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4A Daily News – Tuesday, May 14, 2013 Vitality health & fitness Physical therapists explain how to get better, faster Should doctors get random drug tests? By Sam Boykin The Charlotte Observer (MCT) CHARLOTTE, N.C. — Nearly 2 million people receive physical therapy every day, a number that's likely to increase as the population ages. And for many, it can be overwhelming and intimidating. So we talked to three experts about what to expect, the keys to getting better, and how to avoid "PT" in the first place. When is physical therapy necessary? "Most little aches and pains work themselves out in a day or two," said Dr. David Aiken, manager for Carolinas Rehabilitation's Monroe and Ballantyne sites. "If within a week or so it (the pain) hasn't resolved on its own or begins to affect your functionality, you should seek treatment." Erin Ball, a physical therapist and manager of Rehab Services at Novant Health Huntersville Medical Center (formerly Presbyterian Hospital Huntersville), said many people make the mistake of waiting to seek treatment, hoping the pain will go away. "The trouble is that certain injuries get worse with time. An easy fix now could be a very complicated fix down the road." The assessment: Most PT begins with a thorough assessment, said Nabila Tanas of Tanas Physical Therapy, with offices in Raleigh and Cary, N.C. She delves into the patient's medical history, looking for underlying causes. She also educates the patient about how lifestyle changes may help. The treatment: Most therapy consists of multiple techniques, said Aiken, including therapeutic exercises to restore strength and function, as well as manual therapy, which is a By Andrea K. Walker The Baltimore Sun (MCT) MCT photo Dr. David Aiken works with Haley Pillars on her physical therapy in Charlotte, N.C. "detailed massage" designed to soothe soft tissue and loosen joints and muscles. Tanas specializes in the manipulation of muscles and soft tissue to help relieve pain, either locally or elsewhere on the body along nerve pathways. For instance, if a patient is suffering from chronic headaches, the problem may stem from stiff muscles in the neck or back. Common mistakes: Most PT requires patients to do exercises on their own. Experts agree this key component of treatment is also the most neglected, which can delay healing. To keep his patients motivated, Aiken said, he stresses the correlation between the exercises and the outcome. "They know if they do the exercises, not only will they feel better, but they'll be able to do things like play catch with their kids or get through a work day without hurting." Another common PT patient mistake is not keeping appointments with the therapist, Tanas said. "You have to stick with a routine — usually a few times a week," she said. "(PT) is not something you can do sporadically." It's also important to be honest with the therapist, Ball said. "If you have a lot of job and family responsibilities, be upfront about what is reasonable with your schedule — say one treatment a week versus three." What if I'm not getting better? An important part of PT is continually reassessing a patient's progress, Ball said. "At every appointment we ask what's working and what isn't. This open dialogue provides an opportunity for therapist and patient to go back to the drawing board if necessary. By using a patient's feedback you can always adjust to make sure you're on the right path." Is PT inevitable? Regardless of how well we take care of ourselves, over time the body starts to break down and injuries are more likely. But there's a lot you can do to stay healthy. Ball said a fit lifestyle pays big dividends later in life. "Everything from our sleeping habits, stress management and level of activity is very important as we get older…," Ball said. "Being proactive is crucial to maintaining a high quality of life." Said Aiken: "If people work on their mobility and muscle strength…they can still be active well into their 70s and 80s. Billing issues: Most health insurance limits how many PT sessions you can have. Insurance companies may also want to verify if you require PT as the result of an on-the-job injury that either workers' compensation or legal action could pay for, especially if the injury was caused by an accident. PT is often more costly at hospitals compared to other practices. Even if you receive therapy on an out-patient basis from a hospital-affiliated practice, you may be billed at a higher rate than other practices. Try to find out the billing rate the practice will charge. What if you're doctor smoked marijuana and then performed surgery on you? Not a comforting thought, but it could happen. That is why two Johns Hopkins doctors and patient safety experts say hospitals should make alcohol and drug tests mandatory for physicians. The doctors shared their views in a commentary published online April 29 in The Journal of the American Medical Association. They say doctors should also be tested if a patient dies suddenly or is unexpectedly injured during surgery. "Patients might be better protected from preventable harm. Physicians and employers may experience reduced absenteeism, unintentional adverse events, injuries, and turnover, and early identification of a debilitating problem," wrote the authors of the study: Dr. Julius Cuong Pham, an emergency medicine physician at The Johns Hopkins Hospital and Dr. Peter J. Pronovost, director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality. Dr. Gregory E. Skipper of the drug and alcohol treatment center Promises, in Santa Monica, Calif., also contributed. If a doctor is found to be impaired the hospital could suspend or revoke his or her medical license and report the incident to the state licensing board, the authors wrote. This would all help protect patients, the doctors said. Scientists pinpoint how brain tracks fast-moving pitches and serves By Lisa M. Krieger San Jose Mercury News (MCT) SAN JOSE — The human brain is far slower than a Major League fastball or a blistering tennis serve — but it has figured out a workaround. New research by University of CaliforniaBerkeley scientists solves a puzzle that has long mystified anyone who has watched, in awe, as elite athletes respond to incoming balls that can surpass 90 mph. The brain perceives speeding objects as further along in their trajectory than seen by the eyes, giving us time to respond, according to research by Gerrit Maus, lead author of a paper published in Wednesday's issue of the journal RANDAL S. ELLOWAY DDS IMPLANT DENTISTRY 2426 SO. 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Have you ever been embarrassed by a denture or a bridge? If you answered "yes" to one or more of these questions, call us today at (530) 527-6777 to schedule an evaluation appointment. We would be pleased to evaluate your oral health and discuss treatment options with you. Neuron. This clever adjustment — compensating for the sluggish route from the eyes to neural decision-making — "is a sophisticated prediction mechanism," he said. "As soon as the brain knows something is moving, it pushes the position of the object moving forward, so there's a more accurate measure of where this object actually is," said Maus. This is useful in survival situations far more important than sports — such as when we're crossing a street, in front of a speeding car. Former Yankees catcher Yogi Berra pondered the mystery, once asking: "How can you think and hit at the same time?" You can't, because there's not time for both. "But you don't need to think about it, because the brain does it automatically," said Maus. At the average major league speed of 90 mph, a baseball leaves the pitcher's hand and travels about 56 feet to home plate in only 0.4 seconds, or 400 milliseconds. Tennis is even faster. Last May, courtside radar guns measured a serve by British player Samuel Groth at 163 mph. In that split second, there's a lot of work for the body to do. Eyes must first find the ball. The sensory cells in the retina determine its speed and rush this information to the brain. Then the brain sends messages through the spinal cord that tell muscles in the arms and legs to respond. "By time the brain receives the information, it's already out of date," said Maus. The researchers said it can take one-tenth of a second for the brain to process what the eye sees. That means, for example, that by the time the brain "catches up" with incoming visual information, a fastmoving tennis or baseball would already have moved 10 to 15 feet closer than the image in the eye. A region in the back of the brain, called area V5, computes information about motion and position — and projects where it thinks the ball should be, rather than where the eyes saw it. For the experiment, six volunteers had their brains scanned with a functional MRI as they viewed the "flash-drag effect," a two-part visual illusion in which we see brief flashes shifting in the direction of a motion. The researchers found that the illusion — flashes perceived in their predicted locations against a moving background and flashes actually shown in their predicted location against a still background — created the same neural activity patterns in the V5 region of the brain. In an earlier study, they stimulated this part of the brain to interfere with neural activity, and disrupted this visual position-shifting mechanism. The finding could also help explain why altered trajectories can fool us — such as tennis backspins or baseball pitches with so-called late break. A clearer understanding of how the brain processes objects in motion can eventually help in diagnosing and treating myriad disorders, including those that impair motion perception, according to the UC Berkeley team. People who cannot perceive motion cannot predict locations of objects and therefore cannot perform tasks as simple as pouring a cup of coffee or crossing a road, researchers said. 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