January 2019 PULSE

JANUARY 2019

- COMING UP THIS MONTH Tuesday, January 1st at 11 am Guilford at Frosty 5K Road Race Tuesday, January 15th from 6:30 - 8 pm Tom Kassan presenting on ski injuries at REI

RESOLUTIONS a look back and a look forward

After some reflection, we have the tremendous opportunity to shape our future.

The New Year is upon us! Many people take this change in the calendar as an opportunity to reflect on themselves and the past year.

PTSMC is in “D4D season”. I hope you are taking the time to consider your personal and professional ideals and passions.

The “New Year’s Resolution” is a pretty common occurrence in our culture. According to a recent Forbes article, “Forty percent of Americans will take stock of their year and make a declarative statement of their intentions for the year to come”.

• What are your goals?

• Where will you challenge yourself?

• Why does it matter to you?

• How will you grow?

In my opinion, the Dialogue for Development process (D4D) resembles a series of resolutions.

The process creates an opportunity for all to have an open conversation about the past. A “look back” allows us to celebrate our accomplishments. We can also consider areas we may have fallen short. What’s still important? Is it time to move on?

Wednesday, January 16th from 10 - 11 am Kristen Ludwig presenting at Elmwood Senior Center “Breakfast with Benefits: Anti-Inflammatory Foods and Type II Diabetes” Wednesday, January 23rd from 1 - 2 pm Katy Sullivan presenting “Vertigo: It’s Enough to Make Your Head Spin!” at Milford Senior Center

Dialogue for Development is a conversation about you, an exploration of who you are and who you strive to become.

I hope a year from now you will look back with a sense of accomplishment and pride.

Happy New Year!

PTSMC Essex officially opens on January 2, 2019! It is our 21st clinic to open. We’re excited to welcome the team to the PTSMC family!

StriveHub Fab 5

Alan

“I feel that the therapists really know what they are doing and that they really care about helping their patients.” - Waterbury

What are your New Year’s Resolutions?

Email Emily your resolutions at emily.fillion@ptsmc.com. If we receive a resolution for every one in the clinic, we will hold a raffle and one clinic will win a lunch!

10th Annual Holiday Food Drive Thank you to everyone for participating in our 10th annual food drive! We were able to donate over 1,300 items to communities across the state.

Check out the happenings page for more pictures!

“I appreciate the warm welcome and professional intake. I have confidence in the therapists’ skills and knowledge base. And I enjoy the relaxed atmosphere while appreciating the professional milieu.” - Avon “Alyssa is wonderful to work with. She listens to me about my week and my feelings. She gives helpful suggestions and watches carefully as I do my exercises.”- East Hampton “The staff is very friendly, accommodating and get results. The results are long lasting because of the education that they provide to patients along the way.” - Newington “Everyone is very professional and caring. I believe an important part of getting better is laughter. There is plenty of that at PTSMC, and it is greatly appreciated and therapeutic. Thank you all!” - Watertown

CLINICIAN’S CORNER

BY JACQUIE RISTOW BIRDSALL, PT, DPT GUILFORD Blood Flow Restriction

Blood flow restriction therapy (BFR) is relatively new to the rehabilitation world, however was pioneered in the 1970s and 1980s by Yoshiaki Sato of Japan. Yoshiaki Sato termed BFR Kaatsu training. “Ka” meaning additional and “Atsu” meaning pressure.1 Since then BFR has gained interest and was first implemented for military personnel who were struggling to improve muscle strength after rehabbing amputations and limb salvage procedures. BFR is utilized by professional and Olympic athletes to decrease risk for injury and optimize training.

What is BFR? BFR training involves wrapping an elastic band or cuff around the most proximal portion of upper or lower limbs. The band will partially restrict venous blood flow but will not affect the arterial flow. The restriction of venous blood flow is thought to induce ischemic/ hypoxic environment that enhances the training effect in the exercising muscle leading to increases in muscle mass and strength.1 There are two theories to build muscle; (i) the traditional theory of mechanical tension and loads, and (ii) inducing metabolic stress, which is the theory behind BFR. Increased levels of metabolic stress is the driving stimulus to activate systematic hormone production and increased fast-twitched fiber recruitment which facilitate muscle growth via autocrine and paracrine actions.1 With BFR being relatively new, it lacks standardization of ranges of cuff sizes and pressures and amount of sets and reps. The literature often follows a protocol of 30 x 15 x 15 x 15 or completion of all sets to volitional fatigue theorizing that it will produce greater metabolic stress. Because BFR training uses low loads as compared to high loads used in traditional training, frequency of training can increase with

BFR. Frequency of training has ranged from 2x per week to 2x per day. BFR resistance training 2x per day has shown to be effective for increasing muscle size and strength within six days.3 To build muscle mass and increase strength, loads should be about 70% to 85% for one rep. BFR is theorized to create the same effect using 10% of 1 rep max with less load therefore creating decreased risk of injury. BFR can be beneficial for those who cannot tolerate heavy loads such as the elderly, people with chronic disease, athletes and people rehabbing from injury or surgery.2 Several studies have reported that low intensity aerobic exercise combined with BFR can facilitate strength adaptations whereas hypertrophy and strength only occur with anaerobic exercises.2 Some clinical applications for BFR include but are not limited to: generalized weakness, limb salvage, amputations, sarcopenia, arthrogenic muscle inhibition, tendinopathy, post-surgical cases (TKA, ACL), and OA.

1. Pearson, S. and Hussain, S. (2014). A Review on the Mechanisms of Blood-Flow Restriction Resistance Training-Induced Muscle Hypertrophy. Sports Medicine, 45(2), pp.187-200.

2. Slysz, J., Stultz, J. and Burr, J. (2018). The efficacy of blood flow restricted exercise: A systematic review & meta- analysis. [online] Jsams.org. Available at: https://www.jsams.org/article/S1440-2440(15)00182-6/fulltext [Accessed 23 Dec. 2018].

3. Fahs, Christopher A et al. "Methodological Considerations For Blood Flow Restricted Resistance Exercise". Journal of Trainology 1.1 (2012): 14-22. Web.

Published Article News Mike Gans published an article in the February 2019 edition of Musculoskeletal Science and Practice titled “Reliability and diagnostic accuracy of cervicothoracic differentiation testing and regional unloading for identifying improvement after thoracic manipulation in individuals with neck pain.” Check out the full article online!

STUDENT PROGRAM UPDATE

“The cervicothoracic differentiation test (CTDT), cervical and thoracic unloading are used clinically to guide treatment.

This study sought to determine the reliability and diagnostic accuracy of these tests. A prospective diagnostic accuracy study was performed at two outpatient clinics and one university research center. A convenience sample of 48 individuals with neck pain was recruited. Cervical and thoracic unloading tests and CTDT were performed with symptom relief considered a positive test. Pain was assessed using a visual analog pain scale (VAS) at rest and during provocative movements. The reference standard was pain relief following thoracic manipulation. Change in pain was used to identify improvement at the MCID (15 mm) and 50% improvement thresholds.”

Tyler Naef – Sacred Heart University 3rd year DPT student began his affiliation with Ted Raczka in Branford on December 3rd. He’ll conclude his time in the clinic on February 8th.

Check out the full article online!

Kathleen Barry (Quinnipiac University 2nd yr) will be working with Danielle Dunn in Wallingford from January 7 – March 29.

2019 Courses

Email coned@ptsmc.com to RSVP March 2-3 September 28-29 PTSMC Wallingford PTSMC Guilford Neuroscience RESPONSIBILITY Graston M1 Email coned@ptsmc.com toTherapeutic register Education: Teaching People EDUCATION March 8-10 About Pain Sacred Heart University ATTITUDE Myopain TDN 1 October 12-14 Sacred Heart University MOTIVATION May 17-19 Myopain TDN 3 Sacred Heart University Myopain TDN 2 DEDICATION

January brings 5 additional students to PTSMC:

Zachary Breen (UCONN) has his final affiliation in Newington with Tom Kassan from January 14 – April 5.

Jacob Ciolino (Washington University) will be working with Stephanie Weyrauch in Orange from January 7 – March 1.

Zachary Kaplan (SUNY Stonybrook) – begins his final rotation in Waterbury with Erin Walsh and Joanna Fisher January 14 – March 15.

Megan Manzo (Scranton University) will be working with Kristina Lipeika and Lindsey Scianna in Watertrown from January 14 – March 8.

2018 W2’s

All employees will receive a paper copy of their W2 mailed to their home address by January 31, 2019. Be on the lookout for your 2018 W2 around January 15th in Paychex Flex under your Dashboard. You will see it listed under Tax Documents.

2019 Mileage Rate

New Year News 2019 PTSMC Holidays New Year’s Day Memorial Day Independence Day Labor Day Thanksgiving Day Christmas Day

Tuesday Monday Thursday Monday Thursday Wednesday

Beginning on January 1, 2019, the IRS standard mileage rate has been increased to 58 cents per mile. Updated expense reimbursement forms will be emailed to employees and available under Human Resources by January 7, 2019.

January 1st May 27th July 4th September 2nd November 28th December 25th

2019 Three Payroll Months

There will be three payrolls in the months of January and July 2019. These payrolls will not have medical, dental or Colonial deductions

The holiday schedule can be found in Human Resources under company documents.

All employees please check if you need to update any of the following information for 2019.

Reminder: Holiday Time Off Policy Revised Effective January 1, 2019

Address and Cell Phone Notify Human Resources

The revised Holiday Time Off Policy now includes the hours previously known as personal. The accrual will remain the same for Emergency Contact Information In Human Resources under Personal Information click on all employment categories however the total hours will include hours to use as personal hours. The updated holiday time off accrual Emergency Contact and update. schedule is listed below: W4’s Email or request for changes to Sandra Boccialetti. Changes to Full Time (FT) 56 hours (48 holiday and 8 personal) your deductions can be made at any time during the year.

Part Time 30 (PT 30) 42 hours (36 holiday and 6 personal) Part Time 20 (PT 20) 28 hours (24 holiday and 4 personal) Beneficiary Employees can update beneficiary information on Employee Holiday hours will continue to only be used on the actual holiday.

Personal hours must be used during the calendar year - January – Navigator and John Hancock at any time.

December. For eligible employees, Holiday hour balance is located under “Holiday” in Time and Attendance. This means that Personal Dialogue for Development & Goals and hours are no longer listed as a separate accrual.

Objectives Time is Here!

Employees* who participate in the Dialogue for Development and Personal Goals and Objective process will be receiving a Physical Therapist Continuing Ed Hours communication either verbal or email from your Supervisor to All CT licensed Physical Therapists and Physical Therapist Assistants schedule your meeting time. are required to maintain 20 hours of continuing education per year Sandra Boccialetti will be emailing all employees the following information by position. as a licensure requirement. All internal and external continuing • D4D form to be completed education that employees complete is recorded in HR Online.

• Performance considerations Employees can view and print the courses they have completed • Goals and Objective SMART format samples while employed at PTSMC by clicking on the Training Taken tab under Training, Education and Skills.

Want to review prior D4D’s and Goals and Objectives? They are Employees can view their continuing education expenses for each located in Human Resources under Employee Documents. year by clicking on the Custom Fields tab under Personal Informa- * PTSMC employees who work less than 20 hours may or may not participate in this process. Check with your supervisor. tion.

CURRENT JOB OPPORTUNITIES AT PTSMC

Physical Therapist Avon Southbury Southington

Patient Services Coordinator Southbury

Physical Therapy Aide Branford Middletown New Haven Physical Therapist Assistant Southington Southington Westbrook Check PTSMC.com for our most up to date postings and feel free to share! We’re always interested in connecting with referrals of colleagues and friends.

FLAG

Kristen Ludwig’s 6 week online program is designed to help you learn healthy long-term habits with professional guidance, group support, weekly challenges, and healthy recipes.

Food & Lifestyle Accountability Group Jan. 7th - Feb. 18th $150/person

Payroll deductions options available contact Sandra Boccialetti!

Register online at www.ptsmc.com/FLAG

Kristen Ludwig RD, CD-N, CPT Health Fitness Specialist

By Jim Hungerford, CPA 6 MONEY TIPS TO KICK OFF THE NEW YEAR

Here are a few solid New Year’s money tips to get you started if you’re looking to make 2019 more financially prosperous than 2018: Spending Make a family budget so you understand your discretionary income. Doing a budget may not sound like fun, but it is important in helping you understand your monthly cash flow and discretionary income. The amount of money you earn after taxes, the amount you spend on essential living costs, and any "leftover" amount is your "discretionary income." How much of your discretionary income you spend and how much you save may be one of the most important decisions you make in your financial life. Well-known web sites like BudgetTracker.com or mint.com make it easy to get started.

401(k) Contributions Automatically increase your 401(k) or other retirement plan contributions. Raising the percentage of your income that you defer into your qualified retirement plan can be very easy. A small and relatively painless annual increase can mean a big difference later in life.

Investment Review Analyze your risk tolerance and asset allocation. A new year is a good time to look at your investment portfolio to be sure it still reflects your current thinking on the markets, your time frame until retirement and that it is still in line with your goals and objectives. You may be able to complete this yourself, with the help of some online software, or contact PTSMC’s 401(k) investment advisor, Connecticut Wealth Management, or look for a qualified financial advisor who may be able to offer his or her advice.

Pay Off More Debt Adding extra money to an automatic monthly payment plan is one of the easiest ways to be debt free faster.

Even a small amount adds up quickly. For example, if you pay an extra $25 every month on a $100,000 mortgage at 4% interest, you’ll pay off your debt 2.4 years faster and save $6,327 on interest.

Conduct a Beneficiary Review on Your Retirement Plans and Insurance Policies The beneficiaries named in these accounts take precedent over any legal document you create.

Therefore, you need to review each of these to ensure your beneficiaries are current and your legal documents reflect your wishes. This is especially important if you've had a recent family event such as a marriage, birth of a child, or a divorce.

Review the Adequacy of your Life and Disability Insurance, Especially if You Have Children Don’t forget to consider buying life insurance (or increasing what you have) to protect your children’s or Spouse’s future. The good news is that term life insurance can be relatively inexpensive. Remember, for two-earner families, you may want to insure both parents’ incomes. Insurance companies will typically offer up to 10 to 12 times annual income in coverage. In addition, disability coverage should be considered.

Disability insurance will provide you with a monthly income stream should you become disabled and unable to perform your work duties.

Life Beat Combat the common cold this winter!

We know there is no “cure” for the common cold… however, there are ways to defend yourself and shorten its duration. These cold hacks will get your immune system ready for the seasonal battle!

NEW EMPLOYEES

Welcome to PTSMC. We’re so happy to have you!

ZZZ’s - Rest is the number one remedy for combating a cold. Your body needs to focus its effort and energy into your immune system. If you are running yourself into the ground, you are not setting your body up for success.

Listen to your tiredness, get sleep, and take a break so your cold lasts 2 days instead of 10!

Exercise - Naturally, exercise helps strengthen your immune system. Exercising regularly can prepare your body to better fight off viruses during cold season. If you do catch a cold, low intensity exercise helps keep your body humming and working though it. Additionally, exercise it a great way to alleviate stress. The less stress, the faster you will get over the cold.

Jessica Fontaine

Drew Hungerford

Watertown PT Aide

Windsor PT Aide

Peter Inserillo

Avon PT Aide

Hydration & Warm Liquids - The oldest trick in the book: some high quality H2O! When you are sick, it is even more important to continuously hydrate. Drinking warm liquids can be easier to get down and help relieve congestion.

Purify Your Air - Just like steam from warm liquids, using a vaporizer, humidifier, or diffuser will help with congestion by keeping the air around you moist. Pro tip: add essential oils to your diffuser! Essential oils clear bacteria from the air, help open your airways, and can even affect your mood. Ideal essential oils for when you have a cold are: eucalyptus, peppermint, and tea tree.

Georgeanne Keirstead Guilford PSC

Tabby Johnson

New London PT Aide

Nick Maltese

Guilford PT Aide

Disinfect - Stop the cold in its tracks by washing your hands and disinfecting items you frequently use. For starters, disinfect your cell phone, office phones, desk, counter tops at home and the office, the buttons on the Keurig… You’d be surprised how often you touch those items compared to how often you actually clean them!

Vitamin C & D - Boost your immune system with a little extra vitamin C & D. During the winter we lack vitamin D because we rarely see the sun. Add this supplement to your winter diet to help prevent a cold (and help you imagine sunny and warm places). Additionally, your body burns through vitamin C much faster when you have a cold. To help get rid of your cold quicker, keep your body fueled with vitamin C. Simple ways to get some extra vitamin C & D are: Emergen-C packs, Airborne packs, oranges, and orange juice.

Nikki Matarazzo

Wallingford PT Aide

Abru Santhosh

Newington PT Aide

Zinc - If taken within the first 24 hours of feeling a cold coming on, Zinc is said to help reduce the duration of the cold. Zinc lozenges are an easy way to get the Zinc into action fast and help prevent the cold virus from lodging in your nasal passages and multiplying.

When it comes down to it, use your common sense to combat a cold. Get your rest, stay hydrated, and fuel your body with immune-boosting vitamins. And remember, you don’t want to spread a cold, so make good decisions to prevent infecting your colleagues, friends and family!

Kristen Sinagra

New London PT Aide

Alex Zablan

Orange PT Aide

PTSMC Happenings Food Drive Fun!

Newington’s raffle prize winner!

Watertown

Plainville

Southington

Admin

Waterbury

Branford

Social Media Sensation! PTSMC Employee Spotlight Tom Kassan, Newington PT

Soon to be West Hartford Partner!

Tom has been working in PTSMC Newington, but this spring will be the West Hartford partner! Learn about his transition to partner at www.ptsmc.com/videos

Amy Fichman, PSC Newington

Newington celebrated the holidays with a whole spirit week! Thanks to Amy for sending pics of the week, their food drive donations, and their holiday party at Montana Nights Axe Throwing!

JANUARY BIRTHDAYS Ken Kosior Eleni Medici Bethany Grady Nic Sauerbrunn Sue Ginsburg Danielle Dunn Courtney Duff Andrew Mead Kasey Bascetta Chelsea Cordova Jane Rosadini Kristina Lipeika Ashley Tighe Kristen Forster Rosalinda Tufano

2 5 6 6 15 19 21 24 25 26 26 26 28 28 29

ANNIVERSARIES

Wallingford East Hampton Groton Windsor Guilford Wallingford New London Guilford Windsor Guilford Guilford Watertown Wallingford Admin Waterbury

Kristen Ludwig Nancy Chilson

Alison Rivera Brittany Boscarino Brooke Uliano Katie Player Lauren Mariotti Sylvia Yanez-Carlson

Avon Avon

Health Fitness & Nutrition Specialist Patient Services Administrator

Naugatuck East Hampton Wallingford East Hampton Watertown Watertown

PSC PT Aide PT Aide PT Aide PSC PT Aide

Congratulations!

Meaghan Battige (Windsor) married Trevor Brunelle on October 5, 2018.

Erik Schmitt (Westbrook) got engaged to Stephanie on November 22, 2018 - Thanksgiving!

Mike Antunes and his wife Victoria welcomed their son Evan on December 15, 2018. Pictured left is their daughter Ella meeting her new brother for the first time.