The Bee's Knees

The Bee's Knees


The Evolution of Knee Rehab (with Candice Cawood)

November 06, 2019

The Evolution of Knee Rehab
An Interview with PTA, Candice Cawood.
Candice describes her history of PT work in both outpatient and home care therapy. And she explains how significant is the impact of the X10 on the evolution of knee rehab.
To listen to the full interview click the Play Button above. You can read excerpts from the conversation below.






My name is Candice, and I have been a physical therapist assistant for nearly 17 years. My career started in outpatient care. I did that for five years. Afterwards I was in home care for 11 years. I loved being in people's homes, loved the connection that you get when you're at that level with somebody. And then my friend, Director of PT at X10 Erin Rempher, introduced me to X10 Therapy.






I have worked with probably every diagnosis you can imagine. These are conditions that you would be well enough to be home for, but not well enough to be out in the community for. Of them all, joints have always been my favorite. I've always been fascinated by them: how you can take something that doesn't work, and put these new parts into it, and rehab it? And it just completely changes your world.






My Knee Patients Before X10
In home care, when I would have a knee replacement patient, during the first couple of sessions, I would just give them basic exercises. But really it is more about just being there, creating a relationship. There has to be a trust that somebody is coming into your home and you are not feeling well. There has to be compatibility and a level of trust. So the first couple of visits are always pretty easy-going, ‘let's see what you can do. Here are a few exercises that I want you to start on.’






During the first three to five visits I'm really amping people up, asking a little bit more of them, asking them to do more, starting to work on their gait patterning. If they're going eventually to transition to an outpatient clinic, we address stairs, getting in and out of the house, and doing, a car transfer. And of course working on the infamous range of motion.






Knee Range of Motion
We know that getting to a 90º bend is critical. We also know beyond 90º, you have to be somewhere between 110º and 115º to be functional.  And then going beyond that, 130º is a healthy knee. We never saw that with our patients in home care.
In fact, I rarely saw people pass the hurdles that we set for them. When they reached somewhere between 90º to a 100º we would put them into outpatient care. And I would have been with them for somewhere between two to five weeks depending on what their doctor's protocol was, and what insurance would cover.













My Knee Patients Now with X10
So transition your brain from that to the X10 program. It blows my mind every time. When working with knee patients so many of them move so quickly to 0º and 115º. And you're just thinking, Oh my goodness!
It's not something that we would've typically seen in the home. And we're doing it on a very consistent basis. I'm sure that my supervisors in home care would've thought like I was some sort of superwoman if I was doing that with my patients. It is a big step forward in the evaluation of knee rehab.






Coaching at X10 Therapy
Since I've come to X10 Therapy I work with between seven and 10 people a day. Most of them will be phone calls. And then there are the texts. It depends on where you are in the process,