Frequently asked questions

why breathing?

Breathing is literally the only motor task that all humans alive share. Your body is naturally designed to breathe well, but it can also adopt bad habits. Just like limping after a leg injury leads to problems elsewhere in the body, breathing with accessory muscles or maladaptive patterns uses valuable energy inefficiently and ineffectively, robbing us twice of optimal functional ability. The result is people with chronic pain, early fatigue, decreased activity tolerance, reduced performance and endurance, incontinence, bowel dysfunction, poor sleep quality, stress and an overall decrease in quality of life. If you can't control your breathing, what can you actually control?

how do I improve?

By doing your homework and working with your therapist. As a part of Academy West, we develop a indivdual program that fits into your life. Because your ability to breathe never gets a rest, it needs regular exercise. Prioritizing your body and what it requires yields subtle steady change in your performance. We breathe between 17,000 and 30,000 times each day, can you devote 60 breaths each day to change your life?

what are the benefits of improving my breathing mechanics?

Imagine your body's available energy like a bank account. Your breathing isn't supposed to cost you very much when working properly. Over time, you can develop movement patterns that increase the cost of doing business living your everyday life. When breathing is truly difficult, it takes all the energy you have just to make it through the day, just ask anybody with COPD. When you improve how you breathe, you cut the cost of business drastically saving all that valuable energy for the rest of your muscles and systems to use for function. When operating optimally, incredible changes can be achieved in the human powered machine that supports our respiration. As breathing improves, chronic problems begin to be more manageable and often abate completely. How much more could you be doing right now?

what if my condition is chronic?

Academy West helps to put the big picture together from a functional standpoint. The perspective of a physical therapist is unique in the medical community, trained to understand how the different parts of the body work together. A multi-system body analysis helps to identify where things are working less efficiently and how that impacts you. More complicated conditions require various specialties, but understanding how those specialties tie in to one another is exactly what an ICU therapist is trained to do. Academy West is built on the principle that no breathing problem is too deep-rooted or far gone to gain improvement.

why "Academy"?

A good physical therapist is an educator, and in order to improve your breathing you have to learn with both your brain and your body. Our hands-on approach teaches your body how to move, and we take the time to explain things and so that you can build on that improvement when you leave. Being a part of Academy West means arming you with knowledge about how your body works to meet your functional needs.

can you describe my first session?

You will be in a private treatment space, one-on-one with your physical therapist. We will do a thorough review of your medical history, have a conversatoin about your goals for physical therapy, answer any questions you have, and work together to develop a treatment plan that works in your life. We will examine how you breathe and evaluate your body's ability, taking measurements and performing functional testing as well as obtaining data when necessary. Exams are extremely thorough and may take longer when the nature of your pathology is multifactoiral and or chronic.

what are your hours?

Academy West is currenly open for appointments on Thursdays. Andy Sabatier remains a full-time PT on the intensive care unit. Home visits can be arranged between patient and therapist after initial evaluation outside of normal business hours.

how many visits will I need before I improve?

Without an evaluation, this is hard to answer. Many patients can improve their breathing immediately, but they will have difficulty sustaining these changes without follow-up with their PT as well as diligent but manageable home programs. Typically, patients will leave with a home routine that takes 7 minutes or less. Patients are generally seen once every week, then every 2 weeks, and for additoinal visits as needed. The goal is to teach you and your body how to function and eventrully cut you loose to breathe on your own. However, some patients find that physical therapy on a monthly basis helps keep them functioning at the level they desire and will schedule "maintenance sessions" accordingly. Some patients are better in 2 visits, other patients rerquire a long term approach. There are many factors at play regarding your health, and so much depends on the individual. Commitment to self-care, primary cause of dysfunction, and how long compensations have occurred over time all play a role.

do I need a prescription from my doctor?

No. Oregon is an unrestricted Direct Access state for physical therapy, which means patients are allowed to seek evaluation and treatment from any licensed physical therapist without a prescription or referral from a physician. However, if you plan on seeking insurance reimbursement, your insurance provider may require a physician's referral which you are more than welcome to obtain. You may also chose to self-refer to Academy West. When your evaluation is completed, your therapist will send a Letter of Medical Necessity to your physician. Once signed, this acts as a prescription for physical therapy and can be submitted to insurance. You can also complete the insurance benefits checklist to find out if your insurance requires a prescription or referral, and choose to obtain one prior to your first visit.

how long are appointments?

The initial evaluation will last 60-90 minutes. This is the time that is reserved for you. Please come with your forms completed which will be emailed to you ahead of time or printed off our website. If you need to fill the forms out when you arrive, this will take away from your evaluation and treatment time. Follow up appointments are 45-90 minutes based on complexityand length of treatment. We realize that extenuating cirumstances exist, and we will work to provide you the amount of time that your body requires.

what is the cost?

At Academy West, we feel it is important to be as up-front as possible about our fee structure, which is simple and based on type and length of treatment. 60-90 minute Initial Evalution: $300 60 minute Follow-Up: $200 30 minute Maintenance Sesson: $125 60 minute Performance Training. $125 Payment options include cash, check, HSA or debit cards. There may be an additional charge for credit cards due to processing fees.

do you take insurance?

Yes and no. Academy West is a cash-based physical therapy practice. Payment is collected at the time of service, and you are provided a receipt or "super bill" that you can easily submit to your insurance provider, and the insurance provider will reimburse you directly. If you want to understand more about what your insurance company will and will not re-imburse, call them and have this insurance checklist ready. It is important to understand exactly what your insurance covers.

what about Medicare?

We get this question a lot, and are happy to have a conversation to help answer. Academy West does not have a relationship with Medicare, whcih means patients who wish to submit to Medicare for reimbursement for treatment that Medicare normally covers may not be treated at Academy West. However, the list of conditions that Medicare does not cover is significant and includes any issue that began greater than 1 year from the start of PT service, wellness care, maintenance care, and more. In other words, you may be treated here if your condition is chronic (>1 year), or is considered maintenance or wellness care. Additionally, physical therapy for breathing performance is not really on Medicare's radar. However, Medicare is exceedingly complicated and if you are denied reimbursement, that is a risk you take. Failure to comply with Medicare rules in every case, even with best intent, could result in federal investigation, fines, or other legal action. The Medicare Benefit Policy Manual is available in full as a series of downloads at; outpatient physical therapy benefits are discussed in Chapter 15, which is currently 289 pages. Under current Medicare regulations, it is illegal for a physical therapist to accept cash pay from Medicare patients for services that may be covered under Medicare, even if the services provided meet all treatment, documentation, and HIPAA requrements and have been prescribed by their physician. In some cases, a Medicare beneficiary may pay cash for services that are no longer considered medically necessary, for example a "maintenance" or "wellness" program. Confused? So are we...give us a call and we can talk it through.

how do Physical Therapy and performance training differ?

Physical therapy Intended for patients suffering from breathing pattern dysfunction who seek to improve their condition through 1-on-1 sessions. It involves evaluation, examination, several sessions, baseline and progressive measurements of breathing power and capacity, home exercise program determinaton, and follow-up as needed. In most cases, insurance can be billed. Performance training Intended for those who are not seeking to bill insurance. A baseline breathing performance measurements are taken, and an individualized strengthening program is developed. A variety of exercise techqniues can be combined with Academy West's "breathing first" ethos, and an activity-specific regimen is developed Additionally, training can be provided for those who have completed a course fo physical therapy and wish to continue their improvement. Group classes - coming soon

What about COVID-19?

COVID-19 has changed the way that society values breathing. Whether you are experiencing symptoms from past infection or increased anxiety during the pandemic, training your breathing and strengthening the muscles that support it have never been more important. Academy West is committed to providing care in safe environment that fits your needs. We are available for in-clinic, home visits with strict safety standards, as well as virtual sessions. Masks are required to enter our clinic, but can be remobved during sessions to effectively evaluate breathing.

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