JULY 2020
THIRD PLACE
On May 4th I officially dropped to third place in my son Blake’s eyes. I had been second behind Sandra in our house of three – that is, until we left the Humane Society! We had a cat when Blake was born who lived a long and legendary life. He passed 4 years ago, when Blake was too young to have much of a memory of him. The idea of a new pet had been gaining momentum for at least a year and the time seemed right. A few months ago, we put our name on the waiting list to rescue a kitten. As a family we had discussed the idea of the “right fit” and wanted to be sure Blake understood we might not take the first kitten we met. It was not an easy conversation for a ten-year-old. Only two people from a family are allowed to enter the Humane Society these days. Outvoted 2-1, I ended up waiting in the car! As the “quick look” stretched past 45 minutes, I knew that we were not leaving empty-handed. About an hour into my isolation the doors swung open and Blake and Sandra emerged with a brown box. Even behind his mask I could sense a huge smile and his eyes were glowing with joy. We officially had a new member in our family! An 11-week old “dilute calico” kitten who was born in the wild then fostered. She was in the standard cardboard carry box and remained quiet on the ride home. During the drive she was named “Willow” … once again, the vote was 2-1. Do you see a pattern developing? Willow has been with us for two months. Initially, she was very skittish and often ran away when anyone approached her. I was concerned she might not be the pet I had imagined for us. However, after a few weeks she began to settle into her new home, with her new family. She has a kind and gentle demeanor and has never clawed or bitten anyone. Even during her most fired up daily play sessions she is careful with us, especially with Blake. Somewhere around the third week at home she started napping on Blake’s lap as he toiled away at distance-learning to complete third
Introducing PTSMC Danbury! Congratulations to Josh McAdams, PT, DPT, CMTPT, Partner & Director of PTSMC Danbury (pictured left). PTSMC’s 26th clinic opened its door on June 29th.
StriveHub Fab 6 “The staff are all extremely professional while maintaining a fun, motivating environment. Both Gabby (Didiano) and Mike (Antunes) are extremely thorough and make sure that you’re feeling and performing your best.” - Middletown grade. I am convinced that her long naps helped keep him in front of the computer and helped him see the school year through.
“TThe best part about PTSMC is a tie between the staff and the results that I'm I had forgotten how curious and energetic kittens can be. During her waking hours, she relentlessly explores every drawer, cabinet, box, and achieving. I had a knee replacement done in December and went to another windowsill. Additionally, she has earned a reputation for running at full speed around the house; often, you can see a multicolored blur therapist for about four months. The passing over and under chairs and couches. These full-out sprints results that I've gotten with Joe (Caligiutypically end with an audible thud or crash! Her erratic bursts are usually without anyone’s encouragement. She is young, full of energy ri) are so much better than I got before and enjoying life. and I have only been seeing him for three weeks. Also, Maddy (Edmunds) is very Willow recently made the unilateral decision encouraging and supportive.” - Naugatuck to protect our home from fireflies, an invasion I didn’t know we needed protection from. The photo to the right is the top right corner of the sliding door screen being defended, though I am trying to convince Willow that the fireflies come in peace!
“It is such a wonderful experience. To go out of your way to ease the pain of someone is exactly what they do. I cannot stress how much time was dedicated to With all the fun of a new kitten comes responsibility, and Sandra and I my issue and easing my sciatica. Love are also using Willow to help Blake learn more about what caring for Danielle (Dunn)!!! She is amazing!!!” an animal entails. He complains that it’s “impossible to clean the litterbox because it takes two hands,” which means he cannot hold his - Wallingford nose while cleaning, and can’t hold his breath long enough to get the job done! In Blake’s words, the smell of Science Diet Liver and Chicken kitten food “makes me want to puke.” Experience is a great teacher!
”I have a rare, poorly researched and poorly understood genetic disorder that is In our eight weeks together, Willow has given us more than we’d often counter-intuitive to medical hoped. She brightens the spirit of a ten-year-old boy, as well as those of his parents, and provides laughter and unconditional love on a daily professionals and requires the ability and willingness to ‘think outside the box.’ That basis. quality is very hard to find, and I found it Great lessons, both for a ten-year-old and his parents. here.” - New Haven Being third place in Blake’s eyes is pretty special. Thanks,
Alan
Patient Trends
“Bryan (O‘Neill) is so knowledgeable and helped me tremendously. The casual, friendly atmosphere made me feel comfortable immediately. I really appreciate the entire staff's helpfulness and kindness. - New Milford “I’ve been going to PTSMC for over 6 months and have always had a wonderful experience. Everyone is always responsive and helpful. Most recently, we switched over to Telehealth...the switch has been easier than expected, creating a very smooth transition. I am able to do all the suggested exercises at home and don't feel as though I am missing out by not going to the clinic. In addition, it feels more comfortable than I anticipated and allows for productive communication. I look forward to doing more telehealth sessions.” - West Hartford
CLINICIAN’S CORNER
TREATING PATIENTS WITH CERVICAL RADICULOPATHY By Kyle Wolf, PT, DPT Physical Therapist at PTSMC Newington Cervical radiculopathy is described as a clinical condition resulting from compression of cervical nerve roots.1 Patients who are suffering from true cervical radiculopathy can exhibit many symptoms, ranging from neck pain, sensory deficits, motor deficits, diminished reflexes, dexterity loss, or any combination of the above. The etiology of true cervical radiculopathy is often misunderstood, as the herniated disc theory is designated as the culprit far too often. The majority of cases of cervical radiculopathy are not due to disc herniations, rather cervical spondylosis.1 Cervical spondylosis is a naturally occurring degenerative process in the cervical spine as we age. Over time, the nucleus pulposus will slowly begin to lose its water content, and as a result, the disc overall decreases in height. This decrease in height will lead to foraminal narrowing and bony hypertrophy of the intervertebral joints due to increased stress.1 Both of these result in an individual who is at greater risk for some sort of nerve root impingement.
Overwhelmingly, the literature states that a multi-modal approach is the most effective way at treating cervical radiculopathy.3 A new approach by Mulligan termed Spinal Mobilization with Arm Movement (SMWAM) is suggested in the literature as an effective treatment for patients suffering from pain, disability, and cervical spine/shoulder ROM loss.4 The concept of SMWAM is to sustain a transverse glide to the spinous process of the vertebrae above the entrapped nerve during active cervical/shoulder motion.4 The principle behind the technique is that during active cervical and shoulder motion, due to muscle attachments, spinal motion has to simultaneously occur.4 However, in patients with cervical radiculopathy, the vertebral segments can present with immobility, spurring, hypertrophy of intervertebral joints, etc., which can lead to their radicular symptoms. The study below will demonstrate the effectiveness of SMWAM as part of a multimodal approach to treat cervical radiculopathy.4 Methods4 - 2 groups (Group A receiving SMWAM, neurodynamics, and manual traction; Group B receiving neurodynamics and manual traction) - Neurodynamics: sliding technique for 2 sets of 10 repetitions - Manual traction: 10 minutes (10 seconds on, 5 seconds off) - SMWAM: maintain transverse glide during active shoulder motion 3 sets x 10 reps Results4
How should Physical Therapists examine and treat cervical radiculopathy? For a patient coming in with true cervical radiculopathy, a thorough patient history can lead you to an accurate clinical diagnosis. Symptoms to be aware of during the history are: patterns of pain in a dermatomal distribution, paresthesias, unilateral symptoms, sensory deficits in a dermatomal distribution, and weakness along the corresponding myotome. See table below for potential symptoms exhibited with cervical radiculopathy.1 Table 1 Distribution of sensory and motor weaknesses typically seen with cervical radiculopathy
Level
Muscle weakness
Sensory deficits/location of pain
Reflex
C5 C6 C7 C8 T1
Deltoid Biceps, wrist extension Triceps, wrist flexion Finger flexors Hand intrinsics
Lateral arm Radial forearm, radial two digits Middle finger Ulnar two digits Ulnar forearm
Biceps Brachioradialis Triceps
As the patient history concludes, the first set of objective tests to perform once the cervical spine is cleared of red flags, is the Wainner Cluster. The Wainner Cluster includes four objective tests: Upper limb tension test A (ULTTa), active cervical spine rotation bilateral, cervical spine distraction test, and Spurling’s test A. Definitions of positive clinical test results are as follows: 1. ULTTa: Any one of the following: A) symptom reproduction; B) side-to-side difference >10 degrees in elbow extension; or C) with regard to involved side: ipsilateral neck lateral flexion decreases symptoms and/or contralateral neck lateral flexion increases symptoms.2 2. Distraction test: symptom reduction.2 3. Spurling’s A: symptom reproduction.2 4. Active cervical spine rotation: involved-side cervical rotation ROM < 60 ‘ degrees.2 The literature supports the use of the Wainner Cluster in determining in a cervical radiculopathy diagnosis. See table below for the psychometrics of the clinical prediction rule.2 Number of Positive Criteria
Sensitivity
Specificity
Pos LR
Neg LR
Two Three Four
0.39 (0.16-0.61) 0.39 (0.16-0.61) 0.24(0.05-0.43)
0.56 (0.43-0.68) 0.94 (0.88-1.0) 0.99 (0.97-1.0)
0.88(1.5-2.5) 6.1(2.0-18.6) 30.3 (1.7-538.2)
1.09 0.65 0.77
Pos LR = positive likelihood ratio. Neg LR = negative likelihood ratio.
Once we identify a cervical radiculopathy case, how do we treat this condition? The current literature offers many low-level evidence based articles looking at the effectiveness of particular treatments for cervical radiculopathy.3
Clinician Takeaway A multimodal approach when treating patients with cervical radiculopathy is supported in the current literature. There are several studies showing the effectiveness of certain treatments in the short term, however, long term effectiveness of such treatments are still mainly unknown. If you are currently treating patients suffering from radiculopthy and their progress has plateaued, SMWAM can be effective in conjunction with neural mobilizations and manual traction in reducing pain, improving NDI, and increasing overall active motion. References 1. Iyer S, Kim HJ. Cervical radiculopathy. Curr Rev Musculoskelet Med. 2016;9(3):272-280. doi:10.1007/s12178-016-9349-4. 2. Wainner RS, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine 2003;28(1):52-62. 3. Thoomes, E.J. Effectiveness of manual therapy for cervical radiculopathy, a review. Chiropr Man Therap 24, 45 (2016). https:doi.org/10.1186/s12998-016-0126-7. 4. Shafique, Sadaf, Shakeel Ahmad, and Syed Shakil-ur-Rehman. "Effect of Mulligan spinal mobilization with arm movement along with neurodynamics and manual traction in cervical radiculopathy patients: A randomized controlled trial." JPMA (2019). doi: 10.5455/JPMA.297956.
HUMAN RESOURCES CURRENT JOB OPPORTUNITIES Accruals: Sick and Vacation for May, June and July Employees who are eligible for sick and vacation time accrual the following process is being completed for May, June and July. • HR is manually entering vacation and sick accruals each month based on the number of hours worked according to PTSMC policies: 20-29 hours, 30-39 hours, and 40 hours fulltime. Years of service will be recognized when calculating the accrual amount. Accruals have been paused for employees who are currently working less than 20 hours a week. • May accruals have been added to Paychex and will be reflected in balances. • Manual entries for June will be entered during the weeks of July 6th and 13th. • Manual entries for July will be entered during the weeks of August 3rd and 10th.
July is a Three Payroll Month With the changes that have occurred this year employee medical and dental deductions will be processed with the second and third payrolls, July 15th and July 29th. There will be no deductions with the July 1st payroll.
Has Something Changed This Year?
Moved
Cell Phone
Personal Email
Patient Services Coordinator Essex (part-time) Guilford (full-time)
Physical Therapy Aide Essex Newington
Check www.PTSMC.com/job-openings for our most up to date postings and feel free to share! Call Karen or email at karen.havlicek@ptsmc.com if you are interested in a position.
JULY BIRTHDAYS Steve Platt Laurel Hill Kaylynn Harmann Charlie Bath Laura Nicklis Sandra Boccialetti Katy Sullivan Sammi Seger Eric Welles Jacquie Birdsall Faith Rotas-Burns Jessica Decoteau Rachel Bellone Conner Gavin Stephanie Weyrauch Anthony Lucia Robin Norko Ron Buchetto Scott Olmstead Allyson Melillo Chrys Graboski Anthony Ciaburri Roslin Wilhelm
1 3 4 5 5 6 9 9 10 10 11 13 13 15 18 24 25 27 27 28 28 30 30
Guilford New Milford Southbury Watertown Avon Admin Orange Southington Southington Guilford East Hampton West Hartford Wethersfield Avon Orange Watertown Guilford Westbrook New London Admin Avon Orange Waterbury
JULY ANNIVERSARIES
Birth of a Child
Owed Taxes in 2019
Marital Status
If yes, you may need to change the following: • Address • Cell Phone • Email Address • Emergency Contact Information • Federal and State W4’s • Beneficiary Information • Dependent Information If you need to make changes, notify Sandra at Sandra.Boccialetti@ptsmc.com.
Anthony Lucia Charlie Bath Danielle Pilgrim Eric O'Loughlin Hannah Cook Kelly Cozzolino Mackenzie Cattaruzza
PT Aide PT Aide PT Aide PT Aide PT Aide PSC PT Aide
Watertown Watertown New Milford Newington West Hartford Plainville New Haven
Orthopedic Initial Certification Deadlines have been changed! October 1: Reapplication Deadline October 31: Application Deadline
Student Program Update We are thrilled to be hosting DPT student affiliations! This is an important part of PTSMC’s commitment to giving back to the PT profession by educating future clinicians. Please welcome the following students starting with us this month:
Please note: Due to COVID-19 pandemic, the application and payment deadlines have been extended by three months, automatically, without prior approval. Applications are reviewed in order of submission; potential applicants are encouraged to apply prior to the deadline to expedite the review process. An option for an initial partial payment of the application fee will also be available (excluding reapplicants).
Nathan Clement (UCONN) will be in Plainville hosted by Kevin Connellan.
December 28: Initial Certification Exam Fee Deadline
Caitlyn Ayotte (UCONN) – New London
Scheduling Permits will be issued in late December.
Emma Hart (UCONN) – Groton
Lucas Ferreria (Sacred Heart) will be in Fairfield with Rebecca Petrosino. Shannon Mellon (UCONN) will be in Newington with Joe Allen. We are also extremely excited to announce that these four new graduates will be part of the PTSMC clinical team! All completed final affiliations earlier this year.
Andrew Kalach (Sacred Heart) – Fairfield Katie Newton (UCONN) – West Hartford
Techy Tips
By Dave Lawrence, Information Systems Coordinator
Tips to Stay Safe While Online Shopping
Online shopping may be a convenient way to save time and browse unlimited options without leaving your home, but thieves are always watching for easy prey. So, before you purchase your favorite item online, take into consideration a few tips to keep safe. • NEVER have your browser save your banking or credit card credentials • ALWAYS ensure that when you are entering personal information into the web browser, you see a padlock in the far left of the address bar before entering any information. • If something looks wrong about the website, ensure you typed in the right web address. If it is re-directing you to another site, always be skeptical and call the company’s 1-800 number to report it and ask if the web browser experience is normal. In addition to these simple, useful tips, make sure to have anti-virus software installed on your computer to help combat fraud and online thieves.
What Happened in JULY of 2000? July 8, 2000 - Venus Williams won her first career Grand Slam singles title at Wimbledon.
Spirit day New Milford
July 8, 2000 - Harry Potter and the Goblet of Fire by J.K. Rowling was published in the UK.
Fairfield
July 23, 2000 - Tiger Woods won his first British Open Men’s Golf Tournament and became the youngest player at 24 to win all 4 major titles (what a year for Tiger!).
Guilford Waterbury
Clinics that Opened in JULY East Hampton in 2017. They’re pictured here at their Grand Opening in September of 2017.
Next Month
PATRIOTIC DAY - Monday, July 20th To celebrate America’s birth and independence, wear your best patriotic clothes!
PTSMC UPDATES!
NEW EMPLOYEES
Kirsten Reaves, Danbury Patient Services Coordinator
Wesley Cheng, Avon PT Aide
Erik Lanese, Waterbury Athletic Trainer for Holy Cross, received the Donald Bagnall Secondary School Athletic Trainer of the Year Award from the Connecticut Athletic Trainers Association.
Congratulations!
Welcome Back!
Emma Hart, Groton Physical Therapist former student
Andrew Kalach, Fairfield Physical Therapist former student
Ken King, Westbrook Physical Therapist married Ellen Donahue.
Caty Halpin, Sports Medicine Coordinator and Westbrook Athletic Trainer married Pat Mulligan.
#GETMOVING CHALLENGE
Spring/Summer 2020 #GetMoving Challenge!
Tie Dye Your 4th of July
Can we get a round of applause for the #GetMoving Spring/Summer challengers?? Over the course of the last 3 weeks, PTSMC employees got up, got out, and got moving. Some moved every single day! 22 challengers accomplished the goal of at least 15 days of activity, earning themselves a prize.
Tie dye clothing is back and has been this season’s biggest trend! It is just as fun to make as it is to wear. There are two ways you can make new tie dye gear or you can take your old clothes and turn them into fun and festive gear for FOJ (Fourth of July). Check out these techniques and links below and grab your kids and friends and get to it!
This time around challengers supported each other via the platform Slack. And WOW, the participation was through the roof! All of the pictures you see here were posted at one point in the group. From there, they were liked, loved, laughed at, given the crown emoji, the GOAT emoji- shout out to the Groton crew for deeming fellow competitors kings, queens, and GOATs (greatest of all time). Stories were told of kayaking or getting caught walking in the rain, family members and friends joined in, and we saw some amazing scenic photos of hikes.
Reverse Tie Dye - This is the new DIY craze! Take an already colored piece of clothing and use bleach to make the technocolored design. Feeling the holiday spirit? Start with a red or blue piece of clothing to get that perfect FOJ look. Use these links for directions and inspiration:
Each week there were some workout challenges which sometimes involved a few too many burpees! There were step challenges, stretching challenges, and a #GetMoving with your loved ones challenge.
https://www.youtube.com/watch?v=sHpTe1uRLvc&t=40s https://www.youtube.com/watch?v=gwD0zjByfcA Traditional Tie Dye - The best way to start this process is by purchasing a tie dye kit. This way you have the proper squirt bottles and dye. Grab a white t-shirt (or other white clothing) then decide on your design! The twisting techniques and rubber band placement are what make the different patterns. Use these links for kits and design ideas. Kits: AMAZON, TARGET and MICHAEL’s have wide ranges of kits from affordable to professional. Designs: https://nblibraryteens.files.wordpress.com/2013/03/tie-dye-pattern.jpg PINTREST is also your best friend when it comes to designs!
So congratulations to all who participated, you all rock! Every challenger here was active and posted in our group at least 10/21 days! Allyson Melillo Amber Manville Betsy Holt Chloe Pearce Christina Mogelnicki Danielle Dunn Emily Fillion Emily Hansen Hannah Cook Jack Pearce
Jessica Semmelrock Julianne Balavender Kelley Cahill Kristen Forster Lindsey Scianna Mallory Mason Mary Clark Michelle Gallerani Mike Durand Miranda Jasienowski
Sammi Seger Sandy Wickman Mason Shelby Howe Stef Cagno Steph Weyrauch Steve deCastro Stevie Fell Alan Balavender Sandra Boccialetti
Congratulations Recent Graduates!
Diana Chao, West Hartford PT Aide, graduated with a degree in Athletic Training from UConn and will be applying to DPT school in the fall.
Madeline Lynch, New Haven PT Aide, graduated with a degree in Exercise Science from Southern Connecticut State University and will be pursuing DPT at Sacred Heart University.
Danielle Jaffer, Southington PT Aide, graduated from UHart and will be pursuing a DPT from UHart.
Jessica Semmelrock, East Hampton PSC, graduated with a degree in General Studies, A. S. at Three Rivers Community College.
Chloe Stannish, Southington PT Aide, graduated from Southington High School and will be studying exercise science at CCSU.
Natalie Swanson, Middletown PT Aide, graduated from Naugatuck Valley Community College’s PTA program.
Not Pictured:
Jake Courtman, Guilford PT Aide, graduated from Quinnipiac. Nick Maltese, Guilford PT Aide, graduated from Quinnipiac. Noah Rattet, Guilford PT Aide, graduated from Southern Connecticut State University.
Did we miss you? Kiley Vermette, Middletown PT Aide, graduated with a degree in Health Science from Franklin Pierce University and will be pursuing DPT at UConn.
If you recently graduated or are a new DPT student and aren’t listed here, please email Emily at Emily.Fillion@ptsmc.com. We will honor you in the next PULSE!
Congratulations and good luck to new DPT students! Cody Filinger (Avon) - University of Hartford Arabella Gorski (Newington) - Belmont University Kyle McCormick (Guilford) - Sacred Heart University Olivia Montessi (Guilford) - Northeastern University Eric O’Laughlin (Newington) - UCONN Dhimitri Stojko (Southbury) - UCONN Joy Tso (Avon) - UCONN Emilee Wargo (Guilford) - Northeastern University