“Healthy aging” and “aging well” are used quite often, but people outside the aging services or health care sectors rarely understand the full meaning of these phrases. October is National Physical Therapy Month and a wonderful chance to remind the public of the value of physical therapy in supporting the health and independence of America’s older adults.

In the past, physical therapy was perceived as a reactionary profession; most people believe physical therapists (PTs) only work with people after they were injured. This misconception overlooks much of the value physical therapists offer the older adult community to keep them safe and independent. PTs are changing their profession to include treatment of injury and education on preventive strategies that reduce injuries altogether.

Physical therapists are highly trained health care professionals, with an expertise in movement and exercise. Their skills and knowledge base are essential when dealing with the complexities of aging. Physical therapy training includes assessment, exercise prescription, and progression, all with appropriate monitoring. All these skills can be utilized for older adults before injury happens. And if used more in this way, physical therapists can play a key role in the prevention of injury, functional decline, and disability.
Fitness at any age is made up of five key aspects:

• flexibility
• strength
• endurance
• posture
• balance

Extensive studies have provided norms for each of these categories. By using these guidelines to determine what is normal for older adults of similar age and gender physical therapists can explain how a patient’s circumstances compare with their peers’. More importantly, a physical therapist can assess results against important thresholds related to falls, disability, and even mortality. When areas of concern are identified, a PT can prescribe individualized exercises to strengthen key muscles, improve balance and flexibility, and increase you overall wellbeing. For example, if someone scores low in the area of balance and strength, the evidence-based Otago exercise program could be prescribed. The Otago exercise program has been studied extensively with older adults and is proven to reduce falls up to 50%.
Include PTs in your list of options and resources for aging well. The knowledge and expertise they provide can prevent or reduce issues before they arise, and make it easier for you to stay healthy and independent.
 By Kele Murdin, PT, MPT

Sometimes pain relief can be accomplished through physical therapy. Physical therapy (PT) involves treatments that focus on prevention and management of injuries or disabilities. PT helps to relieve pain, promote healing, and restore function and movement.
PT is practiced by a professionally trained physical therapist. A physical therapist is a specialist skilled and educated specifically in evaluation and conservative management, including rehabilitation, of orthopaedic, neurologic, and cardiovascular conditions..
How Is Physical Therapy Used to Treat Pain?
A therapist may focus on decreasing pain with either passive or active therapy. Examples of passive physical therapy include:

• Manual Therapy
• Massage Therapy 
• Hot and Cold Therapy
• Therapeutic Exercise 

Examples of active physical therapy include:

• Movement based activities, including stretching and range of motion exercises
• Specific strengthening exercises
• Pain relief exercises
• Low-impact aerobic conditioning

Points to Consider About Physical Therapy and Pain
An important aspect to keep in mind about physical therapy and pain relief is that each individual may respond differently to therapy. People have different types of bodies, different patterns of movement, and different habits. Physical therapists and their trained staff can monitor each individual and attempt to correct improper habits and movement patterns.

WebMD Medical Reference 

In addition to medical and surgical treatment, physicians also refer patients to services that provide rheumatoid arthritis therapy practices. These are rehabilitative and therapeutic practices that are focused on restoring joint function, range of motion, and mobility.
​
Physical therapists deliver the RA therapy,  focusing on a better quality of life and overall well-being for their patients.

What is Rheumatoid Arthritis Therapy?
Rheumatoid arthritis therapy is combined with a variety of medications to provide a well-rounded individualized treatment strategy. Rheumatoid arthritis therapy is the non-medication aspect of the treatment strategy which is focused on the physical health and daily living routines of the patient.

Rheumatoid arthritis therapy practices help patients to restore their muscle strength, and adjust their daily activities, with the goal of improving physical and emotional wellness. Different types of rheumatoid arthritis therapies focus on different aspects of physical strength and wellbeing.

Rheumatoid arthritis therapy also addresses the extensive consequences that many patients experience in living with the disease. These may include family, social, physical, work or school obligations that can often suffer as a result of the ongoing condition. Targeted RA therapy helps patients overcome these many challenges.

Rheumatoid Arthritis and Physical Therapy

Rheumatoid arthritis and physical therapy as part of the treatment plan. Physical therapy focuses on restoring strength and mobility, whereas occupational therapy helps patients adjust their routines and activities to their condition while preventing further joint damage.

There are also therapy specialists that patients can choose to see for specialized treatment. Depending on each patient’s unique case, these may or may not be necessary.

Physical therapists work with rheumatoid arthritis patients to maintain and improve their physical strength. This includes regular physical activity, specific exercises, and other methods to keep joints, bones, and muscles moving and stimulated in safe and controlled ways.

Rheumatoid arthritis patients who work with physical therapists on an ongoing basis find that they have more strength, flexibility, and range of motion due to the regular exercises and activities they perform. Physical therapists are responsible for developing and coordinating exercises plans, and they also actively monitor the patient’s progress.

Here are the ways rheumatoid arthritis therapy is performed by a physical therapist:
​
Exercise plan: Predetermined exercise routines and activities can help improve strength and flexibility.

Physical exercise also helps patients improve their overall health levels to protect against infection, illness and other diseases like heart and lung conditions.

Heat and ice treatments: Alternating between heating pads and ice packs can help reduce inflammation and alleviate pain.

Massage therapy: Massage therapy can target specific muscles and provide tension release. Massage therapy can also improve overall levels of well-being.

Encouragement and emotional support: Dealing with rheumatoid arthritis can be very challenging and traumatic. Having a professional physical therapist motivate and encourage you provides positive emotional support.

When the diagnosis of RA is made patients can choose to work with physical therapists on a short-term basis or as needed as their symptoms progress later on in the disease course.  Many patients work with physical therapists regularly for the majority of their lives.

Massage therapist: A specialist who can treat muscle pain in multiple areas of the body. A massage therapist can also help improve joint stiffness and relieve pain.

Electrical stimulation: Electrical stimulation practices like Transcutaneous electrical nerve stimulation (TENS) therapy, can be very effective at relieving pain. These rheumatoid arthritis therapy practices can also improve mobility and joint flexibility.

Thermotherapy: The combination of extreme cold and deep heat to soothe muscles and ease joint pain is called thermotherapy. When extreme cold is used on its own to relieve pain and reduce inflammation, this is a rheumatoid arthritis therapy practice known as cryotherapy.
Hydrotherapy: Physical therapists can also specialize in hydrotherapy, which guides rheumatoid arthritis patients through slow and controlled exercise movements in the water. It’s a relaxing form of exercise and the movements under water help to ease pressure and stiffness in joints.

How Rheumatoid Arthritis Therapy is Included in Treatment

While physical and specialized rheumatoid arthritis therapy treatments won’t cure or stop the disease, they are critical components in helping patients adjust to their disease, improve their quality of life and achieve better health and well-being.

Physical  therapy combined with well-rounded medications treatments can allow rheumatoid arthritis patients to live fulfilling and healthy lives despite their disease.

Those who suffer from arthritis, back, and joint pain often dread winter weather. Every broken tree branch carries the reminder of the dangers of the cold, but why do we feel this way when the weather shifts into the snowy season? Physical therapists often treat injuries related to the cold, like those who slip and fall, but there are ways physical therapists can help you alleviate some of the aches from the cold as well.Outside Temps Affect Your Body
When the temperature drops, most people’s inclination is to swaddle themselves up to keep warm. This reaction is due in part to our muscles reacting to the cold – they tighten, contract, and become more rigid as a result. This in itself can cause soreness and aches in your body just due to prolonged contraction of muscles – you might not intentionally be flexing, but thanks to the cold your back, arms, or legs are getting a tiny workout.
Many people think that the reason behind our aches and pains during winter is simply the temperature itself – your body does contract and tighten in cold as opposed to warm, but it is not the only cause.
​Barometric Pressure
When you can “feel” weather moving in – unfortunately that does not indicate an intuitive quality, but it is 100% real. Your body can feel shifts in barometric pressure, from your muscles to your brain. It can shift the way your brain registers feelings in conjunction, so while most people joke about predicting the weather with their knee or hands, chances are they do have an ailment that is more sensitive to these changes in weather patterns and pressure. Particularly those with arthritis tend to feel these effects heavily – and generally the lower the pressure, the more painful the arthritis pains.
Pains and body issues will vary for everyone, so a specific seasonal plan can be put in place by your physical therapist to help you manage year-round depending on how severe you experience these changes. Some more common methods of managing body soreness in the winter is simply by creating heat in your body. Things like jumping rope indoors, thoroughly stretching, and keeping your body moving will certainly help warm up your muscles, but you can try different topical heating ointments, or even a heating pad to target certain areas of your body.

Not sure where to start? Contact Ken , Betty , or Colette at Zenergy to learn how you can manage this season’s ailments and put together a treatment plan to manage it long-term. If you are experiencing chronic pain or need help recovering from an injury, get in touch with Ken, Betty, or Colette at Zenergy Physical Therapy. Our highly-trained staff can assist you to get you active and feeling great again! 
Contact us today to get started. 

Patients who have been diagnosed with type II diabetes require serious intervention to help them control their blood sugar. While medication can certainly help, lifestyle changes – specifically, diet and exercise – are essential to good blood sugar control.
Unfortunately, by the time many patients are diagnosed with type II diabetes, they have already developed medical conditions that can make exercise difficult. They may be obese, have begun to develop or have already developed full-blown diabetic neuropathy, or have developed metabolic syndrome, for example. Because of that, it may be neither safe nor effective to expect patients to begin to undertake exercise on their own. This is where physical therapy can help with diabetes management.
Physical therapists work with diabetic patients frequently, so they are experienced in handling any difficulties and concerns patients may have that might otherwise keep them from exercising. Because they are so familiar with diabetes management through exercise, they can foresee and circumvent just about any problem that may arise when they construct patients' fitness programs, thus making physical therapy even more effective and preventing injury.
Benefits of using physical therapy for diabetes management

• Provides a safe environment for exercise

If patients are out of shape, or have neuropathy that makes it difficult to feel, to balance properly, or experience cardiovascular problems, or significant obesity, for example, they may actually be afraid to exercise – and rightly so. If patients don't know how to exercise or haven't done so for a while, they could harm themselves by trying to do too much too soon. Just as importantly, if they have comorbidities that make unsupervised exercise dangerous, diabetes management through exercise is actually contraindicated – unless they can do so in a safe, supervised and controlled environment like that provided through physical therapy.

• Provides customized programs specific to patient fitness levels and health

Physical therapists can work with patients to develop customized programs that are specific to their particular health conditions and fitness levels. Patients with neuropathy, balance problems, general lack of conditioning, arthritis, and obesity, for example, can't simply undertake a "one-size-fits-all" approach to exercise. They can, however, work closely with a physical therapist and follow an exercise program that takes these conditions into consideration, gradually improving health and fitness. These programs can also be geared to work on patient-specific difficulties like balance, muscle strength, and general conditioning.

• Provides customized adjunct treatments as needed

Adjunct treatments like anodyne and aquatic therapies and massage may be incorporated into physical therapy sessions to further alleviate symptoms of neuropathy and other conditions like arthritis. This can help patients continue with exercise programs and conditioning when they otherwise may not be able to.

Following a stroke, about two-thirds of survivors receive some type of rehabilitation. This is a time of both hope and anxiety for stroke families: hope that the survivor will make a good recovery; anxiety or fear about what happens next and what to expect.
Of course, the first priority after stroke is stabilizing the patient. Once a hospitalized survivor is medically stable, they may be moved to inpatient rehab. Inpatient rehab is sometimes referred to as acute rehab and requires at least three hours of therapy a day. The goal of inpatient rehabilitation is to return patients safely to their home environment. The average stay is 15 days, although some patients may stay less and others may stay longer. Patients not able to meet the requirements of inpatient rehab may be discharged to a skilled nursing facility.  After leaving inpatient rehab, survivors are typically discharged home.
“Once home, survivors may need ongoing therapy to continue to build their strength and return to the activities they pursued before the stroke,” said physical therapist Kim Brennan, administrative director of outpatient therapy and specialized services at Shirley Ryan AbilityLab in Chicago. In that case, survivors may be transitioned to outpatient rehab, either provided in an outpatient clinic or at home through a home healthcare agency. In outpatient therapy, survivors go into a rehab facility, which distinguishes it from home-based therapy. Prescriptions and insurance vary, but outpatient therapy is typically two or three hours, once or twice a week.
“Whether a patient is referred to inpatient or outpatient therapy depends on the level of medical care required,” said Brennan. “When a patient’s medical status can be managed and monitored without IVs, nursing care and the like, then the patient can be considered for outpatient rehabilitation.”
Outpatient or Home-based Therapy?
The decision of whether to use outpatient or home-based therapy depends on the survivor’s abilities. “If the patient demonstrates difficulty getting in and out of the home, he or she would be a better candidate for home health therapy until he or she is strong enough to regularly attend therapy in an outpatient clinic,” Brennan said. “Stairs can often be a barrier to transitioning out of the house for appointments or community events, and having a therapist come to the house to practice the stairs and negotiate the rest of the home environment can be helpful. Inpatient rehabilitation simulates these activities, but everyone’s home environment is unique and presents different challenges after stroke.”
“Whether a patient is referred to inpatient or outpatient therapy depends on the level of medical care required.” — Physical Therapist Kim BrennanHome therapy is not considered to be part of outpatient therapy; it is a separate level of care. Home health therapy is often recommended when a patient is homebound and may require continued nursing support for issues such as wound care, blood draws, etc., in addition to therapy care.
Bridging Levels of CareAt Shirley Ryan AbilityLab, they offer a program called Day Rehabilitation, which is a bridge from acute inpatient rehabilitation to outpatient therapy. “Day Rehabilitation provides patients with three-to-six hours of therapy three-to-five days per week with the primary goal of community reintegration,” Brennan said. “Upon discharge from this program, outpatient therapy may be considered if ongoing therapy is required.” Not all rehab hospitals have a program like this.
Types of Therapies in Outpatient FacilitiesOutpatient therapy may consist of occupational, physical and speech therapy. Recreational, art, and music therapy may also be offered during inpatient rehab or at a skilled nursing facility. Brennan says that they collaborate closely with their fitness center so that patients have the option to pursue a personalized exercise program with an exercise physiologist upon discharge.
Getting the Most Out of an Outpatient Therapy RxBrennan offered a few recommendations patients should consider for outpatient care:

• Of course, picking the right facility is key. In therapy, one size does not fit all. The most successful rehab is provided by a team of therapists who discuss the various needs of individual patients. Patients and their families need to be included as members of that team. So, a good question for stroke families to ask is “are we involved in patient-care plan discussions?”
• Finding the best providers for your condition is key, so it is important to call ahead to make sure the clinic has the specialists who fit your diagnosis. “What kind of therapy do you offer?”
• It is important to get one-on-one quality time with your therapist so that you can get the most out of each session and make quicker gains. Although group therapy can be beneficial in some instances, avoid situations where survivors are given only or primarily group therapy. Ask: “How much individual therapy will my survivor receive?”
• Patient-established goals are important. They should be set at the beginning of care and monitored regularly to ensure progress is being made. “Are you going to ask my father what his goals are and design his rehab program around those goals? How will they be monitored?”
• Communication is key! Open lines of communication with your provider around progress, goals and any barriers that may arise are important to ensure that you achieve the best outcome  Location shouldn’t be the only considerationIn most areas, there are more outpatient facilities than inpatient, and often stroke families chose a facility that is close to home. Brennan cautions that geographic location may not be the most relevant criterion: “It is very important to find the clinic that is best positioned to promote the quickest recovery and best outcome for the patient, regardless of location,” she said.
  The good news is that despite the inherent complexity of the stroke recovery process, rehab works, and families can expect to see improvement as their survivor recovers and orients to a new self. Carolee J. Winstein, Ph.D., P.T., the lead author of the American Stroke Association’s Guidelines for Stroke Rehabilitation and Recovery for Adults remains optimistic for stroke survivors in rehabilitation: “I think it’s important for family members to expect some recovery. It may not be full recovery, back to the way the person was before, but it is not a death sentence. I think we have to say there is definitely hope. If you made it through the acute phase, there is definitely hope.”
  The End of Medicare Outpatient Therapy CapsThe two-year budget deal, approved by the House and the Senate and signed into law in February, included provisions that expand access for telestroke and cardiac rehabilitation services, remove restrictions on Medicare outpatient therapy caps and help improve the health of patients with cardiovascular disease.
  Past caps on therapy have seriously limited treatment options for millions of Americans. As a result of the budget deal, Medicare patients will have access to medically necessary rehabilitation services without the $2,000 limit that was in place. Brennan cautioned that this repeal does not throw open the doors of rehab facilities for unlimited rehab for survivors. “Although the cap on Medicare therapy has been repealed, established Medicare guidelines are still in place,” she said. “This means there are still limitations to what Medicare will cover, from a medical necessity standpoint.”
  Patient Profile: CONNIE STAGNAROSeventeen years ago, when she was 38, Connie had a TIA while riding a bike in Woodstock, New York. When the EMTs examined her, they thought it was heat stroke, administered fluids and sent her on her way. After returning home to Manhattan the next day, her left side went limp while crossing the street, and she was taken by ambulance to a nearby hospital. Connie had had a stroke. She later transferred to Rusk Institute of Rehabilitation Medicine at New York University for inpatient therapy. “At that point, I could not move the left side of my body and had mild left side facial drooping,” she recalled. “Fortunately, there were no cognitive deficits, and I could speak clearly.”
  She describes inpatient therapy as “boot camp — in the best sense.” Before leaving inpatient therapy, she met with her primary rehab doctor and physical therapist; at that time, her deficits were left side weakness and lack of feeling in her left hand.
  After her discharge from “boot camp,” Connie visited Rusk once a week as an outpatient for a month. “The schedule was rigorous with both occupational and physical therapy, and the exercises focused on my deficits,” she said. “We also discussed how to manage my daily needs. For example, when I should use a cane and how to manage myself in crowds. I did think I would always need a cane, but my confidence grew as I returned to my daily routine. I eventually gave up the cane. My preferred one toward the end was a folding cane that I could keep in my bag just in case I needed one.”
  Her therapist emphasized exercises to boost her stability in crowds because her commute to work involved riding two buses, a subway and walking on crowded sidewalks. “She would gently push me as I walked to improve my balance,” Connie said. “She was particularly kind when I broke down and cried after feeling overwhelmed by my entire post-stroke experience.”
  Survivor Connie Stangaro with her furry friend
  
  Connie describes inpatient therapy as “boot camp — in the best sense.”After discharge from the outpatient program at Rusk, she continued therapy at home on a weekly basis. The exercises included strength exercises on a mat and walking/gait exercises.
  “Those sessions at home were helpful because they were in a nonclinical, real-world environment,” she said. “I lived on a cul-de-sac, so my therapist could safely have me walk outside my home, over ruts and imperfections.”
  Connie’s goal was to feel independent and reduce the anxiety she felt about her commute: “While the buses didn’t unnerve me much, any subway rides made me anxious because of the jostling crowds and the likely inability to sit. It did take me some time to be able to ride on a subway alone. I wanted to feel physical stability again.”
  Connie did return to her job as an archivist in a research library after five months: “I felt confident in my ability to navigate in public areas and often move boxes and files,” she said. Her deficits slowly lessened as she returned to her daily routine. “While I’m considered ‘cured,’ if I get too tired or I’m sick, I do feel mild weakness on my left side, particularly when I’m walking. Doctors never found a cause for my stroke. My paternal grandmother did suffer a stroke at the same age I did, so I most probably had some genetic disposition. I continue taking a blood thinner. The trauma I suffered is past, but my body remembers when I feel depleted emotionally or physically. My left side can feel the effects of any slight physical debilitation. For example, I was recently diagnosed with a problem with my proprioception (the sense that gives you orientation as you move) because of slight arthritis in my neck. My balance is slightly compromised, and my stroke side may feel weaker. But whatever indirect physical impediments I may face as a reminder of my stroke, I know from experience that the brain’s ability to adapt is a marvel!”
  Before Leaving the HospitalHere are some things to keep in mind as you are planning for discharge from the hospital:
• Not all types of facilities are available everywhere; so, depending on where you live, you may have lots of choices, few choices or no choice at all without travelling some distance.
• Insurance may limit what facilities are available, e.g. a specific facility may not be “in-network” on your health plan.
• If there are multiple options in your area, ask the healthcare team for a recommendation.
• Find out more about any recommended facility. Check it out on the Medicare or Commission on the Accreditation of Rehabilitation Facilities websites that share quality rating and accreditation information. Talk with staff of the facility and take a tour.
• Use these free American Stroke Association resources to help:
  • Making Rehabilitation Decisions guide— This 9-page guide helps shine light on what to expect and how to make the best decisions about your next recovery steps.
  • Stroke Rehab Planning List-This 2-page, quick reference will help you ask all the right questions as you make decisions about your stroke rehab.
• Visit the American Stroke Association website for more information and resources about stroke rehab and recovery.
  This information is provided as a resource to our readers. The tips, products or resources listed or linked to have not been reviewed or endorsed by the American Stroke Association.

Reference: 
​http://strokeconnection.strokeassociation.org/Summer-2018/What-to-Expect-from-Outpatient-Rehab/

Each year for over twenty years, we have celebrated Healthy Aging Month.
It is a great time to share the latest insights from the experts about how to live a healthy life as we age.
Healthy aging encompasses many aspects of our lives, whether we are family caregivers or senior adults.
The puzzle of healthy aging is composed of pieces such as healthy eating, physical activity, preventive health care, attitude, behaviors, socialization, engagement, positive lifestyle decisions such as smoking cessation and wearing seat belts, lifelong learning, financial well-being, and more.

Tips for Healthy AgingPick a few or work on many of these tips to improve your own and your senior loved one’s lifestyle so that you can begin reinventing yourselves towards better well-being.
Here are 7 tips for healthy aging from Healthy Aging magazine:

1. Do not act your age! Remember your favorite age – feel it and act it.
2. Be positive in your conversations and actions. Catch yourself being negative and turn it into a positive.
3. Ditch the downer friends. Distance yourself from people who don’t have a positive attitude.
4. Walk like a vibrant, healthy person. Stand straight! Walk with long strides, head held high and step like you mean it.
5. Lonely? Do something about it.
6. How’s your smile? Use it often? Be sure your teeth are healthy by going to the dentist regularly.
7. Get a physical. Physical activity and movement help you stay healthy. So does preventive healthcare. If you haven’t scheduled your health screenings and immunizations, this month is a great time to get that done.

Cash-based practices can be a good investment, even for patients with insurance. Contractual requirements from corporate health plans have intruded into the medical provider-patient relationship. Obamacare with its more than 132,000 pages of regulations has added even more layers of red tape creating a bigger wedge between therapists and patients.
Patients experience this wedge when they have to fill out more forms and provide more personal information. They feel it when sitting in waiting rooms much longer than they do in front of a physician. They experience less time with the primary care providers before they are passed on to supportive personnel. They know they are paying more but getting far less.

What are the big benefits for patients?
​1. Cost effective careTherapists have the extensive education and training to be neuromuscular primary care experts. For the majority of patients’ with movement problems therapists are the provider of choice. For people with high deductibles, it makes financial sense to pay a therapist for a comprehensive evaluation and treatment.
Fifty percent of Americans will experience some type of musculoskeletal episode each year. Skilled cash based therapists are a third-party-free alternative for self-pay patients.
2.  AccessibilityIn most states therapists have direct access. Patients typically have a shorter wait times in a cash practice. Most clinical prediction rules state that the sooner the patient is seen the better the outcome.
Let’s face it, patients are becoming impatient driving around town, filling out insurance forms wherever they go. The busier they are the less tolerate they become with poor customer service.
3. Transparent Affordable PricingFor the self-pay patient finding therapists who offers fair, simple and transparent prices is crucial. Cash based pricing eliminates the added administrative costs when submitting claims to insurance companies. No more “We’ll send to insurance and see what they pay” when both parties know that the charges are coming out of the patient’s pocket.
4. Protected Patient-Therapist Relationship Imagine a practice where that doesn’t demand your insurance card and ID before they say hello. Imagine a practice where money doesn’t get in the way of patients getting to know their therapist.
Taking insurance middlemen out of the equation allows therapists to present themselves as an empathic professional who understands the true cost of healthcare.
5. All Patients Are WelcomeAll patients, insured or uninsured, in network or out-of-network are welcome. Payment is by cash, check or charge. Patients aren’t rejected because of their insurance carrier. Cash practices that are designed for self-pay patients are free from outside interference to address the circumstances and needs of individual patients.
The cash practice alternative seems to satisfy a growing appetite among consumers, especially those who are under 65 and not on Medicare. Today’s healthcare consumer has become embolden to know what care cost and are demanding more transparent pricing.
Just like they do in every other area of their purchasing lives they search online, compare, asks their friends before making a wise purchase.
There is a growing intolerance towards the hidden cost of healthcare. Practices that change their billing practices from the ground up to accommodate the self-pay client will be better prepared for the next generation of healthcare consumers.

https://www.evidenceinmotion.com/blog/2016/09/12/are-cash-therapy-practices-good-for-patients/

Physical therapy may be an option for individuals with autism who need help developing motor skills, have low muscle tone, or have problems with physical systems such as breathing control. Older autistic children can also benefit from carefully constructed exercise programs, which may be led by a physical therapist.
As with other autism therapies, the goals of physical therapy will be determined on an individual basis with the input of parents, physicians, and other members of the autism treatment team. It is good to  practice a patient and family-centered care, so the concerns and goals of the family and patient  are incorporated into the treatment plan and expected outcomes.
Physical therapy  can help someone with autism learn a variety of motor skills, from throwing, catching, and kicking a ball to jumping, hopping, and riding a bike, But there are other less playful physical therapies required by autistic children, such as:​

• Treating impairments in the systems that impact motor function, such as problems with respiratory control and coordination
• Improving posture
• Addressing misalignments in the musculoskeletal system, such as chest wall deformities, and foot and ankle misalignments
• Developing fitness programs for older children with autism; for example, Zenergy Physical Therapy  incorporates  yoga and pilates  into the treatment program for people with autism in a 1:1 setting. 

Physical therapists also become involved with rehabilitation after injuries. Occasionally the diagnosis of autism is secondary, For instance, a patient might have had a leg fracture and be in a rehab hospital for physical therapy, but we have to take the diagnosis of autism into account when designing their plan of care and structuring their therapy sessions.
A lot of physical therapy can seem like structured activities. Teaching individuals  with autism to be comfortable and competent in their bodies is an important and often enjoyable part of autism treatment.

This generation grew up in a time of rapid change, which gives them different priorities and expectations than previous generations. 

In eight years, millenials will make up 75 percent of the U.S. workforce.

​Millennials — those age 22 to 35 — are not only the largest living generation today but also became the workforce majority at the end of 2015. In just eight years, they will make up 75 percent of the American workforce.
This generation grew up in a time of rapid change, which gives them different priorities and expectations than previous generations. Their unique upbringing and subsequent values are reshaping our economy in almost every way possible. Think Uber, Fitbit, Airbnb, Etsy, Lululemon and Twitter. Successful companies that continue to adapt as the result of the millennial trend aren’t just changing the products they sell and how they sell them –- they also are changing their cultures.
A healthier generationWith the exception of family, millennials value health the most. In a recent study, 79 percent said family was important in their lives, followed by health and wellness at 53 percent, friends at 39 percent, spirituality at 31 percent and career at 27 percent.
Wellness is a daily, active pursuit for millennials. They are eating healthier and exercising more than previous generations. They smoke less. Almost half consider healthy eating a lifestyle choice as opposed to a goal-driven diet.
Technology has enabled greater access to wellness information and has put personal health monitoring into the palms of their hands. Millennials use apps and technology to stay healthy; and while they are earning less than older generations, they are spending more on health and fitness.
Millennials and career well-beingMost of today’s leaders inherited 20th century institutions, which are known for lack of agility and punching a time clock. Institutions where seniority and top-down management rules. Institutions that value profits over people.
Millennials often are criticized for their lack of loyalty or “job hopping,” but it is critical to note they leave their jobs for one key reason — they do not share these industrial-age values. They value education, higher purpose and collaboration across organizational ranks, and they want to be recognized and rewarded for their ideas and creative thinking.
Along with their prioritization of health and wellness, it isn’t a surprise that millennials expect work-life balance. They are more likely than other generations to view work-life balance — 41 percent — and not enough free time — 36 percent — as major career concerns. Only 29 percent of Gen Xers and 20 percent of baby boomers feel the same.
Leading today’s “wellness generation”As organizations develop strategies to attract, engage and retain millennials, here are a few tactics to consider:

• Offer flexible work schedules and paid time off.
• Pay and reward employees for results and not hours “clocked.”
• Offer health and wellness benefits, but make sure they are convenient to access.
• Provide wellness tools and supports that contribute to work-life balance, including mental, social and emotional well-being.
• Ensure easy access to healthy meal and snack options at the worksite.
• Create opportunities for collaboration across disciplines and organizational ranks.
• Adopt casual dress codes that embrace “athleisure” — think Lululemon, Athleta — or clothing that promotes comfort and movement throughout the day.
• Make sure your organization’s higher purpose is clear.
• Create work-sponsored outlets to volunteer or contribute to causes that are important to employees.

Leaders who adopt this “wellness generation” view will be much more successful in attracting, retaining and engaging the most powerful generation in the workforce today.