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March 3, 2010

Peak Dosage

Physical therapy is not referred to by some as physical terrorism for nothing. Oftentimes, patients must come to physical therapy to rehabilitate from an injury or a surgery. Moving an insulted joint is painful business. Many patients have prescriptions for pain medication that they are supposed to take before coming to therapy. In-patient rehabilitation therapists are assured that their patients are appropriately dosed thanks to the nursing staff who is caring for them. They coordinate their medications so that they are at their peak dosage when the patient is scheduled for PT.

Other conditions such as patients with spasticity are encouraged to take medications that reduce tone so that they are able to function optimally during their rehab. Excess tone often results in reduced functional mobility because prevents more normal body mechanics for activities such as walking. Sometimes, however, especially in the pediatric population, a certain degree of tone is beneficial for ambulation. Children with congenital (present at birth) hypertonicity may be very weak in the muscles needed for walking and the tone is the only characteristic that gives them any power or spring in their step.

Another population for which it is important to work within peak medication dosage is Parkinson's patients. Patients with Parkinson's disease are characterized by not only tremors, but episodes of freezing and muscle rigidity. Having a patient who has not had their Parkinson's medications one day and has taken it the next day is like working with two different patients. Rigidity, the state where both agonist and antagonist muscles are firing at the same time, prevents movement and it exhausting to the patient. Their motivation for therapy is likely to be low that day because they cannot control their movements and their body is busy expending all its energy contracting muscles.

Medications play an important role, not only a patients health, but the management of many conditions. These are just three examples of the importance that a medication's peak dosage can play in rehabilitation. I'm sure that experienced physical therapists can think of many more types of medications that can both assist or inhibit a patient's performance during therapy.

Posted by linda at March 3, 2010 6:48 PM

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