Therapeutic Exercise & Physical Agents

Hi Everyone,

Hope you had a nice weekend.I had a nice but busy weekend.Human Nature is strange!!!We complain when there’s too much activity; we also complain when we have nothing much to do :D.

Let’s now see what we have to cover in Therapeutic Exercise & Physical Agents.For “Therapeutic Exercise”,I used the following books:

1.”Therapeutic Exercise:Foundations and Techniques” by Carolyn Kisner & Lynn Allen Colby as primary source 1-As I mentioned in Musculoskeletal System post already,this is a very useful book.You can first read the topics covered by RG here and go back to RG for overview.If you do not have much time before exams,then read RG and use this for additional info on each topic.The good thing about the book it has lots of pictures,examples,indications and precautions in colored boxes making it easy to understand.

2.Review Guide & Blue Book as primary source 2.I would suggest reading these thoroughly.Learn to associate each topic in the chapter with major systems.For example Postural Stability Training  would come in handy while planning rehab programs for Neuro conditions such as Cerebellar disorders,Parkinson’s etc.,

For  “Physical Agents & Modalities”,I suggest the following:

1.Review Guide would be the main source.Try to understand the physiological effects of each modality.List the Indications & Contraindications and Precautions for each in a Table.With so many modalities,it might be difficult to remember everything.Try to find what’s common to the various modalities.For example both Ultrasound and Electrical Stimulation can’t be used in patients with pacemakers and healing fractures etc.,

2.You could search online for additional info.I didn’t read anything more than RG for this chapter.So I would leave it to your discretion.

I wish I could write more on these chapters and suggest more books!!!But that’s all the info I have 🙂

Take care.Study Well…I’ll leave with the following thought:

“Success means having the courage,the determination and

The will to become the person you believe you were meant to be”-George Sheehan

OTHER SYSTEMS-Too many to name…

“SUCCESS IS NOT FINAL,FAILURE IS NOT FATAL;

IT IS THE COURAGE TO CONTINUE THAT COUNTS”-Winston Churchill

I felt frustrated when I failed NPTE. I had given my 100% every time and come up short and felt unworthy because of that.Whatever anyone around me said to cheer me up/console me, was falling on deaf ears.Only when I picked myself up from it and realized it is not the end of the world(trust me it is not!!!!!),I was able to focus and do it.So do not judge self-worth by your results.NO ONE IN THIS WORLD IS  SUCCESSFUL 100% OF THE TIME.IF THEY SAY SO ,DON”T BELIEVE THEM :D.EVERYONE STARES AT DEFEAT ONE TIME OR ANOTHER.WHAT MATTERS IS HOW THEY HANDLE IT,WHAT THEY DO ABOUT IT.

Holding that thought in mind,Let’s move on to “Other Systems”.I used the following books:

1.RG & Blue book as primary source 1.This is an extensive chapter.So give yourself enough time to review.Discuss with your friends/study group and frame your own questions from each topic in the chapter.Combine two or more topics in this chapter with other chapters.This will make it easier to read.Pay attention to the tables.If you have enough time,then make a CHART of Endocrine & Metabolic Disorders.For example, you can create a table to study the signs and symptoms of thyroid disorders,parathyroid disorders etc.

2.”DIFFERENTIAL DIAGNOSIS IN PHYSICAL THERAPY” by GOODMAN & SNYDER is a very useful book.It has pictures,examples and tables to help understand the different conditions easily.I studied:

a)Pain types & Viscerogenic Pain Patterns

b)Screening for Gastrointestinal Disease,

c)Screening for Hepatic & Biliary Diseases,

d)Screening for Urogenital Disease,

e)Screening for Endocrine & Metabolic Disease,

f)Screening the Lower Quadrant & Upper Extremity

I recommend trying to understand all the above chapters.Trust me it’s impossible to memorize it all!!! So go through each chapter 2-3 times.If you wish, make notes whenever you feel a topic has too much info and you only need an outline.

[I wish I had read all the chapters in this wonderful book, but I didn’t have the time.I would strongly suggest you read as much as you can in this book.It would be useful even in your clinical practice later]

It may seem daunting at first to remember all the info at one go.But if you go through the tables every now and then in between your review of other chapters,you’ll remember better.Also try to relate each topic in the chapter with other chapters.For example when you study Urinary Incontinence,each type is associated with a condition.Stress Incontinence is associated with pregnancy,menopause.Urge Incontinence is related to Stroke and so on.This will make remembering them easier.

Hope I’ve given you a fair idea of where to start and what to review in this chapter.We’ll discuss THERAPEUTIC EXERCISE & PHYSICAL AGENTS in the next post.

Let me know your concerns/feedback.I’ll try to do what I can to address them.

Take care.Wishing you all success……

INTEGUMENTARY,PEDIATRIC &GERIATRIC PT-It’s not just about Young & Old

When the World says “GIVE UP”,

Hope Whispers, “TRY IT ONE MORE TIME”

Let’s start with Integumentary Physical Therapy.The following books were used :

1.Review Guide would be primary source 1.I would suggest reading the chapter and understanding it well.It has useful tables explaining the standard precautions,methods of debridement, difference between arterial & venous ulcers and various occlusive dressing characteristics.

2.PHYSICAL REHABILITATION by Sullivan and Schmitz(Fourth/Fifth Edition)-I read the Burns, Peripheral Vascular Disease(PVD) and Wound Care in this book.These are very useful chapters and would make studying the Review Guide easier.If you read PVD during your review of Cardio-Pulmonary Physical Therapy,then you could complete this chapter soon.

3.Look for pictures of various degrees of burns,venous,arterial and pressure ulcers online so you would get a good idea of how each degree of burn/ulcer would look like.

For Pediatric Physical Therapy you can use the following books:

1.RG & Blue book as primary sources.You could make your own tables for the milestones and reflexes during development in a child.You could mention at exactly which month the child is supposed to sit,stand,self-feed and how long a reflex should last and so on.

2.For additional info on the reflexes you can refer to the chapter,”Assessment of Motor Function” in PHYSICAL REHABILITATION by Sullivan and Schmitz(Fourth/Fifth Edition).

For Geriatric Physical Therapy I would suggest:

1.Review Guide as the primary source.For additional info on the medications for Osteoporosis refer to the Pharmacology section in the Blue Book.

2.You could search online for X-rays & CT Scan for Osteoporosis,Dementia etc

As I’ve always said,you might find practice test questions on topics not covered by the above mentioned books.So you might need to refer online or other books for those.What I’ve given here is just an outline.Try to do more practice tests.The more you do them, more you learn.What is important is to learn to apply your knowledge to finding the right answer.

Let’s discuss “OTHER SYSTEMS(GI,GU,Metabolic systems etc) in the next post.

I guess that’s all I have for now.Have a Nice Weekend 😀

Cardio-Pulmonary System

“NOBODY GETS TO LIVE LIFE BACKWARD;LOOK AHEAD THAT IS WHERE YOUR FUTURE LIES”-Ann Landers,a famous journalist said this.It seems difficult to follow sometimes,but it is a practical piece of advice 🙂

It doesn’t matter how you’ve done your review until now.What matters most is how you are preparing,going forward.Sure we all do have bad days/weeks.What’s important is to pick up the pieces and move ahead full throttle.

Today let’s discuss what to study in Cardio-Pulmonary System.I used the following books:

1.RG and Blue book as primary source- I read the chapters Cardiovascular and Pulmonary System entirely.The Pharmacology Chapter in Blue book is very good as it explains the medications for a variety of conditions(including cardiovascular).Do not miss that useful chapter.You can search online for additional info on drugs used in cardio-pulmonary conditions.

2.PHYSICAL REHABILITATION by Sullivan and Schmitz(Fourth/Fifth Edition)- I studied Heart Disease,Chronic Pulmonary Dysfunction,Peripheral Vascular Disease & Wound Care.It would be beneficial to read the chapters thoroughly and mark important points with a marker/highlighter, which would help during revision.

3..”Therapeutic Exercise:Foundations and Techniques” by Carolyn Kisner & Lynn Allen Colby 5th edition-You can read Principles of Aerobic Exercise, Management of Vascular Disorders of the extremities,Management of Pulmonary Conditions

4.Wikipedia has a useful article on “Respiratory Examination”.It is simple and can be used as additional reference.If you would understand well by pics,then type “Chest Examination” in Google.You would also find related videos.

5.You could refer MedlinePlus for additional info on Cardiovascular & Pulmonary conditions.

6.BLS & CPR Guidelines-You could go to American Heart Association’s website for the latest guidelines.

7.ECG-This is a vast topic by itself.I would suggest sticking to the basics of ECG and trying to remember ECG changes for most commonly encountered conditions.

If you feel you might not have time to go through all these books again during revision,then try to make notes for each condition during review.As I said before you might come across questions from topics not covered in these books too.So make a note of them and study those.

I’ve given you an outline of the two systems I wished to discuss in this post.Hope it helps you in studying these units.

Let’s discuss INTEGUMENTARY,PEDIATRIC & GERIATRIC PHYSICAL THERAPY units in the next post.

NeuroMuscular System-It’s all about testing your neuronal connections…Literally :D

Scientists say “Learning is accompanied by the development of new neural connections”.I am sure we develop many neural connections while preparing for NPTE as we have to store large amounts of information 😀

NeuroMuscular System is another huge chapter like Musculoskeletal system.So I would strongly suggest not studying them consecutively.It’ll be too much to handle two big chapters one after another.Pair a major chapter with two or three relatively easy ones.

I used the following books:

1.RG by Sullivan-Primary Source 1.I found the neuro-anatomy,physiology and neuro-examination to be comprehensive and didn’t go for additional references.I also studied the Neurological Dysfunctions(i.e Neuro conditions) and Neurological Interventions from here.

2.PHYSICAL REHABILITATION by Sullivan and Schmitz(Fourth/Fifth Edition)-Primary Source 2

a)I studied Stroke, SCI, TBI, MS, Parkinson’s, Vestibular Disorders and RSD from this book.

b)PNF and Motor Learning  Approach has also been explained well.

c)The treatment approaches  for Cognitive & Perceptual Dysfunctions(Agnosia,Neglect etc) and Speech & Language Disorders are also given nicely in this book.(IS YOUR HEAD SPINNING NOW? I GET IT.THERE’S TOO MUCH TO READ.BUT END OF DAY, ALL THE PREPARATION IS WORTH IT!!!)

d)You could highlight important points in each chapter with a marker[provided it’s your book :)] so when you come back to it during revision you’ll find it easy. Once you’ve studied here and go to RG, it’ll be easy.

3.Blue book is good for SCI and additional info on Neuromuscular conditions & Interventions.It is very well presented there.

4.I searched online for additional info on conditions like Epilepsy,Trigeminal Neuralgia,GBS and ALS etc.For PNL you could follow anatomy/ortho books.

When you’ve finished studying anatomy,physiology & examination,pair each major condition like Stroke with a smaller one such as Epilepsy.Try to prepare questions on each topic and discuss with your study group so you’ll know how well you remember them.

This is just an outline of all that you need to study.When you give your practice tests,you might come across topics not covered by either of the sources I mentioned above.Study those too.More importantly try to  understand most of what you study.When you do that learning becomes less of a burden.Memorizing everything is not possible(atleast for me!!!).So if you don’t understand ask others.Don’t be hesitant(EVERYONE CANNOT POSSIBLY KNOW EVERYTHING!! IT IS NOT A CRIME IF YOU DON’T UNDERSTAND SOMETHING.NO DOUBT IS STUPID/SILLY.NO ONE IS PERFECT 😀).Talking from personal experience I’ve asked others whenever I had doubts and got good answers most times.

That wraps it up….Let’s deal with CARDIO-PULMONARY System in the next post.

Musculoskeletal system & Drafting aTime-Table

Hi

Hope all of you had a nice weekend.

I would like to talk about topics I covered in Musculoskeletal chapter.I studied from the following:

1.RG by Sullivan and blue book as my primary sources.

2.”Joint Structure and Function” by Cynthia Norkin-I read about shoulder complex, Prehension,functional position of wrist and hand,vertebral column and gait in this book.

3.Orthopedic Physical Assessment by David J Magee-special tests for upper limb,lower limb,spine.Most tests have pictures which makes it easy to understand.Also the assessment at the beginning of each chapter is useful.The first chapter of this book-“Principles and Concepts” deals with a variety of topics including dermatomes, myotomes,close packed & loose packed  positions,muscle testing grades,UMN signs,LMN signs .It tells you what to look for while taking a patient’s history,examination & assessment etc.Please go through this chapter whenever you find some time.

4.”Therapeutic Exercise:Foundations and Techniques” by Carolyn Kisner & Lynn Allen Colby-I referred this book for additional information on Surgical Repairs of Upper Limb,Lower Limb and Spine.

5.”Muscles Testing and Function with Posture & Pain” by Florence Kendall-This will be useful in learning the function and testing of various muscles.

This chapter is extensive and requires more time for study and review than other chapters.I would suggest pairing it with some chapter you might find relatively easy.Also when you want to cover a particular topic say upper limb,then focus on one joint say shoulder.Focus on the following:

• Anatomy-you need to have a rough idea about the origin and insertion,nerve supply,blood supply,ligaments,muscle actions
• Functional activities affected with weak muscles.For example if shoulder external rotation is painful and weak then combing hair & dressing self would be difficult.
• Dermatomes,Myotomes of shoulder
• Special tests for shoulder eg:Upper Limb Tension tests,Yergason’s test,Clunk test etc..
• Shoulder conditions such as Dislocations,Fractures,TOS,Peri Arthritis etc.
• Surgical Repairs of Shoulder

This approach will give you the satisfaction of having covered the joint in all aspects.

Now let’s talk about the importance of a TIME-TABLE in studying for the exam.A time-table gives you the focus,makes your study manageable and brings to attention the time you have on hand in preparing for the exam.It will propel you to achieve much better than what you would do without a study plan.I’ve been preparing time-tables since school days.I’ve been able to complete 75% of what I planned to study because of that practice.I’ve also modified them whenever I fall behind schedule.But I can emphatically say they immensely benefit anyone studying for the exams.

When you start studying ,you can list the chapters you need to cover & the time (no. of weeks or the no. of days) you have before the exam.This will give you the idea of how much time you can allot for each chapter.Once you’ve got that in place, then you can start planning  topics to study for each week.Club a difficult and easy chapter for each week.This will make things seem less daunting!! Do not worry if you are not able to keep up with the schedule in the beginning.You’ll keep becoming better at it as you gain focus.

Try not to study 7days of the week until you do your final revision(this applies to people who have time to study during the week).Talking from experience, if you can study with concentration 6-8hrs a day from MON-FRI  it is good enough.Your brain can only take so much information :D.Take a break every 2-3 hrs for 15-20mins.Walk,Sing or do anything you like even a short nap.Then come back where you left off.Start giving practice exams 4-6weeks before your actual test.Do them in between your revisions.Also note down the topics from which you are unable to answer questions.Go back to them and learn.

Also once you’ve completed say 2-3 chapters,when you move to the 4th chapter then briefly review the important topics in the previous chapters.This will give you the confidence that you know stuff and it’s not doom and gloom all the way :):)

That’s all I’ve got for you today.Let’s discuss Neuromuscular System in the next post.You can give your feedback and your take on what I write.Study well.Have fun too…

“AT FIRST DREAMS SEEM IMPOSSIBLE,THEN IMPROBABLE,THEN INEVITABLE”-Christopher Reeve

Research a.k.a Vague,Volatile,Tough all these words and more…..

Research is one topic I felt ill at ease initially.But If you form a study group,search online and find examples for each concept voila! it becomes manageable(note I did not say it’s EASY)

I insist on a study group ,as you would gain fresh PERSPECTIVE on concepts which might be difficult for you to understand.Talking from personal experience,When we discuss with a group, we might LEARN better and benefit from a GROUP DISCUSSION.

Also I found I understood better, when I found simple EXAMPLES online.Let’s say I was reading about positive correlation and searched for an example online.I found some like these.

1.SAT scores and college grades-among college students those with higher scores have higher college grades.This example tells you if two variables are positively correlated, then if value of one variable increases the other increases too.

Also look for pictures of various charts(Bar chart,Histogram etc),+/-vely skewed distribution,mean,median etc…They will help you learn faster(I understood better by examples). Apart from reading Review Guide,Giles etc,you can read “Foundations of Clinical Research:Applications to Practice” by Portney & Watkins.It is a useful book and is written by a PT.So you could relate to the examples given in the book.

I would suggest if you read it interspersed with other topics,you wouldn’t feel the monotony.So set aside an hour or two in your revision plan to discuss with your group. If time permits you could make NOTES from the examples you found online and from Portney,so you wouldn’t have to go back online every time.

Whatever book you follow read that THOROUGHLY.If you understand a concept really well, you could answer most questions in the exam.Keep one book as your primary source.This is to avoid getting confused in the last minute during revision.

I will tell you what books I found helpful for each topic as and when we discuss them in the coming weeks.

That’s it from me.Let’s talk about Musculoskeletal chapter,having a time-table for revision in the next post.

Have a good weekend.

Do scores in Practice Exams REALLY Matter???

Hi Everyone,

I would like to thank you all for reading my first post.I’ve started this blog with the intent of helping physical therapists appearing for NPTE.To all those who have not been able to make it through,Let me state these facts:

We all have worked hard,are intelligent people worthy of success and can be good PTs.I am sure all of us gave our best,100% to the exam.It’s just that we may be lacking in a few areas which we need to identify to be successful.

Hope all of you reading, benefit from my tips/experiences one way or other 😀

I would like to discuss the importance of PRACTICE EXAMS in your NPTE preparation.These exams do matter a lot for the following reasons:

• They will help IDENTIFY deficient/weak areas you need to WORK on during your study.
• The rationale will give you some INSIGHT on how to analyze the info and identify the RIGHT option for the question.
• They will help you in finding if you are able to answer 50 questions in ONE HOUR
• If you are able to give one full length practice exam with only a 15 min break in between more often, it’ll help you sit focused for the actual NPTE

Also getting GOOD SCORES in these exams do matter but only to an extent.They cannot guarantee you will make it.Sure they’ll help your CONFIDENCE(I mean who doesn’t want energy boosters:D)To give you an example,I passed my NPTE in my third attempt.In my previous attempts I got good scores in Practice Exams and was confident of getting through because of that.But What I did not realize at that time was the fact that these exams only give you an idea of areas you need to concentrate in your revision.

So please use the practice exams judiciously.The practice exams I found helpful are:

1. TherapyEd’s  Review & Study Guide by Sullivan and Siegelman.This book comes with a 3 practice exam CD.The exams can be given as many times as you wish –3 Tests
2. The PT course manual (BLUE BOOK) by Therapy ed [You need to attend the 2day course in order to get this book.please check out their website]The book has one practice exam but NO CD-1Test
3. Score builders PT EXAM :The Complete Study Guide.The Book too comes with a 3 sample exam CD that can be given as many times as you want.They have the book as well as the same material in app in their website as well as Amazon-3Tests
4. PEAT developed by FSBPT.They have 2 exams which can be attempted only once anytime during the 30day period.the rationale can be accessed as many times as you want during this period-2Tests

The practice exams are close in their format to the actual NPTE.Try to sit in a room with few distractions.You could sit for just 2hrs initially and do half the exam and in a week or so(when you get used to long hours) you can do the full length exam.MARK those questions which you are not sure of/need more time to think.Then at the end of each section, give your attention to them.Make sure you complete 200 practice questions in 4hrs roughly 50 questions in 1 hour.All of us have the knowledge but we have to learn how to apply it for the exams.

Start doing practice tests 4-6weeks in advance so you’ll get the hang of how to analyze,complete each section on time.Also identify if you chose the wrong answer because you didn’t study the particular topic or if you had the knowledge and still didn’t know how to choose the right one.Differentiating between these two are really important for the following reasons:

• If you didn’t study some topic well, you could study it well so you would be better off next time.
• If you didn’t choose the right answer despite knowing the topic well,then try doing more practice tests to develop your analytical skills

That’s all that I have about these exams.In my next post I would like to talk about Research,a difficult topic to tackle for many.I will explain whatever I know from that topic.Let’s take the bull by the horns Shall we??