Cathy Ciolek
Posters: Int J Phys Med Rehabil
E ffective communication is a skill that has been shown to improve patient outcomes and negative outcomes are associated with poor communication skills. Motivational Interviewing has been used to help clients establish meaningful goals for behavioral change across multiple populations, but has limited physical therapy based research. A 66 year old. African American female was referred to outpatient physical therapy 3 years post right THA for osteoarthritis with residual hip pain, long history of back pain and failure to improve despite several physical therapy interventions. Examination revealed hip and knee weakness and limitation in joint ROM/joint play of both the hip and spine. Functional measures also showed major deficits for her age. Skilled PT intervention was provided over 20 visits. Treatment intervention included joint mobilizations, progressive resistance exercises, and stretching. Communication strategies included motivational interviewing to set goals early in the intervention with frequent adjustments and fear avoidant and pain catastrophizing minimizing strategies to minimize negative affective communications. At discharge the patient had made significant improvements in all aspects of the ICF model with improved pain scales and strength measures, functional improvement was noted in stair climb test, 6 minute walk test and steps per day. Additionally, she has resumed walking daily and participating in tai chi class 3x?s/week. Physical therapy intervention is not limited to hands on skills. The ability to use effective communication strategies to build rapport, trust and patient self-efficacy are essential for patients with chronic pain, particularly those who have not been successful in previous therapy interventions.
Cathy Ciolek has a bachelor?s degree in physical therapy from Ithaca College and DPT from AT Still University. She has been board certified as a geriatric clinical specialist since 1996. She is an assistant professor and director of clinical education at the University of Delaware where she teaches geriatrics and principals of adult education and learning theory. She was recently awarded the Lucy Blair Service award from the American Physical Therapy Association.
