Minnesota Chapter APTA		Phone: 651-635-0902 E-mail: info@mnapta.org
Soundwaves		September-October 2007 Volume XXVII, Issue 5
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In This Issue of Soundwaves		Fall Conference is two weeks away! It’s not too late to register! Visit the MN APTA website to download registration pages, or to download the entire brochure.
-- Communicate, Communicate, Communicate by Sarah Walker, PT
-- Minnesota Athletic Trainers Seeking to Change Scope of Practice by Kathleen Picard, PT
-- MN PT PAC: Thank You, Contributors!
-- Laura Gilchrist is Minnesota Recipient of APTA Emerging Leader Award by Joan Purrington, PT
-- New 2007 Certified Clinical Specialists
-- MN APTA Fall Conference is Almost Here!
-- Marilyn Woods Scholarship & Leadership Symposium by Cort Cieminski, PT
-- Membership Moments by Melanie Brennan, PT
-- Evidence in Action
-- Meet the New MN APTA PTA SIG Chair by Julie McDonald, PTA
-- SSIG Events & Activities
-- It’s Time for the Fall Conference Silent Auction!
-- Bear Tracks 5K Walk/Run & First Annual 10K
-- Soundwaves Committee Looking for New Members by Mary Weddle, PT
-- Stand Up & Be Strong! Update by Kris Gjerde, PT
MN APTA Updates
-- From the President: Thanks to Our Members & Staff! by Joan Purrington, PT
-- From the Director of Peer Review: A Review of Quality Improvement by Kris Gjerde, PT
-- From the Executive Director: Professionalism—It’s the Heart of Why We Do What We Do by Judy Hawley, PT
-- Pats on the Back
-- MN APTA Members in the News
-- New and Transferred MN APTA Members
Classified & CE Ads
-- MN APTA Partners
-- Classified Ads
Communicate, Communicate, Communicate
By Sarah Walker, PT APTA Member since 2003
By now, it is old news: the consumer access bill that would remove the remaining barriers to physical therapy in Minnesota has been tabled. Having closely followed the developments with this bill over the last two years, I was disappointed and frustrated at the hold-up. However, the status of the bill gives us an opportunity to re-examine the barriers to obtaining full direct access to physical therapy in Minnesota. In a recent article^1 in Professional Case Management, Lynn S. Muller provides some insight into the problem. The very name of the article helps describe the dilemma: “Direct Access—The Best Kept Secret: A ‘Seasoned’ Case Manager Learns from Personal Experience.” Muller writes about how her own experiences as a patient increased her awareness of physical therapy and the availability of direct access to physical therapy. Her article provides food for thought: WHY is direct access to physical therapy such a secret? There is evidence for better outcomes and cost savings with faster access to therapy, so why is it that even an experienced case manager did not know of its availability for her clients? This raises an even bigger challenge: HOW to make direct access a well-known fact instead of a best-kept secret. Muller’s article provides an answer for increasing awareness of direct access: communicate, communicate, communicate. We rely on communication to improve care when working with our consumers. We communicate with referring providers through progress reports and other updates, but what about other people on the health care team who advocate and care for our patients? With patient permission, keeping everyone in the loop can improve quality of care. It also provides us with an opportunity to increase awareness of physical therapy’s capacity and availability so that we can ask colleagues, such as case managers like Muller, to promote direct access. Only then can we build a strong coalition of support to make changes that further enhance our care of, and access to, consumers who need physical therapy. Consider Muller’s article a call to action: let others in on the secret. Physical therapy and direct access to it is a great resource for consumers, but it is worthless if nobody knows about it. ^1Muller LS. Direct access—the best kept secret: a “seasoned” case manager learns from personal experience. Professional Case Management. 2007;12(3):170-77. < Back to Table of Contents
Minnesota Athletic Trainers Seeking to Change Scope of Practice
By Kathleen Picard, PT, Board of Directors APTA Member since 1977
The Minnesota Athletic Trainers’ Association (MATA) has introduced a bill to the Minnesota Legislature that changes the Athletic Trainers’ practice act. Just like physical therapists, athletic trainers are committed to the advancement of their profession and have an interest in how their scope of practice is defined in statute. The athletic trainers’ bill (HF 2399 / SF 2336) broadens the scope of practice by terminology changes. Currently, by law, athletic trainers: -- Treat only “athletes,” (which is defined) -- Treat only “athletic injuries” (which is defined) -- Are allowed to treat without referral for 30 days -- Have no direct supervision requirement except when providing “physical therapy” -- Work under a blanket “protocol” that indicates which procedures and modalities can be performed. The protocol is signed once annually by the “primary physician” who serves as a medical consultant to the athletic trainer. MATA is seeking to substitute the word, “patient” for “athlete” (above) and delete the word “athletic” before “injuries” throughout their statute. MN APTA has met with MATA to discuss the bill and to better hear MATA’s intent. MATA indicated that it, as an association, is attempting to clarify who athletic trainers are and what they do, and to create statutory language that is consistent with other “medical providers.” MATA is also seeking to reflect the practice settings in which athletic trainers are currently employed, and may be employed in the future. MATA denies that the bill will expand athletic trainers’ scope of practice. MN APTA believes that this bill significantly increases athletic trainers’ scope of practice. Scope of practice language attempts to describe who (or what conditions) an individual can treat and the means by which the individual can treat—WHO and HOW. According to MATA, a Role Delineation Study is done periodically by the National Athletic Trainer’s Association (NATA). This study is based on a survey of practice settings in which athletic trainers are currently employed and on the responsibilities that their employers have allowed. The Role Delineation Study is used to define the scope of practice and becomes the basis of the certification exam. The exam then, drives education. The most recent Role Delineation Study indicates that besides their work with sport teams, athletic trainers are currently employed in: -- School settings treating pediatric patients -- Industrial rehab and occupational health settings -- Physician practices as physician extenders -- Physical therapy practices providing physical therapy -- Inpatient hospitals providing ADL training and exercise in orthopedic units under the supervision of nurses MATA’s bill was discussed by the MN APTA Board of Directors, and MN APTA is strongly opposed to this bill. You can always contact a member of the MN APTA Board of Directors to express your own opinion, and there will be a discussion on this topic at the MN APTA Fall Conference in Duluth. < Back to Table of Contents
THANK YOU! The MN PT PAC would like to thank the 63 individuals who have supported the MN PT PAC so far this year. Without each person’s financial commitment, PTs and PTAs would have a difficult time representing their interests in the legislature. We would like to especially recognize those who have contributed at the following levels:
Contributing ($75-$99) Catherine Barkow, PT Rita Kopp, PT Anne Leck, PTA Cheri McGee, PT Daniel Milejczak, PT Janet Nordstrom, PT Diana Nowatzki, PT Sarah Walker, PT Supporting ($100-$249) Monica Chase, PT Leslie Gentner, PT Kristine Gjerde, PT Trevor Harting, PT Rick Hjelm, PT Alana Howey, PT Peggy Johnson, PT	Supporting, continued ($100-$249) Michael Kern, PT Jeffrey Kittleson, PT Brian Maldonado, PT Paul Neimuth, PT Eva Norman, PT Kathleen Picard, PT Ann Ryan, PT Susan Sandvik, PT Lillian Schroeder, PT David Solheim, PT Leading ($250-$499) Judy Hawley, PT Craig Johnson, PT Visionary ($500+) Joan Purrington, PT Dan Wolfe, PT
If you would like to contribute, send checks to MN PT PAC, c/o Alana Howey, 991 Parker Ave., Roseville, MN 55113. No corporate checks please! < Back to Table of Contents
Laura Gilchrist is Minnesota Recipient of APTA Emerging Leader Award
By Joan Purrington, PT, MN APTA President APTA Member Since 1975
The APTA announced that Laura S. Gilchrist, PT, has received the Emerging Leader Award. It was an honor for MN APTA to recommend Laura for this prestigious award, which identifies and honors one physical therapist or physical therapist assistant from each APTA chapter or section who has demonstrated extraordinary service early in his or her physical therapy career.  Laura is an exemplary MN APTA volunteer and leader within the profession. She has been a member of the APTA since 1996, a member of the MN APTA Research Committee since 1998, and Research Committee Co-Chair since 2003. She is a member of the 2007 House of Delegates (and will also be a delegate to the 2008 House), and a critical member of our legislative consumer access bill (CAB) workgroup. She is an excellent mentor for new MN APTA volunteers within her committee, on the CAB workgroup and in the profession. She is always willing to further the work of our chapter and profession as we strive to reach Vision 2020. Laura is a member of the Cardiovascular and Pulmonary, Neurology, Oncology, and Research Sections of APTA. She attends APTA Combined Section Meetings as well as other continuing education opportunities. She is also a frequent presenter at national APTA meetings. Laura is a reflective thinker and excellent contributor to any discussion. She is invaluable to the MN APTA’s legislative process. She is responsible for leading the Research Committee’s efforts that provide the evidence to support our consumer access bill. She has analyzed and interpreted the research data and put the information into a format that was both understood by members of the legislature, and easily retrieved by MN APTA members who were using it to support critical points during hearings and negotiations. Under her leadership, the Research Committee submits “Evidence in Action” for each issue of our chapter newsletter that reviews the evidence for a stated clinical question and ends with a clinical decision and references. The Research Committee also oversees poster presentations at our Spring and Fall Conferences, and there is always a good turnout. Furthermore, the Research Committee was instrumental in developing and initiating the first “Research Platform Presentation” at our 2007 Spring Conference. The presentation was given excellent reviews by attendees, and we anticipate having platform presentations at future conferences. The Research Committee is always slotted to present a two-hour “Evidence-based Practice in Action” course at one or both of our yearly chapter conferences. Laura oversees the preparation for these courses and she has presented, in collaboration with colleagues, the following courses: “Balance Impairments in a Patient with Diabetic Neuropathy: Should I use MIRE?”, “Doing the Right Thing (Evidence)”, “Walking the Web, A Return Engagement”, and “Am I Doing the Right Thing? Will Aquatic Therapy Help My Patient’s Bone Density?” Laura is Associate Professor at the College of St. Catherine, Doctor of Physical Therapy Program. She is instrumental in getting students to join APTA and to participate in chapter activities. She has overseen multiple St. Kate’s student research projects that have been presented at the MN APTA Spring and Fall Conferences. Laura is unique in the multiple contributions that she has made on behalf of the APTA and profession. Please join the MN APTA Board of Directors and staff in recognizing this exemplary individual. < Back to Table of Contents
New 2007 Certified Clinical Specialists
Congratulations to the following Minnesota physical therapists who became APTA Board Certified Clinical Specialists this year! The new Orthopedic Clinical Specialists (OCS), Neurologic Clinical Specialists (NCS), Sports Clinical Specialists (SCS), and Geriatric Clinical Specialists (GCS) are: Kristopher G. Balgaard, PT, OCS Megan Dowdal-Osborn, PT, NCS Todd J. Duncan, PT, OCS Staci L. Eischen, PT, NCS Amy Bratton Gagnon Garrigues, PT, OCS Marguerite Y. Heie, PT, OCS Timothy L. Hennum, PT, OCS Jerilyn A. Johnson, PT, OCS Christopher D. Kramer, PT, OCS Sara E. Kylander-Johnson, PT, OCS Katherine A. Larson, PT, SCS Bradley J. Leavelle, PT, OCS Karlene M. Madill, PT, GCS James Matheson, PT, SCS, OCS Aaron Rindflesch, PT, NCS Paul J. Solie, PT, SCS Karla Jo R. Thompson, PT, OCS Ryan F. Torgrude, PT, OCS Heather Vander Weide, PT, OCS Derek L. Vraa, PT, OCS Barbara Young, PT, NCS < Back to Table of Contents
MN APTA Fall Conference: A Time for Harvest October 12–13, 2007 Duluth Entertainment and Conference Center (DECC), Duluth, MN Continuing Education: -- A Generational Storm? Preparing for the Ethical and Financial Challenges in Health Care as “Boomers” Retire -- Cognition in the PT Clinic: What Does Thinking Have to Do with Moving and Moving to Do with Thinking? -- Conservative Treatment of Tendinopathy: An Evidence-Based Medicine Approach -- Developing Your Clinical Education Program: Tapping Into Opportunities for Today and Tomorrow -- Ethics in Action -- Getting Organized So You Can Think -- Health, Wellness & Prevention: A Missed Opportunity for Physical Therapy Practice? -- Pediatric Constraint Induced Movement Therapy -- Pediatric High-Intensity Strength Training: It’s Not Just for Athletes Anymore -- Pilates in Geriatrics -- “Stretching the Truth?” An Evidence-Based Look at Stretching Conference Highlights: -- MN APTA 80th Anniversary Retrospective -- Silent Auction -- Exhibit Hall -- Research Poster Presentations -- “The Vision Is Ours” -- Special Interest Group Meetings: Students, Physical Therapist Assistants, Home Health Join us and reap the benefits! < Back to Table of Contents
Marilyn Woods Scholarship & Leadership Symposium
By Cort Cieminski, PT APTA Member since 1986
Announcing the Marilyn S. Woods Scholarship The College of St. Catherine is honored to announce that the family of Marilyn Woods has established the Marilyn S. Woods Scholarship. The scholarship will be used to financially support students of the Doctor of Physical Therapy Program at the College of St. Catherine. Marilyn had a long and tremendous impact on the physical therapy community in Minnesota. This scholarship is a fitting tribute to her commitment and dedication to the profession she loved and it will serve to extend her legacy to future physical therapy practitioners. Tax-deductible donations can be sent to: College of St. Catherine Development Office, F-12 Attention: Becky Rizzio 2004 Randolph Avenue St. Paul, MN 55105 In the memo line of your check please indicate "Marilyn S. Woods Scholarship." ---------------------------------------------- Marilyn Woods Leadership Symposium The Doctor of Physical Therapy (DPT) Program at the College of St. Catherine is pleased to announce that its annual DPT Student Leadership Symposium will be named in honor of Marilyn Woods, starting in the fall of 2008. During the symposium, first year DPT students meet with a panel of local, state and national leaders in physical therapy to hear about their leadership experiences. Then each student formulates his/her individual leadership plan and goals, given the guidance of guest panelists. Ever since it began in 2003, Marilyn took part in this Leadership Symposium and shared her amazing story of commitment to and leadership within the physical therapy profession. The DPT Program is pleased to remember Marilyn in this tangible way by renaming this event the Marilyn Woods Leadership Symposium. < Back to Table of Contents
Membership Moments
By Melanie Brennan, PT, Membership Co-Chair APTA Member since 1996
The MN APTA Membership Committee has been working diligently this year to connect in many ways with both current and prospective members. We connected with over 60 PTs and PTAs at the MN APTA Spring Conference and gained over 20 new volunteers for the Minnesota Chapter. We have introduced prospective members and current members to the benefits of APTA membership during Stand Up & Be Strong! training classes. In the coming months, you will see us at the MN APTA Fall Conference and at a New Professionals event, which is still being planned. We are making meaningful connections with PTs and PTAs in Minnesota one at a time. In this personal way, we hope to understand why members choose membership and why others choose to be non-members. We are also looking at membership retention and ways that we may be able to boost retention. Each one of you can help us in our efforts by doing one or all of the following: -- Talk to a co-worker who is not a member about why they choose not to be a member. Listen to their story and then tell them why you are a member. Do not criticize, but ask him/her to try membership, since there is more value now than ever before in membership. -- Renew your membership on time. If you are late, you will receive a packet from MN APTA reminding you to join. We will soon include a survey to address why you are not choosing to renew so that we can learn what we can do to retain our members. -- Volunteer to help, in some small way, with the APTA, at the state or national level. You will learn much about the value of membership and all that the Minnesota Chapter does for you. Involved members stay members forever! There are many tasks that require only limited time commitment and that can be done from home or in your local community. -- Be a Member Connector. Share “The Link” with your PT friends and coworkers. This Minnesota membership newsletter is full of interesting information for both members and prospective members. E-mail Debbie Roberts at debroberts2@juno.com to sign up. In 2008, you will receive MN APTA’s first official all-member survey. We want to hear from each of you about what you value most in your membership. Thank you for your dedication to your profession – we hope you will be a life long member!! < Back to Table of Contents
Evidence in Action
Reviewed by the MN APTA Research Committee
Clinical Question: You are asked to evaluate a patient who has undergone a coronary artery bypass graft (CABG). She must follow typical sternal precautions such as no lifting over 10 pounds, no excessive movements at shoulder end range of motion, and no pushing or pulling with the upper extremities. Is there evidence to guide what upper extremity movements or factors may place her at higher risk for post-operative sternotomy complications? Evidence: Two recent articles published in Acute Care Perspectives examined the effects of upper extremity movement on sternal skin stress. In the first study1, measurements of sternal skin tension were taken just superior to the xiphoid process while healthy subjects performed full shoulder flexion, extension, and horizontal abduction range of motion. The second study2 measured skin distortion inferior to the sternal angle during shoulder flexion, extension, abduction, external rotation at 90^o of abduction, external rotation at neutral, and horizontal abduction. This study also included the anthropometric variables of body mass index (BMI) and breast size. Measurements were taken during bilateral and unilateral arm movements in both studies. Results: In both studies, significantly greater skin stress occurred with bilateral than unilateral movements. Skin stress was also found to be significantly greater with shoulder flexion and abduction than the other movements tested, with flexion creating the most skin distortion. A significant correlation was found between breast size and sternal stress during movement in the second study. Clinical decision: The patient was educated in traditional sternal precautions with emphasis on avoiding excessive shoulder flexion and abduction. She was taught to utilize unilateral arm movements as able to assist with transfers and bed mobility within the constraints of her precautions. ^1 Irion G, Benefield P, Bolton R, et al. Effects of shoulder range of motion on sternal skin stress. Acute Care Perspectives. 2005;14(1):13-14. ^2 Irion G, Boyer S, McGinnis T, et al. Effect of upper extremity movement on sternal skin stress. Acute Care Perspectives. 2006;15(3):1-6. < Back to Table of Contents
Meet the New MN APTA Physical Therapist Assistant Special Interest Group (PTA SIG) Chair
By Julie McDonald, PTA, PTA SIG Chair APTA Member since 1999
I would like to take this opportunity to introduce myself. My name is Julie McDonald and I am the new chair of the MN APTA PTA SIG. This has been a very exciting year for PTAs, and I am excited to chair this group. PTAs should be proud of their profession, and can always look for future opportunities to help our profession grow and to expand our knowledge. I want to invite all PTA members to attend PTA SIG meetings, which are held at the MN APTA Chapter office on the third Monday of every month at 6:30 p.m.; for a full schedule of PTA SIG meetings, you can visit the MN APTA Online Calendar. Please join us for discussions regarding how PTAs can help their profession and professional organization. During our meetings, we also discuss articles and provide short in-services on courses that we have attended in order to share our knowledge about the different areas that we are currently working in. I also want to invite all of you to the PTA SIG meeting at the MN APTA Fall Conference in Duluth on October 13 from 5:00 to 6:00 p.m. I hope to see you there! < Back to Table of Contents
Student Special Interest Group (SSIG) Events & Activities
By Kevin Gennrich, SPT APTA Member Since 2006
Members of the Student Special Interest Group (SSIG) met once again this past month to discuss and plan exciting events and activities. The main topic of discussion was the upcoming MN APTA Fall Conference being held in Duluth on October 12 and 13. A student meeting will commence at 5:00 PM on Saturday following the last concurrent session at the conference. It will consist of a panel of recent graduates, who will be providing insight on clinical education experiences, the PT licensing exam, and the first years as a clinician. The Minnesota Student Conclave will again be held this fall. Topics may include guest speakers who present students with information about volunteering as a physical therapist. Additionally, students will have a chance to receive feedback on resume writing and interviewing. More information on this event will be forthcoming. Early fall events for the SSIG include attending the Minnesota Twins’ student night and staffing a water station at the Twin Cities Marathon on October 6. Check your email for more information about how to get involved in these activities. < Back to Table of Contents
It’s that time of year... for the Fall Conference Silent Auction! Please support MN APTA through donating a single item or basket to the Fall Conference Silent Auction. Donations in the past have ranged from items such as jewelry and candles to baskets including wine, scrap booking items, and golf necessities. This is an opportunity to call on your creative side! A prize of $50 will be awarded to the top selling basket/item! Please call the MN APTA Chapter Office (651-635-0902) prior to Fall Conference to let us know what you’ll donate.  If you are attending the conference, it is recommended that you bring your donation directly to the conference.  Donations may also be mailed or dropped off at the Chapter Office through Wednesday, October 10. Auction Details When: 6:00 PM Friday October 12 - 3:15 PM Saturday October 13 Where: MN APTA Fall Conference, Duluth Entertainment Convention Center What to bring: Your donation—and get ready to bid on other fabulous items! Questions: Contact Kathy: 651-464-1618 / kjblum@stkate.edu<