Iasi, Romania; Physical Therapy Internship - Jenna

        From the beginning of September until the end of November 2012, I participated in an international internship in Iasi, Romania. Half of my day was spent with a specific group of children in an orphanage while the other half of my day was spent with children in a hospital. Many of the children I worked with had disabilities or developmental delays. I had the opportunity to work with a physical therapist’s assistant at the orphanage. I observed and participated in therapy sessions in which she taught me exercises and activities I could do with the children.

          In the orphanage I was assigned to work with fourteen children ranging in age as well as in physical ability. With the children who could walk on their own, I facilitated group dancing and games to help them to be active. Three of the boys I worked with had muscular

development issues so I would try to spend time with them each day
massaging and stretching their muscles.  The two boys I worked with most both had cerebral palsy. Through attending their physical therapy sessions, I learned exercises I could do with them each day. The older of the two boys had difficultly using his arms and had very little control over his legs. He and I worked on bending and stretching his legs and arms a few times a week. To help with his muscle control in his arms, we would also play a game where he would

grab a toy from one side of his body and place it in a container on the other side. With the younger boy I focused mostly on standing.  Ana showed me activities we could be doing to strengthen his leg muscles and increase his balance. Each day I would get him out of his wheel chair and he would crawl around the room first to stretch his muscles. Next I would stand him up at a table upon which he rested his arms for balance. This allowed him to straighten and strengthen his legs. On my last day at the orphanage, he pulled himself into standing position at the table. It was amazing to see what even a minimal amount of physical therapy could do.

            Through this experience, my appreciation for and understanding of physical therapy has increased. As I practiced what I had been taught, I felt more confident in my ability to facilitate therapeutic exercises.  The practice also taught me that doing therapy is not a one-person deal. I had to get the children I was working with to participate for the therapy to be most effective. This internship has made me want to pursue a degree in physical therapy even more because of the good that I saw accomplished by even small amounts of therapy.

  

Provo, UT; BYU Dance Training Room - Sean

For my internship, I spent a semester shadowing Dr. Ron Nuttall who is a certified physical therapist as well as the athletic trainer for all of the dance majors and members of the dance teams here at BYU. Ron intrigued me from the moment that I heard the way other people talked about him. They say he is the master and has a miraculous healing touch. I came to understand what everyone was talking about when I met him and saw him work. He definitely has his own way of doing things that most physical therapists don't apply. The effectiveness of his techniques was seen in the progress of his patients.

What I liked most about Ron is that he is very much an on hands sort of physical therapist. Most of today's physical therapists will throw you into a machine and let it do all the work. Even though it saves the physical therapists arms some exhaustion, it is not nearly as effective. 

Despite most of my internship being observation, I still learned a lot of things. I learned things like how to check alignment, correct an up and down slip, massage and perform positional releases for knots and how to properly heat and relax muscles through ultra sound and other techniques. It was definitely a rare and worthwhile experience.

Alpine, UT; Alpine Fitness & Physical Therapy - Hyrum

At Alpine Fitness and Physical therapy I have learned many things. The internship includes taking quizzes to learn, how the gym is run, anatomical terms, therapeutic procedures, documentation of therapy sessions and how to use therapeutic modalities. These quizzes were very applicable to the knowledge that we needed to function as a prospective employee at this facility as well as a future physical therapist. I was also able to experience the business side of running a physical therapy clinic by running fliers to advertise for the clinic.

This internship is unique in that it allows the interns to learn and practice therapeutic mobilizations and procedures on actual people. I learned mobilizations, tractions, PNF (proprioceptive neuromuscular facilitation), and massage therapy. I was able to practice these maneuvers on the other interns until I was proficient in completing them autonomously. I also learned how to write SOAP (Subjective, Objective, Assessment, Plan) notes, these notes are the write-ups of a therapy session that will be sent to insurance companies for billing. I also learned to write Treatment and procedure records. The ability to document a therapy session, and give reason as to why the patient needs the therapy given, is vital in physical therapy because without these documents insurance will not reimburse the therapist. At various stages of the internship I was evaluated on the concepts that had been taught to me up to that point which encouraged me to be proficient in all that was taught. If you are interested in an internship at Alpine Fitness & Physical Therapy more information can be found at alpinefitness.com.

Iasi, Romania; Sf. Andrei's Orphanage -Britta

Iasi from my window

 When I first got to Romania, I had no idea what to expect. I hardly knew the language and I knew little about the people and customs, but I knew that I needed to be there and that my semester there would change me in ways I could not expect.  (sidenote: I cannot post any pictures of Romanian children as it is illegal to take pictures of any institutionalized children)

Trip outside of Iasi

Tomesti

outside of Iasi

Romania is in itself an interesting and beautiful place. The countryside in particular is gorgeous and varied.

me and my co-interns 

At the orphanage, I ran a room of 8-11 children, depending on the week. It was a special needs orphanage so most of my children had some sort of disability. The children ranged in ages between 6 months and 7 years.  I spent my mornings with those children Monday through Friday. I taught the older ones to read and write and I worked on all of the children's lingual skills and fine motor skills. My emphasis was to increase motor abilities and I worked closely with the resident Physical Therapist. I did a lot of PT and I saw a lot of success. I received a 2 year old who could not even lift up his head. After a month of rigorous PT, he could not only lift up his head, he could roll over and sit up! He was such a happy and fun little guy. I have many other similar stories but I cannot convey how fulfilling it is to see the results of your hard work, prayer and faith in helping a child.

Co-interns in scrubs coming home from the hospital

In the afternoons, I worked at a Pediatric Hospital and saw some of the most heartbreaking things of my life. I used the PT I learned at the orphanage to help all the little ones without parents who were sick at the hospital and all by themselves. It was so sad to walk into a room of 4-5 babies knowing that each of them had been abandoned either by the death of a parent or by a negligent living parent. I worked with these children to prevent bedsores and muscle atrophy, as well as to try to keep them on-track developmentally. Sometimes a child would be so ill that the best things I could do  was hold them or pat them gently to comfort them. I saw children in so much pain that death came as a relief as it ceased their suffering. In Romania I definitely had both the best and the worst days of life. 

Golia Monastery in Iasi

The very best thing about Romania was the people that I met. The children that I worked with are incredible little people. I am not capable of explaining just how much I love those little ones and how much they have changed me. Nor can I explain how difficult it was to leave them. I’ll just say that if Romania ever changes their adoption laws, I will desperately try to adopt any one of those children. They are so fun and wonderful. Yes, they were difficult at times, but overall they were such a joy. Their ability to love and grow was so inspiring and they really just bring me so much happiness with their sweetness and curiosity. Besides the children, the Romanian people were very kind and helpful. They were quick to try to help us with the language and with finding our way. Our neighbors were kind and interested in helping us and bringing us food. The branch members were the same. The people were really so loving and appreciative of the work we did.
 
I was told before I went that no matter how much I change the children's lives, they will change my life so much more.  This definitely has been true. I would go back to Romania in a heartbeat.  It was an amazing experience and I really am so grateful for it.  I'm grateful for the places I visited, the things I saw, the lessons I learned and the people I met.  It was worth the heartache, the break from school, the expenses and the time. I wouldn't trade that experience for anything.

me at a monastery

Italy -Jarom Bridges 2010

"I finished the internship last week. The first few weeks I spent most of my time just becoming familiar with the clinic and patients and all the different exercises they do for different types of rehabilitation (upper body vs. lower body injuries) as well as comparing different modes of therapy like ultrasound, laser therapy, one called Tecar (similar to ultrasound, but different wavelengths), electrostimulation therapy, and massage. 

In my last week and a half I did a study with as many patients as I could get, which turned out to be about 20 (it's not a very big clinic, and a lot of the patients come 3-5 times per week, so there's a lot of overlap). Anyway, I asked them questions to find out what type of injury they had: chronic or acute, bone v. muscle v. tendon/ligament injury, what sort of situation they were injured in, etc. Then I asked them questions regarding what exercises they were assigned, which ones they found most and least effective, and whether they did exercises at home in addition to their treatments at the clinic. I also asked them about the intensity of pain they felt at the time of injury (or if a chronic injury or post-op, how much pain they felt prior to beginning therapy), compared that with their current level of pain on a typical day at their respective stage of rehab, and then asked if a session of treatment increased or decreased their immediate level of pain. 

In summary - and this is probably all you really need to know - I asked them detailed questions about their manner of treatment, levels of pain at different stages of treatment, and perception of the effectiveness of each of their prescribed exercises/modes of treatment. I haven't compiled all of the results for a specific analysis yet, but that will all go into my paper for Dr. A-Y when I get back. It might be interesting for people to know that I found the style of treatment here was almost exactly the same as what I've seen in the US, and in some cases it even seemed that they were advanced in their variety and technology of treatments. So while the language and the culture were of course different, the science of physical therapy remains the same in practice. Anyway, I had a great experience, met a lot of people and made some new friends, and now I have a great international experience to put on my grad school applications and help me stand out from the rest of the crowd. Plus, they told me when I left that if I'm ever back in Italy and I'm looking for work, I should be sure to contact them because they'd love to have me back. So not only was it a great educational experience, it's also opened a possible door for a career pathway as well, which I would guess is often the case with student internships."

ITALY:  Medical Fisio Gym (through Societa Dante Alighieri)
For more information visit: http://www.dantealighieri.com/