PT Extender Program Validated in forward theater operations

Photo By Capt. Brandon Janson | Maj. Ibrahim Shamma, JTF MED 374, Board Certified Doctorate Physical Therapist reviews the proper technique for assessing the elbow joint with particular emphasis on identifying deficiencies.  

IRAQ

02.03.2023

Story by Capt. Brandon Janson 

807th Medical Command (Deployment Support)

BAGHDAD--Military life has never been easy on the body, especially overseas. Daily life usually involves carrying and moving heavy items and supplies, lugging around body armor from one place to the next, as well as lots of physical activity and working out to pass the time. All the above puts a lot of wear and tear on a Soldiers' body, which usually turns into pains and strains and an eventual visit to sick-call to see the doctor.

According to the Brigade Combat Team Physical Therapy Guide, which uses older data from Operation Iraqi Freedom and Operation Enduring Freedom:
· 87% of all injuries are related to non-battle musculoskeletal injuries
· 11 million limited duty days were linked to musculoskeletal injuries.
· 80% of musculoskeletal injuries were due to repetitive overuse.
· Musculoskeletal conditions comprise approximately 75% of all VA disability cases.

For many, rest and Motrin are the recommended treatment for their musculoskeletal injury, but for others, when pain does not improve in time, further evaluation is needed. This is usually when a Soldier is referred to physical therapy, which makes sense, but there is a problem--there is only one physical therapist assigned in the entire theater of operations. That PT professional is Maj. Ibrahim Shamma who has been doing Physical therapy for 20 years, primarily working in the outpatient setting. Positioned at the Joint Task Med 374 Rolle III hospital center, Shamma cannot physically care for each and every musculoskeletal injury that occurs in theater.

To help bridge this very large gap in manpower and expertise, Shamma has been working on a Physical Therapy course for medical troops working at the different troop clinics in order to reach more Soldiers.

"We're calling it the PT Extender Course," said Shamma. "We take 68W medics and introduce them to some very basic assessments to help triage Soldiers with musculoskeletal symptoms. It's much more task-oriented, focusing on a basic range of motions of all the joints, strength, flexibility, some upper and lower neuro exams and with an emphasis on the deficits."

Through the course, Medics will be taught evidence-based skills that allow them to perform basic tests and measures and implement exercise programs. The course covers human anatomy, musculoskeletal function, triage, physical assessment, and following PT treatment plans initiated by a certified trained physical therapist.

"The PT extender program got started back in the States and was initiated in theater by the last deployed rotation," said Lt. Col. Bridgette Epps, who pushed strongly for the program and is serving in a dual role; Deputy Command Surgeon, Chief Nurse of Clinical Operation for CJTF-OIR. "However, the material had not yet been validated through the Physical Therapy Consultant to the Army Surgeon General, Col. Jason Silvernail. With Maj. Shamma's help, we were able to rework the material and gain the endorsement."

Under a directive given by Lt. Col. Epps, Maj. Shamma and Capt. Daniel Dettman, another certified Physical therapist, assembled the 40-hour course.

"I had a short period of time to update the course material, but we still wanted the material to be academic using evidence-based practices. I developed the class the way I would teach a real PT class for entry-level PT students," said Shamma.

"Working at a Role I troop clinic, we frequently see musculoskeletal complaints,” said Spc. James Gidlund, 68W who, attended the PT extender course. “The most common complaint we see is Soldiers complaining of lower back pain. I enjoyed learning about the different areas of the body and the correlation to physical therapy. I plan on using a majority of the information provided in day-to-day operations inside the Role I where I work," said Gidlund.

Looking back on the student's participation, Shamma thought the class did great.

"At first, they were a little apprehensive, but as they started doing more of the hands-on, I got to see them more confident and more skilled. Practice takes practice and just following the steps. I also think the hands-on kept them more engaged, and they could see how the different information would feed into the different sections," said Shamma.

"The overarching goal is to rotate the Physical Therapist to see more serious patients," said Epps. "To do this, we need high-speed medics that can perform simple PT triaging and carry out basic treatment plans initiated and supervised by PT. We want to be able to offer the care, so we can keep more Soldiers in theater instead of having to evacuate them out for outpatient type care."

• Date Taken: 02.03.2023
• Date Posted: 02.21.2023 09:49
• Story ID: 438650
• Location: IQ
• Hometown: CHICAGO, IL, US
• Hometown: INDIANAPOLIS, IN, US