Amy: Welcome to another episode of Fresh Focus. I am your host Amy Bantz, I’ve been working at Truman VA for a little over 10 years primarily in behavioral health and more recently in primary care as the Health Promotion Disease prevention coordinator.
I have Dr. Bradshaw with me today to talk about her experience working with the MOVE program. . Thank you for joining me! Dr. Bradshaw do you mind telling me a little about yourself?

Dr. Bradshaw: Thanks Amy! I am Dr. Raine Bradshaw, a Physical Therapist for Truman VA in Columbia, MO. I have been with the VA since 2013, and here at Truman since early 2016. I have worked as a PT for about 11.5 years. I currently serve as the Program Manager for our Telerehabilitation Enterprise Wide Initiative team providing virtual care with a mission to reach our more rural veterans. I started working with the MOVE! program this year.

Amy: yeah, we are really fortunate to have you. It seems you are able to bring something very unique I don’t any of the other MOVE programs in our VISN is working as closely with physical therapy as we are. So based on your more recent experience working with MOVE veterans have you found anything to be surprising about working with Veteran’s involved in the MOVE program?

Dr. Bradshaw: I sure have, one of the most surprising things about working with the MOVE! veterans is the variety of care that I get to provide. We are able to provide individual sessions to the veterans that really meet their needs and help them reach their personal goals. For me it’s almost has been less restrictive than a normal PT consult because we can address whatever it is that most meets the veterans needs. And that is going to look different for every single person who comes through the program. I think it’s a more Whole Health approach versus we have this one specific issue that we need to address and that’s what our limitations are.

Amy: yeah, so spending that amount of time up front building that relationship and getting to know the veteran their dynamics, where they live, what barriers they may have, so what do you say to veterans when their asking for physical activity advice?

Dr. Bradshaw: You know I think its important to be mindful about exercise. And that is going to look different for everybody. The veterans are ultimately the only ones that know what they are feeling towards with any activity. Therefore the veteran needs to be in the drivers seat for what we are doing. They understand what their body is feeling They know how an activity feels when we do it and if something feels like it needs to be

changed and the veteran knows what types of activities they like. Exercise should help us connect our mind with our body and that is the important thing I think to keep in mind.

Amy: yeah, that’s great that body mind connection like you mentioned earlier kind of a whole health approach a holistic approach as far as looking at those pieces and putting it together. Something that comes up pretty frequently I would say for myself as a provider working with veterans is chronic pain is there anything when asked do you have any suggestions or recommendations to veterans when you talk about the best use of exercise especially when it comes to chronic pain.

Dr. Bradshaw: one of the biggest thing with chronic pain and dealing with the MOVE folks is do they want to address that chronic pain or do we want to accommodate their activity around it. Its find either way it depends on what really works best for the veteran, what they’ve tried in the past. At a minimum what we can do is work on mechanics that help decrease the stress and strain that they place on their painful areas when they are being active. There are always modifications that we can utilize with exercise to perform and help them reach their goals without exacerbating their symptoms.

Amy: yeah, its great that you take that approach of offering those 2 different you know where do they want to go with their chronic pain is concerned because I would say for the most part this is not usually new this veteran is experiencing chronic pain and that can be frustrating and maybe their experience working with providers and recommendations.

Dr. Bradshaw: yes, so the biggest thing is that exercise should not never be painful. If you are having sharp stabbing pain when you are trying to exercise something is not right. It may be that we need to modify that exercise or change it to a different type of exercise that still meets the need. But there are lots of ways that we can modify to achieve those goals. There are experts that are out there that can help our veterans working towards their physical activity goals and physical therapy is one of those but there is numerous other avenues to go about that personal trainers, we’ve got yoga and tai chi at the VA and other things like that there is no one perfect expert to go to and again that ties back to the veteran is their own body’s expert we just have to help guide along the way

Amy: yeah, that sounds really great they are the driver they are guiding what they are wanting to do and we’ll help them figure that path out something that is also pretty common is while working with MOVE veterans we see is that we often have veterans that are truck drivers do you have any tips to help those veterans and help them increase their physical activity?

Dr. Bradshaw: sure we have come across our fair share of truck drivers and that is one of the common jobs that are out there. There are different ways we can still be active. Tying that back in about building that rapport with the veteran and knowing exactly what their truck driving job entails. Are they somebody who drives long hauls and they are gone from home for a long period of time or are they somebody driving local making lots of stops and drop offs. And knowing that we can help build what works for their day to day to help increase that physical activity level for some its brainstorming together what equipment they may have on their truck that we can utilize for exercise. In other cases its thinking about what short bouts of exercise they can get in during their stops when they are unloading at one facility before they go on to the next facility. And working with the veterans we are really able to find something that does fit well for them.

Amy: yeah so there are options available to them depending on the route they take the distance they are in the truck and what they have at their finger tips its very unique and creative to build those plans with them I would imagine.

Dr. Bradshaw: it is it’s a lot of fun and gets the veteran very much involved in the decisions we are making because it ultimately comes down to what they have and in their environment and what they can do

Amy: and I would assume that would be relatable to all veterans to a veteran who maybe is staying a home more working in office jobs so what is their day to day look like
Is there any experiences you would like to share that maybe have stood out for you
As far as working with Veterans in the MOVE program.
Dr. Bradshaw: sure, since we were just talking about truck drivers, we can talk about one I’ve seen we implemented stuff into his day to day routines so that when he was delivering and unloading at one site he would get in 5-15 exercise in and we’d use some of his hose connections for resistance equipment and he’d also do exercises uses Therapy Bands and stuff like that. But he incorporated it in his routine and made such an impression on some of the other folks he worked with that they all started doing more exercise when they were at their drop offs versus just standing around waiting for that load to be done and moving on to the next site. So I think its great to see our Veterans and then turning around and inspiring others to be more heathy and improve their active lifestyle.

Amy: yeah shifting the culture, that’s great, physical activity is important for all of us so I’m just kind of curious if you;ve got some reminders of the health benefits of exercise. If you can share some of them with our listeners.

Dr. Bradshaw: of course, everyone thinks about oh I need to lose weight or I want to be more physically fit, look better, but ultimately that’s not really what its all about. And for some that is where we get tied up and lose that mind body connection of why we are doing this activity. You know the things that are really important are those other health benefits. Being more physical active improves sleep, improving labs and having better check-ups with your doctors, you can also notice changes in memory. We can increase energy, improving mood, decreasing our stress levels, those are all big things that come with physical activity. The other side of that is being active is and if we choose to go that route we can work on improving pain management, and increasing your endurance to be able to do the activities you love. Whatever they might be.

Amy: that sounds really hopeful, we are fortunate like I said to have you working with us at Truman VA and I know there’s the potential to expand other MOVE Programs. Do you want to mention a little about that.

Dr. Bradshaw: sure so one of the things our program has been very successful in and a lot of our veterans have commented on since we’ve added PT at Truman they feel like its helped fill a gap in that physical activity portion of class and we would like to be able to expand upon that and hopefully help offer to other folks within our Visn. So our goal for this next year is to launch a visn program where providers from the other facilities can Kansas city Leavenworth Topeka and so forth can place an IFC consult to physical therapy and work with us at Truman to help fill that gap for them as well.

Amy: yes that’s exciting, we wanted to share this amazing program to other facilities. Dr. Bradshaw I want to thank you for taking the time and thank you for what you do we are fortunate to have you and I know the veterans and their personal testimonies of working with you, so thank you for that. And just for our listeners
Remember to reach out to your local VA to find out more about the MOVE
program in your area! Thank you for listening, don’t forget to like and subscribe
to this podcast and leave a review. Thank you.