Thousand Oaks Spine and Sport
Menu Of Services
Thousand Oaks Spine & Sport promotes an active “sports medicine” approach to physical therapy, and improved physical fitness. Thousand Oaks Spine & Sport is staffed by a multidisciplinary credentialed health care providers, including Physical Therapists, Chiropractors, Exercise Physiologists, and Certified Athletic Trainers. The following are descriptions of services that can be provided through Thousand Oaks Spine & Sport. These services represent a menu for health care providers which can be tailored for specific patients needs. The foundation of Measurement Driven Rehabilitation Services have been made possible by recent advancements in the development and standardization of spinal and total body functional testing. Through these core principles, it is feasible to accurately and objectively measure an individual's strength, work capacity and progress throughout the rehabilitation of soft tissue injuries. Adjuncts to spinal and extremity rehabilitation include post-offer / pre-hire work capacity exams, on site work readiness evaluations, health and back school seminars, ergonomic evaluations and stretching /conditioning injury prevention programs.
It is the objective of the Thousand Oaks Spine & Sport and associated facilities to provide the highest quality rehabilitation services available for the prevention and management of industrial and sports injuries.
DESCRIPTION OF SERVICES
A full range of traditional physical therapy and rehabilitation services for spine and extremity related disorders are readily available at our centers. However, the following services distinguish our expertise as one of the leaders in physical medicine standardization and application.
McKenzie Evaluation and Treatment:
Robin McKenzie, R.P.T., has developed a system for mechanical diagnosis and treatment of the spine. McKenzie protocols explore passive, dynamic and static loading of spinal joints during both motion and at end range. Clinical studies demonstrate many low back pain patients have a “directional preference” for loading the spine. A dynamic internal disc model has been proposed by McKenzie: an offset load applied to symptomatic intervertebral disc in the “preferred” direction of spinal bending creates a mechanical shift of nuclear content away from the load, thereby alleviating stress on the pain generating annulus and “centralizing” and/or “abolishing” the pain. The movement plane direction of extension has a tendency to cause nuclear material to migrate foreword. McKenzie therapy has been successful with a large majority of patients who have disc derangement and whose pain centralizes and abolishes with directional mechanical treatment strategies.
Aquatic therapy can be utilized in acute, post-surgical patients as a “stand alone” therapeutic intervention or as a compliment to land based treatment. The state of the art SwimEx therapeutic temperature controlled pool can provide variable resistant current. This variable resistance enables the rehabilitation of a wide variety of clinical populations from highly debilitated individuals to competitive athletes. Once the patient demonstrates stability they are progressed to appropriate functional restoration and/or home exercise programs.
Hand Therapy Services:
The goal of hand therapy rehabilitation is to maximize the patient’s functional use of the affected extremity through increasing and restoring range of motion, strength and function, and reduction of pain. The patient and therapist work together as a team to insure timely recovery and prevent re-injury.
Diagnoses treated include, but are not limited to:
cumulative trauma disorders, including carpal tunnel syndrome, epicondylitis and de Quervain’s disease; peripheral nerve and tendon injuries and repair, fractures and degenerative conditions. A variety of active treatment methods are utilized to insure the most comprehensive program. The active hand therapy program is provided by an Occupational Therapist who is assisted by Certified Athletic Trainers and Exercise Physiologists.
A manual procedure that involves a direct thrust which moves a joint beyond its active and passive range of motion (ROM) without exceeding its anatomical limits. High velocity, low amplitude thrusts are commonly applied. Controlled position, leverage, direction, amplitude, and velocity are all components of the procedure.
The REPEX machine is a continuous passive motion device which is used to enhance the effectiveness of repeated end-range movement therapy. This device has been found to be very effective when used in conjunction with the McKenzie system of diagnosis and treatment.
BackStrong is a variable angle roman chair device which can safely and progressively load the spine in order to increase strength and range of motion in low back pain patients. The BackStrong machine is a very practical and therapeutic device with broad application in the treatment of persistent back problems. The gradual progressive resistance allows a therapeutic exercise program for even the most tentative exercise candidate. The use of the BackStrong machines are innovative because they may be utilized complementary to existing low back pain intervention programs such as McKenzie therapy, spinal/pelvic stabilization exercises, spinal manipulation or computerized high/tech lumbar rehabilitation (MedX).
OBJECTIVE MEASUREMENT TESTING AND REHABILITATION
Objective measurement testing and rehabilitation may be initiated 3-6 weeks post-injury in cooperation with an existing Industrial Medical Provider.
MedX Rehabilitation (Disability Reduction Protocols):
These computerized and highly advanced spinal rehabilitation protocols have the ability to specifically isolate the cervical and lumbar musculature. These measures objectively document the presence or absence of functional disability caused by soft tissue injury. This allows doctors to establish or rule out medical necessity for spinal rehabilitation and treatment. For the past 10 years, MedX equipment has been researched and utilized worldwide, with hundreds of thousands of patients. The results of this research have established MedX as the leader in spinal rehabilitation by reducing ratable factors of disability in approximately 81% of chronic spinal pathology patients.
Epic Lift Capacity Post Injury Evaluation (ELC):
The ELC is a standardized functional lifting evaluation that can determine at what level a subject can safely perform the functions of a job. Data obtained with the ELC can also demonstrate if a worker has any functional strength deficits that need to be addressed before returning to work. ELC testing information can be used for placement reference or reassignment of employees by matching there abilities of the Physical Demand Characteristics of Work. ELC testing will be performed by a certified technician (2.5 hours depending on job description).
Spinal Function Sort (SFS):
The purpose of the SFS is to quantify an individual's perception of his or her ability to perform work tasks that involve the use of the spine in various ways. This type of psychometric testing can be useful to provide a baseline measure of the individuals perception of function prior to the onset of symptoms or therapeutic intervention. Subsequent testing will provide the clinician with information about the individual's perception of his/her progression with treatment. Additionally, because the focus of the SFS is on function (not pain), this will assist the clinician to maintaining the disabled individual's focus on function throughout clinical treatment. The SFS can be performed in Spanish or English.
Hand Function Sort (HFS):
The purpose of the HFS is to quantify an individual’s perception of his or her ability to perform work tasks that involve the use of the hand in various ways. This type of psychometric testing can be useful to provide a baseline measure of an individual's perception of function prior to the onset of symptoms or therapeutic intervention. Subsequent testing will provide the clinician with information about the individual’s perception of his/her progression with treatment. Additionally, because the focus of the HFS is on function (not pain), this will assist the clinician to assist the clinician to maintaining the disabled individual’s focus on function throughout clinical treatment. The HFS can be performed in Spanish or English.
Symptom Exaggeration Testing:
Waddell's Non-Organic Physical Signs Survey allows our doctors and therapists to identify the presence of psychogenic components of illness and symptom exaggeration in-patients with illegitimate complaints.
Patient Reliability Testing:
This is a specific spinal testing method that detects malingering behavior. This protocol has been established by the University of Florida and the University of California at San Diego Schools of Medicine in conjunction with nationally respected orthopedic surgeons. This test utilizes MedX equipment, the only clinically valid and statistically reliable spinal testing machines in existence. If an injured worker tests unreliably during these procedures, it constitutes frank evidence of malingering behavior. Once such behavior has been objectively documented, it becomes extremely difficult to establish the presence of disability or the need for future care.
Work Readiness/Return to Work Preparedness:
Upon conclusion of rehabilitation for selected employees who had significant Temporary Total Disability, on site therapists evaluation will be available upon request. A qualified therapist will evaluate the employee work description and assist the safe return of the employee to full or modified duty. Ergonomic safety and conditioning will be addressed over a period of 1-2 on site visits prior to releasing the employee from care.
INJURY PREVENTION SERVICES
Stretching and Conditioning Program for Warehouse Employees:
Supervisors will be appropriately trained to instruct employees at the beginning of their shift for stretching and conditioning exercises lasting 10-15 minutes. Warehouse shift Supervisors will receive hands on training from qualified Exercise Physiologists and Athletic Trainers. The exercise program wil focus on stretching and conditioning of larger muscle groups of the lower back, upper back and extremities. Training the trainer sessions are estimated at 3-4 hours per quarter in order to augment modify exercise protocols. These training session updates will focus on ensuring supervisor and employee compliance and motivation. All exercise handouts and program materials will be designed and updated quarterly with administration of an annual exercise wallet prescription card. Exercise Physiologist and Athletic Trainers on site presence will be made available as necessary in order to assure the programs success.
Ergonomic and Educational Presentations for Clerical Staff:
Ergonomic consulting services include evaluations of workstation logistics and employee biomechanics. Specific recommendations for reducing high-risk activities in the work place are then outlined to help employers prevent injuries before they occur. Various injury prevention educational presentations can be requested on an as needed basis. Presentations available include Carpal Tunnel Syndrome (CTS), lower back injury prevention and exercise conditioning programs for lower back and extremities.
Objective Measurement Testing and Rehabilitation:
All objective measurement testing, physical therapy and rehabilitation charges will be based in accordance to California’s Workers’ Compensation Official Medical Fee Schedule.
The Goal of Thousand Oaks Spine & Sport Centers:
is to provide the highest quality health and rehabilitation services available. Our Industrial athlete philosophy will aid in returning the patient back to normative function as safe and rapidly as possible. Through the utilization of services provided, cost containment strategies will be in place to decrease absenteeism, disability costs, and medical expenses.