Did you know?

• A concussion is a type of brain injury.
• Imaging, such as MRI and CT scans, are not able to diagnose a concussion.
• Most concussions (90%) are not associated with a loss of consciousness.

What is a concussion?

A concussion is a type of mild traumatic brain injury or mTBI. It occurs as a result of a direct blow to the head or a blow elsewhere to the body where the force is transmitted up through the head (think about whiplash and how the brain is bouncing around inside the skull). Loss of consciousness does not always occur. In fact, most people who have a concussion do not lose consciousness.

So, what really happens?

The impact on the brain causes the brain cells to stretch and become damaged. The damage to the brain cells causes them to release neurotransmitters, which are the chemicals of the brain that allows it to function normally. The imbalance of these chemicals causes the brain to have to work harder and requires more energy, resulting in an “energy crisis” within the brain.

What are the signs and symptoms?

Signs and symptoms of a concussion can occur immediately or hours to days following the injury and include¹:

• Emotional: anger, sadness, nervous or anxious, irritability
• Mental: confusion, feeling foggy, poor memory, poor concentration
• Physical: headache/migraine, clumsiness, dizziness or loss of balance, nausea or vomiting, fuzzy or blurry vision, sensitivity to noise or light
• Sleep: feeling tired, trouble falling asleep, trouble staying awake, too much or too little sleep

What is the recovery time?

A typical concussion will fully resolve in less than 3 weeks with minimal intervention, with significant improvement in the first 7-10 days. In about 20% of concussed people, a concussion takes greater than 4 weeks to resolve. A second concussion before fully recovering from the initial injury can have detrimental effects, including prolonged recovery, permanent brain damage, and even death.

How can physical therapy help?²

Physical therapists are part of the multidisciplinary team capable of helping people return to their normal activities and lifestyles after a concussion. Physical therapists will complete a comprehensive assessment and are highly qualified to address and implement:

• Orthopedic issues and pain from the injury
• Balance, dizziness, and vestibular/vertigo problems
• Visual and ocular motor problems
• Concussion Protocol using Korebalance System

What is the Korebalance System?

A state-of-the-art system uses the latest in virtual and interactive technology, offering high-tech balance assessments and rehabilitation.

How it Works:

It’s the world’s first balance training system incorporating Variable Speed Reaction training together with cognitive interaction; it delivers a higher quality of physical therapy by allowing us to customize programming and gradually adjusting difficulty levels and tasks over the course of treatment.  Korebalance® uses visual, vestibular (inner ear) and proprioception (knowing where the body is in space) to find or create new pathways in the brain, improving balance.

What it Does:

• Improves balance, stability, coordination & posture;
• Improves agility, reaction time and motor control;
• Improves confidence for seniors decreasing fall risks;
• Trains the body to respond to an unstable environment (real-life activities);
• Rehabilitates concussions, traumatic brain injuries (TBI’s), and associated dizziness;
• Keeps athletes on the field.

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¹ “Symptoms of Traumatic Brain Injury (TBI).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 11 Mar. 2019, www.cdc.gov/traumaticbraininjury/symptoms.html.

² Mucha, Anne, and Susan Whitney. 4 May 2020., MedBridge Education. https://www.medbridgeeducation.com/certificate_programs/11026-concussion-assessment-medical-management.

Evidenced-based research shows that as few as 1 to 2 sessions of pre-operative physical therapy can reduce post-operative care by 29% for patients undergoing a total hip or knee replacement; this could be a  $1,000 + per individual!

The Facts

Between 2012 and 2050 the number of Total Knee Replacements (TKAs) performed annually in the United States alone is expected to increase by 855%, equating to 2,854 procedures per 100,000 US Citizens over 40 years of age; prevalence was higher for women of 50 years of age.

Globally, hip and knee osteoarthritis (the most common form of arthritis when the protective cartilage that cushions the ends of your bones wears down over time) was ranked as the 11th highest contributor to disability among almost 300 health conditions.

Pandemic Era Hospital Stays Are Shorter

First of all, no one wants to stay in the Hosptial longer than necessary. Second, you most likely won’t be able to during the Pandemic anyways. Finally, depending on the type of surgery – some are outpatient which is why rehabbing is crucial to helping you prepare for the best post-operative health-related quality of life (HRQOL).

Components of Care

Pre-operative physical therapy can be as little as 1 to 2 visits. However, for more acute cases we suggest a minimum of 6 to 10 visits. This way we can complete a full motor function and strength training program while you are awaiting surgery which will increase optimal post-surgical outcomes of associated inactivity and decline for maximum recovery. Your sessions will include:

Thorough Physical Evaluation

Extensive Patient Education

  Pain Management

Customized Pre- & Post-Surgery Plan for Elective/Non-Urgent Procedures

Results

Post-operative outcomes could be achieved in a shorter period of time by maintaining a higher level of training and fitness before your surgery to be able to fully resume outpatient rehabilitation; possibly eliminating admission into respite or residential care, or home health therapy if there are no post-operative complications.

The COVID-19 pandemic has put a spotlight on intensive care units and critically ill patients. Most of the focus has been on survival, which is the first goal. Someone heading into an intensive care unit is very ill, possibly being kept alive by a ventilator or some other piece of medical equipment. But surviving the ICU is only the first chapter.

The second one is much longer, and it tells the story of recovery after the ICU. Being that ill has far-reaching effects. Significant losses of physical, mental and cognitive abilities after discharge aren’t uncommon. This group of problems is called Post-Intensive Care Syndrome or PICS. It’s a serious issue that’s now recognized as a public health burden.

The effects of PICS are wide-reaching. Physical declines can lead to serious difficulty completing basic daily tasks like getting to the bathroom, preparing a meal, or walking to the mailbox. 50% of ICU survivors still have limitations in daily activities 1 year later, showing how serious and long-lasting this problem is.

Mental health issues are common for ICU survivors. They show significant rates of depression, anxiety and PTSD. These conditions have a real impact on the quality of life after leaving the ICU.

ICU survivors also commonly show declines in cognitive abilities. 77% have cognitive impairments at 3 months post-discharge and 71% have impairments 1 year out. Cognitive issues can take the form of poor memory, slower thinking, difficulty making decisions, or difficulty concentrating.

An important professional in combating PICS is the physical therapist. They typically begin seeing the patient in the ICU. PTs are vital in getting the patient up and walking early. A progressive exercise program is also started as soon as it’s safe for the patient.

While PICS isn’t totally preventable, recognizing the losses that remain after discharge from the ICU is an important step. Involving physical therapists and other rehab professionals early helps combat the effects of PICS and allows patients to return to higher-quality lives.

Water isn’t just a refreshing thirst-quencher. It’s essential to almost all bodily functions, from lubricating our joints to pumping blood to our heart. Staying hydrated is a key part of maintaining good health. That’s why the advice to “drink 8 glasses a day” has become a familiar mantra on morning talk shows and in magazines.

What is the meaning of “hydrated”? Being hydrated simply means that your body has enough fluids to function properly. According to the American Heart Association, the amount of water each person needs can vary. A quick way to tell if you’re drinking enough is to check the color of your urine. If it’s pale in color and clear, you are likely well-hydrated. If it’s dark-colored with amber or brown tones, you may be dehydrated.

What is dehydration?

Dehydration is a potentially serious condition that can occur when you don’t consume enough fluids for your body’s needs. This can lead to health complications ranging from mild to life-threatening, such as urinary tract infections (UTIs), heatstroke, heart problems, kidney failure, and blood clot complications. Since dehydration affects the health of your cells, it can also lower your body’s ability to ward off infections and heal from injury or illness.

Why dehydration is more likely to affect older adults

As you get older, it’s even more important to stay hydrated. A study from the University of California, Los Angeles School of Nursing found that up to 40% of elderly people may be chronically underhydrated.

Seniors are more vulnerable to dehydration for a number of reasons:

• Appetite and thirst tend to diminish with age. This means that even when your body is craving fluids, you might not be aware of it—and you may drink less than you need to stay healthy.
• Older adults experience body composition changes over time that leave them with less water in their bodies to start with.
• Seniors are more likely to take medications that increase dehydration risk.

Additionally—according to a recent study—older adults’ bodies don’t regulate temperature as efficiently as those of younger people.¹ This means that during exercise or activity, seniors are more likely to become dehydrated through sweating.

Symptoms of dehydration

Even mild dehydration can cause an array of uncomfortable and debilitating symptoms. Understanding the warning signs can help you take action before the situation becomes severe.

Early dehydration symptoms include:

• Dark-colored urine, urinating less frequently
• Fatigue, or feeling weak
• Irritability
• Dizziness
• Headaches
• Muscle cramps in arms or legs
• Dry mouth
• Confusion, decreased cognitive function

The tiredness and lack of coordination that may result from dehydration can also lead to falls and injury. The best way to prevent dehydration is the simplest: drink more water throughout the day.

How much water do you need to stay hydrated?

As a general rule, you should take one-third of your body weight and drink that number of ounces in fluids. For example, if you weigh 150 pounds, aim to drink 50 ounces of water each day.

However, it’s best to talk to your doctor to determine how much water you should be drinking daily. They can review your medical history with you as well as any over-the-counter or prescription medications you’re currently taking. Certain medications cause the body to flush out more water. And some medical conditions, such as cystic fibrosis, also make people more prone to dehydration.

How to stay hydrated every day

There are simple steps you can take to get the water your body craves. Below are some ideas to get you started:

Choose foods with high water content. If you have trouble drinking fluids, try including water-rich foods with every meal. These include cucumbers, watermelon, lettuce, strawberries, tomatoes and celery. Soups, broths and stews are also a good way to boost your fluid intake, especially in the colder weather. If you’re watching your sodium, be sure to opt for low-sodium versions.

Keep water with you, always. Having hydration at your fingertips can make it easier to get the right amount of fluids. Carry a refillable water bottle with you wherever you go, or keep a lightweight water pitcher and cup near your favorite chair at home.

Avoid or reduce your alcohol intake. Alcohol is a diuretic, which means it prompts your body to remove fluids from your bloodstream. Limiting alcoholic beverages can help your body hang on to more of the water it needs to thrive.

Change it up. Pure, clean water is the best way to stay hydrated. But let’s face it—drinking plain water all day can get boring! Try jazzing up your H2O by adding slices of fresh lemon, apple, cucumber or berries. You may also choose to switch up water with other options such as low-sugar sports drinks or protein and nutritional shakes specifically designed for seniors. Coffee and tea can have a slight dehydrating effect, so they should not be counted toward your daily fluid intake.

Build hydration into your routine. Making it a point to drink water at certain times each day can help transform it into a healthy habit. For example, consume a glass of water when you wake up in the morning, after every meal, and before and after exercise or activity.

If you’re looking for additional tips on how to stay hydrated, ask your healthcare provider. Getting enough water each day is an easy yet vitally important way to stay healthy and active as an older adult.

for more: https://www.ncoa.org/article/how-to-stay-hydrated-for-better-health?

If You Are at Risk for Falls, You Need Us!

Physical therapy training includes assessment, exercise prescription, and progression, all with appropriate monitoring. All these skills can be utilized for older adults before injury happens.

Most people think of heart rate or blood pressure when they think of vital signs. It is common to use numbers to quantify health and risk of disease. The American Heart Association encourages people to “know their numbers” referring to blood pressure, blood cholesterol, blood glucose, and weight. However, research is now showing the importance of moving properly for health. Let’s take a look at some of the numbers you can use to quantify your movement health:

Walking Speed

Walking speed has been called the “sixth vital sign” in medical literature recently. It is easy to measure and takes into account strength, balance, coordination, confidence, cardiovascular fitness, tolerance to activity, and a whole host of other factors. It has also been shown to be predictive of future hospitalizations, functional decline, and overall mortality. Normal walking speed is considered to be 1.2 to 1.4 meters per second.

Push-Ups

Push-ups are popular to build strength, but a recent study found that they can show us a lot about your heart too. Researchers found that men who could do 40 or more consecutive push-ups were at a 96% lower risk for cardiovascular disease than were men who could do less than 10. The push-up test was also more useful in predicting future cardiovascular disease than aerobic capacity measured on a treadmill.

Grip Strength

Hand grip strength has been shown to be strongly correlated with health. The stronger your hand grip is, the less likely you are to suffer from cardiovascular disease, respiratory disease, COPD, and all types of cancer. In the study, muscle weakness was defined as grip strength <26 kg for men and <16 kg for women. Grip strength below these numbers was highly correlated with an increase in disease.

Standing From the Floor

If you can’t easily get down on the floor and back up your health might be in trouble, according to a study that looked at more than 2,000 people. The study asked people to go from standing to sitting on the floor and back up with as little support as needed. They found that if you need to use more than one hand to get up and down from the floor that you were 2 to 5 times more likely to die in the next 7 years than someone who can do it with just one hand, or even better, no hands at all.

Moving well is obviously important to overall health and longer life. These tests can give a snapshot of how you’re doing. If you’re having trouble with any of them, considering seeing a movement specialist – our physical therapists!