How do you balance success and failure during specific tasks during the treatment session?
Answer
That will come down to a combination of a few things. Number one, I am going to take a look at the degenerative disease, the condition that we are dealing with so I can understand. Is fatigue playing a role here? Should I continue to work on this challenging balance exercise or am I taking this person a little too far? I want to keep that in mind because that is going to be a medical maker for me. Number two, I am going to take a look at how frequently are we currently being successful in the practice of this task. I am going to shoot for about a 70% success rate and a 30% failure rate. When I say 30% failure, it means that there is a correction necessary clearly and need for a balance adjustment at a very subtle level. That would be indicated and I want that to happen. I am going to make an adjustment off of that 70% success rate that I am seeing with these clients based on a third factor, and that is going to come down to personality. How much success, how much challenge, and if you want to categorize it as such, how much failure is this client willing to allow themselves to endure. Personalities are going to influence that equation. I am going to let an individual push the envelope of that 70% success ratio if they are willing to be challenged, fail, and willing to try and err. If I have a client that is very self-defeating and depressed by the diagnosis they have been given, I am going to give them a little greater incidence of success and gradually integrate more challenge.
Mike Studer, PT, DPT, MHS, NCS, CEEAA, CWT, CSST, CBFP, CSRP, FAPTA, has been a PT since 1991, a board-certified neurologic PT in 1995, and a private practice owner since 2005. Dr. Studer has been an invited speaker covering all 50 states, 14 countries, and five continents, speaking on topics ranging from cognition and psychology in rehabilitation, aging, stroke, motor learning, motivation in rehabilitation, balance, dizziness, neuropathy, and Parkinson Disease. Dr. Studer was the founder and operator of Northwest Rehabilitation Associates in Oregon for 18 years and is now a co-founder and co-owner of Spark Rehabilitation and Wellness in Bend, OR. He is an adjunct professor at Touro University and has an additional appointment at UNLV. Dr. Studer also assists the USC-led national network of neurologic PT residencies (Neuroconsortium). In 2011, Mike was recognized as Clinician of the Year in the Neurologic and (in 2014) the Geriatric Academies of the APTA. He received the highest honor available in PT in 2020, being distinguished as a Catherine Worthingham Fellow of the APTA, joining a group of fewer than 300 persons then. Mike’s honors additionally reflect his service as Vice President of the Academy of Neurologic PT, and the Mercedes Weiss award for service to the Oregon chapter of APTA. He holds a trademark in dual task rehabilitation and has a patent pending on the same. Over his career, Mike has authored over 45 articles and seven book chapters, and he routinely has clinical research projects in affiliation with one of many universities. He is a consultant to professional athletes, including Major League Baseball players, competitive divers, and some of the most prolific climbers in world history. As a very fun and lighthearted note, Mike is the four-time and current WR holder for the fastest underwater treadmill marathon, a mark set most recently in January 2022. Mike authored The Brain That Chooses Itself, a practical and application-based guide to increasing healthspan and lifespan for laypersons and medical professionals alike.
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