Physical Therapy Commons^™

Development Of A Statement On Autonomous Practice: Practice Committee, Section On Geriatrics, Jason Hardage, Stacey Zeigler, Jennifer Blackwood, Tamara Gravano, Greg Hartley, Jill Heitzman, Joe Libera, Ken Miller

Physical Therapy Faculty Research

Vision 2020 is the official vision statement of the American Physical Therapy Association (APTA). Drafted by the APTA House of Delegates in 2000, this statement contains 6 elements: autonomous physical therapist practice, direct access, Doctor of Physical Therapy and lifelong education, evidence-based practice, practitioner of choice, and professionalism. Autonomous practice has been operationally defined by the APTA primarily through its characteristics: “Physical therapists accept the responsibility to practice autonomously and collaboratively in all practice environments to provide best practice to the patient/client. Autonomous physical therapist practice is characterized by independent, self-determined, professional judgment and action.” The Section on Geriatrics has …

Cross-Cultural Adaptation And Psychometric Testing Of The Hindi Version Of The Patient-Rated Wrist Evaluation, Saurabh Mehta, Bhavna Mhatre, Joy C. Macdermid, Amita Mehta

Physical Therapy Faculty Research

The purpose of this study was to perform cross-cultural adaptation and Hindi translation of the patient-rated wrist evaluation (PRWE) and assess psychometric properties of the PRWE-Hindi. Cross-cultural adaptation and Hindi translation of the PRWE was performed using standardized guidelines. Intraclass correlation coefficient (ICC) was used for assessing test–retest reliability, and Cronbach’s alpha (CA) was used for assessing the internal consistency of the PRWE-Hindi. Construct validity was assessed by examining the correlations between the PRWE-Hindi and grip strength, wrist range of movements, and self-reported pain and disability. A total of 50 patients with distal radius fracture were recruited and assessed three …

A Systematic Review Of The Health-Related Quality Of Life Measures Following Total Knee Arthroplasty, Saurabh Mehta, Mary Law, Jean-Sebastian Roy

Physical Therapy Faculty Research

To perform systematic review and appraisal of common patient-reported outcomes (PROs) used in measuring aspects of health-related quality of life (HRQOL) following total knee arthroplasty (TKA). Especially, the study aimed to examine whether these common PROs assess the domains of HRQOL as described in the theoretical frameworks of the HRQOL.

The Implications Of Chronic Pain Models For Rehabilitation Of Distal Radius Fracture, Saurabh Mehta, Joy Macdermid, Mary Tremblay

Physical Therapy Faculty Research

Distal radius fracture (DRF) is the most common fracture and usually occurs as a result of a fall. Most patients recover following DRF with minimal residual pain or disability; however, a small subset of patients continue to experience pain and disability even one year after the injury. Currently, there are no practice guidelines for early identification and treatment of patients who are potentially at greater risk of developing these adverse outcomes. As a result, hand therapy management of patients following DRF does not incorporate screening of these at-risk patients. The objective of this paper is to apply constructs from learned …

Residency Corner, Tamara Gravano

Physical Therapy Faculty Research

The new Residency Corner will feature articles written by residents that describe topics such as in-depth case analysis, problem solving, and practice as nonphysician primary care providers. Here residents will get to discuss their findings and thought-processes with an audience of their peers--those clinicians and academics interested in the advancement of geriatric health care. Also, for those who may be interested to see what geriatric residency education is really all about, these clinical snapshots can help remove the veil and provide a glimpse into the level of practice our residents are experiencing. Yet, this is only one half of the …

Nationwide Acute Care Physical Therapist Practice Analysis Identifies Knowledge, Skills, And Behaviors That Reflect Acute Care Practice, Sharon L. Gorman, Ellen Wruble Hakim, Wendy Johnson, Sujoy Bose, Katherine S. Harris, Molly H. Crist, Karen Holtgrefe, Jennifer M. Ryan, Michael S. Simpson, Jean Bryan Coe

Physical Therapy Faculty Research

Background and Purpose. Acute care physical therapists have experienced the effects of dramatic changes in health care reimbursement systems and population demographics. Acute care hospitals now serve a patient population of much older, chronically ill patients who are hospitalized for shorter periods of time in a practice environment in which physical therapy staffing resources are often inadequate. The purposes of this study were to document common experiences in the practice of acute care physical therapy and to identify differences in the perceptions of physical therapists with varying levels of experience and in various sizes of acute care facilities.

Subjects …

Understanding Autonomous Practice, Tamara Gravano, Greg Hartley, Heather Mattingly, Joseph Libera, Sabrina Camilo, Jason Hardage

Physical Therapy Faculty Research

What is autonomous practice? As one of the elements of Vision 2020, au­tonomous practice is one whose mean­ing may not always be readily under­stood. The confusion can stem from the meaning of autonomy, which is sometimes misinterpreted to mean that the physical therapist (PT) practices in a vacuum, without coordinating and com­municating with other health care pro­viders. Nothing could be further from the truth. In fact, many PTs might be surprised to learn that they already prac­tice autonomously.

The Effect Of Early Contextual Learning On Student Physical Therapists’ Self-Perceived Level Of Clinical Preparedness, Kevin E. Brueilly, T. Kirk Nelson, Tamara Gravano, Penny G. Kroll

Physical Therapy Faculty Research

Context: Students in health care often describe their feelings of self-inadequacy in clinical skills and report these feelings abate with experience.

Objective: To determine whether early contextual learning experiences can improve entry-level student physical therapists’ self-perceived level of clinical preparedness.

Design: A pair-wise comparison of pre vs. post intervention. Survey of students self-perceived level of clinical preparedness before and after a series of three planned small group contextual learning experiences involving the assessment of actual hospital patients.

Setting: Academic institution and associated medical center

Participants: Thirty-nine first-year student cohort in the 10th month of a 36-month entry-level Doctor of Physical …

Teaching Professionalism: A Survey Of Physical Therapy Educators, D. Scott Davis

Physical Therapy Faculty Research

This study examined the opinions of physical therapy faculty relative to teaching and fostering professionalism in entry-level physical therapy education. A paper-and-pencil survey was mailed to a random sample of 318 physical therapy educators across the United States. Of the 318 surveys mailed, 166 participants (response rate, 52%) completed and returned the survey. Descriptive analysis revealed that 98% of the physical therapy educators view professionalism as an important component of a physical therapy curriculum. Eighty-nine percent of the respondents expressed concern about the professional behaviors of one or more of their entry-level students; however, based on the frequency of negative …

You Can Be Me!, Tamara Gravano

Physical Therapy Faculty Research

Dr. Gravano discusses becomes a physical therapist.

The Geriatric Residency Experience, Sabrina Camilo, Tamara Gravano, Karen Lagares, Gemma Longfellow

Physical Therapy Faculty Research

The Geriatric Residency in Physical Therapy program at St. Catherine's Rehabilitation Hospital and Villa Maria Nursing Center has graduated 4 residents since its inception in 2003. Recently, the 4 of us program graduates convened to talk about our experiences and discovered several similarities. We laearned about our individual reasons for choosing the residency, our experiences during the time we were residents, and our plans for continued professional development. But, of course, there were some differences that made the experience unique for each of us.

Use Of Item Response Analysis To Investigate Measurement Properties And Clinical Validity Of Data For The Dynamic Gait Index, Yi-Po Chiu, Stacy L. Fritz, Kathye E. Light, Craig A. Velozo

Physical Therapy Faculty Research

Background and Purpose. The Dynamic Gait Index (DGI) is a standardized clinical assessment that aids in evaluating a subject’s ability to modify gait in response to changing demands. The purpose of this study was to use Rasch measurement theory to examine whether the DGI rating scale meets suggested psychometric guidelines, whether the hierarchical order of DGI tasks is consistent with a clinically logical testing procedure, and whether the DGI represents a unidimensional construct. Subjects. Subjects were 84 community-dwelling male veterans (age range=64–88 years; mean±SD=75±6.47 years). Methods. Data were retrieved retrospectively from the participants’ clinical records. The Rasch measurement model with …

Central Somatosensory Changes And Altered Muscle Synergies In Subjects With Anterior Cruciate Ligament Deficiency, Carol Courtney, Rose Marie Rine, Penny G. Kroll

Physical Therapy Faculty Research

To clarify the mechanisms of compensation in subjects with anterior cruciate ligament deficiency (ACL-D), we examined proprioception, quadriceps strength, somatosensory evoked potentials (SEPs) and muscle responses during gait in varied combinations of speed and incline. Seventeen subjects with ACL-D were grouped by functional level and report of giving way. Seven subjects without ACL-D served as a control sample for muscle response measures. ACL-D subjects with quadriceps weakness experienced giving way and could not resume sport activities. Those without weakness fell into one of two groups: (1) copers, who had full return to previous activity and no giving way despite proprioceptive …

Feasibility Of Electromyography-Triggered Neuromuscular Stimulation As An Adjunct To Constraint-Induced Movement Therapy, Stacy L. Fritz, Yi-Po Chiu, Matthew P. Malcolm, Tara S. Patterson, Kathye E. Light

Physical Therapy Faculty Research

Background and Purpose. The purpose of this case report is to explore the feasibility of electromyography-triggered neuromuscular stimulation (EMG-stim) as an adjunct to constraint-induced movement therapy (CIMT).

Case Description. The patient was a 72-year-old man, 10 years poststroke, who did not meet traditional CIMT criteria. The EMG-stim was applied to the wrist extensors of the patient's weaker arm for one half of the CIMT training hours.

Outcomes. The intervention was feasible for this individual. Improvements were observed in motor behavior, quality and amount of use, muscle activity, wrist range of motion, and reaction time of the more-affected extremity. These improvements …

Visual-Vestibular Habituation And Balance Training For Motion Sickness, Rose Marie Rine, Michael C. Schubert, Thomas J. Balkany

Physical Therapy Faculty Research

Background and Purpose. This case report describes physical therapy for motion sickness in a 34-year-old woman. The purpose of the report is twofold: (1) to provide an overview of the literature regarding motion sickness syndrome, causal factors, and rationale for treatment and (2) to describe the evaluation and treatment of a patient with motion sickness.

Case Description and Outcomes. The patient initially had moderate to severe visually induced motion sickness, which affected her functional abilities and prevented her from working. Following 10 weeks of a primarily home-based program of visualvestibular habituation and balance training, her symptoms were alleviated and she …

Head And Trunk Movement Responses In Healthy Children To Induced Versus Self-Induced Lateral Tilt, Donnalee Milette, Rose Marie Rine

Physical Therapy Faculty Research

The purpose of our study was to determine head and trunk movement responses that occur in healthy 7-year-old children during induced and self-induced lateral tilt. Twenty subjects, while tailor sitting on a tiltboard, participated in three trials of both induced and self-induced left and right lateral displacements. Measurements of neck and trunk lateral flexion; trunk counterrotation; and neck, trunk, and body anterior-posterior movement were obtained from slide transparencies made at three stages of tilt (original position, initial tilt, and full tilt). For each subject in the two test conditions, changes in these measurements between the stages of tilt were determined …