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tkr - May 29, 2007 2:47:00 PM
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joshua5
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does anyone have a protocol that works well for them. have talked to 2 PTs and looked online. have a good base but would like more to view the variations. called the M.D. for a recent pt but the secretary just said, "no, just use what you have". was a little disapointing as i'm not used to getting blown off. never got medical advice from a secretary before. thanks for any replies.
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Re: tkr - May 30, 2007 2:42:00 AM
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TLB
Posts: 356
Joined: September 13, 2002
From: Arizona
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Josh
PTupdate.com, check it out
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Todd
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Re: tkr - May 30, 2007 9:44:00 AM
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VagusX
Posts: 220
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From: Savannah, GA, USA
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^^^^
2nd
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Re: tkr - May 30, 2007 4:29:00 PM
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PTupdate.com
Posts: 1490
Joined: October 8, 2001
From: Pittsburgh, PA USA
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Thanks for the kind words and trust guys. Just checked, no new member named "Joshua" ?!?!
Duffy
[URL=http://www.PTupdate.com]www.PTupdate.com[/URL] (Hey, membership is tax deductible as a continuing education expense!!)
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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Re: tkr - June 19, 2007 8:36:00 AM
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ragempt
Posts: 111
Joined: August 14, 2006
From: linden, michigan
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why would you pay to get a protocol? Can you really categorize all knee replacements under on treatment program. Here is a protocol for you: get it straight ASAP then do a functional assessment following the individual’s needs, goals, hobbies, complaints and weaknesses based on what you see with your eyes.
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Re: tkr - June 19, 2007 9:27:00 AM
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buckeye
Posts: 181
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There should not be a need to 'pay' for a TKA protocol. But you should think more in terms of guidelines since surgeons will differ in their limitations. Take the time to think through general goals for motion, strength, mobility, balance, etc. Then general time frames to acheive these goals. There is nothing wrong with having similar goals for patients with TKAs but the road traveled to attain those goals may vary from one to another.
Here is a quote from a journal abstract (Der Orthopäde 2003 Jun;32(6):527-34.):
"Rehabilitation programs after total knee arthroplasty vary as much as do the surgical procedures employed. The postoperative range of motion of the knee is considered to be one of the primary indicators of the success of arthroplasty surgery. Protocols focusing on improving range of motion have been widely investigated: the end result does not seem to depend on using specific devices or exercises. There are no prospective randomized clinical trials evaluating the differences in outcome after total knee arthroplasty between patients following different rehabilitation programs. What are the needs of the patient after this surgery? Rehabilitation should focus on physical and functional limitations, and guidance of the patient during this process is important. The patient follows an individual program comprising a sensorimotor progression in weight-bearing positions to allow for improved functional knee stabilization. In knee osteoarthritis, and also after total knee arthroplasty, the neuromuscular system undergoes various adaptations during gait and other activities. Because of this, rehabilitation should not attempt to achieve hypothetical norms, but to help the patient in the motor learning process of acquiring improved motion patterns and stabilization strategies."
I admit to not reading the article - I am not worried about the content of the article, just the abstract informing us to consider more than the 'hypothetical norms' but to look at function.
If you still think having a protocol is important, check out Brigham and Women's Hospital web site. They have various guidelines and standards of care to peruse.
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Re: tkr - June 19, 2007 11:01:00 AM
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TLB
Posts: 356
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From: Arizona
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Who said anything about paying for a protocol? The last 2 posters just showed how ignorant lazy ass people can be, check out the web site and then get back us with your vast wisdom. BTW how long have you 2 been out of school, it's obvious you don't frequent this board.
Todd
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Todd
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Re: tkr - June 19, 2007 11:33:00 AM
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ragempt
Posts: 111
Joined: August 14, 2006
From: linden, michigan
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i think someone is a little defensive?? what does time out of school have to do with anything? why are you swearing? get control of yourself sir.
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Re: tkr - June 19, 2007 12:25:00 PM
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ragempt
Posts: 111
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From: linden, michigan
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Someone just called me an ignorant lazy a__ person for requesting PTs to perform a thorough assessment using the patient's goals and needs as an individual not a piece of paper. Haven’t we learned that protocols don’t work from ACL's?
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Re: tkr - June 19, 2007 12:53:00 PM
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TLB
Posts: 356
Joined: September 13, 2002
From: Arizona
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No one here is advising they pay for protocols it's a great site with lots of helpful information including video, research articles and much more. And yes newbie I called you lazy for dissing the site without checking it out. My bad, I think I may have set Duffy back a few years instead of spreading the word about a great site this is for PT's. My apologies Duff.
Todd
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Todd
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Re: tkr - June 19, 2007 3:06:00 PM
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SJBird55
Posts: 2467
Joined: May 10, 2004
From: Michigan
Status: online
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Men .... here, let me explain the miscommunication that occurred above without having the testosterone raging through my body. ;)
No one has to pay for a protocol. Duffy has a pretty cool internet site that has a lot of information predominantly orthopaedic in nature. Generally, to have full access to his site to all of the material on the site, you need to be a member. To be a member there is a small membership fee. Thus, because of the wealth of information on Duffy's site, there was a recommendation that joshua check out and join the site because the answer to his question would have a high likelihood of being found there. Duffy's site, as Todd alludes, has WAY more than just a protocol and has a lot of clinical value.
So, rage, if you would have clicked on Duff's link there and did a little bit of looking at what was there, I believe you would not have responded as you did.
Todd... you must be having a bad day. :) Tomorrow will be better because it's HUMP day! ;)
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Re: tkr - June 19, 2007 4:21:00 PM
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ragempt
Posts: 111
Joined: August 14, 2006
From: linden, michigan
Status: offline
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Actually you called me more than lazy. I also have been on this website since 2003 or 4 not sure who the newbie is. I changed my name from R. Evans to ragempt because I kept loosing my password. I’m happy Mr. Duffy has a nice website. I was never “dissing” this guy’s site and I was not about to register and sign up for a website just to answer a post. I usually get my information from journals like JOSPT or the journal of manual and manipulative therapy. You’re welcome to get your information where ever you like. I am not sure if Mr. Duffy’s website is common PT knowledge I have never been there. To be honest with you I’m finishing my DPT and at 1500 bucks a class not including books my PT funds are all gone.
Rodger Evans MPT, OCS, COMT, Cert MDT or (Lazy A_ _ ) is fine too
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Re: tkr - June 19, 2007 4:48:00 PM
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buckeye
Posts: 181
Joined: May 24, 2007
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Hope the bad coffee is out of the system. Is the reaction sort of like a case of road rage? It has been seen in other threads in the RehabEdge forum.
I have no knowledge of the PT Update site and was not referring to that site in my message -- just agreeing with ragempt regarding not paying any money to get a TKA protocol.
I do not think the years of practice for me or the frequency of using the forum (or length of forum membership) is a reflection on my post.
Keep the thread on track - concentrate on the original theme of the question.
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Re: tkr - June 19, 2007 5:38:00 PM
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TLB
Posts: 356
Joined: September 13, 2002
From: Arizona
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[QUOTE]Todd... you must be having a bad day. Tomorrow will be better because it's HUMP day! [/QUOTE]Agreed SJ, May I use a baseball analogy? It's the heat of summer, temper are short, and I'm looking for a fight, bring it on Derick Lee (sp). All he has to do is check out the site and all things are solved without the BS of the other two. End of story.
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Todd
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Re: tkr - June 19, 2007 6:34:00 PM
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ragempt
Posts: 111
Joined: August 14, 2006
From: linden, michigan
Status: offline
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So Todd lets here what you have to say about TKR protocols. do you follow a peace of paper when you rehab patients? when doctors call you and ask your clinical reasoning on why your doing cybex knee extensions with your TKR do you refer them to PTupdate? do you have anything to add to this conversation except name calling and picking fights? i believe Joshua said :"does anyone have a protocol that works well for them" lets hear what you have to say? Tell me or us what you consider the essentials of TKR protocol? Cause I have never followed a protocol other than basic recommendations or surgical precautions such as toe touch WB or assistive devices.... I think your comeback of join the club and go to our web site is weak Especially coming from a guy that admits he likes to pick fights and feels he has credibility based on how long he has been out of school or how hot it is outside. Do you really want me to follow your instructions? Sorry Duffy (whoever you are) you seem to have a lot of credibility on the forum, nothing to do with you.
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Re: tkr - June 19, 2007 7:28:00 PM
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TLB
Posts: 356
Joined: September 13, 2002
From: Arizona
Status: offline
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rage, is that your real name? Mine is Todd although in this discussion we might want to switch. I'm what you would call a HUMMER, heat ultrasound and I forget what the rest is for, as I don't have my protocol handy. Sorry I'm just a cling on and have no thoughts of my own. Can you guide me as I really have a hard time treating patients without a piece of paper to help me out. Seriously, this is a great site of which I have no affiliation (other than being a member) and it's not about protocols it's about learning, becomming a better clinician and expanding you knowledge. SJ does a much better job of explaining it than me. I'll leave it at that unless you would like to spare a little more. It's kind of fun, don't you think Newb?
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Todd
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Re: tkr - June 20, 2007 2:38:00 AM
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ragempt
Posts: 111
Joined: August 14, 2006
From: linden, michigan
Status: offline
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Rage= Rodger Alex Glen Evans, Clinical Director at Linden (Michigan) Physical Therapy. I also can be found at the McKenzie website and the Maitland (USA) website. RageMPT @gmail.com
You’re welcome to call me I’m in the book.
if you would like to learn something then participate in a professional fashion. An expert onion which is what the website represents is not what is considered (the most reliable) reliable source. Randomized control trials are usually considered a more reliable measure. If you write a paper and tell your teacher you got the information from a website they would probably check the source as opposed to saying its from JOSPT. I am far from an expert in research.
If you continue to call me names such as “newbie” I will continue to embarrass you. Your response to my question tells me you have no thought process on the topic. At this point I’m questioning if your even a Physical Therapist because you have said anything that represents a valid thought on the topic. When people ask you questions about PT do you always refer them to another PT like SJ? Or when asked questions by patients do you refer them to Magee 6th addition. I asked you what you thought on the topic?????? So you referred me to SJ. Niccccccccce cooomeback.
I know this is a great website that’s why I have been participating for 3 years. I also went to Mr. Duffy’s free area on his site and I said to myself “now there is a dedicated PT”. He probably knows 10 times more than I. I work very hard to represent this profession in the best way I can. I will take partial blame for F’ing up this Post. I am sorry to all but I don’t tolerate certain things.
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Re: tkr - June 20, 2007 4:37:00 AM
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Shill
Posts: 1107
Joined: February 13, 2003
From: Madison WI USA
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Dudes. Chill. Dont make me stop this car.
_____________________________
Steve Hill PT
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Re: tkr - June 20, 2007 5:32:00 AM
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TLB
Posts: 356
Joined: September 13, 2002
From: Arizona
Status: offline
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I'm chilled, rage set me down for a 3 game suspension. Ahhh, the heat of summer.
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Todd
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Re: tkr - June 20, 2007 6:50:00 AM
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SJBird55
Posts: 2467
Joined: May 10, 2004
From: Michigan
Status: online
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Rage... Duffy does interpret what he reads, yes, but he also shares the literature. There is a wealth of information at Duffy's site. I would hope that students would not quote Duffy and I don't believe that his motivation is to have anyone quote him. He's just always reading and summarizing and since he's already doing this, he decided to put the stuff out there for all who join. And there is more than just his pretty much daily summaries..... he gives you lots to think about.
Rage, yes, believe it or not, in the paper submitted by myself and colleagues, we did have internet sites listed as references. Websites are definitely reasonable AND acceptable to list as a reference. The problem with listing websites is when the website becomes no longer active. One reviewer found that one of our websites no longer exists, bummer...
There is a wealth of information at MyPTSpace AND at MyPTSpace there is a fabulous opportunity for a lot of side discussions and networking (unlike the nonworking hasn't been functioning supposed option here for the last 8-12 months).
I also didn't really interpret that Todd wanted anyone to actually talk to me or ask me anything. You know though, it is always good to recommend someone for assistance or clarification or whatever - even in the case when dealing with patients. That is one quality that experts do have as proven in literature by Jensen - experts will seek out. Hmmm, Rage, that could be interpreted that Todd has at least one quality of an expert.
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