Muscle strength is one of the basic building blocks of patient wellness, and, along with mobility, plays a key role in determining a patient's or subject's maximum functional ability. While most practitioners are familiar with the typical "manual resistance" test, some are still not yet aware of the benefits of quantifying and comparing actual force output from a subject's muscles and muscle groups.
Patients may already have a pretty clear idea of the importance of measuring strength: their muscles keep them moving, allow them to do their work, their play, basic activities of daily living, or hug their family. But there's more: in addition to providing a good indicator of therapeutic progress after an injury, subtle changes in bilateral strength or agonist-antagonist joint motions can help to identify changes in wellness that can help to forecast potential injury (or re-injury) in the future, based on changes in performance that might be imperceptible to manual examination alone.
In some cases, a patient themselves may not be aware of their muscle strength limits. Jenny at Baylor Heart and Vascular Hospital told us this story about a 30-year-old heart valve replacement patient who wanted to return to work after surgery:
He was told by his physician not to lift more than 10 pounds or his sternum would crack open. We took him into our lab to test his bicep curl. He curled 79 pounds and when we showed him the graph of what he did, it was like he had a light-bulb moment. He lifted 79 pounds and his sternum did not crack open. We had been telling him over and over he could lift more than 10 pounds but he was still unsure until he saw the JTECH graph. Now he can go back to work and not worry. This is a BIG DEAL for him!
Central to the process of quantifying muscle strength is the concept of muscle isolation. In much the same way a patient might be positioned on a table to leverage limb or trunk strength, testing muscles (or specific muscle groups) on an individual basis allows for greater control and accuracy during tests, as well as providing maximum reproducibility for future tests and comparisons, even with different examiners.
When an examination is performed using standard positions and procedures, measurement tools like JTECH's Muscle Strength Testing devices can capture a highly precise maximum value, as well as variation data and bilateral differences. Using software such as JTECH's Northstar also makes it easier to track progress and generate report output for a variety of referral, med-legal, athletic, or patient education scenarios.
Outcomes, users tell us, have often been based on outdated or simplistic evaluations that don't paint a true picture of the patient's performance, or compare to baselines or other objective indications.
We've only covered a small portion of the uses for trunk and limb strength measurements, and in the future we will also introduce a number of other strength evaluations and give some ideas about how they can be implemented in meaningful ways to improve performance and quality of life through sound evaluation techniques!
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A recent blog post at the Parker College of Chiropractic highlights one of the most prevalent factors in neck and low back pain: forward head posture.
On the Alumni Voices blog at Parker College of Chiropractic, Dr. Gregory Johnson outlines the mechanics of gravity as a primary source of stress on the ligaments, muscles, disc, and joints of the spine. Forward Head Posture (FHP) is a reality of our modern age, and Dr. Johnson says it is a factor that can have significant health consequences over a long period of time.
Constantly leaning forward into computer screens, phones, and other handheld devices not only causes serious postural problems, he says, but can cause compression of the upper cavity and lower cavity, affecting lungs and heart, and can even cause gastrointestinal issues.
Gravity is always pulling us down towards the earth 24/7, whether you’re sitting, standing, sleeping, walking or doing any other activity a human being might do during their everyday activities of living, both at work and at home. We have become a sedentary society for the most part, sitting most of the day as we work on a computer or at a desk with our heads leaning or bent forward from our shoulders. This means FHP is very prevalent in our society.
In addition to adults sitting at desks and workstations during the day, Dr. Johnson says this is also something that affects children from an early age, and should prompt us to be mindful of posture to prevent long-term health problems.
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Among the immense discord around the world, some goals seem universal: live longer, look better, and prevent disease. Many companies have capitalized on these goals by selling new creams, producing new medications, or promoting fad diets promising to help individuals live healthier and feel good. However, even if some of these solutions may have merit, there are easier ways to achieve these goals. An individual searching for better health will find success not in reaching for a magical product, but in lacing up tennis shoes. Incorporating exercise into daily life increases an individual’s overall health and wellbeing.
New technologies and research continually back the benefits of exercise as one of the most fundamental health realities. Study after study has revealed how crucial movement is for overall health. In fact, research has shown even minimal movement throughout the day has significant benefits over sitting sedentary. Small steps towards increasing physical activity can translate to large health improvements over time.
The CDC recommends at least 150 minutes of moderate-intensity physical activity per week for adults, however, any movement is better than nothing!
Studies have repeatedly shown exercise may help with prevention, treatment, or helping relieve symptoms of many adverse health problems. Some benefits including:
The old adages of “motion is lotion,” “rest is rust,” “movement is medicine,” and “use it or lose it” all speak truth. The cause for movement has never been louder. For those dealing with injury or physical discomfort, take the time to meet with a Chiropractor or Physical Therapist as soon as possible. The advancements of adjustment tools and measuring devices allow health professionals to better diagnose and treat patients. With the proper tools and methods, even those with serious injuries have a chance at full recovery. Whatever ability you’re now at, get moving!
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The information age changed how individuals interact with the medical world. In addition to scheduling appointments online and tele-health appointments via video calling, patients are much more likely to research their diagnosis to learn more about causes and treatment. Becoming informed about an ailment helps a patient better articulate their questions and possible concerns to health care professionals. This access to information significantly changes how patients and professionals interact. As patients spend more time researching their ailments, they are more likely to spend time looking into what kind of health care professional will best help them (chiropractor, physical therapist, athletic trainer, M.D. etc.). However, many clinics have adapted to mitigate this task. In a full service health clinic, a patient can visit one health center for evaluation and to work with multiple health professionals for treatment. These multi-disciplinary health clinics help shift patients to the center of attention and elevate their personal care.
In a multi-disciplinary practice (or sometimes called a wellness clinic) several medical specialists work alongside each other to provide a “one-stop-shop” style clinic. The Mayo Clinic famously provides many different services to help a patient in their fight against cancer. Their staff includes doctors, researchers, and scientists all working within their specialties under a united patient-first philosophy. Boston Pain Care provides multiple specialists at the same location to help patients in their fight against chronic pain. Their services include treatment for sleep trouble, medication management, arthritis, neuropathy, herniated discs, migraines, functional rehabilitation, and more.
A full service health practice uses co-located (or closely located) clinics with different specialties coming together under a single patient care philosophy. This type of clinic condones an environment for an advanced and diverse medical team to work together for the benefit of an individual patient. A “one-stop-shop” style allows a patient to walk in the door with multiple health issues and leave the clinic with a comprehensive wellness 'game plan' for all ailments.
Although all independent wellness clinics may work in different ways, the idea of many medical professionals all working together is universal. For an example, imagine a patient entering the full service health care clinic in need of treatment. A chiropractor would objectively evaluate the patient and collect data and medical history for the surgeons to determine when surgical intervention might best suit the patient’s treatment. At post-surgery, the chiropractor would evaluate the patient again prior to undergoing rehab to collect baseline. The patient would then work with the physical therapists for rehabilitation while routinely meeting with the chiropractor to monitor progress. Each medical professional involved still works together by sharing data and discussing processes to make sure the patient stays on the best course for healing. It has long been said that two-heads are better than one—or in this example, three medical professionals better than one. Patient experience and medical expertise both increase exponentially in multimodality clinics.
So, what benefits can a clinic glean from becoming a full-service health care practice? Many full-service health care practices enjoy the following:
The idea of becoming a full service clinic may seem daunting and unreachable at first, but it all begins with small steps. Physical therapy clinics or chiropractic practices may benefit from expanding their own services initially. This may include adding FCEs or Employer Services to the list of offered services. Even small steps toward becoming a full service health care practice will begin to garner the same benefits.
Whatever the first steps may be, JTECH is here with functional evaluation systems to help. The foundation of any practice should include objective data and accurate testing. Contact JTECH Medical today to see how we can help!
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We spend a lot of time at work, doing the same thing day in and out, increasing the risk for repetitive injuries. Employee general well-being seems to be of increasing interest to employers. As a result, more and more employers are opting into wellness plans and offering incentives for those who participate. Some companies even go as far as to bring wellness to work and allow employees to participate during work time.
While it may seem counterintuitive to have employees doing anything but work during work hours, to these employers the benefits are clear.
According to a blog post by TodayinPT, loss of productivity due to strains and injuries has had a measurable impact on businesses, and even skeptical employees have noticed improvements from on-site therapy programs.
We have an onsite manufacturing plant [...] where a lot of our employees are male and wouldn’t make appointments to see a doctor until they were in a lot of pain,” Vissers said. “We want to help them to avoid long-term health problems by being proactive about their health, and realizing that pain isn’t an inevitable part of aging.”
While some of the manufacturing plant workers were unsure whether they actually could benefit from stretching [...] they were taught their roles at the company were as “industrial athletes” because of the lifting and physical labor required. Six months later, when their reach and other outcomes were measured again, employees saw the benefits of stretching. In the maintenance department pilot of 90 employees, only one strain was reported in a 10-month period, compared with 21 strains and sprains in the period before the pilot began.
Although a potential initial investment upfront, it seems wellness programs can offer a big return; employees receive preventative care and healthier employees tend to take fewer sick days. Identifying and reducing potential on the job injuries is a huge incentive as well and may encourage employers to implement pre-employment screenings or ergonomic evaluations once empoyees are on the job.
Some questions to consider:
As an employee, do you feel your employer provides adequate wellness incentives/resources?
As an employer, do you feel wellness programs are realistic and beneficial?
As a clinician, are you approached by employers to participate in similar programs or do you market to employers for these services?
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