Taking away UE is good for balance but also good for strengthening and stabilizing muscles in the lower extremities and easy for patients to progress on their own. This shows the patient how well they can transfer and gives them more confidence with their balance. On top of that, once they can hold weights, having them move the weight away from their body is an extra challenge. Sit-to-stands can take the place of squats as well, and using chairs of different heights or having patients hold weights when able to do so without using their arms to push up is an excellent way to build up strength. Using bodyweight exercises such as squats or wall push-ups is another good way to get proper resistance. If it is possible, tying the band to a table leg can provide easy access for the patient and can be beneficial for compliance as set up is easier. For example, doing knee extensions starting with resistance just below the knee, then moving it down towards the ankle is an easy progression. For LE exercises, one way to modify resistance is to start with weights or bands higher up-closer to the knee or hip-and then progressing down the leg. Once they can do a couple of sets at 8-12 reps, it is time to increase resistance. Use the same methodology as above to progress them. If it’s easy, find something heavier if it is hard, have them do 8-12 reps to help determine progressions.įor many of our patients in the frail state, minimal resistance is hard, so finding the right TheraBand or ankle weight is appropriate. Have the patient lift something heavy and see how many lifts they can perform and if it is easy or difficult. The question for clinicians is how do we challenge our older adults to get into resistance training in their homes? The challenge with going into patient’s homes is that they may not have adequate weights to challenge them, so we need to get creative and find heavy items around their home that we can use to challenge them. There are various ways to find the right resistance for our patients, including using 5 or 1 rep max tests and then working at 70-80% of that weight, using RPE to find a moderate to moderately- hard challenge, or seeing how many they can lift or move a certain weight until they get tired. We have to understand that even though many of our patients are dealing with generalized weakness and many of the same diagnoses, all our patients are unique and we have to approach everything that way. As clinicians, we can read papers and charts and understand the basics of progressing exercises but we need to tailor that to our patients’ needs and motivations. I believe that teaching them about strengthening and how that affects balance and mobility is key for buy-in and engagement. One of my favorite sayings that I heard from another physical therapist is “There is nothing wrong with getting strong.” One of the hardest parts of working with older adults is knowing when to challenge them and when to pull back on how we challenge them. Student & University Partnership Opportunities.Continuing Education & Professional Development.Other hobbies include golf, fishing, and weight lifting. He participates in adult sports leagues including hockey and softball. Before beginning his college education, Tyler spent 2 years playing Junior A hockey in Canada and the US. Away from the clinic, Tyler enjoys spending time with family and friends, especially at the lakes during the summertime. He is also certified in Clinical Weightlifting through ClinicalAthlete and Dry Needling through the Hobbs Masters Needling Series. He is certified in the LSVT BIG program, a specialty program for Parkinson’s disease and other neurological impairments. Tyler enjoys treating in the orthopedic setting, working with people of all ages, and has special interests in neurological and sports rehab. He went on to graduate from the University of Jamestown in May, 2017 as a Doctor of Physical therapy. Tyler attended NDSU and graduated in 2014 with a Bachelor's Degree in Health Sciences. Tyler grew up in Fargo, ND where he graduated from Fargo South High School in 2008.
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