Ameya Kapur

Hi all! If you’re reading this, you have reached the senior research project blog of me, Ameya Kapur. I know it’s very hard to pronounce, not everyone quite gets it on the first time. However, that’s not the real reason you’re here, now is it? As a BASIS Scottsdale senior, I will be conducting a research project, Following Up on Follow Through: Physical Therapy and Patient Compliance, which will analyze the effects and implications of patient adherence to recommended treatment regimens (for more information on my project, click here). From February to April, I will be posting all of my lively experiences and (*fingers crossed*) newfound findings here for each of the 10 weeks, including one final post at the end (so please stay tuned!). But before we delve even further, first, a little about myself.

The first thing people usually say to me is “Wow, you’re tall.” Now, at 6 feet 2 inches, the struggle is real. For example, there are always those awkward moments when you’re standing with a group of people and you’re considerably taller than everyone else. Also, when it comes to buying clothes, it is probably one of the most daunting tasks I have come upon in my 17 years of living so far, especially if you have a lean body type like me. Nevertheless, I have learned to embrace and cherish it as something unique.  

The next thing people usually tell me is “Oh, so you must play basketball (based on my height of course).” Since freshman year, I have been a member of BASIS Scottsdale varsity basketball team. Currently, we are competing for one of the final playoff spots of the state tournament as we enter the final stretch of our season.

Basketball, and simply sports in general, has always served as an escape for me, a place where I can travel to for an extended period of time and not have to feel the stress of ongoing applications and essays, for example. When it comes to my favorite sports teams, I’m an avid supporter of the Arizona Cardinals, Phoenix Suns, and basically any team LeBron James plays for. I also love watching movies and TV shows, especially the Office, a show I’ve watched for more times than I’m comfortable admitting. And finally, I’m a people person. From cracking a simple joke to fostering heart-to-heart conversations, I have always tried to make an effort to connect with those around me and, as a result, develop myself further.

Okay, enough about me for now, let’s get down to the nitty gritty, the moment you’ve all been waiting for, my senior project. Starting the first week of February, I’ll be interning at Synergy PT, a highly specialized rehabilitation clinic dedicated towards helping patients improve their health and lifestyle. You can learn more about it here. As mentioned earlier, I will be studying patient compliance to certain recommended home exercises prescribed from the physician while also analyzing its implications on the patient’s health as a whole. Throughout this process, I will be working with two very intellectually stimulating minds, Ms. Kaur, my senior project adviser and middle school Biology teacher at BASIS Scottsdale, as well as Dr. Peries, my on-site mentor and clinical director at Synergy PT. Though only knowing either for a short few months, I feel confident in their ability to guide me through my first ever research project and excited to collaborate with their spirited personalities.

Wow! That was a lot of words; I can feel my fingers beginning to swell up. So I thank you for taking time out of your day to read my first blog post. February is right around the corner and soon enough I'll be able to make these posts on a more regular basis. If you have any questions, please feel to comment down below, I always love hearing feedback!

Last Week :'-(

Hey everyone! Aaaahhhhh, my time interning at Synergy PT has officially come to an end :’-(. I’ve met so many wonderful new people, and I definitely plan to come back and visit to reminisce all the amazing memories there :-). Now, last week I promised you guys some graphs and data, so let’s get into that first before delving in to my experiences for the week. I hope you guys are ready; buckle up and keep all hands and feet inside the vehicle, the week 10 blog post is officially underway!!

So for my presentation, along with displaying the aggregate data for the entire sample, I decided to implement two case studies on individual patients: one with heightened compliance and thus increasing improvement, the other with depressed compliance and thus stagnant improvement. For confidentiality reasons, I’ll introduce you to them as “Laura” (compliant patient) and “Bobby” (non-compliant patient). Now, with regards to Laura, she first came into the clinic rolling in a wheelchair with completely swollen legs and severe knee dysfunction. Fast forward six weeks of steadily monitoring her progress and analyzing her compliance, Laura transitioned to a walker and ultimately assisted walking (walking with the support of another therapist). Such progress is tremendous in such a short amount of time. But, how could this be? Well, Laura initially wasn’t a very compliant patient in the first two weeks of my survey, receiving scores of 50% (out of possible 100%). And as a result, she was suffering major setbacks and procuring marginal, if any, improvement. Now, this is understandable of course. With a condition as severe as Laura’s, continuous activity is essentially a must in order to regain adequate strength and function. However, she described to me the reason for her low compliance was simply her wanting her life back and enjoying simple yet sweet activities such as watching of TV or just relaxing in the couch. It’s unfortunate that such a simple desire ended up costing her health. Yet, thereafter, she made a point to pursue her therapeutic activities more diligently at home, scoring 100% on each of her final 4 weeks. She described that 75% of her active life was dedicated to physical therapy, highlighting the significance of continued work outside the clinic. And boy did she prove it, way to go Laura! :-)

Now, on to our next case study, we have Bobby. Bobby is a great man and has his heart in the best of places. He suffers from hip/feet pains his walking pattern, postural strength, etc. Now even though we mentioned Bobby is a noncompliant, it’s not because he’s being lazy or doesn’t trust the effectiveness of the therapy; it’s because he has extreme personal matters which really take up all his time :-(. Now yes, this isn’t something the therapists can control, but it just heightens the significance of the hour a week we have with him. Because of his personal situation, he rarely gets adequate sleep (something we high school students have unfortunately become too comfortable with). Yet, with his age and current condition, it is imperative he gets at least a proper and thus playing a factor towards his stagnant improvement. Every week that I’ve worked with Bobby, he has always come in extremely tight (in his muscles) and tired. Now, as we mentioned, this really derails him from “following through” with the treatment regimens we prescribe him at the clinic. And as you’ll see below from these two example, compliance, though as insignificant as it may seem, presents a very direct correlation towards improvement and is obviously not something to be taken lightly.

Now that you all see the power of compliance, let’s get into my experiences for this week! For starters, I got to feel what it’s like to get dry needled :-0!

As you see from the pictures above, it wasn’t exactly a painless experience, but I really wanted to try it as I see Vincent performing it on patients all the time and hear their loud screams thinking, “Cmon, it can’t be thaaatttttt bad.” But, I was wrong. It is THAT bad. But enough of my whining, let me explain what exactly dry needling is. Dry needling refers to a modality of therapy in which fine needles are inserted into myofascial (“muscle tissue”) trigger points, tendons, ligaments, or near nerves. The objective is stimulate a healing response to loosen up scarred tissue, this eradicating tightness within the area. I gotta say after having the needles placed in me, my right shoulder/back felt much more looser and displayed expanded range of motion (even though there was a bit inflammation, but that went away by the end of the night)!

Along with Vincent stabbing needles in my shoulder/back, this week was a great opportunity to thank all the patients I’ve been able to interact with. I’ve so many wonderful and compelling stores from such a diverse patient population; it’s something I will truly remember as I take the next step to college. In addition I got the thank my wonderful Synergy family for guiding throughout these past 10 weeks and teaching me anything and everything they knew. Vincent, Wendy, Danny, Chandra, Drew, Emily, Kathy, and Bruin: THANK YOUUU!!! I will always cherish to even have this amazing opportunity to meet so many new faces and learn leaps and bounds in such a short amount of time. And finally, thank you all for sticking with me during this amazing ride! Moving forward, I’ll be working on my presentation, hoping to nail it to the best of my ability :-). I’m both nervous and anxious, but that just makes it fun, right? Anyways, one last thank you to Synergy and my blog followers!!! Enjoy the weekend everyone :-).

Family <3

Stomach Flu :(

Hi everyone! As you can see from the title, I had the stomach flu this week and let me just say, it was not fun :-(. Currently, I’m almost fully recovered with on-and-off headaches and body-aches. Pretty soon, I’ll be 100%, jumping around and causing trouble just like usual :-). But, I do want to give a quick shout-out to my mom who actually stayed up with me while I was sick and  nursed me back to health. So thanks mom <3! Now with regards to my work at the clinic this week, obviously I wasn’t able to interact and connect as well as I would’ve liked to (Vincent asked to take it easy this week to recover), yet I still found ways to integrate myself and gather the necessary data for my research. I also managed to photograph the Synergy slogan which lies on the wall of the office, overlooking the entire clinic, and I really feel it fits the mood of this post.

That’s right guys, stand strong. I hope for anyone who had a tough week like me can be able to stand up once again and persevere even stronger :-). This slogan is something therapists here work to embed within each patient’s mindset. See, we have to understand that not all patients is privileged with adequate health, financial viability, or simply others to look after them. However, the only way for them to recover is to not focus on the negatives because that just brings them down even further, right? Many don’t understand that physical therapy is not only a physical battle, but a mental one as well. A patient’s will and hard work dictates his/her recovery. This even factors in and affects their compliance. Patients unable to “stand strong” may be less motivated to continue working and improve themselves whereas patients whom display that very will tend to display greater compliance and thus more efficient recovery. In all, always remember to have a positive attitude guys, you’ll be surprised how far it can take you! :-)

Now being that it’s week 9, next week will be my last week working here at Synergy :-(. The interactions and relationships I’ve been able to form with my co-workers and patients will never be forgotten. And speaking of patients, I gathered another week’s worth of data from my sample and am working towards putting everything together for you guys. Next week, I’ll display some graphs for you all, establishing the merits of compliance and its correlation with patient improvement. It’s definitely been a pleasure to share my experiences with you guys for yet another week and I can’t thank you all enough for sticking with me this far and monitoring my progress. Until next week!

Bright New Faces and Familiar Faces

Hi there, everyone! I hope you guys all missed me because I sure missed you. For some reason, it feels like forever since I’ve made one of these posts. Maybe it was the fact that this week was mostly much of the same ol’ process, but every week is progress and I’m still very excited to share it with you all :-).

So here’s the thing. Just when I thought we finally reached consistency within our clinical team, I see two new bright faces walk through the doors. I think it’s safe to say now that there’s always going to be students coming and going for their respective clinical rotations, and there really is no predictability as to how long a certain staff group may stay intact. Nonetheless, I still would like to introduce you guys to Chandra and Marissa. Both of these women are extremely driven and dedicated to their craft as they strive to work their way up in the PT realm. Each were able to connect and work with patients in their own unique way as I was there in the background steadily taking notes :-P. I think it’s safe to say that after my stay here I will have met so many new people, all with diverse traits and methods, yet all equally important to me and my growth as a person :-).

Also, I don’t know if you guys still remember Joe from the first few weeks of my internship (the guy with the amazing beard), but he came back to visit us all on Wednesday. I really got a chance to catch up with him and was able to get advice for college and other aspects of my not-too-distant future. But in case you guys wanted an update on him, he’s currently preparing for a presentation that he has to give in May (just like me!) and entering that final stretch of PT school, eventually making him a free bird :-). He mentioned he’ll also be coming back to visit next Wednesday so I’ll definitely be looking forward to that. But in all, good luck to you, Joe as you begin the end of PT school! :-)

SURVEY UPDATE: So the surveys have been coming along pretty smoothly. I talked to my faculty adviser, Ms. Kaur, and she told me not to worry about the sample size having decreased a bit (phew!). Essentially, since the data of the sample of patients I did manage to survey all seem to prove my hypothesis, there’s really no concern :-). But this week, I managed to compile all my data into a spreadsheet and over the next couple of weeks, I’ll be creating graphs and tables from that data and work to display a correlation between patient compliance and improvement.

Alrighty, that should just about do it for this post. I know this was a kind of shorter than usual, but this week was mostly the same routine as we continue to inch closer to the end. I can’t believe it’s almost here and I’ll definitely miss the family I have at Synergy. But for the next two weeks, I’ll make the most of my time with them and hopefully bring you guys some more exciting and lively experiences :-). As always, thank you all for taking time time out of your day to read my post and I’ll see you guys next week!!

Getting More Hand-sy...

Salutations viewers and welcome to yet another blog post! So, this week actually went by kind of fast; it was mostly the same old good stuff: surveys, stretches, exercises, etc. However, I did manage to take a leap in terms of getting my hands on patients…

This week, Vincent handed me the reigns of performing some palpation on various patients. What is palpation, you may ask? Palpation is a method of examining the body using one’s fingers and hands, usually to perceive or diagnose a particular illness. This is sort of a leg up from the stretches/exercises I performed on/with patients as I now begin to assume a more therapeutic role. Often time’s, palpation is best executed by applying lotion or cocoa butter to the skin (which I did this week :-)). Essentially, this allows for smoother “hand-work” on the body, further facilitating the diffusion of tension out from the afflicted region. 

Vincent also allowed me to prescribe some of my own exercises to several patients during their clinical sessions :-). Basically, he would have me call patients back from the waiting room, seat them on a table, and take down their subjective (just a fancy word for an evaluation form – how the patient’s feeling, any pain that’s concerning them, etc.). From there, it’d be up to me to either assign them to some stretching or have them perform certain exercises. For example, a patient came in yesterday having problems with her posture. She was somewhat of an elderly woman and of course with years of sitting and standing with improper posture, her shoulders began to shrug and her back began to hunch at an extreme degree. As a result, this accumulates slight back pain and a decreased height. See, the body will always want to take the path of least resistance, causing many people to shrug their shoulders and hunch their back because it’s easier than constantly standing up straight, keeping your chest out, and all the other mechanics for proper body posture. Therefore, it’s mandatory for you guys to fight gravity and make sure you’re always walking and sitting with a tall posture so that you won’t be regretting it later on in life. And remember, it may feel awkward at first, but gradually your body will become comfortable with it as it develops into muscle memory :-). 

Annnyyyywaaayyssss, sorry about that tangent, but let me get back to my example. So for this particular patient, I had her do scapular retractions with a band. Basically, she would be tasked with holding out the band in each hand with both her arms straight out in front of her. Thereafter, she would bring her shoulder blades back and pop her chest out without bending her arms at all, keeping her glutes tight, abs in, back straight, and chin up. I know, I know, there are so many little nuances to what appears to be a very simple, straightforward exercise. However, each intricacy is necessary in terms of actually making the exercise effective. Now, why did I choose scapular retractions? Well, for a good posture, the back should be straight and the chest should be prominent outwards. In this case, these retractions eliminate any shoulder shrugs as the shoulder blades are progressively being pushed back (this all while the patient is keeping his/her back as straight and his/her chest as prominent as possible). And finally at the end of the session, I asked her to practice this same scapular retraction motion at home, and hopefully she’s compliant and can achieve a nice straight posture in no time :-). 

Also since we’re on topic, the compliance surveys have been going pretty well. The game plan is to accumulate all the data and compile it into graphs and tables. And from there, I’ll analyze the information and hope to establish a correlation between improvement/muscle functionality with compliance. Hopefully *fingers crossed*, I’ll be able to statistically prove that patients whom are more compliant tend to experience greater improvement and muscle functionality than those whom are not. 

And yeah, that should just about do it for this week’s post. If you have any questions, please comment down below, I’d be happy to answer them and clear up any possible ambiguities. Thank you all for making it this far and have a wonderful weekend!!!

The Luck of the Irish

Hey there, everyone and happy St. Patrick’s Day! I can’t believe Spring break is actually over now :-(; I was just starting to get used to staying up watching the Office all night. But that’s okay because I’m ready to get back to business and man, do I have some interesting stuff to share with you all today. So, as usual, go ahead and grab a snack and buckle up this week six blog post; I hope you enjoy!

Where to begin… ah, where to begin? Well for starters, we added yet ANOTHER member to our team, Danny. Now, I know what you’re thinking: Why is it that every week there’s always someone new or someone leaving (or in some cases, both)? To be honest guys, I’m not exactly sure, but I’m hoping we can at last have some sort consistency as we creep closer and closer towards the end of my project. So again, I’m really sorry for any confusion and thanks for bearing with me thus far :-). But without further ado, let me talk a little bit about our new addition. Danny is on one of his clinical rotations, hailing from the same PT school as Vincent actually (convenient, right?). In just his short time here, he’s already been able to make an impact within the clinic through his simple jokes and reassuring smiles. In all, welcome aboard Danny! I’m really excited to learn even more about the depths physical therapy through a different lens.

 
Now moving on, does everyone remember EJ Gaines from last week’s post? If you need a refresher, he’s an NFL cornerback for the LA Rams coming in for offseason training and therapy. He came in Wednesday and not to brag or anything, buuuttttt… I wrestled him. Okay, maybe that’s a bit of an exaggeration, but hear me out on this. It was essentially a balancing exercise where EJ would have each of feet on a bosu. From there, I would use my hands to try and shove him off the bosus while he would aim to deflect my arms away and maintain his balance. I’ll admit I approached this drill with slight trepidation that I might get snapped in half by a guy who gets paid to tackle people. However, I managed to escape the drill alive, only bearing a couple scars on my arm; nothing too serious really. I even managed to gain some respect from EJ as we would fist-bump after every set. After that happened, I told myself I would never wash my hands again, but of course with the stomach flu and nasty bacteria spreading about, I had to :-(. I also actually felt a little treacherous towards the Arizona Cardinals in training with an LA Rams player; I just hope EJ doesn’t go berserk and get like 20 interceptions against us next year. Regardless, I still feel the Cardinals can manage to pull together a win :-).

   

And finally, let me give you an update on the surveys. I originally planned for a sample size of 20 patients to survey week in and week out to analyze their progress and compliance. However, I noticed that some of the patients don’t return every week because they may be sick or on vacation, etc. As a result, I’ll just have to make do with the sample I already have and possibly incorporate a more detailed analysis of the patients I do have weekly in order to compensate for the decreased sample size. So far, I’ve managed to jot down a set of notes for each patient which basically reflect how they’re functioning in the office and if any progress has been made since prior sessions. Hopefully, as the weeks go by, I’ll be able to establish a clear correlation between compliance and improvement.

Aaaand that should just about do it for this week’s post. Thank you to all who were able to read this far and I can’t wait to post again next week. Have a great weekend and make sure you’re wearing green today so you don’t get pinched!

Spring Break!!!

Hi all! As I mentioned earlier, this is my Spring break so unfortunately there won’t be a post about my research this week. Even though I technically didn’t have to go into work this week, I still visited a couple days for about an hour each to work on the surveys a bit. And GUESS WHAT?! I got to meet an NFL football player for the Los Angeles Rams. His name is E.J. Gaines. Guys, believe me I was trying so hard to keep my jaw from dropping during his PT session. I also felt like if I told him I was a Cardinals fan he wouldn't talk to me so I kept that to myself (for those who don't know, the Rams and Cardinals are HUGE rivals). But now that we're cool, maybe I'll tell him if I see him again and I'll let you guys know what he says :-). Also I’m going to try to get him in my survey sample so I can have an excuse to talk to him each week, but wish me luck guys!

Here's just some proof that I'm not lying :-)

(He's the one who makes the tackle)

Anyways, I hope everyone is having a relaxing spring break and we’ll be back on track next week!