BETHESDA, Md. -- advertisement“Without physical therapy I wouldn’t be able to walk, run, work out or have range of motion in my muscles, and I’m very thankful for it,” said Army Staff Sgt. Travis Mills, one of only five quadruple amputees from the wars in Iraq and Afghanistan to survive his injuries.
Capt. Bradley M. Ritlanda physical therapist at Walter Reed Bethesda, works June 13, 2011 with Marine Sgt. Adam Jacks of Ohio, who lost his right leg when a roadside bomb exploded in Afghanistan. (Photo by Dan Gross)
During a break in running laps inside the Military Advanced Training Center (MATC) at Walter Reed National Military Medical Center (WRNMMC) on Monday, Mills said, “I don’t use my wheelchair very much, and it’s awesome.”
The Soldier was critically injured on April 10, 2012 by an improvised explosive device while on patrol during his third tour of duty in Afghanistan.
“From having no arms and no legs to walking again and barely using a wheelchair in a year and a half, I couldn’t have asked for anything more,” said Mills, who not only appreciates being able to walk again, but more so to be able to hold his toddler daughter, Chloe. The sergeant also snowboards, swims, water-skis and rides a bicycle.
“The most rewarding aspect of the physical therapy profession is watching patients progress through each milestone of physical rehabilitation to reach their ultimate goal of minimal discomfort and independent mobility,” explained Cmdr. Henry McCracking, assistant specialty leader, Navy Physical Therapy and assistant chief of the Physical Therapy Service at WRNMMC.
National Physical Therapy Month, celebrated during October, recognizes the roles physical therapists (PTs) and physical therapist assistants (PTAs) play in restoring and improving motion in people’s lives. This year’s theme for the observance is: “Move Forward PT.”
“Targeted therapeutic exercise and hands-on care comprise most of what we do,” said McCracking. “This year’s theme [for the month-long observance] encompasses a couple of the most basic themes of care in physical therapy,” he explained. “The first is movement. The overarching goal of physical rehabilitation is to restore, as much as possible, normal painless, functional movement. We like to make progress, or ‘move forward’ [with the patient] as early as day one. In addition to improved mobility, there are enormously positive psychological benefits associated with greater physical independence and less discomfort.”
Between the four sections of the physical therapy service at Walter Reed Bethesda, there are approximately 5,500 patient encounters each month, according to the Navy commander.
Whether you are a wounded warrior, living with diabetes, recovering from a stroke, a fall or a sports injury, a physical therapist is a trusted health care professional who will work closely with you to evaluate your condition and develop an effective, personalized plan of care, McCracking explained. “A physical therapist can help you achieve long-term results for many conditions that limit your ability to move,” he said.
McCracking added, “Nowhere is the practice of patient-centered care exemplified better than in the PT clinic.” He explained PTs and PTAs are partners with patients throughout their journeys to restore and maintain motion so they can function at their personal best.
“Our highest profile group of patients is wounded warriors,” McCracking continued. “These brave men and women have sustained complex injuries, some with multiple limb amputations. Their rehabilitation is intense and necessitates the closely coordinating efforts of a multidisciplinary team of providers including orthopaedic physicians, the Prosthetics and Orthotics Clinic, occupational therapy, case managers and many others.”
He went on to explain, inpatient PTs provide acute care to patients who are hospitalized for a myriad of conditions. The traumatic brain injury team of PTs works with patients who have sustained not only musculoskeletal injury and physical dysfunction, but also mobility impairments stemming from neurological conditions such as those associated with head injuries. The outpatient physical therapy section treats patients with conditions typically associated with low back pain, knee pain, sprained ankles and more. “We also provide restorative care for patients following orthopaedic surgery,” McCracking said.
The care PTs and PTAs provide includes therapeutic exercise, functional training, deep soft tissue massage and physical modalities such as electrotherapy and ultrasound. PTs and PTAs may also provide instruction in exercise, proper body mechanics and other injury prevention and wellness topics.
Army Capt. Bradley Ritland, chief of the PT amputee section at Walter Reed Bethesda, attributes the success of patients’ rehab to the patients themselves, especially those injured on the battlefield. “They’re motivated to get back,” said the captain. He added it is that motivation that makes his job rewarding and attracted him to military physical therapy.
Following a successful course of care in PT, patients benefit from an enhanced quality of life, McCracking added. “This is achieved by minimizing pain and discomfort associated with limited functional ability and maximizing physical potential. Patients are then able to perform work duties more easily and participate in activities they enjoy, such as sports.”
“You definitely see results on a daily basis,” said Ritland, who explained a number of service members who have sustained major limb amputations, following care which has included PT, remain on active duty and some have returned to combat operations.
“They put up with our attitudes, they deal with our mood swings and they teach us to be human again,” said retired Marine Corps Staff Sgt. Johnny Jones, who received care at WRNMMC after stepping on a roadside bomb while on patrol in Afghanistan in 2010.
The physical therapy profession and military have a long collaborative history and legacy of providing world-class patient care, McCracking explained.
“The first PT school in the United States opened in 1914 at the former Walter Reed Army Hospital in Washington, D.C. after ‘rehabilitation therapy’ was found to help injured Soldiers returning from World War I,” he said. “The people who were employed to provide care to the injured patients were actually nurses named ‘reconstruction aides.’
“An outbreak of poliomyelitis in the 1920s further increased demand for newly trained physical therapists,” McCracking said. “Massage, exercise and traction were hallmark practices of physical therapy in the 1940s. Until the 1950s, physical therapy was performed only in hospitals. It was not until the late 1950s that physical therapists started treating patients in an outpatient setting.”
He said physical therapy practices in the neuromuscular area expanded significantly during the 1960s with the development of techniques for adults with stroke, cerebral palsy and other disorders of the central nervous system.
“Throughout the 1970s and 1980s physical therapy became more specialized, such as orthopaedic and cardiopulmonary physical therapy,” McCracking continued. “Today, the profession is focused on providing evidence-based interventions in many different practice settings across several subspecialty areas,” he concluded.
Bernard S. Little WRNMMC Journal staff writer