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Grace Walker, DPT, OTD

Walker Physical Therapy1111 W. Town & Country Rd., Ste. 1

Orange, CA(714) 997-5518

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Philosophy of Patient Philosophy of Patient CareCare

Full Spectrum of Care

Pain Relief Function Prevention

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Pain ReliefPain Relief

ModalitiesModalitiesHeat PacksHeat PacksIce PacksIce PacksInterferential Therapy (1-120 Hz)Interferential Therapy (1-120 Hz)UltrasoundUltrasoundLaserLaserTractionTraction

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Why do we give patients Why do we give patients modalities?modalities?

Evidence shows that heat increases Evidence shows that heat increases the extensibility of muscles. Recent the extensibility of muscles. Recent evidence shows that ultrasound may evidence shows that ultrasound may have an effect on tendon healing. have an effect on tendon healing. Interferential has been shown to Interferential has been shown to effectively decrease pain.effectively decrease pain.

Reason #1

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Why do we give patients Why do we give patients modalities?modalities?

Experience shows us that when we Experience shows us that when we address the pain component we get address the pain component we get better cooperation from patients better cooperation from patients when it comes to exercise.when it comes to exercise.

Reason #2

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Why do we give patients Why do we give patients modalities?modalities?

Modalities relieve treatment Modalities relieve treatment soreness resulting from hands soreness resulting from hands on work and new exercises.on work and new exercises.

Reason #3

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Why do we give patients Why do we give patients modalities?modalities?

Patients like it and want it! Our Patients like it and want it! Our referring doctors expect modalities referring doctors expect modalities to be given to their patients.to be given to their patients.

Reason #4

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FunctionFunction

Hands on workHands on work BreathingBreathing FlexibilityFlexibility StrengthStrength Functional ActivitiesFunctional Activities BiofeedbackBiofeedback

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Hands-On WorkHands-On Work Maitland and Norwegian techniques Maitland and Norwegian techniques

including joint mobilization and soft including joint mobilization and soft tissue techniques.tissue techniques.

PNFPNF

Body cueing to turn on Body cueing to turn on selected musclesselected muscles

Cranial TechniquesCranial Techniques

Neural MobilizationNeural Mobilization

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Why do we give patients Why do we give patients hands-on work?hands-on work?

Reason #1Reason #1

Evidence shows that hands on work Evidence shows that hands on work increases joint mobility while decreasing increases joint mobility while decreasing pain.pain.

Reason #2Reason #2

Certain muscle groups that are weak will Certain muscle groups that are weak will turn on with hands-on techniques.turn on with hands-on techniques.

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Reason #3Reason #3

Hands-on techniques have been shown to Hands-on techniques have been shown to improve biomechanical functional improve biomechanical functional patterns.patterns.

Reason #4Reason #4

As patients correct their posture and learn As patients correct their posture and learn new exercises they will develop new joint new exercises they will develop new joint and muscle lesions that can be relieved and muscle lesions that can be relieved with manual therapy.with manual therapy.

Why do we give patients Why do we give patients hands-on work?hands-on work?

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BreathingBreathing

Diaphragmatic BreathingDiaphragmatic Breathing Complete usage of all lobes of the Complete usage of all lobes of the

lungslungs Coordinated breathing with walkingCoordinated breathing with walking Breathing to control stressBreathing to control stress

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Why Breathing Why Breathing Techniques?Techniques?

Reason #2Reason #2

We have numerous references We have numerous references providing evidence on lung function providing evidence on lung function and breathing.and breathing.

Reason #1Reason #1

Correct breathing techniques result Correct breathing techniques result in decreased pain with increased in decreased pain with increased efficiency, body endurance and efficiency, body endurance and circulation.circulation.

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FlexibilityFlexibility

Poor posture habits lead to the Poor posture habits lead to the shortening of certain muscles shortening of certain muscles that need to be stretched out in that need to be stretched out in order to gain full function.order to gain full function.

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StrengthStrength

Weak muscles are present in most Weak muscles are present in most musculoskeletal disorders. A musculoskeletal disorders. A thorough physical therapy program thorough physical therapy program will address these weak muscles.will address these weak muscles.

It may take up to 6 months to It may take up to 6 months to effectively strengthen scapular and effectively strengthen scapular and back muscles.back muscles.

We include concentric and eccentric We include concentric and eccentric exercise, endurance and plyometrics.exercise, endurance and plyometrics.

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Functional ActivitiesFunctional Activities

Gary Gray identifies muscles and Gary Gray identifies muscles and joints that work together, in three joints that work together, in three planes of movement, promoting planes of movement, promoting function.function.

Functional techniques are an Functional techniques are an important part of our physical important part of our physical therapy programs.therapy programs.

Core strengthening and functional Core strengthening and functional spinal stabilization.spinal stabilization.

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BiofeedbackBiofeedback

Muscle relaxationMuscle relaxation

Muscle re-educationMuscle re-education

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PreventionPrevention

Aerobic ExerciseAerobic Exercise PosturePosture Lifestyle NeedsLifestyle Needs Education/ErgonomicsEducation/Ergonomics RelaxationRelaxation Massage TherapyMassage Therapy

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Aerobic ExerciseAerobic Exercise

A person who exercises feels better. A person who exercises feels better. Exercise increases endorphin Exercise increases endorphin production which helps control pain.production which helps control pain.

Walker PT has a walking program Walker PT has a walking program that is effective with the majority of that is effective with the majority of our patients.our patients.

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PosturePosture

Posture is addressed from day one. Posture is addressed from day one. For many of our patients it has taken For many of our patients it has taken

years to develop poor postural years to develop poor postural patterns. This is associated with patterns. This is associated with weak muscles and lack of flexibility.weak muscles and lack of flexibility.

Education is provided along with Education is provided along with postural training and includes our postural training and includes our back and neck care videos.back and neck care videos.

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Lifestyle NeedsLifestyle Needs We address our patients activities We address our patients activities

over a 24 hour period to assess over a 24 hour period to assess ability to function.ability to function.

Recreational activities and Recreational activities and ergonomics in the work place and at ergonomics in the work place and at home are addressed.home are addressed.

We assess the patient’s limitations We assess the patient’s limitations and develop personal goals for their and develop personal goals for their physical therapy. physical therapy.

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Lifestyle Needs (Cont.)Lifestyle Needs (Cont.) Return to sports and activities Return to sports and activities

previously enjoyedpreviously enjoyed Sports enhancement (eg: golf, Sports enhancement (eg: golf,

skiing, volleyball, tennis and skiing, volleyball, tennis and basketball.)basketball.)

Family activities (e.g. bicycling, Family activities (e.g. bicycling, hiking)hiking)

Hobbies (e.g. scrapbooking, Hobbies (e.g. scrapbooking, quilt making, computer games)quilt making, computer games)

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RelaxationRelaxation

Chronic pain typically has a stress Chronic pain typically has a stress component. We find that our therapy component. We find that our therapy is more effective when patients is more effective when patients regularly use a relaxation tape. regularly use a relaxation tape.

Peter Edgelow and Janet Hulme both Peter Edgelow and Janet Hulme both have DVD’s that are effective with our have DVD’s that are effective with our patients.patients.

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Frequency of TreatmentFrequency of Treatment

Most patients benefit from P.T. 3 Most patients benefit from P.T. 3 times a week for 4 weekstimes a week for 4 weeks

Provides continuity of treatmentProvides continuity of treatment Effects of manual therapyEffects of manual therapy Correction/Instruction of exerciseCorrection/Instruction of exercise CommitmentCommitment Enhances resultsEnhances results

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Massage TherapyMassage Therapy

Current and ongoing massage Current and ongoing massage therapy is beneficial to most patients.therapy is beneficial to most patients.

It induces relaxation, moves lymph It induces relaxation, moves lymph fluid and releases muscle tension.fluid and releases muscle tension.

Promotes a sense of well being.Promotes a sense of well being.

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ResultsResults

FOTO (Functional Orthopaedic FOTO (Functional Orthopaedic Therapeutic Outcomes) is used in our Therapeutic Outcomes) is used in our practice.practice.

Recently, we ranked 3rd in the nation Recently, we ranked 3rd in the nation for our orthopaedic outcomes.for our orthopaedic outcomes.

We consistently rank high in patient We consistently rank high in patient satisfaction and functional change satisfaction and functional change scores compared to national norms.scores compared to national norms.

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Questions