Physical Therapy with an OPEN MIND (cont.)

In today’s blog, I will be continuing the discussion of Physical Therapy with an OPENMIND. Last week’s blog post was over physical therapy in Asian and European cultures. This week we will be going over physical therapy practices and cultures of Oceania (Australia and Pacific Islands) and Africa.

AFRICA

With a population of ~1.1 billion people, Africa is the second most populated continent in the world. There are 54 countries, all varying in cultures and languages.7 Africa is said to be the mother of all cultures, so it’s no surprise that most cultures have deep religious influences. Christianity, Islam, and traditional African religions make up the majority of religious views and practices.5 Not only is Africa the second most populated continent in the world, it also holds the most number of diverse languages in the world, there are ~1500 different languages spoken.3 However, the three most spoken languages, mainly for business purposes, are Arabic, French, and English.3 When it comes to healthcare, many African cultures view diseases, and conditions as an attack by evil spirits. As the Western world advances in it’s technology and health care, the African reliance on herbal healing and  traditional medicine becomes stronger.6 Problems can arise when foreigners come into these cultures and the native people are reluctant to change their ways in order to better their education and health.

Physical Therapy in Africa

As I mentioned in my first blog, there are many developing countries in Africa that are lacking in the field of physical therapy. The ratio of physical therapists to people is alarming (ex. Tanzania has a ratio of 250 therapists to a population of 38 million).2 Majority of the health professionals found in African countries are either doctors, or nurses. This is mainly due to the lack of funding, education availability, and lack of awareness of the benefits of physical therapy. Fortunately, physical therapists in Africa have started to focus on special projects on palliative care physical therapy with an emphasis on HIV/AIDS.4 There is a high demand for health professionals in areas where the HIV/AIDS population is high. Physical therapists help prevent misusage of treatments leading to readmission to hospitals, are able to help in pain management, and continue to develop active muscle strengthening in these types of patients. People need to be informed that therapy provides a way to improve quality of life, or death for those dealing with terminal conditions/illnesses.

OCEANIA

Australia and the Pacific Islands make up what is now called the continent of Oceania. There are 14 countries in this continent with a total population of ~36 million.7 Majority of the Oceanic population lives in Australia; it is home to ~22 million people.7 The main religions in these countries are Christianity, non-religious, traditional religions.  Oceania like Africa, has a large diversity of island cultures and languages. However, English is the most common language spoken, mainly because it’s the official language of Australia which makes up the majority of Oceania. While there is still a strong belief in traditional medicine in these Pacific island and Australian aboriginals, modern medicine is primarily practiced. There is strong research being done in all fields of the healthcare that are not only beneficial to those in these countries, but to people around the world.

Physical Therapy in Oceania

As I was researching information about the current physical therapy practices in Oceania, I came across a brief history article of how physical therapy started in Australia. The following is a part of the history article by the APA (Australian Physiotherapy Association):

“During World War I, physiotherapy began to receive public recognition as a valuable treatment through the rehabilitation of injured soldiers. World War II and the polio epidemics that savaged Australia in the 1950s provided further opportunities for physiotherapists to make a significant contribution to the health of Australians.

Today, physiotherapists work independently and alongside other healthcare practitioners to diagnose, treat, and prevent a wide range of healthcare issues. The APA predicts that physiotherapy will play an increasingly important role in maintaining the health of the community over the coming decades.” 1

Due to the all the technology advances and modern world, the concerns of physical therapists have shifted slightly from those problems found in their history. Australia, similar to Europe, has seen a decrease in physical activity and increase in poor nutrition leading to diabetes, heart diseases, cardiovascular diseases, and overweight/obesity problems.8 Physical therapists are also teaming up to provide health services to prevent these types of problems.

Physical therapy is a practice that is currently growing throughout the world. Whether it be to providing therapy to HIV/AIDS patients in African countries, or continuing research in Australia.

Next week I’ll continue this discussion (series) about Physical Therapy with an OPENED MIND in South America and Central America.

Last BUT not least, I have started a new podcast channel Journey of a Pre-PT Student where you can check out a more personal side of my professional career.

References

1History: Australian Physiotherapy Association. (n.d.). Retrieved March 30, 2017, from http://www.physiotherapy.asn.au/APAWCM/The_APA/About_the_APA/History/APAWCM/The_APA/About_The_APA/History.aspx

2JOHN, E. B., PT, PhD. (2012). Establishing and Upgrading Physical Therapist Education in Developing Countries: Four Case Examples of Service by Japan and United States Physical Therapist Programs to Nigeria, Suriname, Mongolia, and Jordan. JOURNAL OF PHYSICAL THERAPY EDUCATION, 26(1), winter, 29-39. Retrieved February 6, 2017.

3Matshego, L. (2016). How Many Languages of Africa Are There? Retrieved March 20, 2017, from https://www.africa.com/many-african-languages/

4Mothabeng, J. (2017, March 07). Africa Region of WCPT. Retrieved March 21, 2017, from http://www.wcpt.org/africa

5Okonkwo, O. (2014, May 11). Top 10 Most Popular Religions in Africa. Retrieved March 17, 2017, from

http://pulse.ng/religion/here-they-are-top-10-most-popular-religions-in-africa-id3048509.html

6White, P. (2015). The concept of diseases and healthcare in African traditional religion in Ghana. HTS Teologiese Studies/ Theological Studies, 71(3), 2762nd ser., 2762-2769. Retrieved March 22, 2017, from http://www.hts.org.za/index.php/HTS/article/view/2762/html

7WorldAtlas. (2016, May 3). How Many Countries Are In The World. Retrieved March 10, 2017, from http://www.worldatlas.com/nations.htm

8Hotez, P. J., Kline, K., Loukas, A., McCarthy, J. S., & Pearson, M. (2013). Neglected Tropical Diseases of Oceania: Review of Their Prevalence, Distribution, and Opportunities for Control. PLOS: Neg, 7(1), e1755. http://dx.doi.org/10.1371/journal.pntd.0001755

Physical Therapy with an OPEN MIND

In a world with a population of ~ 7,484,325,4762, 196 countries6, ~6,500 languages3 ,and ~4,200 different religions1,there are going to be times where people don’t share the same views. As a health professional working in developing countries, it is important to live your daily life with an open mind. In today’s blog, I will be discussing how Asian and European cultures have different effects on physical therapy practices around the world.

ASIA

Asia is usually divided into sections (East, West, Central and South Asia), however to keep this blog short I will discuss Asia as a whole. The Asian continent consists of 48 countries with a total population of 4.4 billion people (62% of the world population).6 There are many spoken languages throughout, but the three most spoken languages are Mandarin, Hindi, and Arabic.6 Asia is the world’s largest continent, which explains the extremely diverse climates (subarctic temperatures in Siberia to tropical climates in India) and geographical features. Religious practices are also very diverse, but the three main religions are Islam (1.1 billion followers), Hinduism (1 billion followers) and although it is not a religion “no-religion” is practiced by 925 million people.6

PHYSICAL THERAPY IN ASIA

Due to the war breakouts in West Asia, countries like Syria and Jordan, are having to bring in foreign physical therapists and health providers to help with patients therapy. As I previously mentioned, different cultures will at times set restrictions to healthcare professionals. For example, in various countries, women have very little to no rights and are required to only be treated by women healthcare providers. Some religions view disabilities as “God’s will, and a test of endurance”, majority of the time family members prefer to “hide” the disabled family member instead of seeking help from professionals.5 Physical therapy is one of the the most growing contributing professions to the health service all over the world. Countries in the Asia Western Pacific Region are making lots of efforts to set education and practice standards to improve physical therapy practices and techniques. Across the Asian continent the popularity of physical therapy varies. One of the goals of multiple organizations is to bring awareness of the benefits of physical therapy to countries that don’t know much about the practice.

EUROPE

Europe consists of 47 countries, and has a population of 739 million (3rd most populous continent after Africa).6 Although religion has been on a decline in Europe, the three most practiced religions are Christianity, Islam, and non-religious.6 Languages vary across the European continent. However, the most spoken languages are the “romance languages” of French, Italian, and Spanish.6 English and Germanic languages are also very widely used, especially English. Although Europeans are very open to healthcare, there are a few cultures that physical therapists need to be aware of; one being the Gypsy/Roma Culture. Gypsies are known for being loud and argumentative (although the majority don’t mean to sound this way). It is important to keep in mind that it takes time to establish trust, mostly due to the fact that most will respect older medical professionals more than younger professionals. Another gypsy belief physical therapists will encounter is the idea that the lower half of the body is impure. Most will refuse to receive orthopedic therapy, even if it is necessary.

PHYSICAL THERAPY IN EUROPE

As mentioned in my second blog, there has been an increase in obesity, cancer, diabetes, and cardiovascular diseases in the past few decades. Health professionals, especially physical therapists are teaming up to promote the EU Platform on Diet, Physical Activity and Health.4 This platform is trying to bring awareness of the negative health issues resulting from bad eating habits. A popular therapy practice followed in Europe is the combination of physical therapy and cryotherapy. Cryotherapy has been used in Europe for several decades and is a treatment that takes place in a cold chamber. “This type of therapy triggers the discharge of endorphins, which in turn come with an immediate pain relieving effect.”7 Researchers have found that combined with physical therapy, this type of therapy can in return leave long-lasting results.

The continents of Asia and Europe make up more than half of the world population. Therefore, it is no surprise that health providers will be at a higher demand and physical therapy is definitely a rising practice.

Next blog I will continue with this topic of Physical Therapy with an OPENMIND in South America, Oceania, and Africa.

References

1Adherents. (2007, August 09). Major Religions of the World Ranked by Number of Adherents. Retrieved March 10, 2017, from https://www.reference.com/world-view/total-number-religions-world-ff89ae17c6068514

2Census Bureau, T. (2017, March 10). U.S and World Population Clock. Retrieved March 10, 2017, from https://www.census.gov/popclock/

3Ethnologue. (2014). Most Widely Spoken Languages in the World. Retrieved March 10, 2017, from http://www.infoplease.com/askeds/many-spoken-languages.html

4EU Platform for Action on Diet, Physical Activity and Health. (2014, November 15). Retrieved March 09, 2017, from http://www.erwcpt.eu/eu_and_advocacy/eu_platform_for_physical_activity

5Handbook of Patients' Spiritual and Cultural Values for Health Care Professionals. (2013, March). Retrieved March 10, 2017, from http://www.healthcarechaplaincy.org/userimages/Cultural%20Sensitivity%20handbook%20from%20HealthCare%20Chaplaincy%20%20(3-12%202013).pdf

6WorldAtlas. (2016, May 3). How Many Countries Are In The World. Retrieved March 10, 2017, from http://www.worldatlas.com/nations.htm

7Therapy, T. O. (2012, November 19). Learn about Cryotherapy Treatment in Europe [Web log post]. Retrieved March 10, 2017, from http://therapies.healthxtourism.com/learn-cryotherapy-treatment-europe/

Sugar, Fat, Salt, and Physical Therapy

Poor nutrition has many negative effects on your body including heart diseases, cancers, obesity, and believe it or not it, your muscle response. The main focus of this post is to inform you of the effects poor nutrition habits has on your overall body, and what physical therapy can do to help you achieve your health goals.

Let’s start off by giving you an example of what I mean by “poor nutrition = a slower you.” So you walk into your favorite fast food restaurant, let’s say it’s McDonald’s (I’m using them as an example because it’s a pretty popular restaurant; there’s approximately 35,000 restaurants serving in 118 countries2) and you order it’s famous Big Mac with a side of fries and coke. More than likely you will feel logarithmic, and in need of a nap after your meal. The question is WHY?  These types of foods are highly processed, contain extra sugar, unhealthy fats, and are loaded with salt. I’ll give you a little background on what effects some of these have on the body.

EXTRA SUGAR

According to the American Heart Association, people are eating way more sugar than they need in their diets. The extra calories from sugar are not only causing people to gain weight, but they are also causing people to develop more heart diseases. There are 3 different types of sugars you can consume:

• Monosaccharide:The sweetest of the three, is a single sugar molecule but causes the greatest insulin spike. They are the easiest and fastest to digest, and the most common in “junk food”.8
• Disaccharide:This type of sugar is also sweet. It is made from a 2 sugar molecule, and also causes an increase in insulin release.8
• Polysaccharide:This sugar is made from of multiple bonds of sugar molecules. Unlike monosaccharides and disaccharides, this type of sugar is not very sweet, and does not create insulin spikes. This sugar is the ideal and healthiest source of carbohydrates.8  

What affect does sugar have on muscle responsiveness? If you are not familiar with the importance sugar (blood glucose) I’ll give you a short review.

“Blood glucose is the sugar that the bloodstream carries to all the cells in the body to supply energy.”

However the only way the glucose can enter the body, then to the muscles, is through the hormone called insulin. If the intake of sugar is more than the amount of insulin produced by your body, you are left with a surplus of sugar.3 There are different things that happen when you have a surplus of sugar. You will more than likely get what most people call a “sugar high”, which doesn’t last very long before your body counteracts the effect with the release of serotonin (a sleep-regulating hormone).9 Which explains the “sugar crash” you experience after the “sugar high”. There are so many negatives of consuming sugar, being more aware of the amounts one is consuming is important to avoid health problems.

UNHEALTHY FATS

If you didn’t already know, there are good fats and then there are bad fats. Our body needs certain fats for fuel, and fats also are also essential for fatty acids. There are four different types of fats:

• Saturated Fat: This type of fat is known as the “solid fat”, found in animal products (milk, cheese, and meat) and in some oils (palm, coconut). Eating an excess of saturated fat can raise your cholesterol.
• Trans Fat: This type of fat is popular in the food industry, especially for frying, baking, and processing snack foods. Trans fat is even worse at raising cholesterol levels, and it also plays a big factor in creating inflammation in the body.2
• Polyunsaturated Fat: This type of fat is considered a healthy type of fat. “The American Heart Association suggests that 8-10 percent of daily calories should come from polyunsaturated fats, and there is evidence that eating more polyunsaturated fat—up to 15 percent of daily calories—in place of saturated fat can lower heart disease risk.”6
• Monounsaturated Fats: This type of fat is also considered a good type of fat. Foods like avocados, nuts (ex. pecans, almonds, hazelnuts), and seeds (ex. pumpkin, sesame) have high concentrations of monounsaturated fat.5

Most unhealthy foods are loaded with “bad fats” that can clog arteries causing heart problems, high cholesterol, and even diabetes. When there’s a surplus of fat in your food you will store that excess fat in your body, causing you to gain weight, and a lot of the time it will lead to obesity. Obesity has so many negative affects on the body. People who are obese may experience the following:

• Fatigue when performing simple daily activities.1
• Joint pain, especially in the legs and back from increased stress that excess fat and weight put on the joints and muscles of the body.1
• Difficulty performing daily activities, such as walking, climbing stairs, or playing physically active games.1
• Frustration or depression about the condition and the inability to lose weight.1

According to WHO (World Health Organization), worldwide obesity has practically doubled since 1980! Monitoring our daily fat consumption is very important to avoid getting to this point. As I mentioned in my previous blog post, there needs to be a push to educate the children over the importance of healthier eating habits.

SALT (SODIUM)

Too much salt in your body can lead issues such as edema, kidney problems, stomach ulcers, and high blood pressure. An excess consumption of sodium will also alter the balance of fluid in your body. In order to maintain a homeostatic environment after you eat a meal loaded with salt, (sodium) your body will start to crave extra water. Your body will start to swell due to the water retention, leaving you with that bloated look. This could potentially lead to edema, the swelling of extra fluid in your body’s tissues. Too much sodium can also lead to development of kidney stones. Kidney stones develop when there is too much waste in too little liquid (water), allowing for crystals to start forming.4 If you are “lucky” you may form tiny stones that can easily travel down the urinary tract into the ureter. However, some stones are too big and have a hard time moving causing a painful backup of urine in the kidney, ureter, bladder, or the urethra.

I have linked a video produced by the National Kidney Foundation which gives a great short illustration on how important it is to drink water to avoid kidney stones.

So how can physical therapy help?

Move Forward, a physical therapy blog, has a great article going into more detail as to how a physical therapist can help with obesity, one of the effects of poor nutrition. I’ll list just a few ways they mentioned physical therapist can help you achieve your healthier lifestyle

• They can help you perform activities and exercises specialized towards your needs including those with physical disabilities.1
• Physical therapists can design a “heart-healthy” program that elevates your body’s metabolism which helps burn more calories.1
• They can teach you exercises that improve your strength. Building muscle can help burn calories, make daily activities easier, and helps relieve joint pain.1

As the number of heart attacks and heart surgeries rise, the need for cardiopulmonary therapy also increases. Most people unaware of cardiopulmonary physical therapy and it’s benefits.

So what is cardiopulmonary physical therapy?

“Cardiopulmonary Physical Therapy is physical therapy focused on the physical function of the cardiopulmonary to prevent cardiopulmonary disease and help those with cardiopulmonary disease function better.”10

This type of therapy specializes in treating patients that have pulmonary fibrosis, heart valve replacement, post coronary bypass surgery, and coronary stent placement. Not only is it a post-op treatment ,but it can also act as preventative therapy to strengthen the heart muscles reducing the risks of suffering from a heart attack.

Physical therapists are a great source to get you started on your path towards a healthier lifestyle.

References:

1Avruskin, A., PT, DPT. (n.d.). Physical Therapist's Guide to Obesity. Retrieved March 02, 2017, from http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=df77f3aa-573b-4d1e-893b-18c88e6cedce

2Chalabi, M., & Burn-Murdoch, J. (2013, July 17). McDonald's 34,492 restaurants: where are they? Retrieved March 8, 2017, from https://www.theguardian.com/news/datablog/2013/jul/17/mcdonalds-restaurants-where-are-they

3Imatome-Yun, N. (2015, April 15). How Does Fat Affect Insulin Resistance and Diabetes? Retrieved March 08, 2017, from https://www.forksoverknives.com/fat-insulin-resistance-blood-sugar/

4Kidney Stones. (2016, January 25). Retrieved March 08, 2017, from https://www.kidney.org/atoz/content/kidneystones

5Madell, R., & Butler, N., RD,LD. (2016, January 20). Good Fat, Bad Fats, and Heart Disease. Retrieved March 1, 2017, from http://www.healthline.com/health/heart-disease/good-fats-vs-bad-fats

6Mozaffarian, D., Micha, R., & Wallace, S. (march 23, 2010). Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLOS: Medicine. Retrieved March 8, 2017, from http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000252

7Mozaffarian,D., Rimm, E. B., King, I. B., Lawler, R. L., McDonald, G. B., & Levy, W. C. (2004). Trans Fatty acids and systemic inflammation in heart failure 1-4. The American Journal of Clinical Nutrition, 80(6), dec, 1521-1525. Retrieved March 08, 2017, from http://ajcn.nutrition.org/content/80/6/1521.full.pdf html

8R. (2015, April 14). Is Sugar Bad For A Bodybuilder. Retrieved March 08, 2017, from https://www.bodybuilding.com/fun/topicoftheweek69.htm

9Voss, G. (2014, June 12). What. Retrieved March 01, 2017, from Voss, Gretchen. "What Sugar Does to Your Body." Women's Health. Women'sHealth, 12 June 2014. Web. 01 Mar. 2017

10The Health Benefits of Cardiopulmonary Physical Therapy. (2013, March 12). Retrieved March 10, 2017, from http://www.lifefitnesspt.com/blog/tag/the-health-benefits-of-cardiopulmonary-physical-therapy/

The BEST and WORST Nutrition around the World

Throughout the world we are seeing different trends in the food industry causing negative and positive changes in eating habits affecting all aspects of health. So, it is no surprise that nutrition has been a hot topic throughout the health industry for the past few decades. One of the main concerns we are seeing is that not only does following an unhealthy diet increase heart and cardiovascular diseases, but it negatively affects muscle response time and alertness. In today’s blog post I will be comparing diets between two countries with different economies and cultures based on the results featured in Health News.

“The Best”

Higher living conditions does not necessarily mean better nutritional habits. A perfect example of this statement is the country Chad. This central African country has a population of 13,670,084 with approximately 47.3% of its population under the age of 15.5 Their economy relies on agriculture; 80% of the current jobs are in farming and cultivating.5 Even though there is political instability and poor infrastructure, Chad is currently ranked as having the healthiest diet in the world.2 Majority of the population eats a well balanced meal consisting of whole grains, vegetables, fruits, and good sources of protein. Across the board, Chad is consuming the most fruit, vegetables, nuts and whole grains than most countries. An example of a traditional meal is boule (a thick grainy porridge made from ground corn) served with spicy sauces of vegetables such as onions, tomatoes, beans, meat and fish. Although Chad is considered an underdeveloped country, most developed countries could learn a thing or two from countries with better eating habits.

                                                   

                                                  

      “The Worst”

Over the span of the past 20 years, researchers have found there has been an improvement with healthy diets in high-income countries.1 Unfortunately, there are several countries who are still practicing very unhealthy diets such as the country of Armenia.2 With a population of 3 million, and steady economic growth, this country is considered to have the unhealthiest diet around the world.4 Unlike Chad, bread and salt are considered a staple in traditional Armenian dishes. There is a prevalence of overweight and obesity among all ages due to the overeating habits of most people. Many health professionals are taking concern with the diets implemented in Armenian schools. Children are the future of any country, therefore it makes sense to start changing the poor eating habits found in schools. Most children in Armenia are consuming lots of carbohydrates and sugars from processed foods rather than vegetables, fruits, and whole grains.3 There needs to be more regulations on the types of food being provided to students. 

We are seeing an increase of overweight and obese populations in developed countries due to the rapid technological advances and lack of caloric exhaustion. As diseases related to unhealthy eating habits arise, there needs to be a push to promote the increase of fruits, vegetables and whole food consumption.  The more awareness we provide to these countries to practice better eating habits, the better the quality of life they will be living.

Next blog topic I will be discussing how poor nutrition affects muscle response time and how physical therapy can help reverse it.

References

1Adair, L. S., Ng, S. W., & Popkin, B. M. (2012). NOW AND THEN: The Global Nutrition Transition: The Pandemic of Obesity in Developing Countries. US National Library of Medicine National Institutes of Health, 70(1), 3-21. Retrieved February 21, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257829/.

2Gander, Kashmira. "Revealed: the countries with the best and worst diets in the world." Health News. Independent, 19 Feb. 2015. Web. 23 Feb. 2017. <http://www.independent.co.uk/life-style/health-and-families/health-news/revealed-the-countries-with-the-best-and-worst-diets-in-the-world-10057363.html#gallery>.

3Hakobyan, J. (2012, July 07). Health concerns and unhealthy lifestyle: Nutrition specialists warn of increased number of overweight children in Armenia. Retrieved February 23, 2017, from https://www.armenianow.com/society/health/41791/armenian_children_obesity_schools_canteens_healty_life_style

4I., & T. (n.d.). Armenia. Retrieved February 25, 2017, from http://country-facts.findthedata.com/l/9/Armenia

5T., & I. (n.d.). Chad. Retrieved February 25, 2017, from http://country-facts.findthedata.com/l/45/Chad