#PhysioTalk Transcript
Healthcare social media transcript of the #PhysioTalk hashtag.
– ().
See #PhysioTalk Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | AGILE @AGILECSP RT @physiotalk: |
 | Justine Musiime - MSc MPH MCSP @JustineMusiime Starting now #physiotalk |
| AGILE @AGILECSP RT @physiotalk: |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @AGILECSP @thecsp @thecspstudents |
 | Janet Thomas @JanetThomas47 @physiotalk Hi I'm on the @physiotalk account tonights from a chilly Edinburgh. Cakes iced, Mince pies made and tree is purchased if not up yet! #physiotalk |
 | Dr Susanne Arnold @FinneganSusanne @physiotalk Hello! Susanne in Coventry - @AGILECSP Secretary! #physiotalk |
| AGILE @AGILECSP @physiotalk Hello, tweeting from my personal account too @lynseyferguson6 from Dundee. Absolutely not Christmas ready 🎄 #Physiotalk |
 | IPTOP @IPTOPphysio Why not take part in tonights #physiotalk tweetchat with our members @agilecsp Starting now! |
| AGILE @AGILECSP RT @IPTOPphysio: Why not take part in tonights #physiotalk tweetchat with our members @agilecsp Starting now! |
| AGILE @AGILECSP RT @physiotalk: |
| AGILE @AGILECSP RT @physiotalk: |
| AGILE @AGILECSP Come on AGILE committee we are so far the worst offenders for missing the #physiotalk 😂 |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @physiotalk Thanks for the reminder #physiotalk |
| AGILE @AGILECSP RT @physiotalk: |
| IPTOP @IPTOPphysio RT @physiotalk: |
 | Matt Liston @ListonMatt @physiotalk Evening! Twittering from a nondescript tonbridge here, I am Christmas ready having eaten all the mince pies! #physiotalk |
| AGILE @AGILECSP RT @physiotalk: |
| AGILE @AGILECSP RT @ListonMatt: @physiotalk Evening! Twittering from a nondescript tonbridge here, I am Christmas ready having eaten all the mince pies! #physiotalk |
 | sarah lambert @sarahphysiomom RT @physiotalk: |
| Dr Susanne Arnold @FinneganSusanne RT @physiotalk: |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @physiotalk Static... Dynamic.. Seated.. Standing.. #physiotalk |
| Janet Thomas @JanetThomas47 @JustineMusiime @physiotalk Now that's a thing I always have a 'thing' about Are we ever truly static? #physiotalk |
| IPTOP @IPTOPphysio @physiotalk Is postural stability more than balance though? So many factors to think about #physiotalk |
| AGILE @AGILECSP @JanetThomas47 @JustineMusiime @physiotalk I guess not while we are living .... #physiotalk |
| AGILE @AGILECSP RT @IPTOPphysio: @physiotalk Is postural stability more than balance though? So many factors to think about #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @JanetThomas47 @physiotalk ? might be a technical term. It is more like 'equilibrium'?Face with tears of joy #physiotalk |
| Janet Thomas @JanetThomas47 @JustineMusiime @physiotalk So our bodies are in 'equilibrium' rather than responding to an external stimulus? #physiotalk |
| AGILE @AGILECSP RT @sarahdebiase: |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @JanetThomas47 @physiotalk True #physiotalk |
 | Marousa @MarousaPavlou @JanetThomas47 @JustineMusiime @physiotalk Static balance refers to maintaining an upright position without a change in base of support thus from a postural control point of view yes but even in this static position there is a small degree of sway even in healthy individuals. #physiotalk |
| sarah lambert @sarahphysiomom @lynseyferguson6 @physiotalk I like this definition. Ultimately it fulfils a functional task. It enables task fulfilment, whether through movement or providing stability for other tasks. #physiotalk |
| Janet Thomas @JanetThomas47 @MarousaPavlou @physiotalk @JustineMusiime I think that's where my issue is - that element of sway always present. I use the term but with that caveat! #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime #physiotalk |
| AGILE @AGILECSP RT @physiotalk: |
| IPTOP @IPTOPphysio RT @physiotalk: |
| Dr Susanne Arnold @FinneganSusanne RT @physiotalk: |
| Janet Thomas @JanetThomas47 @physiokatiek @physiotalk @AGILECSP You best me to it! Just about to answer fear... #physiotalk |
| Dr Susanne Arnold @FinneganSusanne @physiotalk Safety concerns/confidence/fear #physiotalk |
| Marousa @MarousaPavlou @JanetThomas47 @JustineMusiime @physiotalk Yes. Even when responding to small degree perturbations we will normally use an ankle or hip strategy and this will still be considered static balance as there is no change in base of support #physiotalk |
| IPTOP @IPTOPphysio @MarousaPavlou @physiotalk Would you use the terms interchangeably? #physiotalk |
| Matt Liston @ListonMatt @clbowdler @physiotalk Indeed, but don’t forget the efferents! #physiotalk |
 | Chloe Dooley @chloedooley99 @physiotalk Compliance with exercise programmes, fear of falling and belief that it can’t be improved as it’s ‘normal when you get older’ #physiotalk |
| sarah lambert @sarahphysiomom @physiotalk I assess muscle power and co-ordination, vestibular function, proprioception, and if indicated cognition #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime RT @physiotalk: |
| Dr Susanne Arnold @FinneganSusanne @lynseyferguson6 @physiotalk Totally agree @lynseyferguson6 #physiotalk |
| AGILE @AGILECSP RT @sarahdebiase: |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @physiotalk Pathophysiology #Physiotalk |
| IPTOP @IPTOPphysio RT @sarahdebiase: |
| Matt Liston @ListonMatt @physiotalk @lynseyferguson6 i think that's a very good point. You need to feel comfortable and confident making people feel a little unsteady... but keep an eye on what you are challenging and what their response to that challenge is #physiotalk |
| Dr Susanne Arnold @FinneganSusanne @lynseyferguson6 @physiotalk Agree again - as your clinical experience increases and you get to know your patient/client you get a feel for when to try a bit more #physiotalk |
| sarah lambert @sarahphysiomom @physiotalk @sarahdebiase Yes, gradually increase the challenge. But I do find it hard to identify sensitive enough tests with my higher functioning patients #physiotalk |
| IPTOP @IPTOPphysio RT @physiotalk: |
| AGILE @AGILECSP RT @physiotalk: |
| Janet Thomas @JanetThomas47 @lynseyferguson6 @FinneganSusanne @physiotalk And I think how much you see them in their own environment as well. (This can be a good or bad thing!) #physiotalk |
| Dr Susanne Arnold @FinneganSusanne @physiotalk I am planning to update our @AGILECSP outcome measure resource very soon so am very keen to hear what outcome measures people are using in the real world #physiotalk |
| Marousa @MarousaPavlou @ClaireOCPhysio @physiotalk Completely agree. Many patients will say normal to stand on their heels and sway but when you retrain CoG and postural alignment and their sway decreases they can see it is not a normal function of age. Real feedback = important enemy of education #physiotalk |
| sarah lambert @sarahphysiomom @physiotalk Using outcome measures are vital, in this domain I find subjective measures as useful as objective markers because fear of falling is such an influential factor. #physiotalk |
| IPTOP @IPTOPphysio What outcome measures are you using for postural instability? #physiotalk |
| Dr Susanne Arnold @FinneganSusanne @physiotalk @AGILECSP Yes please 👌👌 #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @physiotalk #physiotalk Outcome measures at baseline and at the end of the intervention e.g OTAGO, Berg Balance scale, Elderly mobility scale etc |
| IPTOP @IPTOPphysio @sarahphysiomom @physiotalk What do you use for this - FES-I or something else? #physiotalk |
 | The WeStretch App @We_Stretch What do you notice the most? We found it is the fear of starting it- they don't know what will happen, even if it's for the better, so they don't start. |
| Marousa @MarousaPavlou @sarahphysiomom @physiotalk @sarahdebiase Mini-best is the strongest one available currently. Sensor based systems are gaining momentum but mini-best is free to download, has clear instructions for use and validated in older adults. Particularly good for higher level individual. #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime #physiotalk |
| Dr Susanne Arnold @FinneganSusanne RT @IPTOPphysio: What outcome measures are you using for postural instability? #physiotalk |
| Matt Liston @ListonMatt @sarahdebiase @AGILECSP @MarousaPavlou #physiotalk |
| Janet Thomas @JanetThomas47 @physiotalk @FinneganSusanne @AGILECSP Berg mainly but also individual elements of it and Turn 180 Not used Best or MiniBest and would like to know if others are #physiotalk |
| Dr Susanne Arnold @FinneganSusanne @lynseyferguson6 @physiotalk @AGILECSP I wish 🤪🤪🤪#physiotalk |
| Marousa @MarousaPavlou @sarahphysiomom @physiotalk Absolutely! Recent data we are currently writing up shows balance confidence or lack of it to be a significant contributor to functional gait assessment and mini best performance. #physiotalk |
| sarah lambert @sarahphysiomom @IPTOPphysio @physiotalk Yes, FES-1 , Dynamic gait index and Tinetti for lower level patients. Just been introduced to the mini besTest. Haven’t had a chance to use this but cover more domains than the others #physiotalk |
| Dr Susanne Arnold @FinneganSusanne RT @MarousaPavlou: @sarahphysiomom @physiotalk @sarahdebiase Mini-best is the strongest one available currently. Sensor based systems are gaining momentum but mini-best is free to download, has clear instructions for use and validated in older adults. Particularly good for higher level individual. #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @FinneganSusanne @physiotalk @AGILECSP Berg Otago TUSS TUSS Tog Rhombergs #physiotalk |
| Janet Thomas @JanetThomas47 @lynseyferguson6 @sarahphysiomom @IPTOPphysio @physiotalk And we like a Berg in Fife! I do wonder why we veer to particular measures? Familiarity? I used Tinetti in my research though :) #physiotalk |
| Matt Liston @ListonMatt @lynseyferguson6 @LauraDianeCook @physiotalk Totally! Always start easy and gradually increase challenge.... If they can't do the simpler things then there isn't really a need to go further than that in the assessment. You have stuff to get working on...#physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @Physiomark2 @MarousaPavlou @physiotalk @JanetThomas47 Too right🤣🤣🤣 #physiotalk |
| IPTOP @IPTOPphysio RT @physiotalk: |
| Justine Musiime - MSc MPH MCSP @JustineMusiime RT @sarahphysiomom: @physiotalk Using outcome measures are vital, in this domain I find subjective measures as useful as objective markers because fear of falling is such an influential factor. #physiotalk |
| Dr Susanne Arnold @FinneganSusanne RT @physiotalk: |
| Janet Thomas @JanetThomas47 @lynseyferguson6 @sarahdebiase But they have to wobble to improve! #physiotalk |
| Marousa @MarousaPavlou @ClaireOCPhysio @IPTOPphysio @sarahphysiomom @physiotalk ABC also a valid tool to use and highly correlated with FES-I #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @physiotalk How strong is gait as a predictor for falls? #physiotalk |
| sarah lambert @sarahphysiomom @MarousaPavlou @physiotalk @sarahdebiase Yes, I’m looking forward to using it #physiotalk |
| Dr Susanne Arnold @FinneganSusanne @physiotalk Vestibular for me #physiotalk |
 | Christine @CKelly193 @lynseyferguson6 @JanetThomas47 @sarahdebiase True, or offer a walking aid which can *sometimes* actually be worse! #physiotalk |
| Marousa @MarousaPavlou @JanetThomas47 @lynseyferguson6 @sarahphysiomom @IPTOPphysio @physiotalk No ideal outcome measure exists but if issues observed with standing and basic gait, Tinetti a better tool and FGA or Mini Best can be assessed with progress as appropriate. #physiotalk |
| Matt Liston @ListonMatt @JanetThomas47 @lynseyferguson6 @sarahdebiase Bingo! It's about getting the right 'level of wobble'.... #physiotalk |
| sarah lambert @sarahphysiomom @physiotalk Being given the time to do a thorough and comprehensive assessment! #physiotalk |
 | Ieuan Ellis 🎓🏃🏴 🌍 @Prof_IeuanEllis On balance you are probably correct 🙂 ! #physiotalk |
| Dr Susanne Arnold @FinneganSusanne @ListonMatt @physiotalk @JanetThomas47 @lynseyferguson6 @sarahdebiase I always found trying to find the right environment on an acute medical ward to assess and work on the wobble a bit tricky #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @physiotalk Duration &frequency of input! In some community therapy services, a patient is seen only once a week. Some of the balance re-training exercises are not always appropriate for patients to practice on their own, so, less progress is achieved. #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @FinneganSusanne @physiotalk Same here. #physiotalk |
| Marousa @MarousaPavlou @CKelly193 @lynseyferguson6 @JanetThomas47 @sarahdebiase Medication, poor seep quality or duration, psychological state,, sedentary behaviour all contribute to increased falls risk. Challenging to assess all in one session and may require >1 Ax session or ask patients to complete self report forms before appointment. #physiotalk |
| AGILE @AGILECSP RT @SusanneSyme: |
| sarah lambert @sarahphysiomom @JanetThomas47 @lynseyferguson6 @IPTOPphysio @physiotalk I think familiarity has a lot to do with it #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @physiotalk Services & commissioning. In some places, there are community exercise classes for onward referrals, but in others, there aren't. #physiotalk |
| Janet Thomas @JanetThomas47 @sarahphysiomom @lynseyferguson6 @IPTOPphysio @physiotalk I think probably the main thing is to make sure that we DO measure it using a validated test suitable for the people we are seeing #physiotalk |
| IPTOP @IPTOPphysio RT @physiotalk: |
| Christine @CKelly193 @OSlatarra @physiotalk Perhaps questions addressing function? Eg can both arms be used when sitting, or can certain tasks be done in standing? #physiotalk |
| Marousa @MarousaPavlou @JustineMusiime @physiotalk Exercises should be specific to each patient’s abilities; there are basic exercises to start with even in set programmes like OTAGO or FaME. #physiotalk |
| Dr Susanne Arnold @FinneganSusanne RT @physiotalk: |
| Matt Liston @ListonMatt @JustineMusiime @physiotalk In some cases giving them a week to practise gives you a chance to see if they've improved... There are lots of ways to get people doing exercises, the corner of the room with a chair in front of them is a great place for static exercises. #physiotalk |
| Marousa @MarousaPavlou @OSlatarra @physiotalk Questions, questionnaire/a sent out prior to appointment, specific instructions prior to the appointment for patient to set up at home to Ax standing and even gait, as appropriate. #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @SusanneSyme @physiotalk I think it provides a foundation for the patient to start their rehab, & as they progress, some are able to get rid of it (the equipment). Yet if they didn't have it, they might be unsafe to do certain activities let alone be able to progress/improve. #physiotalk |
| Marousa @MarousaPavlou @JustineMusiime @physiotalk Once a week in person sessions are actually very good and a home programme that is safe, viable and acceptable to the patient for practise at home on days not attending clinic. #physiotalk |
| Matt Liston @ListonMatt @sarahdebiase I think you've hit the nail on the head. It's not just about postural stability training for older adults, the theory has applications across all people with instability... and so this should be used as a framework as how we understand balance #physiotalk |
| Marousa @MarousaPavlou @sarahdebiase Agree development of assessment tree or toolbox may be helpful in this regard.. #physiotalk |
| IPTOP @IPTOPphysio RT @physiotalk: |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @ListonMatt @physiotalk In the community, we meet some people whose balance is really really low. I think sometimes we can be a little risk averse in recommending what they can or can't do alone. #physiotalk |
| AGILE @AGILECSP RT @physiotalk: |
| AGILE @AGILECSP RT @physiotalk: |
| Marousa @MarousaPavlou @ListonMatt @sarahdebiase Absolutely. Balance is balance and studies are consistently showing similar factors affecting uptake, adherence and outcome in multiple populations with balance problems. #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @eephysio1 @physiotalk You are very right. And I find that when the patient is starting to make progress, then it is the time to discharge them, because the rest of the patients also need to be seen! Remember we are commissioned for a given number of visits! #physiotalk |
| Matt Liston @ListonMatt @JustineMusiime @physiotalk It’s a tricky wicket.... but then not doing anything will not improve their balance. It all comes down to risk ax/Mx, clinical reasoning and justifying your intervention. All exercises are tailored to the need and ability of the person. #physiotalk |
| Marousa @MarousaPavlou @CarmichaelClini Low BitaminD levels can also contribute to BPPV. #physiotalk |
 | Lauren stenhouse @lastenhouse @lynseyferguson6 @FinneganSusanne @ListonMatt @physiotalk @JanetThomas47 @sarahdebiase We did have a lovely little therapy room to carry out all our assessments. Unfortunately this has been taken off us at the moment due to covid. Other areas still have their gyms etc though #physiotalk |
| Janet Thomas @JanetThomas47 @JustineMusiime @eephysio1 @physiotalk I find that incredibly hard to hear (not working in England) We need to ensure we can optimise the outcomes for everyone - and sometimes that take time! #physiotalk |
| Matt Liston @ListonMatt @lynseyferguson6 @JustineMusiime @physiotalk Plan, plan and then plan some more! Love the enabling approach there Lynsey! These ex’s may make you feel wobbly, there is a slim chance you might fall (you have fallen previously), but if you do here is our support strategy! #physiotalk |
| AGILE @AGILECSP RT @physiotalk: |
| Janet Thomas @JanetThomas47 @lynseyferguson6 @JustineMusiime @ListonMatt @physiotalk and do you tell them this is in case they fall? Just wondering how this ties in with compliance if they are fearful of falling already? A tricky balance - no pun intended! #physiotalk |
| AGILE @AGILECSP RT @physiotalk: |
| Janet Thomas @JanetThomas47 @lynseyferguson6 @physiotalk I have used the Otago app with a handful of people and I suggest @clock_yourself a fair bit as well #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @ListonMatt @physiotalk You are very right @ListonMatt. It's just the strong desire to sort everyone out and enable them all to achieve their goals before discharge that sometimes leaves one frustrated. 😊 #physiotalk |
| IPTOP @IPTOPphysio Thank you for highlighting this - a great resource I'm sure #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @JanetThomas47 @lynseyferguson6 @ListonMatt @physiotalk Good question @JanetThomas47. I've practiced backward chaining with some in the past, though it is not always appropriate for others. Yet those others might be the ones that need it the most! #physiotalk |
| Janet Thomas @JanetThomas47 @lynseyferguson6 @physiotalk @clock_yourself Now I'm doing home visits rather than being in a 'Day Hospital' setting I would say around 1/3 of patients seem to have smartphone or tablet from what I've seen. By the apps need to be simple and specific for their needs! #physiotalk |
| Janet Thomas @JanetThomas47 @JustineMusiime @lynseyferguson6 @ListonMatt @physiotalk We used to do backward chaining with everyone - but more difficult now when doing community visits. It is important to consider it though! #physiotalk |
| AGILE @AGILECSP RT @sarahdebiase: |
| Matt Liston @ListonMatt @JanetThomas47 @lynseyferguson6 @JustineMusiime @physiotalk I think forewarned is forearmed. They've attended because they have poor balance and have fallen and / or are fearful of falling, so they have an inherent risk. We teach backward chaining as they are likely to end up on the floor at some point... #physiotalk |
| Justine Musiime - MSc MPH MCSP @JustineMusiime @physiotalk @AGILECSP @sarahdebiase @MarousaPavlou @ListonMatt @sarahphysiomom 👏👏👏You've done a great job. #rehablegends #physiotalk |
#PhysioTalk content from Twitter.