Sean Freitas’ Post

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Reaction time plays an important role in our daily lives, such as when we cross the street, catch our keys, and drive. Therefore, it should be a crucial component of any concussion or vestibular rehabilitation program! You can use different tools, such as dowels, balls, bean bags, and rings, as well as external devices, such as visuomotor apps and reaction time training platforms. Here are some ideas: ⏱️ Letting go and catching a dowel at specific marks: going upwards, downwards, or alternating hands ⏱️ Tossing and catching: alternating grip, from different heights, using multiple bean bags, using different shapes (e.g. bean bag, ring) ⏱️ Using a visuomotor app for external cueing: trying different positions, such as 4-point ⏱️ Using reaction time training platforms that allow for variability and versatility: tossing the bean bag of the same colour as the colour that appears You can make the exercise harder by doing it with someone else, increasing the height or distance, adding a balance component (i.e. standing on one leg) or including a cognitive task (i.e. making a choice or go/no-go). All of these exercises require reacting to the stimulus as quickly as possible and are easy to prescribe as home exercises! (Post created in collaboration with Sonia Vovan) #vestibularrehab #vestibulartherapy #vestibularrehabilitation #vestibulardisorder #vestibulardisorders #vestibulardisease #vestibularcondition #vestibulartraining #vestibularawareness #physicaltherapy #physiotherapy #physicaltherapist #physiotherapist #habituation #dizziness #neurorehabilitation #reactiontraining #visuomotortraining *Sign up for the April Journal Club at v1st.co/QOL*

A couple of weeks ago I got into a discussion with a physical therapist about the importance of using force plates with testing vertical jumping for return to play decision-making. The clinician told me that testing raw jump height with a vertec was all that was necessary "because the body won't allow the athlete to jump any higher than the injured limb would be able to absorb at landing". Fast forward a couple of weeks and I was asked to consult on a high level athlete that has a lower extremity injury. Their CMJ data throughout the season shows that their vertical had steadily improved throughout the season, however during that same time that his vertical was increasing, his asymmetry during the concentric phase rose as high as 18% to offload the injured limb and peak landing force asymmetry increased to 28%. The staff reached out to me because they knew there was an injury there but wanted to know how it was affecting his performance and what they needed to look out for. They did not know that their was an asymmetry in his vertical. Going further into the data, the athlete's SLJ on the injured side was higher and produced more force than the uninjured side. (Counterintuitive to what the physical therapist hypothesized.) If we accepted the premise that the body would limit itself, we would have completely missed what was going on with this athlete. This asymmetry over time will put his uninjured limb at risk of injury. We also wouldn't know that his injured limb needs more attention to address the issue. Also at play is that there is likely a psychologically limiting factor caused by the injury. As rehab professionals, we have to accept at this point that there is a level of information that we have completely missed in the past and we must pursue the avenues that will give us that information. #physicaltherapy #physicaltherapist #sportsmedicine VALD

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🧠When should you progress vestibular exercises?🧠 🔹Understanding and pay attention to your patients non verbal queues. 🔹As practitioners we can get caught up in always wanting to progress. Be mindful of our own egos and work with the patient. If the exercise is the same but the patient feels more confident, that’s still a progression. 🔹Feeling psychologically safe is so important, especially in concussion and vestibular patients. Calming their nervous system is key to progression and challenge their beliefs on why they don’t feel safe. 🔹Exercises or tasks should be difficult and achievable. No shame in adapting someone’s program. A lot of programs start off with trail and error and working with your patients on expectations and goals are key. As practitioners you should have a progression and regression for every exercise. 🔹Elite athlete or not, as the therapist you are there to help your patient/athlete achieve their physical readiness. You are not there to hold them back. Make that clear and listen to their needs and don’t just do what you feel is best. Team work makes the dream work.  #concussion #recovery #sportsconcussion #sportsmedicine #physiotherapy #sportsphysio #rehabilitation

How to Measure Strength in the Clinic How we use dynamometers and force plates in physical therapy and sports performance.

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Simple and Effective Vertical Jumps Athlete performance coaches and physical therapists benefit from measuring an athlete or patient's performance. Unfortunately, most assessment tools or tests require intensive observation, lengthy setup, complicated technology, or a combination of all three. Of course, budget is a limiting factor as well. It's worth considering adding vertical jumps as lower extremity performance tests. In the study cited below, researchers attempted to measure the efficacy of vertical jump tests in predicting the likelihood of future ACL injury. They found that the jump tests could: 🔍 accurately predict if a player was low, middle, or high-risk 👣take place rapidly in a small footprint ✅be conducted by a coach or clinician of any skill level #sportsrehab #sportsrehabilitation #sportsrecovery #sportsperformance #sportsperformancetraining #sportsphysiotherapy #physicaltherapy #rehab #acl #aclrehab #reaction #neuroplasticity #neurorehabilitation