pt alberta newsletterhpa impact on physiotherapy alberta physiotherapy alberta will be impacted by...

PT Alberta NewsletterSpring 2011 | www.physiotherapyalberta.ca

New + returning members 1

Privilege of self-regulation 2

President/Registrar’s message 3

Your license. Your responsibility 4

Council news + election results 4

Practice advice 5

Good practice 6

Research in focus 7

Professional development 10

The YOU Movement 11

Working together 12

Member spotlights 13

Media sightings 15

Finding Balance 2010 results 16

University news 18

What’s inside:

PT Alberta - Spring 2011 | www.physiotherapyalberta.ca

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Physiotherapy Alberta publishes PT Alberta to communicate policies, standards and other important matters to members. As all members are sent a copy, we therefore assume it has been read and understood. If you have any questions regarding the content within, please contact us.

Registrar: Dianne MilletteProfessional practice: Iain MuirRegistration: Erin HowesContinuing competence: Audrey LoweCommunications: Mara SimmondsComplaints + conduct: Nancy Jette ChisholmCorporate services: Joyce Vogelgesang

Council 2010/2011President: Nancy LittkeVice-president: Greg Cutforth Secretary-treasurer: Grant IrwinCouncil members: Erica BowenGrant Fedoruk, Gwen HarrisKrishna Prasanna + Nicola SadorraPublic member: VacantStudent representative: Joey Mo, Matt Scott

300, 10357 - 109 StreetEdmonton, AB T5J 1N3

T: 780.438.0338 | 1.800.291.2782F: 780.436.1908www.physiotherapyalberta.ca

Physiotherapy Alberta - College + Association

New/ReturningMegan ArchibaldLeonardo BarbieriTracy BlakeHeather CharetteJackie DaviesNathan DoerksenMelissa HannCecilia LuedemannMarinela MargaritHayley NgVivian OvertonGirish PadmanabhanLeanne PorteousAnjo RoelofsBryce RudlandRhonda SchmulandMelanie ShortLeanne SimmsJulie StennerJennifer SullivanJacquie TownsendTammy UnterinerDoarnie ViragAnthony WillmotBrad Wilson

Temporary licenseLindsay AchesonSarah BuddinghSunjit ChhokarKim DaoNina DumulotCaroline GillMac KimShinya NakamotoRajitha Venugopal

ResignedJoan AilsbyBarbara AshtonTamie AubinAlice BabbAmy BazzarelliBarbara BentleyTracy-Lee BourbeauGrant BrayLinda BuchynskiJody CannamMarilyn ClarkMary CornsKrystyna CzengeryElisabeth DespresShaela DoigKevin Duff

Resigned Michael DunneJames DunnettCatherine EadieHeather ElliottShauna ForbesAmanda FraserStephanie GalesKim GrunlingDarren HagelNicole HarderCrystal HatcherArne HeaynNichole HensonJulie HobernAnita HoelzelJennifer HoffAllen HolmanElke HottentotSuzanne IafollaHolly Jenkins ChantLynne KaneTracy KhaSung KimMargaret KirleyPatricia KorpiChantal LadouceurNancy LambertJennifer LaRoyBarbara LarsonBronwyn LasairJanet LesterKaren LooneCharlene Luciak-CoreaDiane LydersBeverley MacLeodFiona McDevittCheryl MenkemaSarah MeredithPadmaja MukundanSybil MurrayBarbara NagyRobert NajafeeLindsay NicholsJessica OwenGloria PalinkasDonald PatrySarah PercyJason PolkShawna Lee PoundEugenie PrankeRamesh PurushothamanStacey ReedJanet RobertsHelen RobertsonErika Rowden

Resigned Suzanne RysakKirsty SaneshTrish ScottMargaret SenftGailene Shaw

Resigned Joanne SimondsPatricia SpadyFraser SprigingsAnne SymingtonSarah SymmesSharyn Van DammeMegan WaiteAlice WalkerAnna-Marie WeberSusan WithageJeremy WoodfinMargaret WoytiukJennifer ZylstraJanet Roberts1147149 Alberta Ltd.1363990 Alberta Ltd.1414046 Alberta Inc.1510465 Alberta Ltd.1545489 Alberta Inc.422992 Alberta Ltd.Acadia Physical Therapy Ltd.Action Physical Therapy Clinic Ltd.Barb Ashton Physical Therapy Ltd.BodyTalk Physiotherapy Inc.Burnewood Physical Therapy Ltd.Castleridge Physiotherapy and Rehabilitation Corp.Corporate Sport Physiotherapy and Rehabilitation Corp.Enforme Physiotherapy Inc.Galipeau Physiotherapy Inc.Heritage Valley Physical Therapy Inc.Mount Pleasant Physiotherapy Ltd.Onside Sports Rehab Ltd.Royal Oak Sport Physiotherapy andRehabilitation Corp.

New, Returning, Resigned, + Cancelled MembersJanuary 1, 2011 - April 30, 2011. Find a physiotherapist or verify registration at www.physiotherapyalberta.ca

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* Our legal name is the College of Physical Therapists of Alberta; however we do business as Physiotherapy Alberta.

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2PT Alberta - Spring 2011 | www.physiotherapyalberta.ca

New, Returning, Resigned, + Cancelled, Members...continued from page 1

Resigned Sierra Physiotherapy Ltd.Stephanie Dumont Physiotherapy Ltd.Sunridge Physiotherapy Clinic Ltd.TriLife Corporation Ltd.

Cancelled, non paymentMelanie AileyAndrea BarkmanSheela BehlCara BerendsLori Biddulph-DeisrothBecky BurkeKristina DoolingNalin FernandoJodi Forster-MolstadJolie GaleKevin GibsonAntonio GrossiAmy GuidingerNadine HawkinsKyle HeppnerAnna HughtonFlora LeeDarren LonsdaleJoEllen MacPheeAnthony MagnayeJennifer McPhailKyley MohrenbergerOluseyi OlubowaleBarbara RobinsonKelli SchiedelGordon SchutzSarah ShanderaChristie SorochukMatthew TalptTina WhiteDynamic Physiotherapy Institute Inc

Physiotherapists in Canada are fortunate to be afforded the privilege of self-regulation. From time to time; however, we take this privilege for granted. As we come under new legislation (read on for the good news!) we challenge all Alberta physiotherapiststo consider how they support the privilege of self-regulation.

Feature Editorial

The Privilege of Self-Regulation

ExpectationsThe privileges and responsibilities that come with self-regulation are shared by all members of the profession. Council and staff have a duty to govern in the public interest and develop, implement and evaluate regulatory policy that impacts members by being thoughtful, evidence-informed, fair, and transparent. Physiotherapists have a duty to understand regulatory expectations and participate in the self-regulatory process including:

y Governing yourself + being aware of your behaviour.

y Being committed to the profession as a whole.

y Respecting + contributing to the self-regulatory process.

As a physiotherapist you have a role in actively participating in self-regulation (e.g., on Council, committees, work groups, other College projects/business, attending our AGM, voting for Council), knowing/meeting your professional obligations, using practice standards and the code of ethics to guide your practice, participating in key decisions, and never wavering from your commitment to quality of care. When done well, this serves not only your patients but also yourself, your profession and its reputation. These actions and awareness all contribute to maintaining the privilege of self-regulation.

Participation We recently released new standards of practice and code of ethics. For all

physiotherapists, part of your self-regulation participation, is to read, understand and comply with all expectations as set out. Meeting these expectations is not an optional exercise, they are not guidelines, position statements or practice advice articles; they are minimum obligatory requirements for practicing physiotherapy in Alberta.

We recently held an election. There were no nominations from the largest region (Calgary). We need participation to continue to self-regulate as we have done for many years.

AwarenessA few years ago we conducted a member survey. The results were disturbing—over 50% of respondents said they’d never looked at our practice standards.

How is that possible? How can you practice your profession if you don’t know what the standards, expectations and your professional obligations are? What does that say about the profession and its commitment to patient care, safety, public interest, and self-regulation?

We encourage all physiotherapists to consider these comments and examine your role in the self-regulatory process. Do you know and meet your professional and regulatory responsibilities? Do you actively participate in the self-regulatory process and do your part to ensure physiotherapy’s privilege of self-regulation continues?

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President + Registrar’s MessageIt’s here. Physiotherapists now under Alberta’s Health Professions Act

On May 8, 2011, Alberta’s physiotherapy profession was proclaimed under the Health Professions Act (HPA). This event was a long time inthe making and the result of much work and effort from various individualsto develop new regulations and other components to enable this transition.

Nancy Littke, PTCouncil president

Dianne Millette, PTRegistrar

Finally, the day has come! Proclamation was announced by President Nancy Littke at the Annual General Meeting and the new legislation came into effect on Sunday May 8, 2011. As Nancy said at the meeting “Thanks to those who have worked so hard to make this day come to pass: staff, the many members of Council who debated difficult policy issues, physiotherapists and other stakeholders who provided input over the years and to the Alberta government for their assistance. It is an exciting time for the profession.”

The HPA consolidates Alberta’s self-regulating health professions under one umbrella act with common rules for self-governance. In addition to the HPA, each profession has a profession specific schedule and regulation. You can find the Act and physical therapists regulation online at www.qp.alberta.ca/570.cfm?frm_isbn=9780779757053&search_by=link.

How HPA will impact you If you are currently licensed you will see limited change until you renew this fall. At that time, noticeable changes for physiotherapists will be:

y Renewal year changes from January 1 - December 31 to October 1 - September 30.

y Liability insurance will be mandatory.

y Continuing competence requirements will be implemented in October 2011.

y Physiotherapists learning restricted activities (e.g., dry needling + spinal manipulation) will require supervision by physiotherapists authorized to perform the activity.

For new members applying for registration, they will be subject to the requirements of the HPA and Physical Therapist Profession Regulation as of May 9, 2011.

New standards of practice and code of ethics are approved and now in effect. They are posted on www. physiotherapyalberta.ca. Please familiarise yourself with them.

HPA impact on Physiotherapy Alberta Physiotherapy Alberta will be impacted by procedural changes—some of which are already implemented as part of our HPA preparation.

Next steps and acknowledgements In the near future, Council will discuss additional details about HPA implementation. We will ensure all physiotherapists are kept up-to-date. Watch for HPA related information and communication via e-mail and in newsletters.

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Council News Key highlights, discussions and decisions from Council’s March meeting + our AGM

Fee increaseMembers approved a membership fee increase of $96 (for active members) at the 2011 AGM on May 7. The increase will take affect October 1, 2011. The renewal fee in October will be $508.50 for physiotherapists who had an active permit as of January 1, 2011. This fee reflects both the increase and the fact members paid a 12-month fee last renewal but were granted a permit for nine months because the membership year was changed in anticipation of our HPA transition.

Conduct committee appointmentCouncil appointed Mara Shular to the Conduct Committee for a two-year term. Physiotherapy Alberta Councillors for 2011-2012Council and Physiotherapy Alberta is pleased to introduce our newest Council members elected at our 2011 Annual General Meeting:

y Tress Gibson (region 6 Capital) y Candis Whittall (region 8 Peace) y Greg Cutforth (region 7 Aspen) - was re-elected

Awards + financial support Congratulations to the following award winners who were announced at the 2011 AGM:

y Student Leadership Award - Sameera Chaudhary y TD Insurance Meloche Monnex Physiotherapist

Scholarship - Jodi Boucher y Member Presentation Fund - Alicia Olsen, Ashley

Smith, Barb Clemes

Unfortunately there were no nominations for the:

y Pinnacle Award of Distinction y Award for Excellence in Innovation

Your Practice Permit. Your responsibility.Don’t practice without one

As a professional, it’s your responsibility to ensure you’re appropriately registered to practice at all times. This means completing all the registration and renewal documents, attesting to the fact that the information included is accurate and truthful and submitting the requisite documentation to the College. These activities are not appropriate to assign to a partner, business manager or other third-party.

Consequences under HPAGoing forward, under HPA, practicing without a practice permit is an offence that carries significant fines and is punishable by Alberta’s Attorney General.

Consequences of practicing without a practice permit not only apply to the individual in question but also to any employer who knowingly employs someone not meeting registration requirements.

Check your statusChecking your practice permit status can be done quickly and easily, online 24/7/365.

Renewing members already have their log in ID and new applicants are provided one by email within a few business days of Physiotherapy Alberta receiving their application. Because our member register is updated in real time—data is processed as it’s entered so the register is always current.

There is no excuse for practicing without a practice permit. Just don’t do it!


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This column profiles some of the many member questions received by Physiotherapy Alberta’s practice advice department. Featuring examples of these questions in PT Alberta, and some related discussion, enables all members to benefit from the practice advice and information given.

Practice Advice Questions & Answers (Q&As)Helping members apply legislation, standards and policies to real-life practice

TopicThe value of good clinical record-keeping.

QuestionDoes Physiotherapy Alberta have any information to help physiotherapists understand the importance of good clinical record-keeping? What are Physiotherapy Alberta’s expectations regarding record-keeping?

AnswerAll physiotherapists know good charting practices (including specifics on assessment techniques, diagnosis and clinical impression and treatments) help you recall patient care details and communicate that information to others (health professionals, payors, lawyers). Yet despite this recognition, most physiotherapists consider clinical record-keeping one of the more onerous and least valued parts of clinical practice because it takes away from direct patient care.1

Here are just some reasons why quality clinical record-keeping is a critical component of professional practice:

y As chart review is increasingly used to evaluate a health professional’s competence, a positive association between charting and competence was found.2-4

y Physician’s charting performance was found to be related to quality indicators for competence.5

y When physiotherapist performance was assessed using various methods in the College of Physiotherapists of Ontario’s peer assessment program, it was record-keeping performance that had the strongest influence on the ‘physiotherapist’s’ final competence level rating.3

While most physiotherapists think they won’t be subject to a complaint or College proceeding, it stands to reason that over the lifetime of your career a complaint, concern or question may arise. Valid or not, complaints are always followed-up. Patient records are a key indicator of what happened during patient care and are often the starting point when examining a complaint, question or concern. In the case of legal proceedings, charts are commonly presented. Good clinical record-keeping is good patient care, good practice, a good competence indicator, and good risk management.

New standardsPhysiotherapy Alberta has developed new standards of practice, Including standards on:

y Record-Keeping and Management - outlines general expectations for record-keeping and management and record retention, disposal, storage, and security.

y Clinical, Financial + Equipment Maintenance Records - outlines the required elements for each record.

These two are the most detailed of all the new standards and clearly outline your professional obligations. Physio-therapists are expected to review the new standards and assess if their record-keeping measures up. If changes are required, work with a colleague, manager or Physiotherapy Alberta’s practice advisor to ensure compliance. A records checklist is also available to help monitor record-keeping practices.

As always, Physiotherapy Alberta’s practice advice service is here to help physiotherapists understand standards and other practice and regulatory related information.

1. Harman, K., et al., “I Think It, but Don’t Often Write It”: The Barriers to Charting in Private Practice. Physiotherapy Canada, 2009. 61(4).2. Goulet, F., et al., Performance assessment. Family physicians in Montreal meet the mark! Can Fam Physician, 2002. 48: p. 1337-44.3. Miller, P.A., M. Nayer, and K.W. Eva, Psychometric properties of a peer-assessment program to assess continuing competence in physical therapy. Phys

Ther. 90(7): p. 1026-38.4. Jennett, P. and L. Affleck, Chart Audit and Chart Stimulated Recall as Methods of Needs Assessment in Continuing Professional Health Education. The

Journal of Continuing Education in the Health Professions, 1998. 18: p. 163-171.5. Goulet, F., et al., Assessment of family physicians’ performance using patient charts: interrater reliability and concordance with chart-

stimulated recall interview. Eval Health Prof, 2007. 30(4): p. 376-92.


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Good PracticeIs this your definition of good physiotherapy practice?

This column features case studies/scenarios to raise member awareness, encourage discussion and provide advice on topics + scenarios presented. Names and dates are changed or not supplied but the actual events are true. By using these studies as an education and communication tool, Physiotherapy Alberta helps promote prudent, professional, quality practice.

Case studies presented are based on real situations. Situations that can shape and influence stakeholder perceptions of physiotherapy. Unfortunately, cases profiled here are often not isolated one off cases. It’s important to understand and remember your reputation and your profession’s is at stake in the choices you make.

Treating with no improvement and the professional perception createdA physiotherapist assessed a patient (‘Deb’) who had been treated for three months at another clinic following a car accident. When Deb’s funding ran out her doctor authorised additional visits under a primary care certificate. Deb’s primary complaints were headaches, neck pain and radiating pain into the left arm and forearm.

Examination revealed limited neck range of motion (ROM) but the neurological examination was normal except for minor bicep weakness. Deb’s lifestyle remains quite limited and she is unable to resume her regular exercise regime. Deb said her previous treatment had been largely ROM neck and theraband shoulder exercises. She said her treatment never changed. Deb said she faithfully did the prescribed exercises which became increasingly painful. Then her arm symptoms worsened and she was unable to work. Deb said the physiotherapist was frustrated with the lack of improvement but didn’t change the approach or seek another opinion.

The patient’s history concerned the new physiotherapist. While not wanting to doubt a colleague, the new physiotherapist was troubled that care continued for three months with no improvement. The concern was further increased because this patient’s situation was not unique—the new physiotherapist had come across this situation many times before.

What do you think? Is this good practice or not? How would you approach this? Are we ready to be respected as primary care practitioners, consultants, advanced practitioners? And if so, would Deb see us as such given her patient experience?

DiscussionThe profession’s essential competency profile and standards of practice expect more from physiotherapists than that described by Deb. Physiotherapists are expected to assesses, re-assess, modify treatment plans regularly and pay particular attention to evidence supporting continued care when there is little/no improvement. To administer the same treatment over and over with no improvement is not in the patient’s best interest. Some may even suggest it’s an abuse of the system.

Physiotherapists have a duty in these situations to consider:

y Brain storming with colleagues about difficult cases.

y Fostering a culture where ‘second opinions’ are simply part of standard care, free from financial and/or administrative barriers.

y Regularly re-assessing patients + adjusting treatment based on the re-assessments.

y Discharging patients who fail to progress. While difficult, it’s the ethical and professional choice and in the patient’s best interest.

What is the new physiotherapist’s obligation to deal with their colleague’s questionable practice? From Physiotherapy Alberta’s perspective this is the heart of self-regulation. Overlooking poor practice benefits no one, particularly the patient. Nor is it in the profession’s interest to build a perception/reputation of poor service, patient disregard, questionable use of health funds, and no evidence of outcomes.



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Physical Therapy Management for Partial-thickness Rotator Cuff TearsBy Judy C. Chepeha, MScPT, PhD (candidate), Assistant Professor, Department of Physical Therapy, University of Alberta

Research in FocusTo support and encourage evidence-based practice, Physiotherapy Alberta profiles current scientific research on diverse physiotherapy and health topics. Our goal is to showcase articles that will appeal to clinicians across practice areas and illustrate how the evidence applies to clinical practice.

Let us know what you think. Send your comments and/or ideas on future topics to Iain Muir, Physiotherapy Alberta Professional Practice Director, at [email protected].

Rotator cuff (RC) tears are common in young, overhead athletes and individuals 65 years and older. The condition manifests itself clinically in a variety of ways; however, most complaints include pain worsened with overhead activities,strength deficits and functional impairment. Physical therapy (PT) is the usual course of treatment consisting of rest, education, therapeutic exercise, and modalities. Surgical intervention is generally considered only after a failed course of appropriate, conservative treatment (≥ three months).

Despite PT being a mainstay of treatment, very little evidenceexists to support its effectiveness in treating patients with RC tears. An even smaller proportion of this research defines specific parameters and best delivery methods. The following is an overview of evidence related to PT management of the patient with a partial-thickness RC tear.

Non-operative treatment - RC tearsA recent review by Seida et al1 compared the benefits and harms of non-operative and operative interventions on clinically important outcomes in adults with full- and partial-thickness RC tears. Three controlled and seven uncontrolled studies were found that examined non-operative interventions. Only one controlled study2 was specific to PT; a retrospective cohort study that compared rehabilitation focused on protecting the cuff through retraining of other muscles (deltoid, pectoralis major and latissimus dorsi) with no rehabilitation. Differences in function favoring rehabilitation were statistically and clinically significant (absolute difference, 26.9 points on a 100-point scale). A second retrospective cohort study3 compared steroid injections with no steroid injections

among participants undergoing PT (treatment components not specified) and receiving oral medications. Function (absolute difference, 11 on an 83-point scale) and time to maximum range of motion (ROM) (absolute difference, four months) significantly improved in the injection, PT and oral medication group relative to the PT only group. The degree of improvement in functional outcome scores varied considerably in the uncontrolled studies and the strength of evidence was too low to make conclusions for any non-operative intervention.

Operative vs. non-operative treatment – RC tearsThe same systematic review identified five studies that compared non-operative with operative treatments for RC tears. Four of these studies included either PT (treatment components not specified), with or without the addition of steroid injections, oral medications, activity modification or manual therapy.3-6 One study examined the use of shock-wave therapy.7 All study groups showed statistically significantimprovements regardless of the intervention. All but one study5 showed statistically significant differences in function that favored operative repair. Similar to the non-operative treatment studies, the evidence was too limited to draw conclusions regarding comparative effectiveness.

Non-operative treatment – shoulder pathologyThe following section highlights research on the effectiveness of therapeutic exercise, modalities and manual therapy on shoulder pathologies in general. The degree to which generalizations about treatment effectiveness can be made across different shoulder conditions is unknown and requires further study.


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Kuhn8 reviewed the role of therapeutic exercise in treating patients with RC impingement. He identified 11 randomized controlled trials (RCTs) and despite several methodologicalconcerns, concluded that exercise has statistically and clinically significant effects on reducing pain and improving function in patients with impingement, but not on ROM or strength. Kuhn also noted considerable variability and limited detail amongst reviewed exercise programs. Dewhurst9 conducted a similar study to identify evidence-based exercises for patients with RC impingement. Seven studies (four RCTs and three systematic reviews) were analyzed and exercises that had evidence for their use in RC impingement, from either an RCT and/or systematic review were collated and presented (serratus anterior strengthening, scapular control with lateral rotation, pectoralis minor/upper trapezius stretch, posterior capsule stretch, lateral and medial rotation/abduction/flexion/extension/adduction strengthening).

Two studies have investigated the effectiveness of acupuncture in treating rotator cuff (RC) tendinopathy. Both studies included RC tear, impingement syndrome and RC tendonitis in their study groups. One RCT10 found single point acupuncture with PT treatments significantly decreased pain, improved function and resulted in less pain medication compared with traditional PT treatment alone. The second, smaller study11 used six-nine acupuncture sites and reported no beneficial effects of acupuncture compared with PT alone.

A large, blinded RCT12 revealed neither interferential orultrasound was superior to exercise alone for patients with shoulder tendinitis. A subsequent RCT13 similarly found ultrasound no better than placebo when added to a PT regimen, although the cause of shoulder pain was undefined and the ultrasound dosage and exercise regimen were not standardized.

No significant improvement was found when generalized shoulder pain was treated with low-energy laser therapy versus placebo laser.14 Ga-As low-energy laser combined with exercise was also reportedly no more effective in relieving night pain and improving function than exercise alone in patients with supraspinatus tendinitis.15 An uncontrolled RCT16 found high-intensity laser was superior to ultrasound; however, the change in two of the three outcome measures did not reach the accepted minimal clinically important difference.

Several RCTs have supported the use of manual therapy in addition to NSAIDs, exercise or both to decrease pain, improve strength and range of motion in patients with RC

impingement.17,18 Manual therapy in addition to phonophoresis and exercise was found to abolish pain and restore ROM in a small case series of patients with impingement.19

Method of PT delivery- RC tearsFour RCTs have evaluated the method of administering PT to patients following rotator cuff repair.20-23 All but one found comparable ROM, strength and functional outcomes in their respective study groups suggesting different delivery methodsof PT can be equally effective.

The studies compared:

1. Continuous passive motion to passive ROM home exercises.20

2. Standardized home exercises conveyed via videotape instructions to supervised PT sessions.21

3. Individualized, supervised PT treatments to standardized, unsupervised home exercises.22

The fourth study demonstrated that patients who received standardized physical therapy post RC repair, showed statistically significant improvement in function compared with those who received non-standardized treatment.23

Limitations & future challengesThe state of evidence related to PT management of patients with partial-thickness RC tears is limited and of low-moderate methodological quality. Reporting of specific treatment programs is inconsistent and often lacking indetail. Several studies label ‘physical therapy’ as an intervention with no description of treatment components, conjunctive therapies or delivery method. Very little research has examined the effect of PT treatments on partial-thickness RC tears specifically. Most studies combine partial- and full-thickness tears in study populations, despite evidence that large proportions of full-thickness RC tears require surgical repair. Conversely, some studies investigate a specific PT intervention (i.e., laser) but have applied it to a heterogeneous sample of patients with varying types of shoulder pathologies.

The challenge for future researchers and clinicians is to carry out well-designed clinical trials using evidence-based, standardized PT treatment programs for patients with confirmed partial-thickness rotator cuff tears.



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References

1. Seida, J.C., et al., Systematic Review: Nonoperative and Operative Treatments for Rotator Cuff Tears. Ann Intern Med, 2010. 153:p. 246-255.

2. Leroux, J.L., et al., Functional pattern of 115 rotator cuff tears. Eur J Phys Med Rehabil, 1993. (3): p. 242-247.

3. Vad, V.B., et al., Negative prognostic factors in managing massive rotator cuff tears. Clin J Sport Med, 2002. 12: p. 151-157.

4. Moosmayer, S., et al., Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: A randomized controlled study of 103 patients with one-year follow-up. J Bone Joint Surg Br, 2010. 92: p. 83-91.

5. Lunn, J.V., et al., A novel lesion of the infraspinatus characterized by musculotendinous disruption, edema and late fatty infiltration. J Shoulder Elbow Surg, 2008. 17: p. 546-553.

6. Yamada, N., et al., Comparison of conservative and op-erative treatments of massive rotator cuff tears. Tokai J Exp Clin Med, 2000. 25: p. 151-163.

7. De Carli, A., et al., Reparable rotator cuff tears: surgery vs. shock wave therapy. J Orthopaed Traumatol, 2006. 7: S51.

8. Kuhn, J.E., Exercise in the treatment of rotator cuff impingement: A systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg, 2009. 18: p. 138-160.

9. Dewhurst, A., An exploration of evidence-based exer-cises for shoulder impingement syndrome. International Musculoskeletal Medicine, 2010. 32(3): p. 111-116.

10. Vas, J., et al., Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial. Rheumatology, 2008. 47: p. 887-893.

11. Razavi, M., et al., Effects of acupuncture and placebo TENS in addition to exercise in treatment of rotator cuff tendinitis. Clin Rehabil, 2004. 18: p. 872-878.

12. van der Heijden, G., et al., No effect of bipolar interferential electrotherapy and pulsed ultrasound for soft tissue shoulder disorders: a randomized controlled trial. Ann Rheum Disord, 1999. 58: p. 530-540.

13. Ainsworth, R., et al., A prospective double blind placebo-controlled randomized trial of ultrasound in the phys-iotherapy treatment of shoulder pain. Rheumatology, 2007. 46: p. 815-820.

14. Bingol, U., et al., Low-power laser treatment for shoulder pain. Photomed Laser Surg, 2005. 23: p. 459-464.

15. Bal, A., et al., Low-level laser therapy in subacromial impingement syndrome. Photomed Laser Surgery, 2009. 27: p. 31-36.

16. Santamato, A., et al., Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of people with subacromial impingement syndrome: a randomized clinical trial. Phys Ther, 2009. 89: p. 643-652.

17. Bang, M., et al., Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther, 2000. 30: p. 126-137.

18. Senbursa, G., et al., Comparison of conservative treatment with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther, 2000. 30: p. 126-137.

19. Pribicevic, M., et al., A multimodal treatment approach for the shoulder: a 4 patient case series. Chiropr Osteopathy, 2005. 13: p. 20.

20. Lastayo, P.C., et al., Continuous passive motion after repair of the rotator cuff. A prospective outcome study. J Bone Joint Surg Am, 1998. 80: p. 1002-1011.

21. Roddey, T.S., et al., A randomized controlled trial comparing 2 instructional approaches to home exercise instruction following arthroscopic full-thickness rotator cuff repair surgery. J Orthop Sports Phys Ther, 2002. 32: p. 548-559.

22. Hayes, K., et al., A randomized clinical trial evaluating the efficacy of physiotherapy treatment after full-thickness rotator cuff repair. Aust J Physiother, 2004. 50: p. 77-83.

23. Milroy, D.R., et al., Rotator cuff repair: the effect of a standardized post-operative physical therapy protocol versus a non-standardized post-operative protocol. J Orthop Sports Phys Ther, 2008. 38: p. A17-18.

WebinarsWith our spring webinars just behind us, we’re back at work planning more additions to our fall 2011 series and planning 2012 topics. Our confirmed summer/fall 2011 lineup is:

y A guide to automobile insurance accident benefits in Alberta - Presented by Sandy Romanow, PhD, CIP, Rehabilitation Consultant, Peace Hills Insurance Company. This two-part series provides an in-depth under-standing of automobile insurance accident benefits in Alberta. Part I focuses on Section B benefits, specifically the Diagnostic and Treatment Protocols Regulation (DTPR) + Automobile Accident Insurance BenefitsRegulation (AAIBR). Part II focuses on what physiotherapists need to know about how treatment provided under Section B affects the outcome of third-party liability claims under section A and Minor Injury Regulation (MIR).

� Part 1 - June 2, 2011, 8 - 9 a.m. - Alberta Auto Insurance - Rehab-ilitation from an Insurance perspective - Section B (DTPR + AAIBR).

� Part II - June 9, 2011, 8 - 9 a.m. - How section B affects section A and MIR. What physiotherapists need to know.

y Optimizing rehabilitation using the AlterG treadmill - September 12, 2011, 8 - 9 a.m. - Bruce Stewart, PT, Fit Physiotherapy, Lethbridge.

y The effectiveness of interferential therapy in pain modulation - October 19, 2011, 8 - 9 a.m. – Jorge Fuentes, PhD Candidate, University of Alberta.

Remember if you miss a webinar date - All live webinars are recorded and are made available online within five days of the live broadcast.

Online modulesTwo online modules will be launched this fall: Ethics 101 and Infection, Prevention and Control for Physiotherapists. These will be followed by an Occupational Health and Safety module in January 2012. All modules were designed for easy online access, enabling you to complete at your own pace from any computer.

Alberta Rehab 2011We are gearing up for Alberta’s collaborative rehabilitation conference on November 4-5. Information on registration, hotels, conference program streams, and key note speakersis now available online at www.buksa.com/albertarehab.

Upcoming professional development (PD) eventsRemember to regularly check Physiotherapy Alberta’s online PD events section. As upcoming professional development activities and events become available they are posted at www.physiotherapyalberta.ca/physiotherapists.

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Physiotherapists’ responsibility It’s up to every physiotherapist to ensure that the actions of a few don’t tarnish our profession in the public’s, funder’s and government’s eyes.

y Talk to colleagues—don’t ignore poor practice/patient care.

y Offer (and take) constructive criticism both of which are criticalto maintaining and improving competence.

y Contact Physiotherapy Alberta and discuss it with the practice advisor. Or in very serious cases, register a complaint.

What do you think?Contact us at [email protected] to comment or respond to this scenario or forward a suggestion on future topics.

Good Practice...continued from page 6

Professional Development ProgramHelping members increase + enhance professional skills + knowledge


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Health Provider + PatientSleep + Dementia Resources

By 2030, over one million Canadians are expected to have some form of dementia, many of whom will also experience significant sleep disruption.

Researchers in the University of Alberta’s Department of Occupational Therapy recently completed a structured review of evidence for non-pharmacological sleepinterventions. They’ve now launched a knowledge translation website with down-loadable evidence-based sleep resources for health providers and education brochures for caregivers and patients. Find the site at (www.sleep-dementia-resources.ualberta.ca).

Physiotherapy Alberta has launched a consumer marketing campaign to promote that physiotherapy is a proven care health option that can be accessed directly. Our target market (i.e., who we are speaking to primarily) is women aged 35-55—‘Dr. Mom,’ the health decision makers and key health influencers.

Our creative platform‘The YOU Movement’ is the over arching creative platform for all our marketing material. The creative focuses on the individual and illustrates positive results. It can be general (you) or personalized (Ingrid, Dianne, Sandra) and can portray lifestyle or seasonal activities.

Our adsThe advertising campaign began March 21 and runs until early July. All ads (see examples to the right) carry our key ‘no referral needed’ message and Physiotherapy Alberta’s web address—except the online ads. They have visual ‘find out more’ link directly to our website. The print ads carry the direction (‘call to action’) to see a physiotherapist when pain or discomfort gets in the way. Ad timing, placement and rotation is designed to generate the most impact with our target audience.

You’ll see us in:

y Magazine inserts in May (Best Health, Canadian Living, Chatelaine).

y Online ads April - June (on Canadian Parents, Chatelaine, Flair, LouLou, Today’s Parent, Hello!, Good Housekeeping, RedBook, Quick & Simple websites).

y Newspapers April - June (Calgary Herald, Edmonton Journal, Fort McMurray Today, Grande Prairie Daily Herald, Lethbridge Herald, Medicine Hat News, Red Deer Advocate).

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The YOU MovementConsumer advertising and marketing campaign

Other activitiesIn addition to our ad campaign, we have also been working on:

y Member marketing materials which were launched on May 2 to help celebrate National Physiotherapy Month. These professionally designed materials are available to members at no cost. They include:

– Downloadable, customizable marketing and condition sheets.

– Professionally printed brochure and poster.

– Promotional You Move Me DVD that promotes physiotherapists as movement specialists for multiple conditions in various practice settings.

Use these materials now and year round to communicate and promote physiotherapy as an important consumer health care option. Visit www.physiotherapyalberta.ca/physiotherapists for more information or to download the customizable material. To order the printed brochures and posters, or a DVD, email us at [email protected].

y Public and media relations plans are being developed and a list of spokespeople is being created.

Visit www.physiotherapyalberta.ca

to find a physiotherapist near you.

Licensed physiotherapists are experts on how

your body moves and what stops it from moving.

As movement specialists, physiotherapists use a

hands-on approach to help you restore, maximize and

maintain your movement for the rest of your life.

Get moving. Keep moving.

Proud to support the

YOU movement.

Get Moving. Keep Moving.

The Movement Specialists.


www.physiotherapyalberta.ca

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Working togetherto build and promote the profession + its brand

Marketing success happens when marketing, advertising and branding components come together to create a consistent and complete package. Advertising can paint an appealing picture. But if the product/service‘being sold’ isn’t re-enforced or doesn’t live up to the campaign’s promise or consumer’s basic expectations, your marketing becomes ineffective. Your brand image and reputation suffers and consumers can develop negative perceptions about you and your product/service. Perceptions are very important. They are people’s realityand they directly influence purchasing decisions and referrals. Negative perceptions once formed are hard, sometimes impossible to reverse.

Marketing happens everywhereMarketing and brand promotion is more than advertising.They occur at/with each and every contact (or touch point) someone has with you, your practice setting, your staff/co-workers, your profession, etc. To build a strong, successful brand all touch points must support, re-enforce and live up to patient expectations. If not, patients, potential patients, potential referrers, and others become dissatisfied and disinterested.

Physiotherapy Alberta’s role Our role is to establish an over arching brand and platform for physiotherapy and implement a mass market level campaign to promote Alberta physiotherapists and educate Albertans that:

y Physiotherapists are trained to treat many health conditions/issues.

y Physiotherapists are the provider of choice for movement issues (The Movement Specialists).

y Physiotherapy is an accessible consumer/patient driven health option.

y No referral is required.

Our role also includes seeking out various opportunities to reach and educate our target audience en masse (e.g., magazine articles, strategic sponsorships) and support Alberta physiotherapists in their practice and marketing

efforts (e.g., advice, tools and resources like the member marketing tools recently launched).

Now it’s up to youDespite mass media and advertising, the most credible, memorable, meaningful ‘marketing and branding’ occurs during the patient’s experience (appointment booking, treatment, waiting room, billing, follow-up, etc). Because physiotherapists embody physiotherapy,

you are the face of physiotherapy. You are the brand. You are where the ‘rubber hits the

road.’ It’s your actions that form, reinforce and impact the profession’s brand. As such, you are best positioned to:

y Present, re-enforce + promote your profession to patients, the public, physicians, other health providers, insurers, and others.

y Increase physiotherapy’s visibility in your respective community and workplace.

y Ensure Albertans receive the best care possible in your practice setting. Ensure their experience meets their expectations. Ask patients about their experience and how you can better meet their needs.

Your challenge

y Reflect on how you represent and promote yourself and your profession.

y Identify your touch points. Ensure each reflects you/your profession in a professional, credible and clear manner (e.g., does the audience get the information + service they need/want at each point).

y Be familiar with The YOU Movement campaign. Let Physiotherapy Alberta know if a patient mentions the campaign (e.g., seeing an ad).

y Use the member marketing material.

y Identify how you can be the brand. How you can support, incorporate, promote the campaign in your practice and community.

y Let us know what you do and what works for you so we can share with other members.

Your brand is only as good as

your customer’s last experience. ”

”


Member spotlightPutting YOU, the physiotherapist in ‘The YOU Movement’

Physiotherapists are their own best and most credible marketing tool because they are the face of physiotherapy. Each physiotherapist is critical to the profession’s collective promotion, image and reputation. Whenever you interface withothers (patients, public, other health professions, insurers) it’s a prime opportunity to represent, market and promote your profession, its value and benefits. Perceptions created during these ‘touch points’ reflect on both you and the profession.

So what are your touch points? Think about all the opportunities—meeting other health professionals, booking patient appointments, ensuring your waiting room is welcoming and informative, or communicating with an insurer. To help highlight the importance of touch points to physiotherapy marketing and promotion, we’ve decided to profile two members, one from public practice and one from private practice. While the setting may differ, the importance and principles of representing, promoting and communicating physiotherapy’s value and expertise doesn’t.

Member profile #1- Private practice settingSiobhan Duggan, PT, The Downtown Sports Clinics (Bow Valley Square), Calgary

Questions

1. What are some of your brand touch points? There are many including:

y Satisfied patients + word of mouth referrals.

y Crossing paths/speaking with current, potential + past patients in various situations including social situations like restaurants, fund raising events, at my fitness club, etc.

y Exhibiting at corporate health fairs + sporting events.

y Keeping our website current.

y Verbal + written communications with other health professionals (physicians, fitness trainers, dietitians).

y Attending education events and building relationships with other health professionals.

2. How do you use these touch points to educate patients, potential patients, other health professions, etc?I take great pride in my profession and always introduce myself as a physiotherapist not a ‘physio.’ Knowing I am a primary care provider and being confident in my skills and knowledge paves the way for me to invite questions and give advice on musculoskeletal issues in any environment.

y I always carry business cards and respond quickly when contacted by potential new patients or other health professionals.

y My name tag identifies me + my work place. I wear it at work and whenever/wherever I represent the clinic.

y I personally follow-up with patients after discharge to check on their status + allow time for questions.

y I encourage further contact with me if needed and encourage their return if they experience other problems.

3. What do you consider to be your most important marketing tool/brand touch point? Why?Staying current with new information and research, self-confidence and an ability to give clear explanations are my keys to fostering patient trust. My delivery has always been quality versus quantity. I am totally patient-focused from personally greeting them right through the assessment, treatment, education, and exercise program.

4. While all touch points are important, how critical is the ‘patient experience’ to patient perception of your clinic, yourself and other physiotherapists.It’s of the utmost importance, especially the first appointment as it leaves the greatest impression. Our clinic promotes excellent customer service delivery among all our staff, to help ensure positive patient experience and satisfaction, and hopefully a return for further treatment when needed. A satisfied patient speaks well of their whole experience. Our number one referral source is word of mouth and it is a statistic we are very proud of.

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Member profile #2 - Public practice settingKaren Hurtubise, PT, Alberta Children’s Hospital, Calgary

Questions

1. What are some of your brand touch points? Every moment, everyday is a potential touch point— walking through hospital halls, scheduling appointments,

seeing patients, interacting with colleagues in an inter-professional clinic, sending a letter/report to a referral source, volunteering at an event. All are opportunities to make an impression about physiotherapists (PTs) and physiotherapy.

2. How do you use these touch points to educate patients, potential patients, other health professions, etc?I use them as building blocks—to educate. First I build rapport and establish a relationship. Then exchange knowledge and communicate my role as a PT, our training and knowledge base. For example:

• When calling parents to schedule an appointment, I explain who referred them and describe myself and specialty area. I ask about their concerns and changes they’ve observed since their referral. Then explain what the physiotherapy assessment will involve.

• While performing an assessment, I explain what I’m doing and why. Then share my findings with the patient relating it back to their concerns and what I can do for them.

• Working with children, I’ve learned that showing genuine interest in them and engaging them really impacts the trust and rapport with the parents.

• I’ve also found that honest and straight forward responses, even to tough questions, and respecting follow-up time lines really helps the patient/provider relationship and the impression patients and others have of our profession.

I’m always looking for knowledge exchange opportunities.Answering or translating medical language for patients/parents, presenting observations on a case I’ve been askedto consult on, seeking advice/expertise from other professions, sharing/reviewing an article and applying it to a case with my team, or sharing tips on running injury prevention with my running group. All are opportunities to

share my knowledge base with others. In so doing, I help highlight the significant and vast expertise PTs have and help create further understanding of our role and our profession’s image and credibility.

3. What do you consider to be your most important marketing tool/brand touch point? Why?The first impression! Followed closely by non-verbal communication. As health providers most of our daily work relies on communication—and 93% of communication is non-verbal. Studies show that in face-to-face encounters body language (appearance, body position and movement, facial expression and eyecontact) plays a key role in creating first impressions. So I think the visual we present (what we wear, facial expression), how we carry ourselves (e.g. posture, movement), and the interest we show in people is a crucial marketing opportunity/tool; that same interest in the individual can also come across on the phone via tone of voice and appropriate pauses. Email and written communication are more challenging so I tend to resort to a more formal approach.

4. While all touch points are important, how critical is the ‘patient experience’ to patient perception of your clinic, yourself and other physiotherapists.As seen in my previous answers, I’m a strong believer the ‘office’ experience is vital and a distinctive opportunity to:

y Create rapport + foster patient-therapist relationships.

y Showcase our broad skills base and extensive and specialized knowledge.

y Mitigate, if required, factors that influence the patient experience.

As a public sector health professional I see and treat the ‘in office/patient experience’ as a make or break situation. This first impression establishes the patient’s perspective and opinion about me (as a physiotherapist and health provider) and my profession. In these times of fiscal restraint and political turmoil, it is critical to create supporters and advocates for our profession. Every patient, parent, family member, other health provider, and hospital administrator I interact with is an opportunity to promote physiotherapy and its many contributions, role and value.

15PT Alberta - Spring 2011 | www.physiotherapyalberta.ca

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Runners' rehab makes strides3-D analysis of athletes' gait puts physios a step ahead

Physiotherapists at the University of Alberta unveiled a new running ma-chine Monday that will provide high-quality 3-D images to Edmonton runners for the first time. The new gait analysis machine was installed at the Glen Sather Sports Medical Clinic last week and tested for the first time Monday morning. It creates a precise video of a runner’s gait from three angles, and measures exactly how much and how fast a runner’s ankles and knees twist and bend.“It’s millimetre accuracy,” said Reed Ferber, a researcher from the University of Calgary’s Running Injury Clinic, who developed the machine and helped install and test it here. “We could do one patient in an hour, optimally,” said Blair Shular, a physical therapist at the U of A. Machines similar to this have been available in biomechanical research labs for at least 15 years, and are used at the Glenrose Rehabilitation Hospital. But this is the first time any runner can phone up the clinic and get access to such a precise diagnosis. Most lab versions cost about $180,000, said Ferber. But the system he developed costs only $20,000. A session at the Sather clinic will cost a runner about $200 but should be covered under most medical plans, Ferber said.Alexa Hassen, the first person to use the machine, hurt her ankle five years ago playing fastball. The ankle seemed to heal, but it has bothered her ever since and sometimes gets so sore she needs to stop running and massage it. Hassen assumed she needed to strengthen muscles in her ankle, but when she climbed onto the treadmill Monday, Ferber’s report showed that her ankle worked just fine. It was her knee that collapsed inward too quickly. That means instead of working on her ankle, she needs to strengthen her hamstrings and the muscles in her butt.“That’s a typical patient for us,” said Ferber. “They’re just frustrated. A

lot of times it’s complicated and there’s a lot of factors involved.” Who would have thought about strengthening the hamstring to treat a sore ankle? But that’s the weak link in her chain, Ferber said. He previously installed machines in five private clinics, and has partnerships with researchers using his machines in Brazil, New Zealand and at Montreal’s McGill University. Each time one of those machines is used, it gener-ates information for the physiotherapist and sends a copy of the data

automatically to Ferber’s lab in Calgary. That gives him and his research partners reams of data on many specific knee or other problems, far more data than each could collect on their own.News of the new machine is starting to spread through Edmonton. Brian Roppelt said “it sounds like something I’d be very interested in, but at that price point, it might be out of my reach.” The Grade 6 teacher at Patricia Heights School runs six times a week. He’s had a coach use slow-motion video to analyze his stride before, and that helped. The coach recommend-ed inserts for his shoes to help a painful Achilles tendon. But the video only captures problems that can be seen with the naked eye, he said. This would be more detailed.

He would be interested in preventive training, he said, picking up a new pair of track spikes at the Running Room. “Absolutely. I’d rather deal with it before it becomes a problem. Otherwise you just end up wasting time.” Hassen said she thinks runners in Edmonton might be skeptical, but the chance to know what’s really causing a chronic injury is tantalizing.“There are a lot of frustrated runners out there who have chronic injury or

pain,” said Hassen, 24, who is also a kinesiologist at the clinic. “I don’t know how much confidence they would have coming in (to get treatment), but I’m sure they would be absolutely blown away coming out of it getting that kind of knowledge.”

Alexa Hassen uses the 3-D gait analysis system Monday at the Running Injury Clinic in the University of Alberta Glen

Sather Sports Medical Clinic

Media SightingsPhysiotherapy + physiotherapists In the media

y Pelvic pain. What is it and how to get help – advertorial in a special women’s health supplement in IMPACT magazine’s May/June issue. The topic

profiles a common issue for IMPACT’s readers (35-44 year old female - our consumer target). It communicates that pelvic pain is common and can profoundly affect a woman’s life. But because the issue isn’t well known or widely talked about it can create fear in those who experience it. Physiotherapy Alberta wanted to raise awareness of the

issue and let readers know that physiotherapists trained in pelvic health can help. The advertorial was developed in collaboration with Mary Wood (an Edmonton physiotherapist who’s practice focuses on pelvic health).

y Gain insights from your pain - Edmonton Journal highlighted ‘what you don’t know about exercise can hurt you.’ Featured on the front page of the Arts + Life section, the article profiled physiotherapist Kelly Spence. Kelly explained many of his patients have been injured while exercising—often because they exercised the wrong way or at a higher intensity, frequency or duration than their bodies could handle. He advises people not to wait if they get injured because it could worsen if not addressed right away—that the longer it’s left the harder it is to resolve. Kelly also highlighted that physiotherapists develop individual injury prevention exercise programs/approaches.

y Finalists aching to ease their soreness - article accompanied the Edmonton Journal’s Gain Insights article. Piece promotes a 12-week health challenge contest sponsored by The Journal and Edmonton YMCA. Edmonton physiotherapist Kelly Spence is again profiled. He’s been working with the challenge’s three finalists, helping with muscle soreness and previous unresolved injuries that are affecting their workout progress. He also talks

about teaching the finalists muscle strengthening and stretching so they can continue and hopefully win the challenge.

y University of Alberta creates first Canadian research chair dedicated to the rehabilitation of injured soldiers and veterans - the Edmonton Journal announced the University’s Canadian Military and Veteran’s Chair of Clinical Rehabilitation. The research chair is expected to make important developments in the care provided to Canadian soldiers who have suffered combat-related injuries. The chair will provide academic leadership to drive innovations and make new discoveries that will change and improve clinical practices and the health of Canadian Forces personnel and veterans. The new chair is expected to work closely with provincial healthcare facilities, and the new Canadian Institute for Military and Veteran Health Research Network and the U.S. Department of Veterans Affairs.

y 3D gait analysis puts physiotherapists a step ahead - the Edmonton Journal article pro-filed a new gait analysis machine at the Glen Sather Clinic and the health professionals using the equipment, like physiotherapist Blair Shular. The article details how runners can benefit from the new tool by seeing a precise, high-quality 3-D image/video that pinpoints/measures their gait in millimetre accuracy. The machine can also asses how much and how fast their ankles and knees twist and bend. Similar machines have been available in Edmonton before (in biomechanical research labs and the Glenrose Rehabilitation Hospital), but this is the first time Edmonton runners can get such a precise diagnosis at the Glen Sather Clinic.

Tell us if you spot physiotherapy in the media If you see or participate in physiotherapy-related mediastories, articles or appearances, tell us and we will shareit here. Reach us at [email protected].

Recent sightings

Pelvic Pain

ALBERTA PHYSIOTHERAPISTS

Physiotherapists are regulated health care providers who assess, diagnosis and treat health conditions caused by

injury, aging, disability, or medical issues. With an advanced understanding of how the body moves physiotherapists

help patients restore, maximize and maintain optimal physical function, mobility and quality of life.

www.physiotherapyalberta.ca

Pelvic Pain can be a silent enemy for many

women. It can strike as a mild

intermittent ache or steady and severe pain that profoundly affects

your life, your ability to work, move, sit, sleep, care for your family, do

everyday activities, and enjoy life. Pelvic pain can also affect bladder,

bowel and sexual function. But with help from a physiotherapist

trained in pelvic health, there is relief available. Pelvic pain has

many causes. All of which can lead to mechanical joint and muscle

problems caused by a change in the normal movement or alignment

in the pelvic girdle. For many women, pain and function problems can

continue long after the initial cause is resolved.

Do you have Pelvic Pain?

If you feel pain in the front/back of your pelvis or buttocks when

walking, climbing stairs, sitting, moving in bed, or standing on one leg

(e.g. when dressing) consult a physiotherapist or doctor. Often, women

are told the pain is low back pain, sciatica, hormone related, or a

trapped/irritated nerve.

common tyPes of Pelvic Pain for Women ageD 18-40

Pelvic girdle pain during pregnancy – often starts in the second

trimester and can continue postpartum. It affects up to 50% of all

expectant mothers and occurs when the pelvis loses stability and

alignment. Often the pelvic floor responds by becoming overactive

to try and restore stability which can then lead to pelvic floor

muscle dysfunction.

Dyspareunia (pelvic pain during/after intercourse) — is an under

reported symptom, affecting up to 20% of women, that has many

root causes including dermatological, hormonal, pelvic floor muscle

dysfunction, and birth trauma.

helP is available

Pelvic pain is treatable, even during pregnancy. Physiotherapists

trained in pelvic health will fully assess your situation and function.

While specific treatment depends on the diagnosis and symptoms, it

usually involves a complete posture and muscle assessment followed

by manual therapy and techniques to relieve your symptoms and

improve function. Some pelvic pain conditions, like dyspareunia,

will require collaboration between you, your physiotherapist and

your doctor.

finD a PhysiotheraPist

To find a physiotherapist who treats pelvic pain visit

www.physiotherapyalberta.ca and under practice area select

women’s health, urological/gynecological, perineal

or postnatal. For more information and resources visit

www.pelvicpain.org and www.nva.org.

Mary Wood, PT, physiotherapist and clinic director of CURA Physical

Therapies in Edmonton, has been treating pelvic health issues for 17

years and helping women take back control of their bodies and lives.

What it is and how to get help

WoMen’s HealTH & sPorT

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Finding Balance is a public health campaign that educates Alberta seniors on the importance of preventing falls. The campaign’s three key messages are:

1. Watch your step

2. Keep active – exercise for strength and balance

3. Check you medications

Everyday physiotherapists treat seniors with fall related injuries and see the consequences of these falls on the individuals and their families. The importance of preventing falls from happening in the first place, prompted Physiotherapy Alberta to sponsor the Finding Balance 2010 Campaign. As an added bonus, our brand and ‘The Movement Specialists’ tagline was broadly communicated through:

y Physiotherapy Alberta logo on promotional materials, Finding Balance website and all TV + print media materials.

y A ‘Talk to Your Physiotherapist’ message on 20,000 campaign flyers.

2010 campaign resultsLast year’s campaign was the most successful to date. Highlights include:

y 669,700 flyers/posters were distributed to Alberta pharmacies, libraries, hospitals, and seniors facilities.

y 552 TV ads on Global TV (Calgary + Edmonton). y Print ads in 36 different weekly newspapers, total

circulation of 550,350.

y 73% increase in traffic to Finding Balance website.

y 17 print media stories—5 featuring physiotherapists!

y Campaign messaging translated into 12 different languages.

Talk to your physiotherapist

Wherever you are

Watch Your Step!

Finding Balance 2010Campaign analysis + results

Global Edmonton also ran a segment with a physiotherapist talking about falls prevention on its morning news show.

Still more work requiredDespite the campaign, there’s still much work to be done. While there is high awareness of falls, 61% of Alberta seniors say they want to learn more about preventing falls and only 37% believe other Alberta seniors know enough about it.

In terms of key prevention tips and messages, 39% of seniors suggested watching your step, 16% suggested exercising, 13% suggested being careful in the house, and 10% suggested using mobility aids. Clearly there’s an opportunity for physiotherapists to provide seniors and their families with the education needed and desired.

How YOU can help prevent falls

y Champion falls prevention. Make falls prevention materials available in your clinic or facility.

y Visit the Finding Balance website at www.finding-balancealberta.ca. The site provides great educational materials and practitioner resources.

y Encourage families to talk to their parents, grandparents and other senior family members about falls. Safety Superheroes has resourcesdesigned to get children to talk to their grandparents visit www.safetysuperheroes.com.

y Conduct a talk at a local senior’s centre, social club or recreation centre.

y Promote exercise classes that focus on balance, strength and mobility.

y Host a local event for the 2011 Finding Balance Campaign (November 1-30, 2011).


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Physiotherapy Alberta Email Communications

Physiotherapy Alberta often communicates important and time sensitive information electronically. To ensure you receive email notices from Physiotherapy Alberta make sure you add [email protected] to your address book and/or safe senderslist. Doing so will help keep you in the loop and prevent important updates being filtered to your junk mail folder.

If you have trouble receiving Physiotherapy Alberta email messages at work, consider changing your work email in your member profile to your home email.

Research StudyClinical Decision Making of Physical Therapy Graduates. Physiotherapists Required

By Patricia (Trish) Manns, PT, PhD

Researchers at the University of Alberta are looking for 35 physiotherapists who graduated between 1996-2000 or 2004 - 2007 to participate in a research study considering how physiotherapists make clinical decisions, what resources they use and how clinical experience influences clinical decision making.

For more information or to volunteer contact Dr. Trish Manns at [email protected] or 780.492.7274.

Meet Dr. Linda Woodhouse the new Dr. David Magee Endowed Chair in Musculoskeletal ResearchBy Laurie Wang

A leading research clinician, originally from Montreal who cheers for—brace yourself—the Toronto Maple Leafs. Meet Dr. Linda Woodhouse, the new Dr. David Magee Endowed Chair in Musculoskeletal Research. Last summer, the Faculty of Rehabilitation Medicine announced its first endowed research chair named for one of the world’s foremost physical therapists Dr. David Magee, an internationally recognized physical therapist, author, associate dean and professor at the Faculty. The Endowed Chair will have a direct impact on patients because of its focus on maximizing physical therapy care by finding improved methods of clinical assessment for arthritis, injury prevention and sports injury and low-back pain treatment. Dr. Linda Woodhouse, who will join the faculty on June 1, is a leading research-clinician from the School of Rehabilitation Medicine at McMaster University, the Departments of Orthopaedics and Rehabilitation at Hamilton Health Sciences, and the Department of Surgery at Sunnybrook and Women’s Health Sciences Centre.

Dr. Woodhouse has made significant contributions to the development and evaluation of inter-professional models of care for patients accessing hip and knee surgery. She has also developed innovative clinical programs for patients with osteoarthritis, osteoporosis and cancer survivors who receive conservative treatments in the community.

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More Funding for MScPT Program Satellites The current University of Alberta (U of A) Augustana MScPT pilot in Camrose has been well received. So well that the government has provided additional funding for at least three more sub-cohorts in Camrose and two sub-cohorts at a new Calgary MScPT satellite. The additional students will increase the total MScPT cohort size to approximately 100 students by fall 2012.

The U of A Faculty of Rehab Medicine is working closely with the University of Calgary to secure classroom and lab space and to ensure the U of A MScPT students in Calgary will have access to adjunct student services (library, campus facilities, etc). However, all MScPT students irrespective of their location of study will be enrolled in the U of A MScPT program. Local (Camrose and Calgary) staff to coordinate the satellite operations, assist with teaching and optimize clinical placements will be hired in the next few months. Watch the PT Department website for position postings!

A full evaluation of the pilot project has begun. Many educators, not just in physical therapy, are keen to see how the technology used in the MScPT program can change the traditional classroom.

Multiple Mini Interviews: A Positive Addition to the MScPT Admissions ProcessOn Saturday April 30, 164 MScPT applicants were interviewed using the Multiple Mini Interview (MMI) format. Similar to an objective structured clinical exam (OSCE) or practical exam each individual applicant met with seven separate interviewers, one after the other and answered a different question at each station.

Developed at McMaster University, the MMI is designed to evaluate important variables not clearly expressed by an applicant’s grade point average alone, for example interpersonal skills, integrity and/or professionalism. MMI questions typically pose a predicament, present an ethical situation or inquire as to an applicant’sknowledge of a health related topic. Applicants are encouraged to ‘think aloud’ and discuss how they would react in the posed situation.

Feedback from both applicants and interviewers was overwhelming positive about the process. Applicants appreciated the opportunity to present their suitability for the profession and interviewers found the process to be valuable in assessing applicant communication skills.


Canadian publications mail#40063092

Return undeliverable Canadian addresses to:

Physiotherapy Alberta 300, 10357 - 109 Street Edmonton, AB T5J 1N3

Please read carefully This supplement to the PT Alberta Newsletter is dedicated to Health Professions Act (HPA) changes that most significantly impact member’s registration, renewal, competence requirements, and reporting.

Membership year The membership year is now October 1 to September 30. Practice permits (i.e., licenses) must be renewed before October 1, 2011 for the period October 1, 2011 to September 30, 2012. Online renewal will be available the beginning of August. You will receive an email notice from Physiotherapy Alberta when the system is ready for you to renew online.

Liability insurance If you are a regulated member on the general1 or provisional2 register, you must hold individual professional liability insurance in the amount of $5 million per occurrence/patient and a $5 million minimum for the policy year. Coverage must extend to all activities related to your practice of physiotherapy, e.g., clinical practice, teaching physiotherapy, volunteering at a sporting event.

When renewing your practice permit, you must provide the insurance provider’s name and policy number.

Practice permit fee The 2012 practice permit fee for the period October 1, 2011 to September 30, 2012 is $646.00.

However, fees to be paid for the 2012 renewal year will vary depending upon the legislation in place when you paid your last fee.

If you are currently registered and hold an active license under the Physical Therapy Profession Act and wish to renew your practice permit for 2012, the fee is $508.50. This fee takes into consideration fees already paid for the 2011 renewal year.

If you are currently registered and hold an active license under the Physical Therapy Profession Act and plan to retire between October 1, 2011 and December 31, 2011 you may renew your practice permit until December 31, 2011 without additional fees. This fee takes into consideration fees already paid for the 2011 renewal year.

If you are currently registered under the Health Professions Act (anyone who registered after May 8, 2011) and wish to renew your practice permit for 2012, the fee is $646.00. This takes into account that fees paid to date only cover the period to September 30, 2011.

Penalty for late renewal Renewals submitted after September 15 will be charged a $100.00 penalty for late renewal.

Inactive registration category Under the HPA, the inactive category is discontinued. If you currently have an inactive license under the Physical Therapy Profession Act, you have three options:

1. Renew your practice permit as a regulated member on the general register if you meet the current registration requirements.

1 General register – formerly active license 2 Provisional register – formerly temporary license as a Registered Practitioner

2. Cancel your registration. Prior to returning to practice in Alberta, you may apply for reinstatement of registration and must meet the registration requirements at that time.

3. Apply for registration on the non-regulated alumni3 register. Prior to returning to practice in Alberta, you may apply for reinstatement of registration as a regulated member and must meet the registration requirements at that time.

Practice hours The practice hour requirement remains 1200 hours of physiotherapy practice during the preceding five years; however, the reporting period changes to October 1 – September 30 to align with the membership year. For this transitional year only, members will report practice hours for nine months only (January 1 to September 30). The hours required are pro-rated to 900 hours.

Restricted activities Members on the general register learning to use dry needles or perform spinal manipulation may do so only with the consent of and under the supervision of a physiotherapist who is authorized to perform the activity. The supervising physiotherapist must be on site or present when the activity is being performed and able to observe, promptly intervene to stop or change the actions of the supervised practitioner if required.

Continuing competence program Participation in the continuing competence program is mandatory for members on the general register. Two components of the program will be phased in as follows:

1. Jurisprudence module: an evaluation of your understanding and application of legislation, practice standards and the code of ethics. ● All members on the general register (with the exception of volunteers from the pilot) must

complete the online jurisprudence module between November 1, 2011 and April 30, 2012 ● Members will receive their official notice in October along with instructions for access,

completion and timelines ● A user guide, frequently asked questions document and sample questions are available now on

Physiotherapy Alberta’s website in the physiotherapists section/continuing competence

2. Competence portfolio: competence development including self-assessment and reflection leading to identifying and implementing a learning plan. ● All members on the general register must complete their self-assessment between April 2012

and 2012 renewal ● Members will receive their official notice in March 2012 along with instructions, forms and

timelines

Reporting changes to information The HPA requires regulated members to report changes to the following information within 30 days of a change occurring:

● full legal name ● home and business mailing addresses ● employer information (e.g., name, location where services are delivered) ● employment status, areas of practice and job title or position description ● restricted activities performed ● degrees and other qualifications ● registration with another college that provides health services

Login to your online account through Physiotherapy Alberta’s website to report changes as they occur throughout the year.

3 Alumni register – formerly retired member category

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