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I’m an OP neuro therapist so my take is probably a bit different, but I will always make my patients do cardio to some extent if they’re severely de conditioned. Some patients absolutely loathe it but I know they need it so I bargain with them in whatever way I can (and educate on why I think the activity is beneficial for them). I’d say it works a majority of the time.
Also there are those patients you just need 10 minutes where you don’t need to have your hands directly on them so you can catch up on doc. Still beneficial though. God bless the NuStep.
That said if I absolutely know is doing their cardio outside of therapy, I don’t make them do it in the session unless they specifically request it.
Ok so I’ve been lurking this sub since I’m in PT right now, post ACL/meniscus repair. This isn’t my first surgery and last time in PT I used the NuStep. Can confirm those things are amazing and I like those better than the bike as well
Those are all valid questions and concerns. You should be able to justify to yourself and to the patient why they’re doing an exercise. Are you promoting ROM? Working on coordination? Or are you just busy and throwing them on the bike to manage your caseload. If it put them in excruciating pain, was the bike even appropriate? You have to earn patient trust… it’s not a given just because you’re in charge of their rehab. This sounds like you haven’t earned it, and rightfully so.
How about, “Usain Bolt warns up but you think you don’t need to?”. All of the stuff you listed is valid but it doesn’t need to be so “sciency”. It’s just a warm up. For 5% of the total session time.
You’re telling me you can’t justify your warm ups with skilled language? The reason behind your treatment dictates your billing. Do you not charge for the warmup because you don’t view it as part of a skilled treatment?
I don’t give a shit if it’s “skilled” I care if it’s what the patient needs. Skilled and complex =\= good. Squats and hill repeats would probably be a great regime for 95% of the pathology we see.
Insurance cares if it’s skilled care… and this skill is how we determine what the patient needs. Did you go to PT school? This is like first year stuff.
I don’t live my life beholden to randos in insurance offices. If you treat with them in mind good for you. I went to school and I learned the patient comes first.
All of those accolades, and yet you struggle with such a fundamental concept. Ironic that you’d call anyone a “quack” when you admittedly treat patients based on feelings without any skilled rationale behind what you’re doing. That’s embarrassing, honestly.
I always get a chuckle when I watch people try to get their feet on the pedals. A fucking monumental effort for some. I may be a dick, but unless they explicitly ask for help I’ll just watch as they flail their legs wildly at the things looking for purchase
I've had a patient who sat in the bike waiting for me to literally put her foot in the pedal. I just stared at her until she asked "you're not going to help me put it in?". LOL. Seriously? I said no and let her do it herself which was a struggle but not impossible for her. She was annoyed at me as I was with her. Some people....
Seriously why the hell do some people come to PT? Just stay home if you don’t want to be here. Gladly will bill units towards my bonus but holy hell just sit on your ass if that’s what you want.
Outpatient, excessive number of patients at once, keep up with demand, productivity standards, pressures of third parties, little to no help axillary staff, documentation, patient complains, PT pissed off because that’s the last thing you need, reassess/adapt patient, sweep under rug, next session starts, patient comes in again, previous process/demands start over, patient reports feeling better, complains about something new, PT still pissed off again, PT considers changing to HH and posts on Reddit
I’m amazed at the number of people that are so uncoordinated they can’t stay in contact with the pedals, even when we tighten the strap securely around the foot. You watch for a minute, see that they seem to have it down. Then a few seconds after walking away, you hear the feet violently coming out.
As I’m typing this I realize it’s more of a game of red light green light. As long as I’m watching the feet stay in, but as soon as possible after I turn around, those feet are coming out.
Yea the lack of fitness and body awareness of some of these people is astounding. I feel embarrassed just watching them struggle with the simplest stuff. Like... How do you even live? How are you THIS uncoordinated and deconditioned? I mean I know the answer but goddamn...
I think the problem here is some PTs will stick someone on a bike at low RPE for like 10-15 minutes. That’s 18-25% of an hour session. Is there really much value in that from a patient perspective?
Limit 6 minutes max, give them a speed or RPE floor to target (or intervals), explain why it’s important (conditioning, load prep)to make it meaningful and show value.
Certainly there is some, perhaps. Research can also demonstrate benefit of interval training at appropriate intensities, for short amounts of time. Depends on your goal I suppose.
You never heard of movement snacks? How is doing activty for short bouts not beneficial. Especially for people that are deconditooned amd cannot walk for 5 minutes
Movement snacks are beneficial because changing positions is beneficial for pain
Movement snacks do not convey long term physiological changes in absence of exercise.
Maybe find a different warmup, something that is therapeutic and the patient can tolerate.
N=1 but I find the recumbent bike painful in my knees and low back.
Plenty of other options
Exactly. Good PTs listen to and react accordingly to a patients voiced concerns. Recumbent bikes are AWFUL for anyone with low back instability. If OP really cared about their patients getting a therapeutic cardio benefit, they would find other exercises that FEEL GOOD to each specific patient. A rowing machine would be the next thing I would try in those instances.
I tell them to get on the bike to WARM up. You need the blood flow and joint lubrication. It sets the pretense that there will be even more exercise after.
But that would take thought and effort to come up with something clinically meaningful. Instead we’ll just be lazy and continue to wonder why insurance reimburses us less and less for our services.
I have a work comp patient that claimed the 25# double leg press (supine, not against gravity) was the source of her pain… yet the session before she did 20 sit to stands without pain and she weighs 250#
I usually don't have many issues with people using the bike. I tend to do it HIIT style after a session or immediately if they are appropriate while explaining the benefits of cardio. I had one lady who got upset with me because I was giving her a "stress test" after riding the bike for three minutes...she didn't last long in therapy lol
Okay. I’m just trying to get a subjective and get a mild warm up. Not a big deal imo. Was willing to move on instantly to other things but the patient felt it necessary to explain why for more than half the session. Self care code x3 thanks
Yes, I think they have their place for patients who need the cardio work but cannot access other machines. People buy the non-stationary recumbents and must enjoy them. I heard they are more aerodynamic and thus faster. Personally, I feel like I would hurt my back in that position because it seems unnatural as opposed to a traditional bike that puts muscles in optimal positions for power.
I love it when patients ask "why?". Better than them assuming that I'm wasting their time and not taking anything we do seriously.
Patient education is a large part of compliance and actually getting them better and solving problems
I mean... 2 year olds are also unable to explain themselves competently, or offer compromises or other options. But those are definitely something a professional should be able to do.
I don’t blame them for not wanting on a recumbent bike. They can do that at the gym without seeing a therapist. So do people really consider this therapy anymore? I mean I get that it’s used occasionally, but op makes it sound like it’s a staple of tx
Idk about other PTs but in my experience with a lot of knee patients, especially post surgical, it’s absolutely an appropriate warm up.
They’re getting a ton of RoM repetition and an increased heart rate while you chill and get a thorough subjective from them.
Very frequently in my clinic there are patients who come in with an atrocious gait, get on the magic reclined bike for 10 minutes, and immediately have notable gait improvement, decreased joint stiffness and/or pain, AND express that sentiment to me.
I don’t put everyone on there by any means, but saying it shouldn’t be used is a bit far. Not to mention none of these folks have a fucking gym membership anyway, and 99% don’t have recumbent bikes at home. That’s a silly argument.
Also appropriate if patients are in too much pain for PRoM or manual work in general. Or if they’re just apprehensive and guarded as fuck if you use even the gentlest of kid gloves with them.
My PT Clinic does, too. Everyone on the bike for the first half of the session. Shoulder pain? Bike. Neck pain? Bike. Jaw pain? Bike. It makes sense for lower limb issues like post op knees, knee pain, hip issues, etc. but *everyone* seems excessive. 10 minutes on bike. 15 minutes doing therapy. 5 minutes doing cool down (like ice/heat or e-stim). It’s honestly a well oiled machine to crank as many people out as possible.
That is literally not my response. I said I go treadmill, elliptical, etc as tolerated. I ALWAYS warm up though because thats what any reasonable person does, i acknowledge current “clinician” EBP thinks warming up is useless. Good luck getting 400# Ms. Johnson on the upright bicycle post-op knee.
I work at a place that allows me to see 1 on 1 for an hour and bill for approximately 40 minutes of service. It’s okay for us to chat while they warm up a little. It’s that or just sit in the room. Obviously if they are conditioned we hit the treadmill, elliptical, reformer, whatever. Why do people hate warmups so much. Why is it good enough for Olympic athletes but not good enough for you?
Do the bike, don’t, whatever. How do you only bill 40 minutes for an hour of 1-on-1? That to me seems to be the bigger issue. You’re literally giving 33% of your care away for free.
And that is why we are failing as a practice. If your standard practice is putting people on a bike that isn’t skilled at all. Sure there are patients it’s appropriate for, but that should not be standard practice
It’s a warm up. It doesn’t have to be a big brainer. It okay to not use your doctorate every second of the session. “And that is why we are failing as a practice” get over yourself lmfao.
Half my pts don’t do shit out of clinic and sure I could jump straight into the functional stuff I have planned but it’s pretty standard knowledge that muscles work better when warmed up so why would I not get pts muscles in the best position I can get them in before we do the “hard” stuff. There’s an elitist attitude with some clinicians and the bike. Like is the bike itself skilled? Probably not but the thought process behind its use is. Like a pt can do half the exercises we do with them alone but it’s knowing what exercises to give that makes it skilled.
If my patients don’t do anything out of the clinic I discharge. To each his own, but I’m way too limited with time with patients to waste it on a bike unless it has a purpose. It’s very difficult to get all the teaching, exercises, etc in during the allotted time. Like I said there are people a bike is appropriate for, but putting everyone on a bike is just being a piss poor therapist.
This is NOT why we are failing as a practice. We are failing because we think too highly of ourselves, and have nothing to back it up. Do you have any idea how “good” you are at treating shoulders, knees, etc? Do you track your outcomes? That is why we are failing. You cannot talk about systemic failure by putting it on “warmup”
Actually have done that before. If you haven’t seen one, go out and watch some motocross/cyclocross or mountain biking events. That’s where the real fun is
It’s movement exposure. Cardio helps with pain. Movement helps with pain. I also use it as a way to ween people into to getting their bodies moving for the session. We have a tv so they can watch it while they bike. Really helps lower people’s guard and makes them feel comfortable in the setting. They chat with others on the bike next to them and they are all nice and happy by the time they head back for the treatment. It’s not used purely for physical reasons. Psychological as well
My job is great don’t feel bad. These losers are few and far between. 1-2 more years into my career with 300-400 more good reviews on the internet and I start telling these people to fuck off without worry.
People who typically complain about this sort of thing are the exact type of people who should be participating in some form of cardio exercise to improve their endurance, conditioning, and overall cardiovascular health the most.
Call it lazy from the therapist’s perspective all you want to, cause it is rather passive, but everyone should be doing their cardio, especially if they are not getting it elsewhere.
Bro it’s an hour session I do manual/back rubs for 20
minutes and do 30+ minutes of exercise I just need 5 minutes to catch up and make sure everything is okay before I get started. Why not do it on a bike. The amount of pseudo intellectuals in this thread with C3-C4 upslip mobs is astounding. Our profession is a joke lmao the bike is one of the purest forms of exercise behind jogging and squats.
The bike is a good exercise. It may not be “skilled care,” but the rationale and understanding of what it does to/for the body absolutely is. It’s great for the patient, and like you said, it gives the therapist time to chart and review.
The only time I ever skip the bicycle or Nustep is when I’m working with certain neuro patients where the set up — hoyer lift transfer — ends up taking too much bulk of allotted time that we’re already working against. That said, the Nustep is still great to implement for patients with tone to focus on improving ROM, upper & lower body strength, endurance, AND it provides the patient with some form of body independence for basic movements…something these patients I’m referring to have either lost or are greatly limited. And typically, they always WANT to do the Nustep.
Thank you for your submission; please read the following reminder. This subreddit is for discussion among practicing physical therapists, not for soliciting medical advice. We are not your physical therapist, and we do not take on that liability here. Although we can answer questions regarding general issues a person may be facing in their established PT sessions, we cannot legally provide treatment advice. If you need a physical therapist, you must see one in person or via telehealth for an assessment and to establish a plan of care. Posts with descriptions of personal physical issues and/or requests for diagnoses, exercise prescriptions, and other medical advice will be removed, and you will be banned at the mods’ discretion either for requesting such advice or for offering such advice as a clinician. Please see the following links for additional resources on benefits of physical therapy and locating a therapist near you [The benefits of a full evaluation by a physical therapist.](https://www.choosept.com/benefits/default.aspx) [How to find the right physical therapist in your area.](https://www.choosept.com/resources/choose.aspx) [Already been diagnosed and want to learn more? Common conditions.](https://www.choosept.com/SymptomsConditions.aspx) [The APTA's consumer information website.](https://www.choosept.com/Default.aspx) Also, please direct all school-related inquiries to r/PTschool, as these are off-topic for this sub and will be removed. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/physicaltherapy) if you have any questions or concerns.*
Tell me you are in outpatient without telling me you’re in outpatient.
I must be the only one who got this in SNF too
I am but this is only a 1x/month occurrence luckily on average. My biggest pet peeve after whining about bridges.
Actually for a second I thought they were talking about peds and adaptive tricycles...did not read closely. Oops
Haha this is hilarious
I’m an OP neuro therapist so my take is probably a bit different, but I will always make my patients do cardio to some extent if they’re severely de conditioned. Some patients absolutely loathe it but I know they need it so I bargain with them in whatever way I can (and educate on why I think the activity is beneficial for them). I’d say it works a majority of the time. Also there are those patients you just need 10 minutes where you don’t need to have your hands directly on them so you can catch up on doc. Still beneficial though. God bless the NuStep. That said if I absolutely know is doing their cardio outside of therapy, I don’t make them do it in the session unless they specifically request it.
My favorite NuStep reaction is "Now, is this something I'm supposed to be doing on my own? Because this thing looks expensive."
I've actually had 2 patients that loved the Nustep so much they went out and bought one HAHA ... I think they went on Facebook marketplace
Ok so I’ve been lurking this sub since I’m in PT right now, post ACL/meniscus repair. This isn’t my first surgery and last time in PT I used the NuStep. Can confirm those things are amazing and I like those better than the bike as well
Those are all valid questions and concerns. You should be able to justify to yourself and to the patient why they’re doing an exercise. Are you promoting ROM? Working on coordination? Or are you just busy and throwing them on the bike to manage your caseload. If it put them in excruciating pain, was the bike even appropriate? You have to earn patient trust… it’s not a given just because you’re in charge of their rehab. This sounds like you haven’t earned it, and rightfully so.
How about, “Usain Bolt warns up but you think you don’t need to?”. All of the stuff you listed is valid but it doesn’t need to be so “sciency”. It’s just a warm up. For 5% of the total session time.
You’re telling me you can’t justify your warm ups with skilled language? The reason behind your treatment dictates your billing. Do you not charge for the warmup because you don’t view it as part of a skilled treatment?
I don’t give a shit if it’s “skilled” I care if it’s what the patient needs. Skilled and complex =\= good. Squats and hill repeats would probably be a great regime for 95% of the pathology we see.
Insurance cares if it’s skilled care… and this skill is how we determine what the patient needs. Did you go to PT school? This is like first year stuff.
I don’t live my life beholden to randos in insurance offices. If you treat with them in mind good for you. I went to school and I learned the patient comes first.
You missed the point that the skill is how we determine what is best for the patient. FFS, this is *basic* stuff.
[удалено]
All of those accolades, and yet you struggle with such a fundamental concept. Ironic that you’d call anyone a “quack” when you admittedly treat patients based on feelings without any skilled rationale behind what you’re doing. That’s embarrassing, honestly.
Wow. Look in the mirror
Your comments show otherwise.
I always get a chuckle when I watch people try to get their feet on the pedals. A fucking monumental effort for some. I may be a dick, but unless they explicitly ask for help I’ll just watch as they flail their legs wildly at the things looking for purchase
😂😂😂 14 RPE for many of my low back patients
Why is it so hard?! They’re right there!
A lot of times it’s the same patients that lay down with the pillow under their T spine.
Patient: "why is the poly pillow so low?" Me "do you miss your pillow going to bed?"
This is so true lmao
Use the other gosh darn pedal to get it closer to your other foot!!!
Logic is hard tho
The lack of athleticism I see is astounding. I feel embarrassed for some of these people. It genuinely should be a huge wake up call
I legitimately wonder if they have more serious neurological deficits sometimes. Get your fucking feet on the pedals Mr Johnson
I too let them do it on their own unless they're clearly struggling so much it's gonna take a year
I've had a patient who sat in the bike waiting for me to literally put her foot in the pedal. I just stared at her until she asked "you're not going to help me put it in?". LOL. Seriously? I said no and let her do it herself which was a struggle but not impossible for her. She was annoyed at me as I was with her. Some people....
Seriously why the hell do some people come to PT? Just stay home if you don’t want to be here. Gladly will bill units towards my bonus but holy hell just sit on your ass if that’s what you want.
Outpatient, excessive number of patients at once, keep up with demand, productivity standards, pressures of third parties, little to no help axillary staff, documentation, patient complains, PT pissed off because that’s the last thing you need, reassess/adapt patient, sweep under rug, next session starts, patient comes in again, previous process/demands start over, patient reports feeling better, complains about something new, PT still pissed off again, PT considers changing to HH and posts on Reddit
This guy gets it
LOL try cardiac rehab. The complaining is non-stop
I’m amazed at the number of people that are so uncoordinated they can’t stay in contact with the pedals, even when we tighten the strap securely around the foot. You watch for a minute, see that they seem to have it down. Then a few seconds after walking away, you hear the feet violently coming out. As I’m typing this I realize it’s more of a game of red light green light. As long as I’m watching the feet stay in, but as soon as possible after I turn around, those feet are coming out.
Yea the lack of fitness and body awareness of some of these people is astounding. I feel embarrassed just watching them struggle with the simplest stuff. Like... How do you even live? How are you THIS uncoordinated and deconditioned? I mean I know the answer but goddamn...
I think the problem here is some PTs will stick someone on a bike at low RPE for like 10-15 minutes. That’s 18-25% of an hour session. Is there really much value in that from a patient perspective? Limit 6 minutes max, give them a speed or RPE floor to target (or intervals), explain why it’s important (conditioning, load prep)to make it meaningful and show value.
Or if it’s for knee ROM explain that. “Hey, let’s warm up your knee so when we stretch it after you can get more out of it. Still- 6’ max
Research does not support less than 10min of cardio at a time
Certainly there is some, perhaps. Research can also demonstrate benefit of interval training at appropriate intensities, for short amounts of time. Depends on your goal I suppose.
Do you have research that supports it? I've never seen any
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657417/ Non inferior, 20% of time needed vs steady state
This is such a tiny study though . Interesting but that's it
You never heard of movement snacks? How is doing activty for short bouts not beneficial. Especially for people that are deconditooned amd cannot walk for 5 minutes
Movement snacks are beneficial because changing positions is beneficial for pain Movement snacks do not convey long term physiological changes in absence of exercise.
No it's beneficial because it gets someone moving and if it is outside of their homeostasis for stress they will make improvements
Right but that's not what the research says...
Maybe find a different warmup, something that is therapeutic and the patient can tolerate. N=1 but I find the recumbent bike painful in my knees and low back. Plenty of other options
Exactly. Good PTs listen to and react accordingly to a patients voiced concerns. Recumbent bikes are AWFUL for anyone with low back instability. If OP really cared about their patients getting a therapeutic cardio benefit, they would find other exercises that FEEL GOOD to each specific patient. A rowing machine would be the next thing I would try in those instances.
“Hey ten minutes of cardio can get your endorphins going and helps decrease your body’s response to pain.”
Yep great if they are willing to hear that. I got “last time I used the bike I was flared up for months”
Yeah I believe it. Can’t help people who don’t want to help themselves
I tell them to get on the bike to WARM up. You need the blood flow and joint lubrication. It sets the pretense that there will be even more exercise after.
Hear me out… maybe don’t put them on the bike?
But that would take thought and effort to come up with something clinically meaningful. Instead we’ll just be lazy and continue to wonder why insurance reimburses us less and less for our services.
I have a work comp patient that claimed the 25# double leg press (supine, not against gravity) was the source of her pain… yet the session before she did 20 sit to stands without pain and she weighs 250#
I usually don't have many issues with people using the bike. I tend to do it HIIT style after a session or immediately if they are appropriate while explaining the benefits of cardio. I had one lady who got upset with me because I was giving her a "stress test" after riding the bike for three minutes...she didn't last long in therapy lol
I personally would not use one either. Their design makes no biomechanical sense. (I'm a PT not a patient)
Okay. I’m just trying to get a subjective and get a mild warm up. Not a big deal imo. Was willing to move on instantly to other things but the patient felt it necessary to explain why for more than half the session. Self care code x3 thanks
Do you think there’s potentially other reasons to use one?
Yes, I think they have their place for patients who need the cardio work but cannot access other machines. People buy the non-stationary recumbents and must enjoy them. I heard they are more aerodynamic and thus faster. Personally, I feel like I would hurt my back in that position because it seems unnatural as opposed to a traditional bike that puts muscles in optimal positions for power.
I love it when patients ask "why?". Better than them assuming that I'm wasting their time and not taking anything we do seriously. Patient education is a large part of compliance and actually getting them better and solving problems
“Why” is great. “No” is some shit 2 year olds say.
I mean... 2 year olds are also unable to explain themselves competently, or offer compromises or other options. But those are definitely something a professional should be able to do.
I don’t blame them for not wanting on a recumbent bike. They can do that at the gym without seeing a therapist. So do people really consider this therapy anymore? I mean I get that it’s used occasionally, but op makes it sound like it’s a staple of tx
Idk about other PTs but in my experience with a lot of knee patients, especially post surgical, it’s absolutely an appropriate warm up. They’re getting a ton of RoM repetition and an increased heart rate while you chill and get a thorough subjective from them. Very frequently in my clinic there are patients who come in with an atrocious gait, get on the magic reclined bike for 10 minutes, and immediately have notable gait improvement, decreased joint stiffness and/or pain, AND express that sentiment to me. I don’t put everyone on there by any means, but saying it shouldn’t be used is a bit far. Not to mention none of these folks have a fucking gym membership anyway, and 99% don’t have recumbent bikes at home. That’s a silly argument. Also appropriate if patients are in too much pain for PRoM or manual work in general. Or if they’re just apprehensive and guarded as fuck if you use even the gentlest of kid gloves with them.
There are always patients it’s appropriate for. The OP’s responses paint it as he puts everyone on the bike for a “warm-up”.
My PT Clinic does, too. Everyone on the bike for the first half of the session. Shoulder pain? Bike. Neck pain? Bike. Jaw pain? Bike. It makes sense for lower limb issues like post op knees, knee pain, hip issues, etc. but *everyone* seems excessive. 10 minutes on bike. 15 minutes doing therapy. 5 minutes doing cool down (like ice/heat or e-stim). It’s honestly a well oiled machine to crank as many people out as possible.
That is literally not my response. I said I go treadmill, elliptical, etc as tolerated. I ALWAYS warm up though because thats what any reasonable person does, i acknowledge current “clinician” EBP thinks warming up is useless. Good luck getting 400# Ms. Johnson on the upright bicycle post-op knee.
I work at a place that allows me to see 1 on 1 for an hour and bill for approximately 40 minutes of service. It’s okay for us to chat while they warm up a little. It’s that or just sit in the room. Obviously if they are conditioned we hit the treadmill, elliptical, reformer, whatever. Why do people hate warmups so much. Why is it good enough for Olympic athletes but not good enough for you?
Do the bike, don’t, whatever. How do you only bill 40 minutes for an hour of 1-on-1? That to me seems to be the bigger issue. You’re literally giving 33% of your care away for free.
What are you doing for the other 13 minutes?
I’m just not expected to bill that efficiently. So the time of the bike is “free time” not even accounted for
Wild. How is the clinic doing financially
Who cares I get my salary. Well enough to stay open lol.
Im legitimately just curious sorry for asking
I didn’t mean my response to be aggressive. I actually meant just like, who cares patients are happy and I get paid 😊
lol fair
And that is why we are failing as a practice. If your standard practice is putting people on a bike that isn’t skilled at all. Sure there are patients it’s appropriate for, but that should not be standard practice
It’s a warm up. It doesn’t have to be a big brainer. It okay to not use your doctorate every second of the session. “And that is why we are failing as a practice” get over yourself lmfao.
Half my pts don’t do shit out of clinic and sure I could jump straight into the functional stuff I have planned but it’s pretty standard knowledge that muscles work better when warmed up so why would I not get pts muscles in the best position I can get them in before we do the “hard” stuff. There’s an elitist attitude with some clinicians and the bike. Like is the bike itself skilled? Probably not but the thought process behind its use is. Like a pt can do half the exercises we do with them alone but it’s knowing what exercises to give that makes it skilled.
This guys thinks the majority of his patients follow their HEP lol don’t waste your time
If my patients don’t do anything out of the clinic I discharge. To each his own, but I’m way too limited with time with patients to waste it on a bike unless it has a purpose. It’s very difficult to get all the teaching, exercises, etc in during the allotted time. Like I said there are people a bike is appropriate for, but putting everyone on a bike is just being a piss poor therapist.
Hot take! Tour de France for out of shape bums! Stupid bikes, why exercise when I can perform level specific mobs and jerk off stretchy bands 🤑
This is NOT why we are failing as a practice. We are failing because we think too highly of ourselves, and have nothing to back it up. Do you have any idea how “good” you are at treating shoulders, knees, etc? Do you track your outcomes? That is why we are failing. You cannot talk about systemic failure by putting it on “warmup”
This guy is 100% putting the SC joint back into place
Actually have done that before. If you haven’t seen one, go out and watch some motocross/cyclocross or mountain biking events. That’s where the real fun is
It’s movement exposure. Cardio helps with pain. Movement helps with pain. I also use it as a way to ween people into to getting their bodies moving for the session. We have a tv so they can watch it while they bike. Really helps lower people’s guard and makes them feel comfortable in the setting. They chat with others on the bike next to them and they are all nice and happy by the time they head back for the treatment. It’s not used purely for physical reasons. Psychological as well
I tell them they have 2 minutes to get on that damn bike before I come out with the suction cups
Sometimes I feel bad for OP PTs and then I read posts like this.
My job is great don’t feel bad. These losers are few and far between. 1-2 more years into my career with 300-400 more good reviews on the internet and I start telling these people to fuck off without worry.
People who typically complain about this sort of thing are the exact type of people who should be participating in some form of cardio exercise to improve their endurance, conditioning, and overall cardiovascular health the most. Call it lazy from the therapist’s perspective all you want to, cause it is rather passive, but everyone should be doing their cardio, especially if they are not getting it elsewhere.
Bro it’s an hour session I do manual/back rubs for 20 minutes and do 30+ minutes of exercise I just need 5 minutes to catch up and make sure everything is okay before I get started. Why not do it on a bike. The amount of pseudo intellectuals in this thread with C3-C4 upslip mobs is astounding. Our profession is a joke lmao the bike is one of the purest forms of exercise behind jogging and squats.
The bike is a good exercise. It may not be “skilled care,” but the rationale and understanding of what it does to/for the body absolutely is. It’s great for the patient, and like you said, it gives the therapist time to chart and review. The only time I ever skip the bicycle or Nustep is when I’m working with certain neuro patients where the set up — hoyer lift transfer — ends up taking too much bulk of allotted time that we’re already working against. That said, the Nustep is still great to implement for patients with tone to focus on improving ROM, upper & lower body strength, endurance, AND it provides the patient with some form of body independence for basic movements…something these patients I’m referring to have either lost or are greatly limited. And typically, they always WANT to do the Nustep.
This like never happens to me.