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Thursday, March 16, 2000

Orthopaedic surgeons need to advocate PT for rehabilitation

Orthopaedic surgeons need to advocate, define and monitor the progress of physical training for their patients, especially those with degenerative and post-traumatic musculoskeletal conditions, according to a panel of orthopaedic surgeons.

"Rational physical treatment for musculoskeletal problems should be focused at physical training," states Vert Mooney, MD, Medical Director of the San Diego Spine Center, San Diego, Calif.

Dr. Mooney was joined by Nicholas DiNubile, MD, of Havertown, Pa., and Hamilton Hall, MD, Medical Director, CBI Health, Toronto, Ontario, at a press conference Wednesday before an afternoon symposium titled "Bloodless Orthopaedic Care for Fun and Fame - Measurement-Driven Physical Treatment." The purpose of the symposium is advocacy of physical training for degenerative and post-traumatic musculoskeletal conditions.

According to Dr. DiNubile, the role of the orthopaedic surgeon is to outline or modify each patient's exercise program based on the patient's needs, level of physical conditioning, and past or present injuries or ailments. However, all exercise programs should be devised to encompass three key elements: cardiovascular training, strength training and flexibility.

Patients resist exercise therapy because it is more difficult than passive and pharmacotherapy. Orthopaedic surgeons need to partner with their patients to develop programs that are both effective and tolerable for the patient. To this end, Dr. Mooney asks his patients, "Do you want to just feel good or get better?" Dr. Mooney is referring to use of passive modalities, such as hot packs, to alleviate pain and discomfort.

Despite the fact that such modalities have not been proven effective in clinical trials, they remain popular, mainly because they are easy to use, require little or no supervision and often can be self-applied. The panel members agreed that in order to gain widespread support and insurance reimbursement for physical training programs, documented results are essential.

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Last modified 16/March/2000 by IS