Different strokes for different folks

Stroke survivors face two realities: Each one’s functionality is affected differently, so individualized therapy is important; and not getting that therapy on an ongoing basis can cause a stroke survivor’s abilities to decline. Tackling those realities was the idea behind DMU’s first “stroke camp” on campus March 19-23. Six patients, ranging from their 30s to their 70s, participated in intense therapy sessions with 12 second-year physical therapy students, five faculty members and seven community-based physical therapists.

“I was amazed at how motivated and hardworking the patients were. They would refuse to take a break and just keep working,” says Jenny Lewis, D.P.T.’13. “I didn’t want them to get bored doing the same thing every day. It really made me think and get creative.”

The creativity and intensity benefited the patients, says Kathy Mercuris, P.T., D.H.S., associate professor in the doctor of physical therapy program and organizer of the camp. In pre- and post-camp tests to measure gait, balance, strength and dexterity, patients improved in most categories. For example, by week’s end, one patient increased his distance by 160 feet in a six-minute walking test; another improved his balance to go from a major fall risk to no risk.

“By Friday, the patients were exhausted but still had those improvements,” says Mercuris, who participated in a similar camp last year during a DMU global health service trip to Jamaica.

The DMU physical therapy students say they’re glad they gave up their spring break to participate in the camp. “This was truly one of the most rewarding experiences of my life,” says Marie Schilling, D.P.T.’13. “I had very limited exposure to the neurological patient population, but after this opportunity, I feel I could see myself in this area of physical therapy.”

In addition to the camp sessions, each patient received a post-camp home exercise program.

“One of the main things that I took away from stroke camp is that it is impossible to classify a stroke patient with a set of clinical signs and symptoms,” notes Katie Sandvig, D.P.T.’13. “I also learned more about what it means to have the title of a physical therapist. We are not only treating our patients, but we are giving them motivation, confidence and life skills…It made me realize how rewarding it is to be able to help a patient get their life back.”

Carol Guttenfelder has experienced first-hand the impact of physical therapy on her husband, Wayne, who participated in the camp. After his stroke in 2005, she worried he would have to be institutionalized, but now he’s able to walk and dress himself. “I’m totally amazed by physical therapists,” she says.

Mercuris plans to organize the stroke camp annually, so long as enough patients and providers participate. She and the DMU students praise the community-based physical therapists who volunteered their time; they included alumni Kate Mercuris, D.P.T.’10, who practices at Covenant Medical Center in Waterloo, IA, and Tosha Hammer, D.P.T.’08, who’s with the Veterans Administration Medical Center in Des Moines.

“None of this could have happened without those physical therapists,” says Kathy Mercuris. “Our students were very appreciative to be able to learn from them. They were critical to our success.”

Method teaches thoughtful movement

Among the lessons learned by participants in DMU’s stroke camp in March were those conveyed via the Feldenkrais Method®, a way of teaching movement to reduce physical limitations and pain or improve performance. Named after Moshe Feldenkrais, D.Sc., the Ukrainian- born engineer who developed it, the method uses gentle movement and directed attention to go beyond strategies of exercise and posture.

“One of the things that make the Feldenkrais Method compatible with DMU’s mission is that it’s very much an integrated approach,” says Pat Buchanan, Ph.D., an associate professor in DMU’s doctor of physical therapy program who is certified by the Feldenkrais Guild of North America. “As a learning method, it can be used broadly across the age span and span of abilities.”

Buchanan says the method is effective for many patients because it makes them aware of automatic, habitual ways they move that are causing them problems or limiting their function. That educational aspect of the method is why Feldenkrais practitioners refer to patients as “students.”

“There are a lot of variables in each person’s condition, and they interact in different ways,” she says. “A person’s perception, cognition and actions influence each other. Feldenkrais explores the relationships among moving, sensing, thinking and feeling to teach and treat people.”

Buchanan, one of only two Feldenkrais-certified practitioners in Iowa, is among the organizers of this year’s Esther Thelen Research Symposium, named after one of her mentors, a prominent developmental psychologist who died in 2004; the two-day symposium will be held Aug. 30-31 in conjunction with the Feldenkrais Method annual conference, themed “Embodying Neuroscience,” Aug. 31-Sept. 5 in the San Francisco Bay area.

“This symposium and conference bring together world-class researchers and practitioners to learn from each other – it’s a twoway street,” she says.

Buchanan also has conducted two surveys of U.S. Feldenkrais teachers. The latest survey investigated the differences in practice patterns of Feldenkrais teachers who are also physical therapists compared to Feldenkrais teachers who are not. Nicole Nelsen, D.P.T.’12, and Simon Geletta, Ph.D., an associate professor in DMU’s public health program, were co-authors on the second survey findings.

“We want to create a better understanding of the effectiveness of the Feldenkrais Method and its safety,” Buchanan says. “That’s the information consumers, health care providers and health care payers want to know.”

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