7 medicine in our environment and the purpose of trialing equipment is to ensure new

technologies are going to hold up to our harsh demands Additionally and most importantly we need to see results and experience positive feedback from players

Time is not on your side when you have a match right around the bend Finding the right methods and tech-nologies to incorporate can be a challenge when yoursquore looking for outcomes fast and trying to keep players comfortable and happy

Exceeding Expectations As I conducted research and talked to my colleagues it was recommended that we take a look at deep-tissue laser therapy I had encountered laser therapy 15 years ago but did not pay it much mind

Historically my impression had been that laser therapy was limited in its application But I was told that the new higher-power lasers were more versatile and effective We decided to bring it in for evaluation When we began our trial of the laser with Watford FC it was a rebirth of laser in terms of application potential and results

Wersquove been so impressed with the wide variety of conditions we can effectively treat Of all our modalities the laser is most versatile We treat the array of acute chronic post-surgical and early degenerative condi-tions with fantastic results Results have been extremely positive in players with Achilles shoulder and patellar tendinopathy Numerous knee pathologies have also responded extremely well

With our eyes open to the newfound versatility of laser therapy our club did in fact invest in the tech-nology and Irsquom sure wersquoll be looking to expand with it over the coming years

Player FavoriteAs we prepare for play we monitor injuries and attempt to get players on the field so they can compete safely and without discomfort Laser therapy has been excellent in reducing overall recovery times and is a fast easy

Earning Elite-Level StatusWatford Football Clubrsquos athletes get a leg up thanks to high-power laser therapy

By RICHARD COLLINGE MSC

Richard Collinge is Head of Medical for Watford Football Club in Watford United Kingdom

Getting that extra 1 of performance or the extra 1 of recovery can make a difference between winning and losing

TMLASER THERAPYDEEP TISSUE

bull Over 70 Evidence-Based Protocols

bull Patented Laser Massage Application

bull Advanced Software For Patient-Specifi c Treatments

bull Premium Easy To Use Interface

LightForceeLaserscom 3027090408

To request more information about LightForce Therapy Laser visit LiteCureInfocomLightForceLaserSolutions

LightForce is a proud partner of the Pro Football Legends group and offers programs designed to help past NFL players

have access to this drug-free surgery-free technology to help them fi nd relief from their chronic pains lingering from

their days on the fi eld

TMLASER THERAPYDEEP TISSUE Better Outcomes Consistent Results Satisfied PatientsBetter Outcomes Consistent Results Satisfied Patients

LightForce will give you the outcomes you desire - FASTER Treat a wide range of conditions Treatments are soothing for patients and easy to perform Patients will come in asking for Deep Tissue Laser Therapy


Untitled-5 1 11516 1255 PM

treatment that we feel gives us tremendous results leading up to a match

As a pre-performance treatment the ability to quickly stimulate blood f low and warm up deep-tissue structures makes players more comfortable as they prepare for heavy competition Players come in for treatments before they go to the gym to

work out before practice and especially before matches Players are more comfort-able in their movements after receiving laser therapy treatments

Players now come in and ask for the treatment There is a deep-heat feel-ing in the tissue and they can really feel the difference

Player feedback is crucial to compliance and outcomes You can believe that the technology is the greatest in the world but if the players do not gravitate toward it you will have an uphill battle trying to make it a daily event The therapy laser has actually become a mandatory part of my kit based on player demand

Simple SolutionsLaser therapy has been easy for staff to grow accustomed to Wersquove learned dosing techniques that were completely foreign to us in the past and are developing our skill through education opportunities

Wersquore finding that the technology is not intimidating and is actually quite the opposite Built-in protocols have made it easy to set up and delegate treatments and keep things consistent Treatments are fast and easy and you donrsquot have to be a laser scholar to operate

Wersquove learned to use the laser adjunc-tively with shockwave therapy cryotherapy chambers and other recovery strategies As an added benefit wersquove been combining laser with manual therapy treatments by utilizing the massage ball head attachment This allows us to work with the tissue more effectively while delivering a dose of laser energy

Portability is a massive bonus We stay in hotels every night before home and away games Having equipment that can become part of our travel kit is important since we often set up our medical clinic in a hotel room A battery-operated unit allows us more mobility in tight work spaces

Proof CaseIn January we signed a player who had come to us from another club He had undergone surgery in November for a meniscal injury When we conducted his initial medical exam there was still inflammation in the area however we accepted this as a risk that came along with the player

In his previous rehabilitation program he had not been exposed to the therapy laser so we began that straight away We started at a medium power and progres-sively became more aggressive

After just the first treatment the player reported positive results and the swelling quickly subsided Six months later we still treat him with the therapy laser pre-train-ing and pre-game He comes in asking for it every day because it has worked so well

We have also seen impressive results in surgical cases where scar tissue had per-sisted The laser is helping optimize the tis-sue in a state in which it is more prepared to heal The results we saw on scar-tissue from a post-surgical lower-abdominal pro-cedure were impressive

A Kit EssentialWe are well underway and having fantastic experience with deep-tissue laser therapy Wersquove had terrific outcomes and the play-ers have come to expect and appreciate the benefits

The portability and ease of use have made it easy to adopt and the unit has been great for the entire staff regardless of level of expe-rience I can confidently say the therapy laser is an essential part of our medical kit n



Professional soccer players for Watford Football Club in the United Kingdom now request laser therapy treatment from the medical staff There is a deep-heat feeling in the tissue and athletes can feel the difference Player feedback is crucial to compliance and outcomes

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MANAGEMENT FOCUS

aving qualified and appropriately placed staff could mean the difference between a well-functioning practice and a disaster

Attracting the right candidates for your open positions may require a bit of extra work and motivation but the addition of these physical therapists can make a differ-ence in the profitability of your facility the standard of care and your staffrsquos overall job satisfaction

Elizabeth Gibson director of human resources at HealthSouth Mid America Rehabilitation Hospital in Overland Park Kansas has over 10 years of expe-rience in HR eight specifically related to healthcare

While teamwork and a motivational focus are per-sonal qualities that she looks for in potential candidates a steady work history for both students and established physical therapists may be the most valuable quality someone can possess

ldquoEven if yoursquore in school and yoursquore volunteering somewhere consistently it shows to me that you have commitment and loyaltyrdquo Gibson said ldquoIf you are showing initiative by going out and finding internships or if you reach out to hospitals in your area and shadow-ing those are all things I look for in a new graduaterdquo

Matching Core ValuesCriteria for established physical therapists are slightly different ldquoWhen it comes down to someone who has experience I want to see consistency with job duty I completely understand if yoursquore getting moved up within a company and your duties change thoughrdquo Gibson said ldquoI also like to see someone whorsquos taken an initiative to do something So if yoursquore working for anyone you could take an initiative to be a part of a specialized teamrdquo

Gibson mentioned that overall a candidate should be patient-care oriented and want to work in a team to create the best patient outcomes

Study McKee PT CEO of San Francisco Sport and Spine Physical Therapy and senior director of client executives at Clinicient has been in private practice for 17 years and founded San Francisco Sport and Spine Physical Therapy 15 years ago with business partner Jerry Durham They currently have three loca-tions in San Francisco The key to finding staff that work well with his practice is to establish and follow a set of core values

ldquoAll of our hiring at this point is focused on match-ing with our core values Itrsquos important that therersquos alignment with them and that the candidatersquos behav-iors reflect themrdquo McKee said ldquoWersquore really looking for people who put the patient first who are seeking to increase their knowledge and strive for excellencerdquo

In order to attract candidates with these values McKee uses clear concise and straightforward language in his job postings ldquoIf physical therapists are uncom-fortable with direct frank communication then itrsquos probably not going to be a good fit for our culturerdquo he said ldquoBeing really open and honest about what yoursquore trying to build and how your team interacts and works together will attract the people that think thatrsquos a good thing and want to be a part of that As an industry we try to appeal to everybody and thatrsquos really not the best way to attract people to your organization You want to appeal to the right peoplerdquo

Diversified RecruitingMcKee suggests that practices should seek therapists who have had some experience in the ldquoreal worldrdquo or have played competitive or team sports saying that those who simply have a higher-level degree or cer-tifications may not be the most qualified candidate for your practice

ldquo[Those involved with sports or have had an estab-lished career] have learned to work with others and pass the ball whereas there are folks who are coming out of school with doctorate-level degrees in physical therapy and who have been in school almost their entire livesrdquo said McKee ldquoTheyrsquove been taught and conditioned to work by themselves and not rely on other people Thatrsquos really the opposite of what happens in the real world We need people to work togetherrdquo

While Gibson also uses targeted job postings she also relies on a diverse recruiting campaign to catch the attention of the right physical therapists ldquoHaving a diversified recruiting campaign is always my num-ber-one rule I look in many different places for qualified physical therapy candidates including our shadowing program and we have great affiliations with schools where the students can come and do their clinicalsrdquo Gibson said ldquoWersquove actually found quite a few staff members that wayrdquo

In addition to their shadowing program HealthSouth

Finding the Right FitEnhance your recruiting and hiring process to sidestep costly staffing mistakes

By KATHERINE BORTZ

Katherine Bortz is on staff at ADVANCE Contact kbortzadvancewebcom


Mid America also invests in Facebook ads career fairs and text message campaigns Though Gibsonrsquos facility does not search for international therapists many HealthSouth facilities look abroad for qualified staff and even offer a relocation allowance

According to McKee it helps to have the ideal candidate in mind when creating recruiting materials ldquoWersquore writing that candidate the job positing materials and guiding the initial contact to appeal to that personrdquo McKee said ldquoIf wersquore telling you that we have a lot of vacation and great ben-efits but yoursquore going to work really hard when yoursquore here and we have a culture of accountability where everything is trans-parent that tends to weed out people who are afraid of accountability or donrsquot know how that worksrdquo

Shaking up the interview process can also be beneficial in sorting through candidates Gibson changed the way interviews were held and that quickly revealed which can-didates were most qualified

ldquoFinding the right physical therapist

could even come down to something as easy as having a supervisor interview first and then having a peer interview afterrdquo Gibson said ldquoThe candidates would come into our facility and they would be great with me but be terrible with the front-line staff So I wouldnrsquot hire them Irsquove also had the oppo-site happen where people are more relaxed with the peer team

ldquoWhen we interview like this not only do I have the buy-in because I have the rec-ommendations from my front-line staff but they have the buy-in of this person as wellrdquo Gibson continued ldquoWhen theyrsquore on the floor theyrsquoll take the extra time to mentor them because they have a connection with the new hirerdquo

Gibson urges practices to remember that recruiting is not just a duty of HR or talent acquisition

If facilities and practices want to find suitable candidates it is important to make sure that the director of your physical ther-apy department is on the front line and helping to promote the department

Getting it RightHiring the right physical therapist for your practice is undoubtedly important but it is imperative not to hire the wrong candidates

ldquoI think not hiring the wrong people is as valuable as hiring the right people If you make the wrong hire itrsquos really hard to recover from that It takes time energy and effort and itrsquos uncomfortable People will make mistakes but the best compa-nies in the world are about 90 accurate in their hiring If you just do a general hire itrsquos about 25 accurate Thatrsquos a huge marginrdquo McKee said ldquoBy adopting some of these practices making sure that yoursquore writing and appealing to that individual and not being afraid to scare some people away you can get a much better fit Yoursquore looking for a fit with the culture a fit with the setting and a fit with the teamrdquo

Though their strategies may be different Gibson and McKee agree on one part of the recruiting process It takes more than aca-demic achievements to be a qualified mem-ber of a productive physical therapy team n


MANAGEMENT FOCUS

Join the conversation at the ADVANCE HEALTHCARE JOB FAIR

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Monday September 12 20161000 am - 200 pm

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GERIATRIC JOURNAL

n June 9 2016 I delivered the pres-tigious Mary McMillan Lecture to a thousand-plus at the American Physical

Therapy Associat ionrsquos NEXT conference in Nashville I was honored and truth be told eager to share my ideas about the profession But I also felt a bit in awe to be included among the professionals who have won this award

I was notified that Irsquod been selected in March 2015 and immediately got to work My first task was to read all 46 preceding McMillan lectures I am so happy Irsquom not recipient 128 The instructions for the lecture stated that I should describe my journey in physical therapy and reflect on issues for the profession

As I watched Lynn Snyder-Mackler PT ScD SCS ATC FAPTA deliver her lecture last year I had a creative but edgy idea Many years ago Irsquod seen Barbra Streisand perform a duet with the video of a young Marlon Brando from the movie ldquoGuys and Dollsrdquo She brought down the house

As I watched the stoic picture of McMillan during Snyder-Macklerrsquos lecture the idea came to me to ani-mate McMillanrsquos lips so we could have a discussion I enlisted col-leagues at Great Seminars Online to create this effect

I was worried that some in the audi-ence might perceive my effort as disrespectful But hun-dreds came up to me afterward to say how much they loved this part of the lecture The video is available at wwwaptaorgNEXT2016McMillanLecture and the print version will be published in an upcoming issue of the Journal of the American Physical Therapy Association

As I researched McMillanrsquos life I found that she was a maverick and a tremendous advocate for physical ther-apy all over the world In the first McMillan Lecture delivered in 1964 Mildred Elson founding president of the World Confederation for Physical Therapy jokingly stated that McMillan was almost desperate enough to sell her body to help sell the profession

I am paraphrasing but one could clearly see this womanrsquos passion She is credited for starting our national association and is an incredible role model for our profession

I spent months writing drafts My friend and co-col-umnist Jason Dring DPT GCS told me ldquoCarole your take-home message canrsquot be 10 pointsrdquo Thus I began narrowing my scope Here is my call to action1 Dedicate a course to geriatrics as part of the core

curriculum in our PT and PTA schools Donrsquot keep this important part of our practice as a neglected stepchild

2 Commit to ravenous lifelong learning Seek edu-cational opportunities that will improve our skills and move the profession forward Learn some-thing new at least monthly and encourage stu-dents and colleagues to do the same

3 Refocus on the clinician as the center of our pro-fession Create partnerships that include them as equals in research policy development education and awards

4 Embrace the unprecedented professional and per-sonal opportunities presented by our aging popu-lation I put to you that ageism is prejudice against not just our current patients but our future selves Age acceptance recognizes that one can be active involved curious and a full participant in life until the very end

This was an overwhelmingly emotional experience To be recognized for my passion makes me feel kin-ship with those who have gone before me to develop this wonderful profession I think we can all agree that therersquos something about Mary that tends to bring out the best in us n

Something about Mary (McMillan)

By CAROLE LEWIS PT DPT GCS GTC CCOEE MPA MSG PHD FAPTA


Carole Lewis is a pri-vate practitioner in Washington DC and consultant to Pivot Physical Therapy She lectures exclusively for Great Seminars and Books and Great Seminars Online She is editor-in-chief of Topics in Geriatric Rehabilitation and an adjunct professor in George Washington Universityrsquos College of Medicine

CA

ROLE

LE

WIS

COVER STORY

very summer the Association of Volleyball Professionals (AVP) kicks off their annual beach volleyball tournament tour leading into a season of fun in the sun (or rain)

Founded by Leonard Armato in 1983 the AVP has been the United Statesrsquo premier beach volleyball tour for professional athletes This yearrsquos open locations included New Orleans Huntington Beach Cincinnati

Seattle New York City San Francisco and Manhattan BeachThe championship tournament will take place Sept 1-4 in Chicago Behind the scenes

of excitement and competition is a fully staffed medical tent including PT clinicians prepared to take on any illness or injury that strikes these elite competitors

Heroes off the SandKarena Wu DPT MS COMT CSCS CKTP CPI FMS amp SFMA president of ActiveCare Physical Therapy in New York City and member of the medical board of the AVP had previously volunteered in the medical tent before being asked to return in 2013 to run the show

ldquoOur day is usually 12 hours or morerdquo said Wu ldquoMedical is expected to be ready one hour before matches start and then up to one hour after matches end which is when a lot of athletes routinely come inrdquo Wursquos interest in volleyball stems from her time man-aging the boysrsquo volleyball team as a way to get out of participating in her high school gym class though shersquos always enjoyed the sport

Derrick Sueki PT DPT PhD GCPT OCS FAAOMPT assistant professor in the physical therapy department at Azusa Pacific University Azusa Cal and president of Knight Physical Therapy Inc in Garden Grove Calif first became interested in volleyball while in college playing intramurals at Cal Poly San Luis Obispo ldquoAfter that I played in leagues weekly for the next 20 yearsrdquo he said ldquoSo volleyball has been in my bloodrdquo

After receiving his post-doctorate degree Sueki began teaching continuing education courses ldquoAt one of the courses I taught Stephen Paulseth approached me and asked me

Safeguarding athletesrsquo

bodies at the highest

levels of professional

beach volleyballBy Dillon Stickle

BUMP

SPIKESET

to become involved in the AVPrdquo said Sueki ldquoHe was in charge of medical staffing at the time I jumped at the opportunity because it gave me the chance to work in a sport that I lovedrdquo

The Three PhasesWhen it comes to injuries there are three phases of ldquoat-eventrdquo medical provision mdash pre-play during play and after-play mdash each with specific requirements and injuries

ldquoFor pre-play the role of the medical provider is to get the player ready for playrdquo said Sueki ldquoIt involves stretching warming up muscles and loosing up structures As the season progresses players generally need more work in order to get ready to playrdquo

According to Wu and Sueki itrsquos important during this time for the physical therapist to not use a diagnosis as this could have a psychological impact on the playerrsquos performance ldquoOf courserdquo Sueki admitted ldquothere is assessment and diagnosis that goes on if there is a legitimate injury that is new and will potentially endan-ger an athlete This is brought up to the player and an informed decision is made on whether they should competerdquo

During play the job switches to managing any crises that develop during the game ldquoWe provide on-court coverage that oversees the health of the athleterdquo explained Sueki ldquoCommon acute injuries during play include blisters cramps ankle sprains dehydration dislocated fingers and shoulders ACL injuries and low-back injuriesrdquo

Finally post-play involves managing injuries According to Sueki overuse injuries are usually the main target during this phase ldquoCommon overuse injuries include lumbar pain cervi-cal pain [and] ankle sprains but probably the most common injury is shoulder pain caused by overuserdquo he said ldquoThese can include impingement rotator cuff pathology bicep tendinop-athy and labral involvementrdquo

Unpredictable EventsThere are risks among beach volleyball players that hard-court players wouldnrsquot normally ldquofacerdquo One is facial lacerations ldquoThis comes from athletersquos jumping so high above the net that they take a ball into the face when itrsquos hitrdquo said Sueki ldquoUnlike indoor play players are wearing sunglasses that can cause injury to the facerdquo

Beach Volleyball in the OlympicsBeach volleyball at the 2016

Summer Games in Rio de

Janeiro will see 96 athletes

representing 24 countries bat-

tle for the gold medal Beach

volleyball was introduced at

the 1992 Summer Games in

Barcelona as a demonstration

event and officially debuted

in Atlanta in 1996 as an

Olympic sport

Since its inception the

United States has won a

gold medal at every Summer

Games in either the menrsquos

or the womenrsquos competition

while Brazil has won gold or

silver in every menrsquos or wom-

enrsquos tournament

The AVP follows the Rule

Book of the FIVB n The court A sand court is

26 feet 3 inches by 52 feet

6 inchesn The net A 28-foot long net

stands 8 feet high for men

and 7 feet four inches high

for women It is forbidden

to touch the net A blocker

may reach beyond the net

as long as it does not inter-

fere with the opponentrsquos

attack A ball can be played

off the net as long as itrsquos

within the limits of a teamrsquos

three hitsn Points When a team wins

a rally they are awarded a

point and serven Set The first two sets are to

21 points and the third is to

15 points Teams must have

a two-point advantage to

win set with no capn Match The best of three

sets In the case of a 1-1 tie

a third set is playedn Serve The team that wins

the point serves with serv-

ers alternatingn Hit A team has three hits

(including blocks) to return

the ball The ball may touch

any part of the body but

cannot be caught or thrown

mdashSource AVP August 15 2016 ADVANCE for Physical Therapy amp Rehab Medicine 13

For a printable infographic on common volleyball injuries and their treatments visit wwwadvancewebcompt and look for the Infographics box

Semi-pro beach volleyball player Rachel Johnston (pictured on cover with her sister and team partner Devon) serves on the sand at a recent competition in Cape May NJ

Photo by Kyle Kielinski

ldquoOne of the more uncommon injuries is a hyphema a collection of blood inside the front of the eye which can potentially block visionrdquo added Wu ldquoThatrsquos basically treated with eye drops an eye patch and even bed rest One player had a partially detached retina from getting hit in the eye mdash that unfortunately requires surgeryrdquo

A big difference between beach and indoor according to Sueki is the weather and terrain

ldquoUnlike the indoor game which is a relatively controlled environment the beach game is unpredictablerdquo he explained ldquoThe ground is unstable the wind is never the same and the sun affects play So the player is forced to make quick adjustments and many times are required to hit the ball in less-than-ideal positionsrdquo This he says is why shoulder injuries are so common

Erratic weather can affect the playersrsquo

bodies according to Wu ldquoIf it rains which it often does the sand gets wet and becomes more hard-packed and athletes feel a lot of compression from thatrdquo she said In addition many athletes fly to international events in economy class due to a lack of money ldquoA lot of the athletes become concerned about their low-back pain from flyingrdquo she said

Commitment to AthletesA large part of maintaining the volleyball ath-letersquos condition is preventing and tending to injury when theyrsquore not on the sand

ldquoPrevention really involves off-season pro-grams and cannot be done well during the seasonrdquo said Sueki ldquoDuring the season the goal is athlete management but change occurs during the offseason I am a big proponent of at least a six-week off period to allow athletes to recover and heal This is when injuries and movement faults can be correctedrdquo

He emphasized that without an off-season athletes ldquonever get a chance to heal and con-tinue to break down until catastrophic injury forces them to take time offrdquo

Asked why he enjoys working for the AVP and beach volleyball athletes Sueki had a clear idea ldquoI think the one the thing that speaks volumes about the AVP is the fact that every single medical provider is volunteering their timerdquo he said ldquoThey are working with the AVP medical team because they love volleyball and love working with the athletes They work for the love of the game When I first started working AVP events I was excited to work with the people that I had admired both on the court and in the medical tent I loved having the opportunity to work and learn as part of an interdisciplinary team There were and are no egos in the medical tent We treat in the scope of our practice but also have no turf to defend We work together all with a common goal of helping the athletes in any way we canrdquo

ldquoItrsquos a lot of work but itrsquos also so gratifyingrdquo added Wu ldquoWhen you can work with the ath-letes and help them at least because they got off a flight with low-back pain and get them to move and get them through the match mdash when you see them at their most broken at the start of the tournament and come in to see you each day and you see that yoursquore helping their performance mdash it makes all the differencerdquo n

Dillon Stickle is on staf f at ADVANCE Contact dstickleadvancewebcom

COVER STORY


Do you treat patients with any of the following issues

learnaltergcomadvance (510) 270-5900

Get Your Patients ldquoBack to Betterrdquo with AlterG

bull Balance problemsbull Incorrect gait mechanicsbull Neurological conditions

bull Sports and Orthopedic injuriesbull Post-surgical mobility challengesbull Chronically debilitating diseases such as osteoarthritis

Learn how taking one small step with AlterG can allow your clinic to take one giant leap forward into the future of rehab

Wersquore pretty confident you answered ldquoyesrdquo to at least one of the above and that means that AlterG is for you

orking as a rehabilitation therapist can be a reward-ing experience However one key challenge is the

physical demand placed upon therapists as they are literally called upon to support cli-ents as they work toward recovery

There are requirements to lift someone into and out of equipment and to help some-one stand or sit At the very least therapists are on their feet moving around during almost all therapy sessions

Clearly it helps to prepare for this phys-ically demanding scenario and therersquos a tool that more therapists are finding valu-able The X-Y system is a rehabilitation support system for the exercise of upper- and lower-limb motor function The sys-tem supports physical and occupational

therapy and is used for upright mobil-ity exercises including gait balance and reaching exercises while in an upright safely supported system

Standard of CareThe X-Y system is a ceiling-mounted body-weight-support system with a linear track that can be used in the X and Y geomet-ric planes in a gym This allows clients to progress from standing and walking in parallel bars to virtually anywhere in the gym It also provides therapists with more confidence in their ability to work with patients of varying sizes

Today these systems are used almost universally as the standard of care in hos-pitals nursing homes and even homes in Europe Canada and Australia In the

United States these ceiling lifts are less-widely used in lieu of manual lifting by caregivers resulting in the highest low-er-back injury rate of any profession

In the harness and ceiling support that an X-Y system offers the client feels more secure and safe to push forward and attempt tasks that might otherwise be considered too chal-lenging This also means that less hands-on physical assistance is required by the clini-cian who can then focus more on helping clients assess movement patterns and improve their quality of movement

Therapists often find that geriatric clients have multiple chronic conditions that affect their progress and typically there is also a

TECHNOLOGY


First Steps to RecoveryAn X-Y gait system can boost patient confidence while easing the burden on therapists By Carmen Van Hart DPT

The therapy team at Lutheran Home amp Harwood Place in Wauwatosa Wisconsin employs an X-Y rehabilitation support system to augment a range of functional lower- and upper-extremity tasks

CA

RM

EN V

AN

HA

RT

history of a fall or a new high-risk status after an orthopedic injury or surgery Picture for instance a client who had previously been living independently in an apartment with no need for an assistive device who recently suffered a stroke and suddenly canrsquot use one side of his body Not only does he have to relearn complete tasks but there are often

new fears to overcomeGait and balance deficits lead to a reduc-

tion in independence and quality of life Older adults already fear losing their inde-pendence Ensuing physical limitations and injuries increase this fear and subsequently the risk of falls

Orthopedic clients who must remain

non-weight bearing post-surgery often have difficulty taking that first ldquohoprdquo with a trans-fer Reducing bodyweight on the non-opera-tive leg helps clients produce enough power to hop as well as increase standing tolerance for bathroom visits and other upright activities

One example is a recent client who had both legs amputated above the knee and needed to learn how to use his new prosthetic legs He was able to progress to a rolling walker with the use of the X-Y system If he started to lose his balance to one side with a misstep the har-ness caught him and allowed him to correct his center of gravity with a delayed righting reaction The percentage of bodyweight was adjusted to allow increased pressure on the prostheses as the patient progressed

Who BenefitsThis type of rehab support system has also proven useful for higher-mobility patients who before returning home will be work-ing on fall-recovery training including floor transfers The harness supports them while transitioning from floor to four-point (hands and knees) positions

Getting to this position can be challenging as it requires enough upper-body strength to push up on the arms and allow room for the leg to be pulled up under the hips The harness supports the client so the therapist can focus on assisting the arms and legs into the proper position without being concerned about client safety The client will then transition to tall kneeling and eventually a full stand

The harness can be lifted toward the ceil-ing to help the client up if he is not able to produce enough force from the hamstrings and quadriceps muscles Eventually the goal is that the client completes the transfer independently as strength and confidence improve The X-Y system eliminates any fears of complications from the client and therapist while attempting the transfer

Although the system is most often used for clients with stroke or weight-bearing limita-tions therapists will find it useful in a variety of situations Weight-bearing and standing are vital for bone mineral density and healing yet for many overweight or debilitated clients it is too challenging to stand for any length of time in parallel bars

Another benefit is staff productivity Typically it might take multiple therapists to help clients stand and a client might

TECHNOLOGY


For more information contact usinformationR82com

R82com(800) 336-7684

Qui

ck R

aise

r 1

By virtue of its compact design and low weight Molift Quick Raiser 1 is stable and easy to maneuver The unique wheel position and near perfect weight distribution of the base pro-vides a small turning radius with easy maneuverability even in narrow spaces The inclined straight column imitates the natural pattern of movement and fulfills the lifting needs of users with some degree of weight bearing capacity

spend less than 10 seconds in an upright weight-bearing posture before all involved are too tired and the client begins sinking back toward the chair

An X-Y system enables one therapist to transfer clients and offers different-sized slings that increase the success rate for cli-ents of all sizes and shapes Therapists must position the clientrsquos sling tight enough and low enough that it truly helps support the pelvis and trunk comfortably

Purchasing a SystemIf you are considering using an X-Y system there are various brands to evaluate Here are some general tips to keep in mind

Cost A system can range from $5000-$10000 and cost goes up as the complexity

of the system increases While lift systems can be installed in most facilities even after the fact the type of structure (concrete subfloors steel beam wood trusses steel joists etc) will impact the cost and feasibility as do the sys-tem dimensions the amount of space above the ceiling and even the seismic zone status of the region Most systems have one corner that serves as a docking station for recharging the system as needed

Staff training Any staff member using the system must be trained on proper adjustment of the harness If not properly fit the system will be uncomfortable and not as successful in supporting the clientrsquos weight The sling will be lifted but if not snug and properly fit with supportive straps the client will not be lifted along with it Training with a team when the

system is installed takes about 30 minutes Safety features A hand control used by the

therapist or client advances the system on the track if not in ldquofreerdquo mode in which the system automatically advances as the client moves In ldquofreerdquo mode the client is supported but able to freely walk and advance the system on the track with their momentum

There is also a safety switch and pull cord that will stop the system immediately Typically the pull cord can be positioned so itrsquos easily reached by the client They feel in control and confident that they can stop even if the therapist is advancing the system

While nothing can replace the eyes and hands of a trained rehabilitation therapist todayrsquos tech-nological advances can augment their services and give patients the confidence boost they need to achieve higher goals in therapy n

Carmen Van Hart is program director and phys-ical therapist at Lutheran Home amp Harwood Place Wauwatosa Wis Contact carmenvan-hartthelutheranhomeorg


OnlineFor more stroke rehabilitation articles and resources visit wwwadvancewebcomptgaitandbalance

n last monthrsquos issue I described how occupational and physical therapists who offer ldquoindustrial rehab servicesrdquo are actually ldquoindustrial specialists

in the wellness businessrdquo Many providers donrsquot realize that they can engage in direct-pay relationships with employers and assist them in preventing injuries and containing workersrsquo compensation claims

Instead these providers hope for phy-sician or case manager referrals provide single services or a couple of disjointed ser-vices and rely on insurance companies to pay them an increasingly smaller reimburse-ment rate for their valuable professional time Providers have it in their power to transform their work into something more substantive But they have to think bigger mdash itrsquos a matter of perception

An integrative comprehensive injury pre-vention and injury containment program should form a continuum that incorporates both ldquoupstreamrdquo and ldquodownstreamrdquo interven-tions The continuum should be dynamic and ongoing and contain an objective method to assess its effect mdash good or bad

Upstream ServicesUpstream services are injury prevention ser-vices Here are a few examples

Job demands analysis (JDA) A JDA is an ADA-compliant document that outlines a basic description of the job essential job

functions and their related physical demands (material handling and non-material han-dling) in a concise report

A JDA has many uses It can be used to design a job-related new-hire and return-to-work test and can assist a physician in deter-mination of work readiness

Post-offer employment test (POET) POETs are job-related selection criteria performed on conditional new hires in a specific job or job class POETs match physical capabili-ties of new-hire candidates with the physical demands of a job

POETs identify direct threat risks They assist an employer in determining reasonable accommodations POETs establish baseline criteria that can be used later in the event of

a claim to determine apportionment Ergonomic analysis (EA) EAs extend the

benefits of JDAs through the addition of standardized ergonomic assessment tools EAs are the accepted method to identify hazards imposed by job risk factors

EAs can be used prophylactically in setting up a workstation or reactively in adjusting a workstation after a complaint of discom-fort If job hazards are identified abatement strategies are recommended so the appropri-ate control can be implemented to reduce or eliminate the hazard

Onsite injury prevention (IP) IP can take many forms depending on the desire of the employer or client The best IP strategy is an early intervention program that combines an

WORKPLACE REHABILITATION


Welcome to theWellness Business Part 2Part 2 of a 2-part series

For todayrsquos industrial specialist making a difference is often a matter of perceptionBy Vic Zuccarello OTRL CEAS II ABDA

JEFF

RE

Y LE

ESE

R

interview of an employee experiencing early signs of discomfort with education in symp-tom management and a workstation assess-ment IP can also include body mechanics instruction stretching instruction and general safety awareness

When implemented and followed faithfully upstream services can prevent many work-re-lated injuries The industrial specialist should be an active member of their employer-clientrsquos safety committee so they can continuously monitor the programrsquos effectiveness However some claims will still occur When they do they require downstream services

Downstream ServicesDownstream services can also be referred to as injury containment services

Causation analysis (CA) CA is an ergonomic analysis performed after a claim of injury is filed A worker may indeed suffer from a mus-culoskeletal disorder However the question is whether the condition is work-related mdash to identify whether job risk factors exist or rise to the level of a hazard

A CA report video and still images of the job are sent to a physician reviewer who will make a final determination of work-related-ness after review of the analysis and examina-tion of the worker The claim can either be accepted if deemed work-related or denied if deemed not work-related If denied the worker can pursue treatment for their condi-tion with their primary care provider rather than in the workersrsquo compensation system

Targeted rehabilitation and functional

progress notes (FPN) Injuries happen and part of the rehab process should involve muscu-loskeletal measurements and rehabilitation But the bottom line in rehabilitation of the injured worker is not how many degrees of range of motion are in a knee or the muscle grade of their quadriceps Itrsquos about how close the worker is to returning to full-duty status

FPNs provide exactly that information FPNs are conducted at regular intervals throughout the workerrsquos post-acute cycle and should assist an employer in a transitional return-to-work program

FPNs decrease lost time by increasing physi-cian awareness of a jobrsquos requirements relative to their patient The final goal of rehab is for the injured worker to have met all physical demands of their pre-injury job or at least


The bottom line in rehabilitation of the injured worker is not how many degrees of range of motion are in a knee or the muscle grade of their quadriceps Itrsquos about how close the worker is to returning to full-duty status

8664704440 | wwwoccupronet | infooccupronet

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FOR 25 OFFALL ON DEMAND COURSES

(OFFER VALID UNTIL 83116)

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Exceptional as always Jim is a wealth of knowledge and based on his presentations you know he continues

to review the latest research and literature and incorporates it into the lectures and software

Lynda White PT MBA

Available On Demand and Live Continuing Education CoursesFunctional Capacity Evaluation bull Advanced Functional Capacity Evaluation bull Work HardeningConditioning

Post Offer Employment Testing bull Industrial Ergonomic Evaluator bull

identify where they are relative to those metrics so an objective deter-mination can be made as to what work they can perform subsequent to residual problems

Fit-for-duty testing (FFD) FFDs are essential function tests utilizing the same selection criteria as POETs Together POETs and FFDs form a comprehensive employment testing program

FFDs are conducted when a worker has been off work following an injury or illness Performed at regular intervals during time off an employer can imple-ment a transitional (modified duty) work plan Employers can place a timetable on a worker achieving full-duty status after maximum medical improvement and if necessary build a case for termination

Functional capacity evaluation (FCE) Some injuries turn chronic and involve extended periods of time off work Despite what some naysayers would have you believe the FCE is still the best eval-uation performed on chronic injury cases off work for extended periods

The best FCEs are those performed by experienced providers using a kinesiophysical method FCEs determine not only the level of work the subject can perform but whether the subject is fully participating in the test FCEs can provide employers with guidelines for alternative job placement a case closure or termi-nation tool or an important functional component for a vocational rehabilitation program

When implemented faithfully and consistently downstream services can expedite return-to-work or case closure They can identify fraud and abuse They can assist an employer in denying claims for conditions that did not occur in the workplace

When integrated with upstream services an effective injury preven-tion and containment program can be established with the industrial specialist acting as a vital helping agent Annually the industrial spe-cialist should provide a return-on-investment report detailing the effec-tiveness of their services on injury rates injury severity and disparate impact in the selection process

A Matter of PerceptionTo summarize I propose that occupational and physical therapists who treat injured workers begin to see themselves as industrial specialists They should realize the challenges of employers who staff smaller less-healthy and aging workforces They should realize that the Total Worker Health Model is an invitation to do business

Educated employers cognizant of this model are telling us what they want Other employers need us to increase their understanding of whatrsquos available mdash programs and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being Welcome to the wellness business n

Vic Zuccarello is vice president of research and development for OccuPro Kenosha Wis Contact vzuccarellooccupronet


22 ADVANCE for Physical Therapy amp Rehab Medicine August 15 2016

Online

Visit our Industrial Rehab Resource Center at wwwadvancewebcomotindustrialrehab

Functional Capacity Equipmentwwwfcesoftwarecom

ARCON FCEldquoThe World Leader in FCE softwarerdquo

Heel Lift Incwwwgwheelliftcom18002354387

A Short Leg Caused By Hip or Knee ReplacementFracture of Lower ExtremityOr Other Lower Extremity IssuesCan Diminish Their Quality of Life Our Products Can Help Them Rehab Better Walk better And Feel Better

Help Your Patients

ost private physical ther-apy practices that provide aquatic therapy offer such services as an adjunct to

traditional land-based rehabilitation usu-ally in a smaller therapy pool or offsite facil-ity But Aquahab a four-location practice in the Philadelphia region has turned this model upside down taking an aquatics-first approach to patient care with ldquotraditionalrdquo therapy assuming a supporting role

ldquoItrsquos sometimes difficult to find practices that provide true aquatic therapyrdquo said Colleen McGinley DPT vice president of clinical operations and business development at Aquahab ldquoMost of the time itrsquos offered as an add-on therapy or an afterthought We position ourselves as total wellnessrdquo

Aquatic-first PhilosophyA physical therapist since 2001 McGinley has been in outpatient orthopedics for 15 years and arrived at Aquahab two-and-a-half years ago

ldquoI fell in love with the whole conceptrdquo said McGinley whose role with the company today is primarily administrative mdash staffing budgeting scheduling mdash but shersquoll contrib-ute to patient treatment in times of increased census or vacations

Founded in 1991 Aquahab is celebrat-ing its 25th year in business this fall The companyrsquos pool lineup includes both full-sized therapy pools and deep-water pools for traction cardiovascular conditioning and stabilization programs Water is kept at a therapeutic temperature of 92-94 degrees in the shallow pools and 86 degrees in the deep-water pools Depth resistance and

AQUATIC THERAPY

Room with a Water View Pioneering practice assumes an aquatics-first approach to patient care By Jonathan Bassett

OnlineVisit our Aquatic Therapy Resource Center at wwwadvancewebcomptaquatictherapy

August 15 2016 ADVANCE for Physical Therapy amp Rehab Medicine 21

Lisa Smith PTA has been with Aquahab since its inception in 1991

KYL

E K

IELI

NSK

I

therapist assistance fluctuate based on the capabilities of the patient and the parameters of the multidisciplinary treatment plan

A therapy staff of two dozen physical therapists occupational ther-apists and physical therapist assistants deliver treatment Aquahabrsquos therapists used to be in the water with their patients during the dura-tion of all sessions said McGinley But that can take a toll over time so the company has recently transitioned to a poolside therapy model Therapists primarily direct treatment from the pool deck though theyrsquoll still put on their bathing suits for compromised patients or those who need direct hands-on care

ldquoThe chlorine can definitely have an effect over timerdquo said McGinley ldquoNot to mention the physical toll of being in the water and changing out of swimsuits throughout the day We find that this is a more effective way to provide therapy and more satisfactory for the therapy teamrdquo

Complementary Business ModelOwner Les Littman founded the Aquatic amp Fitness Centers in Philadelphia and Cherry Hill NJ in 1991 before growing the com-pany to four locations and adding the rehabilitation business line as a separate entity Despite the companyrsquos name and reputation for being

the premier aquatic therapy provider in the region a robust list of land-based physical therapy services are provided as well mdash vestibular therapy sports and post-concussion rehabilitation TMD treatment active release technique IASTM body mechanics and a ldquoBack Schoolrdquo program are just a few

ldquoWe live on landrdquo said McGinley ldquoAs supportive as a water envi-ronment can be we understand that the ultimate objective is returning function to patientsrsquo lives whatever form that may takerdquo

It can be a challenge educating new patients and referral sources that the company provides more than just water-based therapy ldquoWe pride ourselves on being the premier provider of aquatic physical ther-apy but we donrsquot limit ourselves to that modalityrdquo stressed McGinley Consistent community education and presentations to patient groups are part of the marketing plan

Referrals from physicians and area health systems remain the primary avenue for patients entering the care stream at Aquahab The two busi-nesses complement each other mdash members of the fitness club are familiar with the facility and the therapy staff if they become injured or need physical therapy while discharged patients receive a free month mem-bership to AFC Fitness along with two complimentary sessions with a


AQUATIC THERAPY

Stenosis and back pain arthritis hip and knee replacement radiculopathy chronic pain tendonitis conditions and more respond to water-based rehab

Underwater treadmill with speeds ranging from 1-10 mph

Resistance therapy jet with deep tissue massage

Freedom to perform multi-planar activities

Construction-free fits through 36rdquo doorway

Safely and precisely adjust unweighting levels as patients progress with a touch of a button

Can be placed next to land-based therapy equipment

Learn more today by visiting ww2hydroworxcom300

AFFORDABLE AQUATIC THERAPY

Perfect for Existing Spaces and Facilities

Introducing theHydroWorx

Series

personal trainer and a complimentary appointment with a licensed dietitian This eases the transition to water-based fitness programs under clinician guid-ance and paves the way for full recov-ery and healthier lifestyles

Periodic meetings with personal trainers keep therapists apprised of former patientsrsquo progress and alert them to any setbacks If a member desires physical therapy services the therapy team will complete an evalu-ation and direct the patient to obtain a referral for treatment if advised While Pennsylvania is a direct-ac-cess state many insurance plans still require a referral and state law stipu-lates that physical therapists can only treat a patient for 30 days before a referral is necessary

Patient PopulationsStenosis and back pain arthritis hip and knee replacement radiculopathy chronic pain tendonitis conditions and more respond to water-based rehab said McGinley ldquoAquatic ther-apy lets you start rehab soonerrdquo she said ldquoAthletes and post-surgical patients who arenrsquot yet ready for land-based treatment can get in the water and get movingrdquo

Aquahab positions itself as a pro-vider of patient wellness addressing all areas of a patientrsquos lifestyle from nutri-tion to stress management to exercise and preventive medicine Monthly ldquocheck-insrdquo are encouraged for former patients and members of AFC

For practice owners looking to expand with aquatic therapy services but who may not have the capital or

the physical space for the investment McGinley recommends a busi-ness model similar to what made Aquahab a success Find an existing aquatic facility not currently offering physical therapy and enter into a mutually beneficial partnership

ldquoThere are fitness centers looking for professional [clinicians]rdquo said McGinley adding that not having to purchase clean and maintain the equipment is a major advantage in both time and money savings ldquoOnce they see how quickly it catches on in the community and the volume starts to build they realize the advantages You can really position yourself as the go-to therapy destination in your areardquo n

Jonathan Bassett is on staff at ADVANCE Contact jbassettadvance webcom


Benefits of Aquatic TherapyWarm water facilitates muscle relaxation and increases peripheral circulation

Viscosity of water provides resistance for strength training

Warm water stimu-lates body awareness balance and trunk stability

The reduction of gravitational forces in the pool allows the patient to stand and begin gait training and strengthening exer-cises without causing further damage to healing structures

Warm water and buoyancy results in decreased pain sensitivity

Improvement of patient morale and confidence can be established by providing a positive medium in which to function

mdashSource AquaHab

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ONCOLOGY


An UncomfortableSubject

elvic rehabilitation encompasses both female and male pelvic wellness to include incontinence and dysfunctions of the lower urinary tract bowel problems pelvic pain and sexual dysfunction These symptoms greatly impact a significant

number of people yet frequently remain undisclosedUnlike a joint or muscle problem pelvic symptoms are too

embarrassing if not taboo for some people to disclose even to a healthcare provider This is unfortunate as in this specialized area of rehabilitation we are able to provide relief and positively impact peoplersquos lives

Recently the role of physical med-icine and rehabilitation is becoming more recognized in oncology With this the role of pelvic floor rehabilita-tion in this field is likewise emerging particularly in female gynecologic and male pelvic cancers

However it is important to note that other cancers may also present with pelvic dysfunction as a result of metastases or as a consequence of cancer treatment Pelvic floor rehabil-itation can have a significant impact on improving the quality of life for cancer survivors

Cancers Affecting Pelvic FunctionThe most common oncology diagnoses in which pelvic rehabilitation can be of benefit are primary cancers of the bladder prostate gynecologic origin or the colorectal and anorectal regions to name a few In these cases the following pelvic symptoms are common urinary and fecal incon-tinence frequency-urgency difficulty of evacuation constipation pelvic pain and sexual dysfunction

Pelvic floor rehabilitation can begin as a ldquoprehabilitationrdquo inter-vention (prior to or in preparation for cancer treatment) provided there is clearance from the oncology physician team In such cases prehabilitation can help identify pre-existing problems perform a baseline assessment and address the problem promptly

Bladder cancer As one might expect urinary symptoms are com-mon in bladder cancer Painful urination and blood in the urine1

are the most common symptoms These can be aggravated or new pelvic symptoms may arise as side effects of cancer treatment In the case of radical cystectomy with neobladder creation pelvic floor therapy will also include voiding training to empty the new bladder effectively and thereby manage urinary incontinence

Prostate and gynecologic cancers In the United States prostate can-cer is one of the four major cancers based on incidence It is the most common cancer in men

Prostate cancer has a 100 5-year relative survival rate and a 99 10-year relative survival rate2 However prostate cancer and its treatments (surgery radiation therapy chemotherapy hormone

Pelvic floor dysfunction is a troublesome side effect of many cancer treatmentsBy Glenda Arcilla Borreo MHSc PT EP-C CLT CCET

JEFF

RE

Y LE

ESE

R

Online

View a free archived webinar by cancer rehab specialist Julie Silver MD at wwwadvancewebcomptmultimedia Click lsquoWebinar Archiversquo and select the Clinic amp Practice Management category

Completely seamless garments offered in arm sleeves gauntlets and gloves

Medically correct graduated compression in 20-30 mmHg and 30-40 mmHg

Moisture-wicking and lightweight fabric with silicone and latex free construction

All garments available in over 100 beautiful designs created with your patients in mind

Made in the USA

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Visit us at

to request a sample

Celebrate SeamlessCompression and style from armpits to fingertips

PT-1606002_EA_EK_lymphedivasindd 1 81216 1248 PM

suppression therapy) can have significant side effects that mostly impact continence voiding and sexual function Considering the survival rates side effects of treatment should be addressed to ensure favorable quality of life

Similar to prostate cancer gynecologic cancers and their treatments can affect bladder bowel and sexual function Although both men and women can be afflicted with urinary incontinence incidence in women is about twice as high3

A considerable number of women may already have incontinence issues prior to cancer These patients may experience a worsening of symptoms as they undergo cancer treatments

Cancers of the colon rectum and anus Colorectal cancer is the fourth-most common cancer in the United States with a 5-year rel-ative survival rate of almost 654 Common pelvic dysfunctions seen in this population include incontinence of feces and flatus bowel frequency and urgency pain and voiding dysfunction

Pelvic Rehabilitation InterventionsSurgery and radiation can cause fibrosis (scarring) and muscle weakness Likewise some damage to the surrounding nerves can result from these treatments or from space-occupying cancer lesions These conditions can lead to pelvic dysfunctions

As with all therapy evaluations a thorough evaluation must be per-formed to identify baseline function as well as impairment and dys-function The therapist should obtain as much clinical information as possible as well as accurate subjective input from the patient

The basic principle of pelvic floor rehabilitation is not much different than that of the non-oncology patient Retraining and neuromuscu-lar re-education of the pelvic complex (pelvic diaphragm transversus abdominus multifidii) is a vital component

Re-education of the muscles must address both the ability to con-tract efficiently (up-training) as well as the ability to relax effectively (down-training) The former addresses the function of stability and control while the latter addresses the function of evacuation Both functions of the pelvic complex are equally important

Many therapy modalities are useful in training muscles For example electrical stimulation of weak pelvic muscles is quite effective partic-ularly when active attempts of muscle contraction and facilitation are performed concurrently

Biofeedback and surface EMG are also valuable tools in pelvic floor rehabilitation Biofeedback provides visual and auditory feedback on the quality of contraction and thereby facilitates training As such it is excellent for up-training as well as down-training of pelvic muscles Surface EMG provides objective data of the same which is valuable for determining the direction of treatment as well as tracking outcomes

Also important is the behavioral component of pelvic retraining Acquired dysfunctional voiding behaviors stress and anxiety can rein-force impairments of pelvic function Biofeedback training is beneficial for managing such dysfunctional patterns

Pelvic resistance is effective for up-training pelvic muscles However the clinician must be cautious in regard to the timing of such challenge as overtraining a shortened muscle can most likely lead to or reinforce voiding dysfunctions

Manual therapy is another valuable treatment modality Both direct and indirect manual therapy techniques can be utilized with due


ONCOLOGY

caution The clinician must consider absolute and relative contrain-dications before applying manual therapy and obtain clearance from the medical oncologist or surgeon when necessary

As with any rehabilitation program patient education and home exercise programs are not only valuable but necessary Clear and con-cise written or illustrated instructions are particularly useful because of the ldquochemo brainrdquo phenomenon that affects short-term memory in varying degrees

Although the basic principle of pelvic floor rehabilitation applies to the oncology patient as well there are certain nuances The clinician must use caution and sound clinical judgment

For example intravaginal manual therapy may not be appropriate for a patient undergoing radiation to the vaginal canal or cervix During radiation treatment tissues can present with some degree of burn and irritation rawness and sometimes bleeding Direct pressure can lead to further tissue breakdown

Knowing the primary cancer site as well as locations of metas-tasis (such as bone metastasis) will enable the clinician to make sound treatment choices Information regarding previous cancer

treatments (past and present chemotherapy agents surgeries etc) is also helpful if not essential

Beyond Physical ImpairmentAlthough pelvic dysfunction presents as physical impairment its impact goes beyond the physical aspect Clinicians must recognize its impact on the cancer survivorrsquos self-esteem and self-image emotional burden and anxiety and personal relationships Prompt referral to appropriate disciplines must be performed when deemed necessary

Cancer care throughout the continuum involves a multimodal approach with the cancer survivor as the central focus Indeed we must identify impairments but focus on the survivor n

References are available at wwwadvancewebcomptreferences

Glenda Arcilla Borreo is an oncology physical therapist certified exercise physiologist certified cancer exercise trainer and certified lymphedema ther-apist at Cancer Treatment Centers of America at Midwestern Regional Medical Center in Zion Ill

WHERE WE WORK

re you looking for an exciting job with opportunity to grow Do you want to engage with your

community on a local level Consider a career with a passionate team committed to the highest level of hands-on care

Pivot Physical Therapy was founded in 2001 and is a premier provider of physi-cal therapy at 123 clinics throughout the East Coast including Maryland District of Columbia Virginia Pennsylvania Delaware West Virginia and North Carolina

Pivot provides rehabilitation services for all orthopedics and sports-related injuries as well as post-op for all ages They run specialized programs for geriatrics concus-sion-related injuries vestibular dysfunction hand therapy lymphedema and pelvic floor dysfunction Other services include occupational therapy speech therapy aquatic therapy and athletic training

Pivot Physical Therapy is seeking quali-fied candidates at multiple locations mdash staff physical therapists senior physical therapists

and clinical directors While there are imme-diate opportunities throughout all regions Pivot is expanding with new locations and is recruiting in northern Virginia the greater Baltimore-Washington DC area southern Maryland Fayetteville NC and Seaford Del

ldquoWe welcome new grads as well as expe-rienced therapistsrdquo said Brian Hoy director of clinical operations and director of the Clinical Excellence Team

Pivot is seeking energetic and passionate clinicians interested in joining their engag-ing culture ldquoWe want clinicians interested in clinical advancement and professional growth opportunitiesrdquo Hoy added

Pivot offers a variety of geographical opportunities mdash city living in Washington DC and Baltimore rural and affordable set-tings in the Panhandle of West Virginia and close to beaches on the Eastern Shore of Maryland Delaware and North Carolina

Pivot promotes excellence through a strong clinical services program Advancements include a new grad

mentorship program OCS residency and fast-track programs from NxtGen Institute of Physical Therapy manual therapy and other certifications through Evidence in Motion SFMA and FMS certification and advancement to clinical director positions

ldquoWe believe in giving back [to the com-munity] by participating in and sponsoring community events health fairs and offering screens and education on health-related

topicsrdquo said Hoy ldquoWe are synonymous with clinical excellence and our culture is simple mdash best-in-class clinical care customer ser-vice and patient experiencerdquo

To join the Pivot team contact Lisa Hyder director of talent acquisition at lhyderpiv-otphysicaltherapycom or visit wwwpivot-physicaltherapycomjoin-our-team n

SPECIAL ADVERTISING FEATURE

Pivot Physical Therapy Offers Best-in-class Care


EDUCATION OPPORTUNITIESONLINE SEMINARS

ON-SITE EDUCATION

ONLINE EDUCATION

Become Your Own BossStarting an In-Home Therapy Practice

Reap the personal and financial benefits of working for yourself This online seminar will teach you the ins and outs of how to successfully start and operate an in-home therapy practice under Medicare Part B Therapists will learn about the start-up process business structures Medicare Part B requirements and regulations proper documentation and billing and marketing and practice expansion Participants can access the seminar through our web site ContactIn-Home Therapy Services LLC 888-253-6077 wwwinhometherapyservicescom for more information and to register online

ONLINE EDUCATION

Tired of BoringOnline Courses

Learn and earn 5 hours of continuing education credit from our exciting interactive and clinically focused online courses Hip Fracture Multiple Sclerosis Total Knee amp Hip Arthroplasty Functional Assessment amp Treatment Gait and Balance Knee Osteoarthritis Seating and Mobility Lumbar Stenosis Wiihabilitation Stroke Medically Complex G-codes Vestibular Documentation and Home Health Well-known instructors such as Dr Carole Lewis and Dr Richard Bohannon bring these courses to life with real patients case studies and a focus on practical application Fast and easy to complete Visit our website to watch 2 minute videos on the most current studies impacting your practice - for free Use code ADV25 for $25 discount Contact wwwGreatseminarsonlinecom

ONLINE EDUCATION

Unlimited CEUsThree Great Options

Clinicianrsquos Viewreg offers Unlimited CEUs for one low price Three great options 7 months for $177 1 Full Year for $199 and Super Saver 2 Full Years for $299 Over 640 contact hours approved for CEUs by BOC for Athletic Trainers New York California and Illinois state PT Boards and accepted in numerous other states Check our website for states accept-ing Clinicianrsquos Viewreg courses Take as many courses as you want for the duration of your unlimited coupon Contact575-526-0012 or go to wwwclinicians-viewcom for pre-views of all courses and details Click on Unlimited CEU offer

SEPT 10-16 2016 SAN FRANCISCO CAOCT 10-16 2016 HOUSTON TXOCT 16-22 2016 NEW YORK NY

Yoga for the Special Childreg LLCCertification Programs - Basic Part 1

This comprehensive program of Yoga techniques is designed to stimulate the development of children wspecial needs Our teaching methods are gentle amp restorative safe for babies amp children wDown Syndrome Cerebral Palsy Autism Spectrum Disorders amp other developmental dis-abilities These methods also provide an effective Tx for

children diagnosed wADDADHD amp learning disabilities Taught by internationally renowned Yoga therapist amp author Sonia Sumar our certification program curriculum includes instructions in Yoga poses breathing exercises infant massage amp deep relaxation techniques Contact 1-941-925-9677 or wwwspecialyogacom for a complete list of program dates amp locations

SEPT 16-17 2016 EDISON NJ

Parkinsonrsquos DiseaseThis two day course will present an overview of Parkinsonrsquos Disease(PD) with the primary focus on comprehensive inter-professional treatment approaches Day 1 of the conference will open with an overview of PD covering neuropatholo-gy risk factorsgenetics and epidemiology Other medical issues will be explored including pharmacological treatment and side effects symptom management and non-motorautonomic dysfunction Day 2 will begin with a case-study based workshop designed to address the current evidence for examination evaluation and treatment of this population throughout the disease progression The afternoon work-shop introduces a holistic philosophy of well-being where medical professionals are helping to empower patients and families with a comprehensive approach to active coping and adaptation through education exercise and support Early bird rates in effect until 819 Contact Marianne

Mohary 732-632-1570 via email mmoharyjfkhealthorg or to view the brochure and register online please visit httpwwwcventcomd1VQ78M

SEPT 17-18 2016 HELENA MTOCT 8-9 2016 VANCOUVER BCOCT 22-23 2016 PHOENIX AZ

Myokinematic RestorationAdvanced lecture and lab course explores biomechanics of contralateral and ipsilateral myokinematic lumbo-pel-vic-femoral dysfunction Treatment emphasizes restoration of pelvic-femoral alignment and recruitment of rotational muscles to reduce synergistic patterns of pathomechan-ic asymmetry Emphasis on restoration recruitment and retraining activities using rotators of the femur pelvis and trunk Techniques to inhibit overactive musculature will enable the course participant to restore normal resting mus-cle position Learn assessment and management skills when treating piriformis syndrome right SI joint dysfunction and low back strain This course awards 15 EBP CEUrsquos through the BOC Mention this ad to receive a 10 tuition discount Contact Postural Restoration Institute 888-691-4583 (toll-free) wwwposturalrestorationcom

advancewebcomsubscribeFREE DIGITAL SUBSCRIPTIONS

FREE E-NEWSLETTER SIGN UP AT advancewebcom

Demand for physical therapists is expected to grow nationally by

341 between 2014 and 2024 West Coast University offers a focused Doctor of Physical

Therapy degree Build a career in a growing industry and help improve

peoplersquos lives New classes are forming

APPROVED BY WSCUC2GRANTED CANDIDACY BY CAPTE3

Learn more now

866-851-87931 httpwwwblsgovoohhealthcarephysical-therapistshtm

2 (WSCUC) WASC Senior College and University Commission - 985 Atlantic Avenue 100 Alameda CA 94501 510-748-9001 wwwwascseniororg

3 Effective February 25 2014 the West Coast University Doctor of Physical Therapy program has been granted Candidate for Accreditation status by the Commission on Accreditation in Physical Therapy Education (1111 North Fairfax Street Alexandria VA 22314 phone 703-706-3245 email accredita-tionaptaorg) Candidate for Accreditation is a pre-accreditation status of affiliation with the Commission on Accreditation in Physical Therapy Education that indicates that the program may matriculate students in professional courses and that the program is progressing toward accreditation Candidate for Accreditation is not an accreditation status nor does it assure eventual accreditation Graduation from a physical therapist education program accredited

by the Commission on Accreditation in Physical Therapy Education (CAPTE) 1111 North Fairfax Street Alexandria VA 22314 phone 703-706-3245 accreditationaptaorgis necessary for eligibility to sit for the licensure examination which is required in all states

For graduation rates median debt of graduates completing these programs and other important information visit westcoastuniversityedudisclosures

DDDDDeeDDDDemamamaam dnddndn ffffororro ppphyhyhyh sisisiicalll thththerere apappisisistssstt iss expxppppppppppppppppppppppppppeccecececececcecececececeecececeececeee tetetetetttttetettttettttttet ddd tooo ggrorowww w nanatiitionono alalallyyl bbby yy

34344444444444444444444441111111111 bbbbbbbbbbbbbbbbetete weew ennee 22220100 4 4 anananddd 2020242424WWWWWWeWeeWWeeWWeWWWWWWW ststtstststttttttttt CCCCoooaoaaao stts UUUUU iininininiveveveveveversrsrsrsititittity y ofofoffefeferssrs aaaaaaaaa fffofofoffffffofofoffofofofffooff cucuuuuccuucuuuuuuuuusseeees ddddd DDoDooooooooDoctctcttorroororr oooooooooofffff ff ffffffff PhPhPhPhPhyssysicicicalala

yyy

TTTThThThhThT erererrerererrraapapapapappppaapy yy yy y y yyy dedededededdegrgrgg eeeeeee y

BuBuBuBuBuuBB ilililililiillildddddddddd aaaaaaaaaa caaacacacacacacccarererereererereeerereerrrrreeeeer iiiiiiiinnnnn nn aaaaaa a a grgrgrrgrgrggggggggg owowowwowowoooo iiini gggininininniinnnnduddudddududududud stststtss ryryryyyy aaanddnddndddnddndndndddndnddnddnddd hhhhhhhhhh leleeeleleeee p ppppp imimimimimimimmmmimi prpprpprpprpppprovovo e e

gggggg g

peppepepepepepepepepepepp opopopopppopo leleleleleleleelelel rsquosrsquos lliiivvesesesesppp ppppp

NNeNeNeNeeNeeeeNNNNewwwwww wwwwww wwwwwww ccclcllcccccclasaaa sseeeeeses s ss ararararrrrrrrarreeeeeee fffffoffffoff rmrmrmrrminininingggggggg

AAAPAPAPAPAPPPPPPRPRPRPRPRRPRPRPRPRPRRPPROVOVOVOVVVEDEDEDEDDDEDEDDDD BBBBBBBBYYYYYY YYY YY WSWWSWSWSSSWSWSWSWSWSWSWSSSCUUUUCUCUCUCUC CCCCCCCCCCCCCCCCCCCCC2222GGGGGRGRGGRGRRAANANAANANTETETED D DD CACACACAAACANNDDNDNNDN IDIDDDDDIIDDDDDDAAACACACCACAAACCAACACAA YY Y YY BYBYBYYYYBYBYBYYB CCCCCAPAPAAPAPTTTTETETTETTEETT 33

LLLLeaeaeaaeaearnrnrnrnrnn mmmmmorororo e eeee nonnnowwwwwww

WestCoastUniversityedu866 851 8793WWWWWWWWWWeeeeeeeessssssstttttttCCCCCCoooooooaaaaasssssttUUUoooooaaaaaaaasssssstttttttUUUUUUUnnnnnnnniiiiiivvvvvvveeeeeeeerrrrrrsssssssiiiiiitttttttyyyyyyyyeeeeeeeeeddddddddduuuuuuuWestCoastUniversityedu

PT_EDU_081516indd 23 81216 422 PM


SEPT 17-25 2016 BOSTON MAOCT 1-9 2016 CLEVELAND OHNOV 5-13 2016 LAS VEGAS NV

LymphedemaTherapy Certification

The Norton School of Lymphatic Therapyrsquos Advantage Optimal Access Format is a blended live amp web-based certification program producing LANA-eligible lymphedema therapists in only 9 continuous days Only 5 workdays and 2 weekends make this course the most sensible cost-ef-fective unmatched choice Save large expenses on staff coverage travel hotel and meals Take our online Virtual Tour and compare to other schools This course teaches Manual Lymph Drainage (MLD) amp Complete Decongestive Therapy (VodderFoeldi Tech) covering 135 hours basic and advanced MLD bandaging amp Tx protocols Tx of primary amp secondary lymphedema extremity amp non-extremity lymph-edema All Norton School instructors are recognized national experts and are available via e-mail amp phone consultation for Tx of complex patients We offer Advanced Training Programs Reviews Bi-Annual Conferences Specialized Training Videos amp free lifetime listing in our Therapist Referral Database Multiple courses offered per month nationally Inquire about hosting a course MD RN PT OT PT amp OT Assistants Nurses amp MTs qualified The Norton School is recognized by FPTA NJ SBPTE AOTA amp NCBTMB for CEUs Senior Faculty Steve Norton MLDCD CLT-LANA Andrea Cheville MD Medical Director Contact 866-808-2249 (toll-free) 866-681-5349(fax) infoNortonSchoolcom or wwwNortonSchoolcom

SEPT 23-25 2016 HOUSTON TX

Helping Kids with HemiplegiaIntegrating CIMT BIT and NDT

This course is designed to instruct clinician on using a combination of constraint induced movement bimanual intensive therapy and neurodevelopmental treatment with children diagnosed with hemiplegia You will be able to demonstrate to process of cast fabrication utilized with CIMT select NDT based handling strategies to guide sym-metrical posture and enhance bilateral hand use with this clinical framework Instructors Margo Haynes PT DPT PCS CNDT and Holly Holland OTRL CNDT Contact Angela Dumas 832-826-6311 E-mail courseregistrationtex-aschildrensorg or register online wwwtexaschildrensorgpmr and click on course

SEPT 29 2016 EDISON NJOCT 25 2016 EDISON NJ

PT Ethics VThis 25 credit Ethics Course is designed for therapists wish-ing to satisfy the mandatory New Jersey Ethics requirement with an interactive problem solving course It builds on the basic course provided by the speakers during the previous licensure period The course is designed to be an interactive case based demonstration of the interaction and indepen-dence of ethics and law in the practice of physical therapy The relationship of competence to professional behavior will be explored This course requires your active participation in problem solving It is recommended that you only select this format if you are willing to participate in group discus-sions Early bird rates in effect until 91 Contact Marianne Mohary 732-632-1570 via email mmoharyjfkhealthorg or to view the brochure and register online please visit httpwwwcventcomd7VQMSX

EDU

CAT

ION

AL

OPP

ORT

UN

ITIE

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1-877-776-6680

Promote your facility recognize your staff or celebrate important healthcare events with custom

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LymphedemaManagement Courses

wwwacolscom | 18008635935Call for more information discounts and financing options

Academy of Lymphatic Studies is a Proud Member of

Joachim E Zuther PT MT CDTI ndash Founder of the Academy of

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Management A Comprehensive Guide

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Complete Lymphedema Certification Course (135 hours)

Lymphedema Management Seminar (31 hours)

Management of Lymphedema for the Head and Neck

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or call (800) 863-5935

CLT Recertification Program

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skills today Call for more details

PT_EDU_081516indd 24 81216 422 PM

Taking Balance to the Limits Janene Barber PT GTC

Watch for upcoming 2017 classes

Manual Therapy for the Geriatric PatientMaitland Mulligan and McKenzie Techniques for the Older Patient

James Gose PT DPT OCS Cert MDT COMT CMP

Nashville TN September 17-18 lsquo16Albuquerque NM October 15-16 lsquo16Las Vegas NV December 3-4 lsquo16

Functional Stabilization Strategiesfor Osteoporosis

Frail to Fit with Therapeutic Pilates PrinciplesSherri Betz PT GCS CEEAA PMAreg-CPT

Toledo OH November 5-6 lsquo16

Put Some Muscle Into Ther Ex Dr Wendy Anemaet PT PhD GCS CWS GTC COS-C

Atlantic City NJ September 17-18 lsquo16Tacoma WA October 1-2 lsquo16

Home Health A Specialty of Its OwnDeborra Rodgers PT GCS GTC CEEAA

Charlotte NC September 17-18 lsquo16 Bismarck ND October 15-16 lsquo16

Comprehensive Rehabilitation Strategies for the Geriatric Patient

Doug Dillon PT GTC CSST

Richmond VA October 15-16 lsquo16

Clinical Geriatric NeurologyEffective Examination and Intervention Strategies

Dr Carole Lewis PT DPT GTC GCS MSG MPA PhD FAPTA

San Diego CA September 17-18 lsquo16Atlanta GA November 5-6 lsquo16

Clinical Geriatric OrthopedicsSafe and Effective Evaluation and Treatment

Dr Carole Lewis PT DPT GTC GCSMSG MPA PhD FAPTA

Syracuse NY October 15-16 lsquo16Fort Lauderdale FL December 3-4 lsquo16

Pharmacology for Therapists Workingwith the Geriatric Population

Kenneth L Miller PT DPT GCS CEEAA

Philadelphia PA September 17-18 lsquo16

Acute Care RehabilitationMark Nelson MPT

Toms River NJ December 3-4 lsquo16

Geriatric Therapeutic ExerciseUsing Effective Examination and Intervention

Strategies to Guide Exercise PrescriptionsMark Traffas PT GTC

Denver CO September 17-18 lsquo16Nashua NH October 15-16 lsquo16Jackson MS December 3-4 lsquo1

GSB Great Seminars and BooksGeriatric Rehabilitation and Training

Check out our website atwwwgreatseminarsandbookscom

2016 SCHEDULE

Home Study CoursesSee website for details

Improving Mobility in Older Persons with Functional Assessment amp Treatment

Health Promotion amp Exercise for Older Adults

Rehab Roadie Ride and Learn (5hrs)

Toll Free 1-877-794-7328Email GreatSeminarsaolcomFax 330-865-6941Looking for GREAT Online courses Visit greatseminarsonlinecom

All GREAT Courses are 20 Contact Hours Qualify for your Geriatric Training Certi cation once you have completed 8 courses See website for details Visit our website for clinical tips and reference materials such as The Functional Toolbox I amp II Geriatric Clinical Strategies Prevention and Wellness Toolbox Interested in Hosting a GREAT Seminar Give us a call

Putting It All TogetherUsing Case Studies for Excellence in Evidence-based

Geriatric Treatment One Patient at a Time

Linda McAllister PT GCS GTC CEAGN

Charleston SC October 15-16 lsquo16New Rochelle NY November 5-6 lsquo16 Sacramento CA December 3-4 lsquo16

Rehab of Persons with Common Medical Pathologies

Dr Steven Tepper PhD PT

Little Rock AR September 17-18 lsquo16Idaho Falls ID October 15-16 lsquo16Minneapolis MN November 5-6 lsquo16

Safe Steps Measuring Gait and Balance to Show Treatment Works

Dr James Wall BSc MSc MEd PhD

Omaha NE October 15-16 lsquo16

Total Joint ArthroplastyAlisa Curry PT DPT GCS GTC

Jacksonville FL September 17-18 lsquo16

Powerful Treatment for Fragile PatientsMuscle Energy and Soft Tissue ReleasesCarleen Lindsey PT MScAH GCS CEEAA

Kansas City MO November 5-6 lsquo16

Watch for 2017 Dates and Locations Coming Next Month

NEWLOCATION

Dr Carole B Lewis PT DPT GTC GCS MSG MPA PhD FAPTA

receives the APTArsquos highest honor the Mary McMillan Lecture Award for 2016

Congratulations Dr Lewis

PT_EDU_081516indd 25 81216 422 PM


OCT 7-15 2016 AUSTIN TXOCT 14-22 2016 ST PAUL MNNOV 4-12 2016 DETROIT (TROY) MI

Lymphedema Therapy CertificationVodder MLD amp Foeldi CDT

Klose Training offers the highest-quality lymphedema certi-fication course in the US Itrsquos the most efficient amp cost-ef-fective way to become certified 45 hrs of online home study + 90 hrs of classroom (lab) instruction (Fewer days away from work lower travel costs) UE-only option 90 hrs Pathophysiology diagnosis amp DD are taught by an expert lymphedema physician Lab instructors are the most experi-enced in the field Approved for CEUs Meets requirements to take the LANA exam Free post-graduate services Program est 1990 by Guenter Klose Certified Instructor Contact Klose Training 303-245-0333 infoklosetrainingcom or wwwklosetrainingcom

OCT 19-21 2016 TAMPA BAY FLDEC 5-9 2016 TAMPA BAY FL

Get AIB Certified inVestibular Therapy

The American Institute of Balance has trained thousands of therapists from around the world and is one of the few insti-tutions that provide certification Our 3 day program includes an overview of anatomy and physiology disorders special populations migraine head-impact psychiatric fall risk and VRT protocols for therapy programs Our 5 day course is a perfect solution for practitioners wanting to learn the entire spectrum of care Corporate clients include Mayo VA Select Kort Accolade and more Contact Rochelle 800-245-6442 for program questions or visit wwwdizzycom to register

OCT 21-23 2016 HOUSTON TX

NDT Cerebral Palsy SeriesSpastic CP Dyskinetic CP Hypotonia CPThis course will provide a comprehensive perspective of the unique attributes that children with different clinical diagnoses of cerebral palsy demonstrate as a foundation for therapeutic intervention purposes Movement analysis and problem solving sessions are utilized to develop and improve handling skills and expand the cliniciansrsquo repertoire of NDT treatment strategies based upon concepts of the Dynamic Systems Theory Movement practicums will be done with other course participants and observation of live patient demonstrations will be sued to facilitate syntheses and application of material presented Instructor Lauren Beeler PT DPT PCS CNDT Contact Angela Dumas 832-826-6311 E-mail courseregistrationtexaschildrensorg or register online wwwtexaschildrensorgpmr and click on course

NOV 11-12 2016 HOUSTON TX

Aquatic Training Options for the Collegiate Professional amp Elite AthleteThis class is designed to teach the therapist trainer coach and athlete now to capitalize on both deep and shallow water includes samples of hard-core aquatic training regimes for the uninjured athlete active recovery drills and post-injury rehab protocols Appropriate for therapists and trainers working with individual sport athletes (such as football or volleyball) Includes instruction in the following hands-on aquatic techniques shallow water plyometrics deep and shallow running drills agility drills vertical accel-eration training edema control and management and more Instructor Kim Gordon MPT MAqI Contact Angela Dumas 832-826-6311 E-mail courseregistrationtexaschildrensorg or register online wwwtexaschildrensorgpmr and click on course

NOV 30-DEC 3 2016 HOUSTON TX

Aquatic Integration (AI)Aquatic Integrationtrade (AI) is a new approach to hydrother-apy that blends clinical principles for treatment with alter-native philosophies in Rehabilitation AI combines eastern meridian and point work with myofascial release proprio-ceptive neuromuscular facilitation and breath work This technique is highly effective in restoring sensory perception and motor control as well as increasing range of motion and reducing muscular spasticity and has proven a profoundly effective tool in pain management AI is well suited for the physical therapist massage therapist adaptive physical educators occupational therapists kinesiologist chiroprac-tors and somatic therapists working with neurological or musculoskeletal pathologies and rehabilitation Instructor Cameron West Contact Angela Dumas 832-826-6311 E-mail courseregistrationtexaschildrensorg or register online wwwtexaschildrensorgpmr and click on course

FIND TOP CAREER ENHANCEMENT TOOLS AT ADVANCEWEBCOM

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More classes coming For the most up-to-date course locations and schedule visit wwwklosetrainingcom

303-245-0333 bull infoklosetrainingcom bull klosetrainingcom

Get the Klose Training Advantagebull Visually dynamic 45-hr online home studybull Efficient 90hr9 day classroom education

bull Exceptional LANA-certified instructorsbull Exclusive post-graduate resources

bull Discounts available

Approved for PT OT MT continuing education Meets the requirements to take the LANA exam

Vodder Manual Lymph Drainage (MLD) amp Complete Decongestive Therapy (CDT)

Chicago (Elgin) IllinoisSeptember 17 ndash 25 2016 Austin TexasOctober 7 ndash 15 2016 St Paul MinnesotaOctober 14 ndash 22 2016 Detroit (Troy) MichiganNovember 4 ndash 12 2016 Waterbury VermontNovember 11 ndash 19 2016 Boulder ColoradoDecember 2 ndash 10 2016 Pittsburgh (Cranberry Township) PAJanuary 13 ndash 21 2017

EDU

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ION

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LOOKING FOR DEGREE CERTIFICATION

AND CE PROGRAMS

WE CAN HELP

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PT_EDU_081516indd 26 81216 422 PM

CLASSIFIED EMPLOYMENT OPPORTUNITIESMassachusetts New York

reaches active qualified physical therapy professionals nationwide every issue

1 New England p 312 Middle Atlantic p 314 Lower South Atlantic p 329 Southwest p 33 National p 33


rsaquorsaquo MIDDLE ATLANTIC

KIDZ THERAPY SERVICES PLLC

PHYSICAL THERAPISTOCCUPATIONAL THERAPIST

NassauSuff olkbull New Full-timePart-time Clinic and School District Positionsbull EI Preschool School-based Independent Contractor Positionsbull State-of-the-Art Sensory Gym and Equipmentbull Excellent benefi ts for full-time employeesbull Supervision and Professional Development Availablebull New Grads Welcome

Contact HumanresourcesKidztherapycom orPhone 516-747-9030 (Nassau) or 631-382-7311 (Suff olk)

Fax 516-877-0998 (Nassau) or 631-382-7399 (Suff olk)Equal Opportunity Employer

DRY HARBORNURSING AND REHABILITATION CENTER

H

PTs and PTAs for short-term rehab

setting in Queens Immediate

Openings forFull-Time PositionsFaxe-mail resumes to Angelo Crimeni at

718-505-7863acrimenidryharborrehabcentercom

Join our team of dedicated professionals and enjoy the privilege and rewards of working with patients and their familiesFull-time per diem and weekend positions available in Greater Boston and South of Boston

Please emailJennifer_Mcfadenvnacareorgor apply online

httpscareersvnacareorgjobsaspx

SIGN ON BONUS AVAILABLE

Physical Therapists

PT flex or FT at our center-based pre-school in Dix Hills Must have NYS licreg and experience with ped pop

(school setting preferred)

EI Contractors needed for home-based cases in Suffolk amp Nassau Flex schedules

Physical Therapists

Spec Ed Pre-school Program and Early Intervention Programs

Email Resume toannemariemongiardo

alternativesforchildrenorgor fax 6313316865

EOE

14 Research Way E Setauket

Physical Therapists Hawthorne Country Day School

wwwhawthornecountrydayorgNYS Licensed Salary exempt for Westchester amp Manhattan Sites

FT amp PT 12-month calendar Special Education autism amp multiple disabilities Great Salary amp Bene ts EOE

914-592-8526 x3039 or mreddhfadmorg

rsaquorsaquo NEW ENGLAND

1-877-776-6680




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PT_05092016_REC_ALSindd 27 81216 504 PM

CLA

SSIF

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EM

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YMEN

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PPO

RTU

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New York New Jersey South Carolina


Carolinas Hospital System is Hiring Physical and Occupational Therapists

Up to $10000 Commitment Bonus available (Must meet eligibility criteria)

Join a team who values respect for people and emphasizes commitment to patients physicians and employees Our commitment to being South Carolinarsquos hospital and employer of choice is what makes the difference

Be Proud to Work for a Nationally Recognized Hospital Wersquore the only facility in the Region accredited by CARF (Commission on Accreditation of Rehabilitation Facilities) Our mission is to have a collaborative approach which includes patients families and professional staff Our services include Case Management Neuropsychological Counseling and Testing Nursing Speech Therapy Social Work and Vocational Independence

EXPERIENCE THE CAROLINAS DIFFERENCEhellip

THERAPIST REQUIREMENTS CurrentActive SC OT or PT License BLS Certi cation

BENEFIT HIGHLIGHTS On-site Employee Gym Tuition Reimbursement up to $2500yr Vacation Sick and Personal days Comprehensive Healthcare Dental and Vision Plans Life and Disability Plans 401k Retirement Savings Plan Cafeteria Discounts Community Discounts

Apply online athttpwwwcarolinashospitalcomcarolinas-hospital-systememploymentaspx

IvyRehab is breaking ground and seeking exceptional clinicians and entrepreneurial directors that areseeking the opportunity to be a meaningful part of leading our expansion in these NJ locations

Cedar Knolls bull Midland Park bull Jersey City bull Sparta

WHY JOIN OUR TEAM

Become an integral part of a successful and growing company that has 50 clinics and counting throughout New York New Jersey Connecticut and the Midwest Find out how ful lling it is to work in a dynamic environment with dedicated professionals

Other Director Opportunities

Briarcliff Manor NYEast Windsor NJHillsborough NJBurlington NJ

bull Industry Leader In Continuing Educationbull Career Advancementbull New Grad Mentorshipbull FREE Residency Program ndash OCS Prepbull Partnership Opportunities

bull Promoting From WithinmdashOpportunities To Growbull Exceptional Salariesbull Health 401k and generous Paid Time Offbull Robust Incentive Plans

Apply NowDavid Diehr bull 914-777-8700 ddiehrivyrehabcom

wwwivyrehabcom

We offer every Physical Therapist Competitive Salary Health Coverage for Each Employee 3 Weeks PTO Vacation Retirement Plan w Company Match $1000 CE Allowance Per Year Growth Potential

PT amp PTA openings in Anderson Greenville Seneca Spartansburg amp Simpsonville SC

Prides itself on clinical excellence and we are looking for additions to the team

If you pride yourself on clinical excellencethen you should apply

864-271-2599 fax or infoelitetherapycenterscom

rsaquorsaquo LOWER SOUTH ATLANTIC

YOUR ONE-STOP

CAREER CENTER

ADVANCEHEALTHCAREJOBSCOM

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IES


Arizona National

Management OpportunitiesFive Star Senior Living

www5sslcom

The Forum - Tucson

Rehab Director amp Outpatient Coordinator

Independent LivingAssisted LivingSkilled Care

Full Time Full Benefits incl 401k wmatch

Must be AZ licensed Physical Therapist

For more details amp to apply visit careersfivestarseniorlivingcom click

ldquoJoin our Teamrdquo and use the ldquoAdvanced JobSearchrdquo feature to find the appropriate opportunity or contact Dave Glassburn

Tel 866-670-8721 email dglassburn5sslcomeoe

Great Physical Therapy Opportunities

with Five Star Senior Living

www5sslcom

KansasBrandon Woods at Alvamar - LawrencePhysical Therapist - Full Time - New Grads

New JerseyVoorhees Senior Living - Assisted Living

Physical Therapist - Full Time

$2500 Sign On Bonus Available

For more details amp to apply visit

careersfivestarseniorlivingcomclick ldquoJoin our Teamrdquo and use the

ldquoAdvanced Job Searchrdquo feature to find

the appropriate opportunityeoe

Your career with the Navajo County Education Service Agency is much more than a job It is an ad-venture Our employees enjoy the monuments and majesty of northern Arizona while serving our local school children on the Navajo Reservation Now is the time to have the lifestyle you have always wanted Visit our website call or e-mail for more information on

Current Opportunities Available for Physical TherapistsThe position offers the following bull Professional Development bull $3500 Sign-on Bonus bull Salary of $52000 - $65000

Vehicle Allowance bull 170-Day Contract

(928) 524-2123 phone bull (928) 524-1748 faxE-mail LannieGillespienavajocountyazgov bull httptinyurlcomNCESASSC

rsaquorsaquo SOUTHWEST

rsaquorsaquo NATIONAL

EXPLOREINDUSTRY NEWS

INSIGHTFUL ARTICLES

CAREER EVENTS

JOB LISTINGS

ONLINE CE

WEBINARS

SHOPPING

AND MORE

ADVANCEWEBCOM

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YOUR ONE-STOP SHOP FOR ALL THINGS PHYSICAL THERAPYShow off your professional pride everywhere you go with exclusive apparel accessories and gifts from ADVANCE

Donrsquot see what you are looking for Visit us online atAdvanceHealthcareShopcom to see our entire collection of apparel gifts and more

18774059978AdvanceHealthcareShopcom

Stay Connected with ADVANCE

Favorite PT Apparel

Perfect Gifts Work GearWhatever occassion yoursquore celebrating shop our spectacular selection of gifts

The perfect place to find workplacebags accessories and more

FREE SHIPPING OVER $35 bull USE PROMO CODE PTSHIP35

cular selection of gg p

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Shop your favorite brands and exclusively designed for your every day wear

Full Page Bleed Tempateindd 1 71416 100 PM

Editorial

Sports Medicine Focus

Management Focus

Geriatric Journal

Bump Set Spike

First Steps to Recovery

Welcome to the Wellness Business Part 2

Room With a Water View

An Uncomfortable Subject

Where We Work

Education Opportunities

Classified Employment Opportunities

wwwadvancewebcompt

ON THE WEB

SALARY SURVEY INFOGRAPHIC

THE GENDER DIVIDEOur annual PT salary survey unearthed some revealing data disparities

PATIENT HANDOUT

WHAT IS DRY NEEDLINGMore patients are inquiring about this mysterious pain-relief technique

TRENDING TOPICS

TREATING THE WORLDrsquoS TOP ATHLETESThe Olympic Games bring together thousands of volunteer healthcare professionals

NEW BLOGGER

SHIFTING REHAB PARADIGMSMeet Viktoriya Friedman a rehab manager in New York who will challenge your thinking

ANNUAL CONTEST

PRACTICE OF THE YEAR 2016Itrsquos time to submit your entry for this esteemed honor Donrsquot delay

PLUS Daily News Watch multimedia offerings webinars and much more

VOL 27 | NO 10 | AUGUST 15 2016

ADVANCE FOR PHYSICAL THERAPY amp REHAB MEDICINE

Coming Next IssueThe growth of the performing arts industry is highlighting the need for dance medicine programs to keep these athletes free from injury Meet the physical therapists tasked with helping professional dancers do what they love

FEATURED ARTICLES

COVER STORY

15 First Steps to RecoveryGait support systems are the standard in other countries mdash why not here

18 Welcome to the Wellness Business

Why ldquoindustrial specialistsrdquo are really ldquowellness providersrdquo Part 2 of a series

21 Room With a Water ViewOne private practice is redefining the delivery of aquatic therapy

24 An Uncomfortable SubjectPelvic floor dysfunction is a troublesome side effect of many cancer treatments

ADVANCE for Physical Therapy amp Rehab Medicinereg is published 15 times a year by Merion Matters 2900 Horizon Drive King of Prussia PA 19406-2651 ADVANCE was established March 1990 as a national newsmagazine Its purpose is to provide in-depth coverage of news and employment opportunities to therapists in the nation Subscriptions are free to all PTs PTAs and senior students as well as to national PT schools amp health care facilities employing PTs

Postmaster send address changes to ADVANCE for Physical Therapy amp Rehab Medicinereg Merion Matters Circulation 2900 Horizon Drive King of Prussia PA 19406-2651 Contents are not to be reproduced or reprinted without permission of publisher copy2015 Merion Matters

Our company publishes magazines and websites for audiologists laboratory administrators health executives health information professionals medical laboratory professionals respiratory care and sleep medicine profession-als nurses occupational therapy practitioners nurse practitioners and physician assistants physical therapy and rehabilitation professionals and speech-language pathologists

Advertising Policy All advertisements sent to Merion Matters for publication must comply with all applicable laws and regulations Recruitment ads that discriminate against applicants based on sex age race religion marital status or any other protected class will not be accepted for publication The appearance of advertisements in ADVANCE Newsmagazines is not an endorsement of the advertiser or its products or services Merion Matters does not investigate the claims made by advertisers and is not responsible for their claims ADVANCE is a member of the National Association for Health Care Recruitment

4 Ad Index

5 Editorial

6 Sports Medicine Focus Treating Soccer Injury

9 Management Focus Building a Staff

11 Geriatric Journal Honoring Mary McMillan

26 Where We Work Pivot Physical Therapy

27 Education Opportunities

31 Classified Employment Opportunities

DEPARTMENTS amp COLUMNS

CONTENTS

Find us on


SILVER-LEVEL PARTNER IN RESEARCH

Bump Set Spike

Professional beach volleyball is a high-octane sport fraught with potential dangers(Photo by Kyle Kielinski)

12

ADVERTISER WEB PG









R82 r82com 16






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Your Career

Job Title Keywords

City State Zip

Radius

SEARCH JOBS
































































(800) 355 5627



































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MEDICAL CLAIMS amp

BILLING EXPRESS







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MANAGEMENT FOCUS
















By KATHERINE BORTZ















MANAGEMENT FOCUS


advancewebcomevents



LEARN MORE

SPONSORS


t th

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FACE-TO-FACE



GERIATRIC JOURNAL



















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TECHNOLOGY



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KYL

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Series
















mdashSource AquaHab





online or call






needs







ONCOLOGY















JEFF

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Y LE

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Online






Made in the USA


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yyy



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EDU

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ION

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OPP

ORT

UN

ITIE

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1-877-776-6680














for Practitioners









or call (800) 863-5935




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2016 SCHEDULE






















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EDU

CAT

ION

AL

OPP

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UN

ITIE

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AND CE PROGRAMS

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ADVANCEWEBCOM

PT_EDU_081516indd 26 81216 422 PM












H









Physical Therapists




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1-877-776-6680





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AND LINK TO

YOUR FAVORITE

ADVANCE

MAGAZINE

JOB SEARCH

SHOPPING

CE AND MORE



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SSIF

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EM

PLO

YMEN

T O

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RTU

NIT

IES













WHY JOIN OUR TEAM







wwwivyrehabcom







YOUR ONE-STOP

CAREER CENTER


PT_05092016_REC_ALSindd 28 81216 504 PM

CLA

SSIF

IED

EM

PLO

YMEN

T O

PPO

RTU

NIT

IES


Arizona National


www5sslcom

The Forum - Tucson










www5sslcom
















INSIGHTFUL ARTICLES

CAREER EVENTS

JOB LISTINGS

ONLINE CE

WEBINARS

SHOPPING

AND MORE

ADVANCEWEBCOM

PT_05092016_REC_ALSindd 29 81216 504 PM

PT_05092016_REC_ALSindd 30 81216 504 PM





Favorite PT Apparel





giftsgif

34784

32537

26309

3550734031 34182 New

34722


34784

ries

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New



Editorial


Management Focus

Geriatric Journal

Bump Set Spike





Where We Work



ADVERTISER WEB PG









R82 r82com 16






ADVERTISER WEB PG







Your Career

Job Title Keywords

City State Zip

Radius

SEARCH JOBS
































































(800) 355 5627



































Untitled-5 1 11516 1255 PM



















MEDICAL CLAIMS amp

BILLING EXPRESS







2016 Promotions







MANAGEMENT FOCUS
















By KATHERINE BORTZ















MANAGEMENT FOCUS


advancewebcomevents



LEARN MORE

SPONSORS


t th

Talk to more than


FACE-TO-FACE



GERIATRIC JOURNAL



















CA

ROLE

LE

WIS

COVER STORY













BUMP

SPIKESET


















Olympic sport








enrsquos tournament













































COVER STORY



















TECHNOLOGY




CA

RM

EN V

AN

HA

RT












TECHNOLOGY



R82com(800) 336-7684

Qui

ck R

aise

r 1

































JEFF

RE

Y LE

ESE

R





















Lynda White PT MBA















Online






Help Your Patients







AQUATIC THERAPY





KYL

E K

IELI

NSK

I










AQUATIC THERAPY












Series
















mdashSource AquaHab





online or call






needs







ONCOLOGY















JEFF

RE

Y LE

ESE

R

Online






Made in the USA


Visit us at

to request a sample

















ONCOLOGY











WHERE WE WORK



















ON-SITE EDUCATION

ONLINE EDUCATION



ONLINE EDUCATION



ONLINE EDUCATION



















Learn more now








yyy



gggggg g






PT_EDU_081516indd 23 81216 422 PM










EDU

CAT

ION

AL

OPP

ORT

UN

ITIE

S

1-877-776-6680














for Practitioners









or call (800) 863-5935




PT_EDU_081516indd 24 81216 422 PM
































2016 SCHEDULE






















NEWLOCATION




PT_EDU_081516indd 25 81216 422 PM
























EDU

CAT

ION

AL

OPP

ORT

UN

ITIE

S


AND CE PROGRAMS

WE CAN HELP

ADVANCEWEBCOM

PT_EDU_081516indd 26 81216 422 PM












H









Physical Therapists




Physical Therapists




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1-877-776-6680





CHECK OUT

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YOUR FAVORITE

ADVANCE

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JOB SEARCH

SHOPPING

CE AND MORE



PT_05092016_REC_ALSindd 27 81216 504 PM

CLA

SSIF

IED

EM

PLO

YMEN

T O

PPO

RTU

NIT

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WHY JOIN OUR TEAM







wwwivyrehabcom







YOUR ONE-STOP

CAREER CENTER


PT_05092016_REC_ALSindd 28 81216 504 PM

CLA

SSIF

IED

EM

PLO

YMEN

T O

PPO

RTU

NIT

IES


Arizona National


www5sslcom

The Forum - Tucson










www5sslcom
















INSIGHTFUL ARTICLES

CAREER EVENTS

JOB LISTINGS

ONLINE CE

WEBINARS

SHOPPING

AND MORE

ADVANCEWEBCOM

PT_05092016_REC_ALSindd 29 81216 504 PM

PT_05092016_REC_ALSindd 30 81216 504 PM





Favorite PT Apparel





giftsgif

34784

32537

26309

3550734031 34182 New

34722


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ries

r

New



Editorial


Management Focus

Geriatric Journal

Bump Set Spike





Where We Work























































(800) 355 5627



































Untitled-5 1 11516 1255 PM



















MEDICAL CLAIMS amp

BILLING EXPRESS







2016 Promotions







MANAGEMENT FOCUS
















By KATHERINE BORTZ















MANAGEMENT FOCUS


advancewebcomevents



LEARN MORE

SPONSORS


t th

Talk to more than


FACE-TO-FACE



GERIATRIC JOURNAL



















CA

ROLE

LE

WIS

COVER STORY













BUMP

SPIKESET


















Olympic sport








enrsquos tournament













































COVER STORY



















TECHNOLOGY




CA

RM

EN V

AN

HA

RT












TECHNOLOGY



R82com(800) 336-7684

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ck R

aise

r 1

































JEFF

RE

Y LE

ESE

R





















Lynda White PT MBA















Online






Help Your Patients







AQUATIC THERAPY





KYL

E K

IELI

NSK

I










AQUATIC THERAPY












Series
















mdashSource AquaHab





online or call






needs







ONCOLOGY















JEFF

RE

Y LE

ESE

R

Online






Made in the USA


Visit us at

to request a sample

















ONCOLOGY











WHERE WE WORK



















ON-SITE EDUCATION

ONLINE EDUCATION



ONLINE EDUCATION



ONLINE EDUCATION



















Learn more now








yyy



gggggg g






PT_EDU_081516indd 23 81216 422 PM










EDU

CAT

ION

AL

OPP

ORT

UN

ITIE

S

1-877-776-6680














for Practitioners









or call (800) 863-5935




PT_EDU_081516indd 24 81216 422 PM
































2016 SCHEDULE






















NEWLOCATION




PT_EDU_081516indd 25 81216 422 PM
























EDU

CAT

ION

AL

OPP

ORT

UN

ITIE

S


AND CE PROGRAMS

WE CAN HELP

ADVANCEWEBCOM

PT_EDU_081516indd 26 81216 422 PM












H









Physical Therapists




Physical Therapists




EOE







1-877-776-6680





CHECK OUT

ADVANCEWEBCOM

AND LINK TO

YOUR FAVORITE

ADVANCE

MAGAZINE

JOB SEARCH

SHOPPING

CE AND MORE



PT_05092016_REC_ALSindd 27 81216 504 PM

CLA

SSIF

IED

EM

PLO

YMEN

T O

PPO

RTU

NIT

IES













WHY JOIN OUR TEAM







wwwivyrehabcom







YOUR ONE-STOP

CAREER CENTER


PT_05092016_REC_ALSindd 28 81216 504 PM

CLA

SSIF

IED

EM

PLO

YMEN

T O

PPO

RTU

NIT

IES


Arizona National


www5sslcom

The Forum - Tucson










www5sslcom
















INSIGHTFUL ARTICLES

CAREER EVENTS

JOB LISTINGS

ONLINE CE

WEBINARS

SHOPPING

AND MORE

ADVANCEWEBCOM

PT_05092016_REC_ALSindd 29 81216 504 PM

PT_05092016_REC_ALSindd 30 81216 504 PM





Favorite PT Apparel





giftsgif

34784

32537

26309

3550734031 34182 New

34722


34784

ries

r

New



Editorial


Management Focus

Geriatric Journal

Bump Set Spike





Where We Work





































Untitled-5 1 11516 1255 PM



















MEDICAL CLAIMS amp

BILLING EXPRESS







2016 Promotions







MANAGEMENT FOCUS
















By KATHERINE BORTZ















MANAGEMENT FOCUS


advancewebcomevents



LEARN MORE

SPONSORS


t th

Talk to more than


FACE-TO-FACE



GERIATRIC JOURNAL



















CA

ROLE

LE

WIS

COVER STORY













BUMP

SPIKESET


















Olympic sport








enrsquos tournament













































COVER STORY



















TECHNOLOGY




CA

RM

EN V

AN

HA

RT












TECHNOLOGY



R82com(800) 336-7684

Qui

ck R

aise

r 1

































JEFF

RE

Y LE

ESE

R





















Lynda White PT MBA















Online






Help Your Patients







AQUATIC THERAPY





KYL

E K

IELI

NSK

I










AQUATIC THERAPY












Series
















mdashSource AquaHab





online or call






needs







ONCOLOGY















JEFF

RE

Y LE

ESE

R

Online






Made in the USA


Visit us at

to request a sample

















ONCOLOGY











WHERE WE WORK



















ON-SITE EDUCATION

ONLINE EDUCATION



ONLINE EDUCATION



ONLINE EDUCATION



















Learn more now








yyy



gggggg g






PT_EDU_081516indd 23 81216 422 PM










EDU

CAT

ION

AL

OPP

ORT

UN

ITIE

S

1-877-776-6680














for Practitioners









or call (800) 863-5935




PT_EDU_081516indd 24 81216 422 PM
































2016 SCHEDULE






















NEWLOCATION




PT_EDU_081516indd 25 81216 422 PM
























EDU

CAT

ION

AL

OPP

ORT

UN

ITIE

S


AND CE PROGRAMS

WE CAN HELP

ADVANCEWEBCOM

PT_EDU_081516indd 26 81216 422 PM












H









Physical Therapists




Physical Therapists




EOE







1-877-776-6680





CHECK OUT

ADVANCEWEBCOM

AND LINK TO

YOUR FAVORITE

ADVANCE

MAGAZINE

JOB SEARCH

SHOPPING

CE AND MORE



PT_05092016_REC_ALSindd 27 81216 504 PM

CLA

SSIF

IED

EM

PLO

YMEN

T O

PPO

RTU

NIT

IES













WHY JOIN OUR TEAM







wwwivyrehabcom







YOUR ONE-STOP

CAREER CENTER


PT_05092016_REC_ALSindd 28 81216 504 PM

CLA

SSIF

IED

EM

PLO

YMEN

T O

PPO

RTU

NIT

IES


Arizona National


www5sslcom

The Forum - Tucson










www5sslcom
















INSIGHTFUL ARTICLES

CAREER EVENTS

JOB LISTINGS

ONLINE CE

WEBINARS

SHOPPING

AND MORE

ADVANCEWEBCOM

PT_05092016_REC_ALSindd 29 81216 504 PM

PT_05092016_REC_ALSindd 30 81216 504 PM





Favorite PT Apparel





giftsgif

34784

32537

26309

3550734031 34182 New

34722


34784

ries

r

New



Editorial


Management Focus

Geriatric Journal

Bump Set Spike





Where We Work





















MEDICAL CLAIMS amp

BILLING EXPRESS







2016 Promotions







MANAGEMENT FOCUS
















By KATHERINE BORTZ















MANAGEMENT FOCUS


advancewebcomevents



LEARN MORE

SPONSORS


t th

Talk to more than


FACE-TO-FACE



GERIATRIC JOURNAL



















CA

ROLE

LE

WIS

COVER STORY













BUMP

SPIKESET


















Olympic sport








enrsquos tournament













































COVER STORY



















TECHNOLOGY




CA

RM

EN V

AN

HA

RT












TECHNOLOGY



R82com(800) 336-7684

Qui

ck R

aise

r 1

































JEFF

RE

Y LE

ESE

R





















Lynda White PT MBA















Online






Help Your Patients







AQUATIC THERAPY





KYL

E K

IELI

NSK

I










AQUATIC THERAPY












Series
















mdashSource AquaHab





online or call






needs







ONCOLOGY















JEFF

RE

Y LE

ESE

R

Online






Made in the USA


Visit us at

to request a sample

















ONCOLOGY











WHERE WE WORK



















ON-SITE EDUCATION

ONLINE EDUCATION



ONLINE EDUCATION



ONLINE EDUCATION



















Learn more now








yyy



gggggg g






PT_EDU_081516indd 23 81216 422 PM










EDU

CAT

ION

AL

OPP

ORT

UN

ITIE

S

1-877-776-6680














for Practitioners









or call (800) 863-5935




PT_EDU_081516indd 24 81216 422 PM
































2016 SCHEDULE






















NEWLOCATION




PT_EDU_081516indd 25 81216 422 PM
























EDU

CAT

ION

AL

OPP

ORT

UN

ITIE

S


AND CE PROGRAMS

WE CAN HELP

ADVANCEWEBCOM

PT_EDU_081516indd 26 81216 422 PM












H









Physical Therapists




Physical Therapists




EOE







1-877-776-6680





CHECK OUT

ADVANCEWEBCOM

AND LINK TO

YOUR FAVORITE

ADVANCE

MAGAZINE

JOB SEARCH

SHOPPING

CE AND MORE



PT_05092016_REC_ALSindd 27 81216 504 PM

CLA

SSIF

IED

EM

PLO

YMEN

T O

PPO

RTU

NIT

IES













WHY JOIN OUR TEAM







wwwivyrehabcom







YOUR ONE-STOP

CAREER CENTER


PT_05092016_REC_ALSindd 28 81216 504 PM

CLA

SSIF

IED

EM

PLO

YMEN

T O

PPO

RTU

NIT

IES


Arizona National


www5sslcom

The Forum - Tucson










www5sslcom
















INSIGHTFUL ARTICLES

CAREER EVENTS

JOB LISTINGS

ONLINE CE

WEBINARS

SHOPPING

AND MORE

ADVANCEWEBCOM

PT_05092016_REC_ALSindd 29 81216 504 PM

PT_05092016_REC_ALSindd 30 81216 504 PM





Favorite PT Apparel





giftsgif

34784

32537

26309

3550734031 34182 New

34722


34784

ries

r

New



Editorial


Management Focus

Geriatric Journal

Bump Set Spike





Where We Work



MANAGEMENT FOCUS
















By KATHERINE BORTZ















MANAGEMENT FOCUS


advancewebcomevents



LEARN MORE

SPONSORS


t th

Talk to more than


FACE-TO-FACE



GERIATRIC JOURNAL



















CA

ROLE

LE

WIS

COVER STORY













BUMP

SPIKESET


















Olympic sport








enrsquos tournament













































COVER STORY



















TECHNOLOGY




CA

RM

EN V

AN

HA

RT












TECHNOLOGY



R82com(800) 336-7684

Qui

ck R

aise

r 1

































JEFF

RE

Y LE

ESE

R





















Lynda White PT MBA















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PT-1533007 EA DB Altimate Medical.indd 1 7/21/15 9:22 AM · s I write this, the USA beach...

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Transcript of PT-1533007 EA DB Altimate Medical.indd 1 7/21/15 9:22 AM · s I write this, the USA beach...