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April 2004

By Sarah Schmelling

It is no surprise that the rehab community places a huge emphasis on the body. After all, the first word in physical therapy is “physical.” But on the sidelines of many practices, we are seeing more of what were once, and sometimes still are, considered “alternative” methods of practice that also focus on participants’ minds and overall well-being.

These include two practices featured in this issue, Pilates (“Inside and Out,” page 16) and the aquatic therapy method, Ai Chi (“The Chi of Water,” page 20), which are both seeing rising popularity. Christine Romani-Ruby, MPT, ATC, whose business, PowerHouse Pilates, is featured in our cover story, says several universities now offer for-credit courses in Pilates, while Ruth Sova, MS, who writes about Ai Chi, was surprised to find more interest in this practice than in the more familiar topics she writes about. “I think people are looking for ways to make their traditional methods of therapy work better,” Sova says.

More than this, both of these methods are riding the crest in popularity of preventative medicine and focus on wellness. “In the late ’70s and ’80s, we realized our lifestyles were making us sick. We decided we needed exercise, and that became a huge industry,” Sova says. “Now we are realizing that our lifestyles are making us sick again—not just from being sedentary, but from stress.” She adds, “We are only trained to be productive—not how to relax.”

Sova and Romani-Ruby agree that because these methods require participants to focus very intently on what they are doing, this helps people relax their minds and concentrate on themselves. “If you are running on a treadmill, you have time to think about all kinds of things other than what you are doing,” Romani-Ruby says. “But when you are doing Pilates and breathing and concentrating, you cannot think about anything but yourself. Just focusing on ourselves is something we do not do enough of.”

This kind of focus improves well-being and self-confidence, she adds, which in turn helps clients improve their physical conditions.

So when will insurance companies realize this as well? That might be a longer road. Still, Colorado has a billing code in place for Pilates, and Romani-Ruby has even received Pilates prescriptions (that she returned to physicians for a more billable treatment description). And through both client education and PT and ATC training, practitioners believe these methods will someday become mainstream. “One of the most central parts of Ai Chi is breathing—well, you cannot bill for breathing,” Sova says. “Still, you can bill for improving someone’s sleep. You can bill for the fibromyalgia patient who feels less pain.”

There will also be sustained interest, Romani-Ruby says, because these methods are seen as lifelong activities that can be practiced at home, with or without physical ailments.

Do you see a place for these “alternative” practices within traditional therapy? If so, what are the best ways to get the word out? As always, we welcome your feedback.

-—Sarah Schmelling
cwolski@medpubs.com

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