#PhysioTalk Transcript
Healthcare social media transcript of the #PhysioTalk hashtag.
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Joe Middleton @_JoeMiddleton RT @physiotalk: | |
Pamela Kipps Hansford @PamKHphysio @physiotalk @physiotalk #physiotalk Please repeat setting up tweetdeck instructions didn't manage last time but did manage 3rd sept | |
Leah @Leahphysio577 @physiotalk Hello! Leah from Manchester #physiotalk | |
Fran Hallam-Bowles @FranHallam_PT @physiotalk Hi! Fran from Nottinghamshire #physiotalk | |
Joe Middleton @_JoeMiddleton @physiotalk Hi, I'm Joe. I am a physio in the South West of England. #physiotalk | |
francis rogan-physio @francisrogan @physiotalk Hello, Francis tweeting from South Africa #physiotalk | |
Jess Thorne @_velocityphysio @physiotalk Brighton! 🙌 #physiotalk | |
Central Health @central_health #physiotalk Click now to read our #OlderPeoplesDay blog! https://t.co/yNjKQMbThM | |
IPTOP @IPTOPphysio The #physiotalk chat on #falls has started - join in! #geriPT | |
Joe Middleton @_JoeMiddleton Everyone's. Nurses will include in their admission paper work. Doctors will ask, but usually only if that is a feature of the presentation (Geriatricians are an exception to this). However, nobody asks as frequently or as in depth as physiotherapists (imho!). #physiotalk | |
Janet Thomas @JanetThomas47 I think this is an interesting question. In my setting (Day Hospital) we all ask (not all at the same time!) , but with differing reasons and questions. Hopefully not too repetitive though! #physiotalk | |
Joe Middleton @_JoeMiddleton RT @IanTyrrell5: | |
Janet Thomas @JanetThomas47 @_JoeMiddleton Cant disagree in my opinion as well! Although the rest of the MDT in my workplace are very thorough :) #physiotalk | |
Jess Thorne @_velocityphysio @physiotalk Drs & consultants during clerking and post taking patient. Then the physiotherapists with their CGA of the patient #physiotalk | |
Joe Middleton @_JoeMiddleton @IanTyrrell5 @physiotalk A doctor asks because they want to know why you fell. A nurse asks because they want to keep you safe in hospital. We ask because we want to know why you fell, how we can minimise the risk, how we can get you home, and how we can keep you living the life you want #physiotalk | |
Joe Middleton @_JoeMiddleton @physiotalk @IanTyrrell5 Physiotherapists can approach falls from multiple perspectives, encompassing the bio, the pyscho, and the social. #physiotalk | |
Fran Hallam-Bowles @FranHallam_PT @_JoeMiddleton @IanTyrrell5 @physiotalk Agree, one of our strengths as physios is to see the whole holistic picture and put all the pieces of the jigsaw together #physiotalk | |
Joe Middleton @_JoeMiddleton RT @Louise_Brennan_: | |
Pamela Kipps Hansford @PamKHphysio @physiotalk #physiotalk Pam Hansford from CT SA, a 75 yr-old neurophysio now also recovering quadriplegic (biggest challenge: mild L hemi-athetosis) who wonders why therapists still want to focus on the problem first (falls)?Lets make #healthyaging & #Wellbeing our goaldirected startingpoint | |
Joe Middleton @_JoeMiddleton RT @FranHallam_PT: @_JoeMiddleton @IanTyrrell5 @physiotalk Agree, one of our strengths as physios is to see the whole holistic picture and put all the pieces of the jigsaw together #physiotalk | |
Jessica Metcalfe @JLMPhysio RT @_JoeMiddleton: @IanTyrrell5 @physiotalk A doctor asks because they want to know why you fell. A nurse asks because they want to keep you safe in hospital. We ask because we want to know why you fell, how we can minimise the risk, how we can get you home, and how we can keep you living the life you want #physiotalk | |
Joe Middleton @_JoeMiddleton Great point. As with most assessments, it is what is done with the findings that matters. #physiotalk | |
Joe Middleton @_JoeMiddleton I assume we're not allowed to replace 'fall' with a mime? #physiotalk | |
Ọpẹyẹmi @opewalker @physiotalk Usually the physiotherapist #physiotalk | |
Joe Middleton @_JoeMiddleton RT @physiotalk: | |
francis rogan-physio @francisrogan @IanTyrrell5 @physiotalk Agree devil is in the detail. From physio point of view I ask about activity, do strength test. However I think physician who sees patient should be looking at medication etc. it needs to be a team approach #physiotalk | |
Janet Thomas @JanetThomas47 @AliceKilbyPT @_JoeMiddleton @IanTyrrell5 @physiotalk It is worrying though how often when we met after our MDT assessment how often we have all been told different things. Why? Is it linked to how we ask? #physiotalk | |
Joe Middleton @_JoeMiddleton Ask re: balance (whether patient has ever loses balance or whether they feel balance is poor). Ask whether able to get up from the floor? #physiotalk | |
Leah @Leahphysio577 @physiotalk Ask about mobility in the house/outdoors? Then move towards how they perceive their balance as this usually sparks the conversation about previous falls #physiotalk | |
Janet Thomas @JanetThomas47 @_JoeMiddleton I'm often told at the start of an assessment that they feel their balance is poor and they struggle with STS or stairs People know their own bodies! #physiotalk | |
Joe Middleton @_JoeMiddleton @IanTyrrell5 @caldwell_pt Blasphemy!!! #physiotalk https://t.co/Q8imJISMqs | |
IPTOP @IPTOPphysio @IanTyrrell5 @caldwell_pt @_JoeMiddleton NOOOOOOOOOOOO #physiotalk | |
Joe Middleton @_JoeMiddleton RT @JanetThomas47: @_JoeMiddleton I'm often told at the start of an assessment that they feel their balance is poor and they struggle with STS or stairs People know their own bodies! #physiotalk | |
Joe Middleton @_JoeMiddleton RT @IanTyrrell5: | |
IPTOP @IPTOPphysio @PhysioArmstrong @mariand84 @physiotalk It probably should be Lots of evidence behind frailty screening in MSK outpatients #physiotalk | |
francis rogan-physio @francisrogan @Louise_Brennan_ @IanTyrrell5 @physiotalk Agree. And the from there to feedback to the patient too. I think patients are lost in the follow up ( working in a private setting) #physiotalk | |
Joe Middleton @_JoeMiddleton This is so, so vital. e.g. the patient said 'oh, I don't know... I must have tripped' vs. the patient said she 'tripped' #physiotalk | |
IPTOP @IPTOPphysio @IanTyrrell5 @physiotalk And does the type of injury help you assess - falls forwards onto face, ability to get saving arm out etc etc #physiotalk | |
Leah @Leahphysio577 @physiotalk We don't just ask, we observe too. As many of the things that can contribute to a fall can stem from age, past medical history, mobility, medication, eye sight... #physiotalk | |
KB @KBNeuroinfo RT @caldwell_pt: | |
Leah @Leahphysio577 RT @caldwell_pt: | |
IPTOP @IPTOPphysio @hmlyoungphysio @physiotalk To assess …. Or to screen for risk? (Spoiler - do they work?) #physiotalk | |
Janet Thomas @JanetThomas47 @AliceKilbyPT @physiotalk It wouldn't be the first time I've defined a fall (in laymans terms) first! #physiotalk | |
Alex Fisher @alex_fisher1969 @IanTyrrell5 @_JoeMiddleton Oops #physiotalk | |
Joe Middleton @_JoeMiddleton - Number in past 12/12 - Frequency - Nature & Pattern (inc. location & time) - Prev. injury - Preceding symptoms - Ability to summon help/get off the floor - Fear of falling - Self-reported balance problems - Mobility - Function - PMH & DH of note - Recall of events #physiotalk | |
Joe Middleton @_JoeMiddleton As a starter for 10. #physiotalk | |
Leah @Leahphysio577 RT @_JoeMiddleton: - Number in past 12/12 - Frequency - Nature & Pattern (inc. location & time) - Prev. injury - Preceding symptoms - Ability to summon help/get off the floor - Fear of falling - Self-reported balance problems - Mobility - Function - PMH & DH of note - Recall of events #physiotalk | |
KB @KBNeuroinfo RT @_JoeMiddleton: - Number in past 12/12 - Frequency - Nature & Pattern (inc. location & time) - Prev. injury - Preceding symptoms - Ability to summon help/get off the floor - Fear of falling - Self-reported balance problems - Mobility - Function - PMH & DH of note - Recall of events #physiotalk | |
KB @KBNeuroinfo RT @caldwell_pt: | |
Joe Middleton @_JoeMiddleton - Continence - Vision - Hearing - Bowel habit - Footwear - Environment (e.g. lighting, flooring etc.) #physiotalk | |
Janet Thomas @JanetThomas47 @_JoeMiddleton Are all your falls the same... Any common factors? Strength (not just functional strength although that's vital!) Gait speed as well as gait (if you know what I mean!) #physiotalk | |
Joe Middleton @_JoeMiddleton #physiotalk | |
Joe Middleton @_JoeMiddleton @JanetThomas47 Do you ask about gait speed or just assess it? #physiotalk | |
Janet Thomas @JanetThomas47 @_JoeMiddleton Timed walk but also ask about community mobility, can they get to toilet in time etc Also distance - whats the furthest you've walked in the past week / month #physiotalk | |
francis rogan-physio @francisrogan @hmlyoungphysio @physiotalk In screening we have used TUG, and now introducing hand grip strength. This helps us to decide if patient discharged with walker/ crutches. It also has helped us manage expectations of patients, and to help them plan. We use in combination with RAPT score to plan d/c #physiotalk | |
Axelle Mokry @axelle_mokry RT @physiotalk: | |
Joe Middleton @_JoeMiddleton All patients in hospital, aged 65 or older, are to be considered at risk of falling #physiotalk | |
Janet Thomas @JanetThomas47 @HealthPhysio @caldwell_pt @physiotalk I fell last weekend.... Now I know I have grey hair but.... #physiotalk #overwhelmingextrinsicfactors #segway | |
francis rogan-physio @francisrogan @mariand84 @physiotalk Ideally yes. But often depends on the funder and patients means (in private setting) #physiotalk | |
Joe Middleton @_JoeMiddleton @IanTyrrell5 @JanetThomas47 Frequently get that look of bewilderment and annoyance on a relative's face. 'He was worse than this this morning. Honest!!!' #physiotalk | |
Fran Hallam-Bowles @FranHallam_PT @physiotalk Before asking anything I start assessing as soon as I arrive at the person's house, looking at the access, how long they take to answer the door, use of mobility aid, footwear, signs of injury….#physiotalk | |
Joe Middleton @_JoeMiddleton RT @avington_suzann: | |
Leah @Leahphysio577 @physiotalk Chair based exercise to start to build confidence and them move to strength, balance and propripception exercise #physiotalk | |
Pamela Kipps Hansford @PamKHphysio @physiotalk #physiotalk need to ask about medication - @Atul_Gawande Atul Gawande in his fascinating book Being Mortal points out that people taking more than 4 prescription medications are at risk of falling! Only 4? Also: #Deprescribing & @TheIHI are promoting understanding of this aspect | |
Joe Middleton @_JoeMiddleton Must take the opportunity to plug the @MDTea_podcast episode on 'Fear of falling' https://t.co/FFW3QPa5VL #physiotalk https://t.co/Mzzj8BibJT | |
Janet Thomas @JanetThomas47 @Leahphysio577 @physiotalk Would you always start with chair based? I'm wondering why? #physiotalk | |
Joe Middleton @_JoeMiddleton Must take the opportunity to plug the @MDTea_podcast episode on 'Acute management of falls' https://t.co/i7FZ78Pcz6 #physiotalk | |
IPTOP @IPTOPphysio @caldwell_pt I totally recommend the @MDTea_podcast A great listen on all types of subjects #physiotalk | |
francis rogan-physio @francisrogan @physiotalk Depends on setting, but I often ask them if I can test there balance and time their stride standing balance. I use this as opener for them to say “oh my balance is good/bad” and the I can ask “why?” #physiotalk | |
Alex Fisher @alex_fisher1969 @physiotalk #physiotalk embedding 'exercise' into meaningful activity. Again alot if the folk I work with are cog impaired & have neuro apathy. They may not have insight into 'needing' exercise | |
Joe Middleton @_JoeMiddleton Must take the opportunity to plug the @MDTea_podcast episode on 'Falls prevention' https://t.co/aUYUJkzT0p #physiotalk https://t.co/vC0kxrvNax | |
IPTOP @IPTOPphysio Here's a few that I saw during #FPAD2018 promotions #physiotalk https://t.co/0LVMjmY9Gp | |
Leah @Leahphysio577 @JanetThomas47 @physiotalk Not always. Depending on the individual patient. I tailor each program individually as everyone is different and some more confident than others #physiotalk | |
Fran Hallam-Bowles @FranHallam_PT @HealthPhysio @physiotalk Sustainment is a really good point and often difficult to achieve #physiotalk | |
Janet Thomas @JanetThomas47 @HealthPhysio @physiotalk Agree! Challenge, tailoring and progressions are vital #physiotalk | |
Janet Thomas @JanetThomas47 @Louise_Brennan_ @physiotalk @clock_yourself Promotional tweet alert! We have @MegLowryPT from @clock_yourself speaking at #AGILE18 on 10th Nov #physiotalk | |
Joe Middleton @_JoeMiddleton @physiotalk Working in the very acute setting (ED/AMU), I don't get to do much in the way of exercise with my patients. However, I believe resistance exercises and tai chi are both pretty good. Otherwise, what ever the patient will continue to do, and challenges them! #physiotalk | |
Janet Thomas @JanetThomas47 At a risk of being too promotional - recommend the training from @LaterLifeTrain (Yes, I do tutor on their courses :) ) #physiotalk | |
Alex Fisher @alex_fisher1969 @physiotalk #physiotalk Consideration should also take into account carer burden. Their time in managing compliance with what we px and advise | |
Joe Middleton @_JoeMiddleton https://t.co/NZg2rfxqyb @LaterLifeTrain #physiotalk | |
Joe Middleton @_JoeMiddleton @IanTyrrell5 @JanetThomas47 I find that validating patients fear is a big step. Telling them that it is okay to be scared of falling, but together we canm bit-by-bit, get on top of this. #physiotalk | |
IPTOP @IPTOPphysio @_JoeMiddleton @physiotalk The best exercise is the one the person will do! On the other hand, we do need to motivate them to do the evidence based exercises - otherwise no good for falls! #physiotalk | |
Alex Fisher @alex_fisher1969 #physiotalk I am v much enjoying hanging out with u lovely lot | |
francis rogan-physio @francisrogan @mariand84 @physiotalk One of my favorites for patients. Often introduce it early and do sit-stand test as there are norms. Patients quite like the challenge and to see an improvement #physiotalk | |
Pamela Kipps Hansford @PamKHphysio @physiotalk #physiotalk start with a,b,c, (not #Strengthening!) #Alignment to gain #Balance to work on #Control and create #DynamicStabilisation through #Education & #EnergisingThroughExercise in meaningful #FUNctionalActivity in #DailyLife | |
Alex Fisher @alex_fisher1969 @IanTyrrell5 @physiotalk #physiotalk get friendly with yr local CNRTs. If u're discharging folk their way, they may order off the peg | |
Joe Middleton @_JoeMiddleton I'm still waiting to see my first patient that has summoned assistance via Alexa #physiotalk | |
Pamela Kipps Hansford @PamKHphysio @physiotalk #physiotalk Also #Dancing for People with PD would be appropriate for all people whose balance is challenged | |
Fran Hallam-Bowles @FranHallam_PT @caldwell_pt @PhysioArmstrong @HealthPhysio @physiotalk Get to know the person, what motivates them, their interests, their lifestyle. And if this fits with an evidence-based activity for improving muscle, bone strength and balance even better! https://t.co/yDcYxj38YQ #physiotalk | |
francis rogan-physio @francisrogan @physiotalk Have been using Otago exercises. Easy, standardized and patient can do with a family member. Need to think of ways to decrease costs etc #physiotalk - using family members helps get extra sessions in. | |
Alex Fisher @alex_fisher1969 @physiotalk #physiotalk Emerging tech is great. Sadly it's the funding which is the bug bear in the era of austerity & folk being turned down for PIP. I get slightly aerated when I think of the cost savings. End of rant! | |
Leah @Leahphysio577 @physiotalk We've got access to the OTAGO program that we can refer via the local leisure centre which has been really popular and recommended by lots of patients #physiotalk | |
Pamela Kipps Hansford @PamKHphysio @physiotalk correction #physiotalk Also #DancingForPeopleWithPD would be appropriate for all #peoplewhosebalanceischallenged | |
Alex Fisher @alex_fisher1969 @caldwell_pt @physiotalk #physiotalk Can u tell I'm an OT? Honestly can't do my job without u all | |
Janet Thomas @JanetThomas47 @IanTyrrell5 @_JoeMiddleton Don't forget the new Apple watch as well! #physiotalk | |
Joe Middleton @_JoeMiddleton I think @IanTyrrell5 summed it up at the start. The devil is in the detail. Go full on #Sherlock or #Poirot #physiotalk | |
Leah Devlin @Leahdevlin1989 RT @physiotalk: | |
Alex Fisher @alex_fisher1969 @physiotalk #physiotalk thank you | |
Janet Thomas @JanetThomas47 @PhysioArmstrong @francisrogan @physiotalk Lots of strength exercises - just make sure you use an appropriate leg weight #physiotalk | |
francis rogan-physio @francisrogan @physiotalk Prevention is better. Test patients, encourage strengthening and physical activity in every patient. #physiotalk | |
Joe Middleton @_JoeMiddleton @JanetThomas47 @IanTyrrell5 Probably still face the issue of these amazing people not wanting to 'cause a fuss' or not wanting to 'bother anyone'. Having said that, I assume there is some sort of accelerometer in an apple watch? So it could detect the fall itself? #physiotalk | |
gemma weatherby @gemmaweatherby Very interesting tweetchat tonight about falls! #physiotalk | |
Janet Thomas @JanetThomas47 @HealthPhysio @physiotalk Some interesting apps discussed at the last @LaterLifeTrain conference for exercises and adherence. Just can't quite remember what they were called... #looksforconferencetweets #LLTconf #physiotalk | |
Joe Middleton @_JoeMiddleton Great chat @physiotalk. Thanks for hosting @caldwell_pt #physiotalk | |
francis rogan-physio @francisrogan @PhysioArmstrong @physiotalk In the very weak Patient it is a great start. I have started using hand grip strength in every older patient. Some are surprisingly week, and then others surprisingly strong. #physiotalk In the very week, Otago is good. | |
gemma weatherby @gemmaweatherby RT @_JoeMiddleton: Must take the opportunity to plug the @MDTea_podcast episode on 'Fear of falling' https://t.co/FFW3QPa5VL #physiotalk https://t.co/Mzzj8BibJT | |
Pamela Kipps Hansford @PamKHphysio @HealthPhysio @physiotalk #physiotalk Lets start by asking them #WhatareyourStrengths? Working in water can be amazing for those who enjoy swimming | |
Janet Thomas @JanetThomas47 @IanTyrrell5 @_JoeMiddleton I think you could describe my approach as gentle sarcasm in general. But depends on individual #physiotalk | |
Joe Middleton @_JoeMiddleton @HealthPhysio @physiotalk I remember a big @thecsp campaign about falling not be an inevitable part of ageing. My thought was; but it is an inevitable part of bipedal ambulation? #physiotalk | |
Janet Thomas @JanetThomas47 @_JoeMiddleton @IanTyrrell5 That's what I understand. But you can switch it off..... #physiotalk | |
Janet Thomas @JanetThomas47 @_JoeMiddleton @HealthPhysio @physiotalk @thecsp I don't think you can count my Segway fall as bipedal ambulation! But it was probably inevitable... #physiotalk | |
Joe Middleton @_JoeMiddleton I'm ready. #physiotalk |
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