You will never get people to reach their potential until they are motivated to do so. Everyone knows that motivation has peaks and valleys. However, it is your responsibility to stimulate motivation in patients/clients, so they can reach their desired goal.
The main way to do this is to ASK each patient/client what goal he (or she) has in mind. Then explain exactly how that goal can be reached.
Patients/clients who have suffered a life changing injury, may have to go through the stages of grief before accepting a hard fact…such as they will never walk again. If the goal is totally unreasonable, tactfully direct the person to a realistic goal. For example: if a person with a severed spinal cord says, “My goal is to walk my daughter down the aisle at her wedding next month.” I suggest you tactfully tell him that it is not a realistic goal. But offer an option that IS doable. Something like, “Let’s concentrate on building up your strength so you will be able to attend the wedding and the reception.”
Remember what the patient/client wants and make sure goals meet the SMART criteria. A SMART goal is:
Written goals are more concrete; they motivate people. The person can see exactly where he (or she) is going. I’ve had success motivating people by telling stories or showing them pictures of other s who have overcome the same obstacles…or worse. It is hard for a person to wallow in self- pity because of an arm injury after hearing about a soldier who lost both of his arms in an active combat scenario. And when they learn that the ex-soldier now shovels the snow off his walk…it blows away excuses for NOT doing more. A person can hardly feel sorry for himself after hearing something like that. The person learns that no one is hopeless.
One patient became despondent after his leg was mangled. He wasn’t even trying to improve. I brought in a journal article that included a before and after picture of someone who had an even worse injury. He said, “You mean my leg can actually look almost normal and move again?” Whenever a person learns that something is possible, he (or she) is more likely to work towards a goal that seemed impossible before.
When I worked in one Rehabilitation Hospital, most of my patients were quadriplegics, paraplegics, and hemiplegics. The doctors and therapists asked our “old” patients to come back to talk to the newly traumatized ones. It gave encouragement to the newly injured. The newbies asked the “old pros” things they would never ask a professional. Issues like: catheters, bowel function, and sex were discussed candidly. Seeing people who were working, going to college, dating, and raising families while in a wheelchair, inspired them. It motivated them to do more than they had been doing. It gave them new hope. Even if life would never be “normal” again…they understood that life was still worth living. Eventually, they developed a new normal.
That’s where you come in. Show the patients/ clients what their new normal will look like. Then show them how to achieve it. Motivate people by showing them what they will get from all their hard work. Nothing is more frustrating than failing at something when you are trying your best. Yet that is exactly what happens when someone is recovering. So encourage people to keep trying. Be sure to break the goals down into manageable tasks and praise all efforts. It will be your job to routinely review the goals and the progress. Remind people they can reach their goals IF they continue to work at it. Then do your best to keep your patient/client moving forward.
While gyms are one-stop-shopping for just about any type of workout, there isn’t always enough time in the day to make it there. If you find yourself short on time for exercise or if you prefer to exercise at home, here are the best at-home workout items.
1. Yoga or exercise mat – Sometimes the carpet isn’t clean but that shouldn’t be a reason to miss a little core work. Slippery floors can make certain exercises (like lunges) dangerous because of sliding. Alternatively, you may need a little extra padding during supine abdominal exercises or stretching.
2. Exercise ball – Fitness balls have declined in popularity but they’re still a great inexpensive item to have at home. Choose a ball that is appropriate for your height. You should be able to sit on the ball with your knees at a 90-degree angle. Use your exercise ball for lunges against a wall, lower back support during crunches or overhead reaches.
3. Balance Trainer – While these are a bit on the expensive side, they’re relatively small and easy to store. The purpose of a balance trainer to add instability to exercise in order to recruit more muscles. Hands down, the most versatile balance trainer is the BOSU ball. You can use it ball side up or down. If you have knee or ankle stability issues, the Step 360 may be a better choice. The flat surface of the Step 360 prevents torqueing of the knee or ankle. Either can increase instability during upper or lower body exercises.
4. Resistance Bands – Light weight and easy to store, resistance bands are an excellent choice for an at-home strength training workout. Typically, different colors indicate different levels of resistance. Color codes may vary between brands. Use them for both upper body and lower body workouts. Never miss a workout when you’re traveling!
5. Hula Hoops – When your child is at school, take her hula-hoop for a spin. Although they are technically a toy, they’re actually great exercise. Hula hooping gets the heart rate up and is an excellent way to strengthen the core and hips flexors. Don’t fret if it’s not as easy as it once was – it does take a little practice. Search online for videos and how-to’s.
6. A Step – Steps are another relatively inexpensive piece of equipment and they’re multi-functional. Depending on the length of your step, it can double as a weight bench. Use them to add different levels to lunges and squats. Step aerobics are also a fantastic cardio workout.
7. Gliding Discs – Gliding discs add another dimension of instability to leg work and core work. Use them to up the ante and challenge yourself. Pro tip: Instead of splurging on “official” discs, opt for the furniture moving discs – they have the same purpose, work just as well and usually cost less. Additionally, you can use folded towels on tile or wood floors.
8. Foam Rollers – Unless you live with your massage therapist, there will be days when your muscles need intervention and a massage isn’t possible. A foam roller is the next best thing. Utilizing a similar technique as a massage therapist, foam rolling involves myofascial release. You use your own body weight to find the knots and roll them out. Foam rollers differ in hardness and if you’re new to foam rolling, start with a softer version.
Fitness equipment doesn’t have to be expensive or bulky to be effective. With just a few items, you can have an arsenal of items for home workouts. Don’t forget DVD or online exercise videos too!
It's not only "back to school" time for students, it's also time for Illinois physical therapists to start thinking about their education too - their continuing education, that is! This post will review the key points for the renewal process for physical therapists because Illinois PT assistants are not up for renewal until next year on September 30, 2015. For a quick refresher, physical therapy assistants are expected to complete a total of 20 hours of CE by the renewal deadline, 10 of which may come from online CE courses and 10 that must come from live courses.
For even more specifics and details, review Section 1340.61 (Continuing Education) in the Illinois Administrative Code. And don't worry if you haven't purchased your online courses yet, because Milestone CE has got you covered there!
With an approaching deadline of September 30th, PTs in Illinois will need to complete 40 hours of continuing education in order to qualify for renewal. The state rules allow for 20 of those hours to come from online sources like Milestone Continuing Education, but the remaining 20 hours must come from physical therapy seminars, live courses, conferences, university classes, etc. According to the rules, 50 minutes is the literal clock time for 1 CE hour. After the practitioner completes the first CE hour (remember, that's only 50 minutes by the clock), a full CE credit will be awarded for half hour increments (See Section 1340.61 [a]4).
The rules weigh live courses differently, depending on the activity itself. For example, CE credits coming from a semester's worth of university courses will be weighed as 15 CE credit hours. If the practitioner takes college or university courses for CE credit for a quarter of a semester, then they would receive recognition for 10 completed CE hours. Be sure to review the rules governing credits for live courses so you can calculate your credit hours accurately (yes, I'm talking to you!).
Now about those online courses. If you've finished up the live seminar/PT conference portion of the renewal requirement and want to complete your remaining CE hours with self-paced home study courses, then you've come to the right place. Milestone provides high impact continuing education courses for physical therapists and physical therapy assistants licensed in Illinois and 29 other states - review our State Approvals here. With over 1,000 hours to choose from, and customizable CEU Bundle Packs which allow you to combine modules at a discounted rate, you can be sure you will be receiving the latest information in your field in convenient mail order or downloadable PDF format without sacrificing a variety of course content! Opting for the latter (online courses) allows you to instantly access your course materials on your office, home computer, or tablet device. The choice is yours! Click here to get started today!
Visit our FAQ section to learn more about Milestone, or contact a knowledgeable CE Specialist at 1-800-709-8820 or via e-mail at info@MilestoneCE.com to get your questions answered!
It's been exactly one month since we announced our office fitness challenge, so we thought it was time to share some updates from some of our participating staff members. Your fitness tips, advice, and stories are welcome! Just leave your comments down below or on our Facebook Page in the comments section announcing this post. Ready? Set... Here we go!
Kellene - Fitness Goal: Run a full marathon
The avid runner in our office, Kellene has been diligently training in preparation to enter her first marathon in the fall or winter. She's been so diligent, in fact, that she's kept her "missed opportunity" money out of the collection jar (What? Money? Huh? Read more about that here). She has been following the guidelines from the Higdon Novice 1 Training Program to help her get ready for her race. Which race you ask? She's not sure yet, but take a look at the list below to see the ones she has her eyes on.
Kellene's Picks for Fall Marathons -
Kellene's Picks for Winter Marathons -
Lindsey - Fitness Goal: Lead Rope Certification
If you haven't read our previous MCE Fitness Challenge post, then you may not know exactly what this means. There are many forms of rock climbing, but the main three that are found in most indoor rock climbing gyms are: bouldering; top roping; and lead roping. This type of climbing requires a pre-established and demonstrable skillset in order to qualify the climber for certification. At minimum the climber must be able to "send" (that means complete in "rock climber-speak") a lower-advanced route without making a mistake. I have tackled a few advanced routes in the last month, but I haven't completed one without making a mistake yet. Only time, diligence, and hard work will tell if I make my goal of lead rope certification by the end of summer. It's going to be a close call!
So tell us, have you initiated an office fitness challenge where you work? Are you participating on your own with us? We want to know! Use the hashtag #MCEfitnessChallenge in your social media posts so we can see how you're doing! More announcements are to come, so stay tuned.
Newly certified personal trainers may wonder how and where to get started. With a bevy of options including gyms, private studios, health clubs and private training, you have much to consider when applying for jobs.
After receiving my ACE certification, I applied for a job at my gym and I was hired almost immediately. The upside was that because I’d been a member there for a few years, I knew a lot of the staff, trainers and instructors. That alone made starting there much less intimidating (and I was grateful because this was a significant career change).
Starting your new career as a certified personal trainer in a gym environment is an excellent way to get your feet wet. Supervisors and trainers can mentor you about designing programs, interacting with clients and problem solving. If you run into issues with a client, you have access to support and ideas. You also have the advantage of observing other trainers and group fitness instructors. It’s helpful to see how different fitness professionals teach classes, maintain files and connect with clients and members.
You also have the option of trading sessions with other trainers or other gym employees who offer related services. You will be required to complete CPT continuing education and your facility may offer continuing education for CPTs in the form of training or conferences that count for your requirements.
My personal experience working at a gym taught me the ins and outs of personal training. I shadowed other trainers to see how they worked with their clients, kept records and created programming. I used that knowledge to develop my own system and I continually revised it to meet changing needs. I regularly traded sessions with other trainers because A) it was a nice treat to let someone tell me what to do and B) I learned new techniques in terms of exercise and communicating with clients. Good trainers are always on the lookout for new ideas and ways to inspire clients. Training with other trainers and attending group fitness classes are excellent ways to freshen up one’s exercise repertoire. I had a supervisor who encouraged gym employees to trade services with in-house spa employees and it turned out to be a fantastic method for cross-promotion. I traded with an aesthetician and when my clients asked me about our spa services, I was able to tell them first hand.
Support is critical for new trainers. Whether this is your first foray into the working world or if this is a career change for you, it’s essential to have the ear of others in your business. Personal training in a gym offers the opportunity to meet other trainers and fitness professionals. Collaborating with others may save you time and energy in terms of client relationships, paperwork, etc.
Even if you work at a gym, always be open to private training. In most cases, it pays significantly better and there is little overhead. However, you must legally protect yourself with appropriate paperwork and insurance. Most certifications offer liability insurance at a discounted rate. Your insurance provider or certifying agent will likely have boilerplate consent and liability forms. Review these documents with a qualified lawyer to make sure they meet your needs.
Because I had a couple of private clients while I worked at the gym, I was already set up to continue independently. I had already put together a medical history packet and legal documentation. I trained the majority of clients in their homes but a few trained in my home.
Private training is definitely more lucrative than working in a gym but it has its own issues as well. You’ll need to factor in travel time for appointments. You’ll also want to decide how far you’re willing to drive. When setting your prices, keep in mind fuel prices, wear-and-tear on your vehicle and any other operating costs. Invest in the kinds of equipment you can reasonably bring with you. Establish days and times you are not available. Don’t spend a lot of money on a fancy website. You need a website that is easy to read, easy to understand and depicts you as a qualified professional. Remember that you’ll still be responsible for completing certified personal trainer continuing education courses. Choose CE courses for personal trainers about unfamiliar topics to give you a well-rounded knowledge base. Keep any continuing education for CPTs coursework or textbooks for future reference.
I often have contact with clients in between our meetings. If a workout was particularly tough, I’ll send a follow-up email the next day to check on them. During sessions, I always make it a point to ask them how they felt after the last session and follow up on things we discussed in the previous session. I find this practice adds a continuity to the client-trainer relationship.
Getting clients is one of the most challenging aspects of working independently. Referrals are the best way to get new clients. Offer your clients a free session or two if they refer someone who decides to train with you. In terms of advertising, you can try print or online advertising, connecting with local health professionals and leaving your cards with them or putting up flyers in your neighborhood.
I got creative with advertising. I put together a stretching handout for a local chiropractor and in exchange, he kept my business cards on his front desk. I paired with a registered dietician and we offered a joint nutrition and training package. I advertised in a local magazine. Ultimately, my Google AdWords campaign proved to be the most fruitful. I have been contacted many times by search engine optimization companies offering to increase my ranking. Generally, these services are very overpriced and you’ll get similar results using Google AdWords.
As a whole, I prefer private training to working for a gym because it is devoid of politics, pointless meetings and urging from management to be salespeople in addition to being personal trainers. I also enjoy being able to set my own hours, decline clients who are not a good fit and manage my business in ways I feel are most beneficial to my clients and myself. However, starting my career in a gym was irreplaceable groundwork for working privately. I learned so much about myself, how I wanted to conduct myself as a trainer and invaluable information about working with diverse populations. It gave me the confidence to forge out on my own and create a successful business.
"Strokes are the leading cause of disabilities in adults,” reports The American Stroke Association. So, stroke victims will require a large segment of therapy resources.
The majority of strokes occur for two reasons:
1. A stationary blood clot (thrombus) forms and interferes with the circulation to the brain.
2. A traveling blood clot (embolus) gets lodged and stops the flow of blood to the brain.
The thrombus is a solid mass that forms in a vessel. The embolus is often a piece of thrombus that broke away and travelled through the bloodstream…until it reached a spot too narrow to pass through. Once it becomes stuck, it cuts off circulation to that area. These clots account for 80% of strokes.
Vascular ruptures account for the other 20% of strokes. An example would be an intracranial hemorrhage, or bleeding in the brain.
Any one of these events causes a blood flow interruption and damages the brain, resulting in a stroke.
The level of impairment depends on the area of the brain damaged, and the extent of that damage. If the damage is on the right side of the brain, the left side of the body will experience problems. If the damage is on the left side of the brain, the right side of the body suffers.
Hemiplegia is the total paralysis of half (hemi) the body. The person has NO control over it.
(When dealing with hemiplegia, you need to approach from the “good” side so the person can see you.)
Hemiparesis is weakness of half of the body. The person has some control and movement, but it is awkward and unstable.
The main impairments that will concern physical therapists will be:
· Emotional control
Patients with strokes usually have difficulty communicating.
Dysarthria is when the speech becomes slurred, slow, or difficult to understand. However, the person CAN speak.
Aphasia often accompanies the stroke in the forms of expressive aphasia or receptive aphasia.
Expressive aphasia is when a person is not able to produce the words he wants to say. He cannot express himself. The person may answer “Yes” when he means to say “No”.
Receptive aphasia is when the message someone else transmits gets garbled inside the patient’s brain.
You might ask the person to close her eyes but she lifts her hand instead. She is having difficulty receiving the message.
The National Institute of Health has a standardized measure that shows the relationship between the damage and prognosis. It gives detailed instructions on testing and obtaining a score which will help determine what therapies the patient will need.
CRITERION FINDING SCORE
Level of consciousness (LOC) Alert 0
LOC questions Answers both correctly 0
(Ask patients their age and the month) Answers one correctly 1
Answers both incorrectly 2
( Ask patient to open and close eyes Performs both correctly 0
and to make a fist) Performs one correctly 1
Performs neither task correctly 2
Gaze Only horizontal movements are tested. Partial gaze palsy means that gaze is abnormal but forced deviation or total gaze pareses is not present. Forced deviation, or total gaze paresis NOT overcome by the oculocephalic maneuver. That maneuver is done by turning the head quickly to the right and left and watching to see if the eyes move normally. NOTE: The oculocephalic maneuver is done on comatose patients.
Partial gaze palsy 1
Forced deviation 2
Visual field (Hemianopia is the loss of vision on the left or right side)
No visual loss 0
Partial hemianopia 1
Complete hemianopia 2
Bilateral hemianopia/blind 3
Facial palsy None 0
Minor (assymetry on smiling) 1
Partial (paralysis on lower face) 2
Complete (absence of facial movement) 3
Motor arm function No drift (holds limb at 45° or 90 ° for 10 sec) 0
(score for both left and right sides) Drift (drifts down before 10 sec.) 1
Some effort against gravity
(limb drifts but has some effort ) 2
No effort against gravity (Limb falls) 3
No movement 4
Motor leg function No drift (Holds 30 ° position for 5 sec.) 0
(score both left and right sides) Drift (falls before 5 sec. but does not hit bed) 1
Some effort against gravity ( leg falls by 5 sec.,
but has some effort against gravity) 2
No effort against gravity ( falls on bed immediately) 3
No movement 4
Limb ataxia Ataxia is poor coordination, unsteadiness, or difficulty functioning.
(Finger to nose and heel to shin tests are done )
Present in one limb 1
Present in two limbs 2
Untestable ( explain why) __
(Test by pinprick on face, arm, leg) Normal 0
Mild to moderate loss (feels, but less so than usual) 1
Severe loss (is not aware of being touched) 2
Best language function No aphasia 0
Mild to moderate aphasia 1
Severe aphasia 2
Mute, global aphasia 3
Dysarthria Normal articulation 0
Mild to moderate dysarthria 1
Severe dysarthria (unintelligible or worse) 2
Untestable (explain why) __
Neglect For this test it means the lossof ability to see, hear, use space correctly, or pay attention.
No neglect 0
Partial neglect 1
Profound neglect 2
(does not recognize own hands or orients to only one side of space)
Total the score of each individual test. The higher the score…the worse the damage.
(You may download a copy of this by typing--nih stroke score—into your computer search engine.)
Exercising effected areas is vital. Physical therapists can help determine the person’s progress.
When you explain what is going to happen and why therapy is the key to a better outcome…the person is more likely to do it.
What you do and what you get the stroke victims to do, will make all the difference in their recovery. Therefore, YOU are essential to their progress!
It's that time of year again; the time of year where something changes in the atmosphere and it's clear that summer is coming to an end. Store aisles are filled up with decorations for autumn and the days, while still hot, don't seem quite as long. Fall is my favorite time of year, so forgive me for romanticizing it. If you are one of those people that loves the wonderful warmth that comes with the summer months, then you'll have to forgive my indulgence. I crave crisper days, colorful leaves, and pumpkin spice lattes from Starbucks.
Unfortunately, my favorite time of year is also synonymous with all of the hustle and bustle (and that admitted touch of dread) that comes with "back to school" season. Admit it, you've woken up in a cold sweat dreaming you'd slept through a final exam, or that you forgot to register for the one class you needed this semester, long after graduation has passed. It can't just be me. When you finally figure out that those unique problems are long gone with your student days and settle back into sleep, it hits you: homework assignments and test days have only evolved into work deadlines, CE courses and exams. Drat! And you thought you had escaped all of that...
While the young people in your life start preparing for school it's time for you to start preparing for your CE deadlines. You can skip the parent teacher conferences and orientations and go straight to the Course Catalog with Milestone. Browse through thousands of hours of online CE courses designed with your success in mind. No need to dread exam time either, one of the many perks of self-paced study. When you've completed your study guide, (included with all Milestone CEU Courses), log in to the exam center and take the multiple-choice test. It is graded immediately after you submit it so you don't have to wait to see your score, and your Certificate of Completion is unlocked and sent to your Milestone CE Account with a score of 70% or higher. It's that simple!
Get started today! Don't procrastinate like you did in school, you know you'll regret waiting until later...
It's that time of year again. The stores are filling up school supplies and fall decor, signaling an impending change of seasons. But before summer slips away until next year, there are a few things Delaware and Montana massage therapists have to do. This post will cover the basic CE requirements for massage therapists up for license renewal in these states, but always be sure to reference the state board's website for updates and changes to the requirement.
The renewal period, established back in 2012, ends on August 31st. By that time practitioners are expected to have completed and submitted 12 hours of continuing ed. and submit an "attestation" confirming the completion of the full requirement. It is advised that the practitioner keep track of their records for up to 3 years before discarding them because the board periodically conducts random audits on 2-5% of licensees throughout that time.
Delaware has similar requirements for LMTs, but there are a few key differences. Licensees in this state will need to have completed 24 hours of approved CE by August 31st (the renewal period is biennial - always ending on August 31st of even-numbered years). However unlike in Montana, the total requirement is broken down into specifications: 18 hours of the total 24 hours must come from "core" courses, whose content pertains directly to the practice of massage therapy. The remaining 6 hours are elective, which means the course content may discuss topics outside of the practice of massage therapy and bodywork.
As for choosing a CE provider, practitioners in Delaware have to either select a board-approved company, choose a CE company approved through the NCBTMB, AMTA, or ABMP, then the courses offered do not have to be directly approved through the board. Be careful when selecting course formats, as the board specifies that only 15 hours may be taken from online course providers (all 6 hours from the elective group and up to 9 from the core group).
Milestone CE is a NCBTMB Approved Provider (#491) and currently offers over 85 hours of online courses for LMTs in Delaware and Montana. Explore titles derived from the most recent content available, make your selections, download them to your computer or tablet and you're ready to get started. It's that simple... Click on the course titles below for detailed descriptions, module information, professional objectives and more!
Working as an ACE certified personal trainer has brought me into contact with people from all walks of life. Every workday is different and every client is an individual with specific needs and concerns. I’ve trained men, women, teenagers, post-rehabilitation adults and the elderly.
I’ve worked in the fitness industry for ten years and I’ve noticed many trainers have the education and knowledge but lack the “personal” part of personal training. A client’s experience is highly dependent on their relationship with their trainer. While it is a business relationship, it’s definitely a personal relationship too. To that end, I learn about my clients and their interests. I ask about their careers, families and hobbies. From session to session, I ask follow-up questions about things discussed in our previous meeting. The fact that I remember these things and ask about them lets my clients know that I am truly interested in who they are.
When I first meet with a client, I ask many questions about what they want to get out of their sessions. Does she want to learn about exercise physiology and biomechanics? Does he prefer to chat about topics other than exercise to make working out more enjoyable? Does she want to know how many repetitions are left or does she prefer to work until I tell her to stop? We also set goals and determine a course of action together.
In the beginning of my career, I worked in a gym facility catering to women. Being onsite enabled me to see up to eight clients in a day. I often had breaks between clients and used those periods to eat or work out. Our sessions were 55 minutes long and I used the last five minutes for stretching unless the client requested otherwise. I completed any paperwork or notes immediately afterward so as not to forget anything.
For the past seven years, I’ve worked with private clients in their homes or occasionally mine. Because of travel time, I can’t see nearly as many clients as I previously did but the pay is better and it’s easier to develop rapport with new clients because we’re on their “turf.” Clients also tend to be more forthright about difficult topics in private environments. I also enjoy being able to set my own hours and work with clients who are a good fit.
Although the intent of every session is to give the client a good workout, sometimes things take a more serious turn and they disclose things that factor into a dislike of exercise or issues affecting self-esteem. I’ve learned that I need to prepare for just about anything.
I don’t schedule more than three to four sessions per day and I limit myself to specific geographical boundaries because I could easily spend an entire day driving if I didn’t.
How much pre-session prep I do is dependent upon what equipment we’re using. I have a standard bag of tricks that accompanies me to every session but I also have a wide selection of equipment I can bring. I’ve stocked my home gym with transportable items such as a Step 360, BOSU ball and an adjustable kettlebell. I do need to schedule my departure time, make sure there’s gas in my car and keep it in good working order since it serves as a mobile gym/office.Working as an independent personal trainer gives me the freedom and flexibility to cater to client needs and preferences as well as my own. Personal training is an incredibly rewarding career and the best part about it is that I’m always learning something new!
It's been a while since we've published a puzzle post (wow, say that three times fast!) so we thought we'd send you into the weekend with a little bit of fun! You know what to do: search the puzzle for the continuing education keywords listed below. Good luck!
And by the way, we solve all the puzzles we post just to make sure all of the keywords are in there.