Rehabilitation and Therapy Commons^™

Holistic Approach To Managing Grade 3 Vaginismus: An Obg Physiotherapy Perspective, Nagma Khan

Internet Journal of Allied Health Sciences and Practice

Background: Vaginismus is a condition characterized by involuntary pelvic floor muscle contractions, which can make vaginal penetration painful or impossible. This disorder has both physical and psychological components, often leading to significant emotional distress, anxiety, and relationship difficulties. Effective management requires a holistic, multidisciplinary approach, combining physical therapy with psychological support. This case report examines the treatment of a 29-year-old woman with grade 3 vaginismus, highlighting the role of Obstetrics & Gynaecology (OBG) physiotherapy in improving both physical symptoms and emotional well-being.

Case Presentation: A 29-year-old female presented with grade 3 vaginismus, with a history of severe pelvic floor tension …

Navigating The Path: Barriers And Motivators For Physical Therapy Students Pursuing Residency Programs Or Board Certification, Lauren Butler, Amanda L. Thomas, Erasmo Alvarez, David Capote, Teresa Munecas, Abigail Adjei, Erik Estevez, Robert Haller, Isabella Satizabal, Leonardo Valdesuso,, Mark D. Rossi

Internet Journal of Allied Health Sciences and Practice

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Introduction: While the number of physical therapists (PTs) pursuing post-graduate education has increased since the inception of residency programs, the volume of new Doctor of Physical Therapy graduates applying for residency training has remained low. Therefore, the purpose of this study is to examine the barriers and motivations of PT students in their pursuit of PT residency programs and board certification. Review of the Literature: The American Physical Therapy Association provides licensed PTs with a wide range of opportunities to advance their knowledge through residency programs and board certification.The decision to pursue these opportunities is left to each individual …

Prevalence Of Stress Urinary Incontinence In Female Strength Athletes, Meghan Rohde, Jason Brumitt, Jodi Sandvik, Kari Bo

Internet Journal of Allied Health Sciences and Practice

Background: Stress urinary incontinence (SUI) is a symptom during pregnancy and in the postpartum period, but a high prevalence of SUI is experienced in sports involving running and jumping. Objectives: Identify the scope of the problem of SUI in women participating in strength sports, movement patterns that elicit SUI, and the impact on quality of life in female athletes with SUI. Study Design: Survey mixed methods with qualitative focus groups. Methods: The International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and a sport-specific and obstetric/gynecological history questionnaire were sent to women who are United States citizens, age 18-65, and …

Predictors Of Sleep Duration In Undergraduate Students Attending A Health Sciences University In Japan, Aaron M. Eakman, Yuki Kawakatsu, Miki Takahata, Daisuke Kudo, Shinji Satake, Toshiaki Sato

Internet Journal of Allied Health Sciences and Practice

Background: Inadequate sleep is a pressing public health concern contributing to absenteeism and poor school performance, especially in health sciences students. In this study we investigated the sleep quality and duration of undergraduate students in a prefectural university of health sciences program and explored factors explaining sleep duration (i.e., < 6 hours per night vs > 6 hours) using multiple variable logistic regression.

Method: This cross-sectional survey study included 369 nursing, occupational therapy and physical therapy students who completed Japanese versions of the Pittsburg Sleep Quality Index, in addition to well validated sleep-related and mental health-related assessments.

Results: We found just 11.7% of the …

Navigating Cultural Barriers In Clinical Education: Unique Experiences And Insights From Culturally And Linguistically Diverse (Cald) Physiotherapy Students, Non-Cald Students, And Clinical Educators, Annie Yu, Neil Tuttle, Andrea Hams, Benjamin K. Weeks, Saras Henderson, Liisa Laakso

Internet Journal of Allied Health Sciences and Practice

Purpose: Culturally and Linguistically Diverse (CALD) students commonly face cultural barriers in the clinical learning environment that can impact on the success of clinical education experiences. Lack of effective strategies to facilitate clinical learning can be challenging for students and clinical educators alike. This study aimed to explore the issues impacting on clinical learning from the perspectives of CALD physiotherapy students and their clinical educators, and seeks suggestions from both participant groups to improve the clinical education experience. Methods: Qualitative descriptive design using grounded theory principles was utilised to gain insights from physiotherapy students and clinical educators regarding their clinical …

A National Study Of Opioid Knowledge Of Physical Therapy Professionals, Shelene Thomas, John Kiesel, Steven G. Kinney, Isain Zapata

Internet Journal of Allied Health Sciences and Practice

Purpose: Deaths from opioid overdoses persist as the leading preventable cause of death in the United States. Musculoskeletal pain remains the primary symptom for opioid prescription. Physical therapists (PTs) and physical therapy assistants (PTAs) provide non-prescription pain management strategies to people with musculoskeletal pain. Currently, there lacks research quantifying opioid overdose management knowledge possessed by PTs, PTAs, and their respective students. The purpose of this study was to quantify opioid overdose knowledge by PTs, PTAs, and their respective students, collectively termed physical therapy professionals (PTP). Methods: The electronic survey included several demographic characteristics and the opioid overdose knowledge scale (OOKS) …

Conflict Between Student Physical Therapists And Clinical Instructors During Full-Time Clinical Education, Megan W. Moran

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to determine what conflicts student physical therapists perceive with their clinical instructors during full-time clinical education experiences and if there was an association between conflict and the students’ opinions of their learning and the overall clinical education experience. Students in other healthcare disciplines experience conflict during clinical education. Additionally, research shows that licensed healthcare providers report conflict in the workplace. These conflicts can result in positive and negative consequences for the learner or provider and the patients. Tailored training may help to minimize the negative consequences; however, there is a lack of available …

Evaluating Assistive Technologies In High Acuity Patients: A Scoping Review With Swot Analysis, Mallory Kargela Pt, Dpt, Amanda Anderson Pt, Dpt, Lindsay Anderson Pt, Dpt, Tian Gong Pt, Dpt, Kylie Scott Pt, Dpt, Edd

Internet Journal of Allied Health Sciences and Practice

Purpose: This publication examines the application of assistive technologies (AT) in high-acuity environments, including intensive care units (ICUs), acute care hospitals, and others. The aim is to systematically explore and synthesize the use of AT across these settings, identifying key strengths, weaknesses, opportunities, and threats (SWOT) associated. Methods: A literature search was conducted from 2016 to 2023 using PubMed, Tufts and Midwestern University Library databases. Search terms included ('physical therapy' OR 'physiotherapy') AND ('critically ill' OR 'acute' OR 'intensive care') AND ('assistive technology' OR 'technology' OR 'telerehabilitation' OR 'telePT' OR 'functional electrical stimulation' OR 'FES' OR 'cycle ergometry' …

Do Gender-Related Characteristics Impact Female Faculty Career Progression In Academic Doctor Of Physical Therapy Programs?, Bridget Eubanks

Internet Journal of Allied Health Sciences and Practice

Purpose: This study explored the experiences of female faculty in academic Doctor of Physical Therapy (DPT) programs in the US and if gender, or more specifically any gender-related characteristics such as pregnancy or motherhood, impacts female faculty career progression. Evidence has demonstrated that several challenges disproportionately affect women in academia, but there is currently no research available related to female faculty experiences in academic DPT programs. Methods: This study used a qualitative research design with a descriptive statistics component. It utilized a descriptive, cross-sectional design with a nonexperimental survey methodology. The Culture Conducive to Women’s Academic Success instrument was used …

Defining And Addressing Student Unprofessional Behaviors From The Physical Therapy Clinical Instructors’ Perspective, Michele "Shelly" Lewis, Nicole Biltz, Moyo B. Tillery, Jamie Dunlap Coates, Tracy Ellison, Elsa M. Drevyn

Internet Journal of Allied Health Sciences and Practice

Purpose: Developing professional behaviors is an integral part of health professional education. Despite physical therapy education programs’ efforts to assist student physical therapists in developing professional behaviors before entering the clinic, some students still struggle with professional behaviors during clinical education experiences. Literature describing unprofessional behaviors in the clinic and providing guidance for clinical instructors to assess and address professional behavior issues is scarce. This study was conducted to investigate the type of unprofessional behaviors student physical therapists display during clinical education experiences and to describe successful and unsuccessful strategies used by clinical instructors to address challenging behaviors. Method: A …

A Model For Teaching Social Determinants Of Health In Doctor Of Physical Therapy Programs, Elise N. Bjork, Rupal M. Patel Pt, Phd, Rebecca Operacz, Deandrea B. Melvey, Luciano Garcia Iii

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to 1) describe the development and implementation of a novel educational module on social determinants of health (SDOH) for Doctor of Physical Therapy (DPT) students, and 2) to assess the effectiveness of the module on altering DPT students’ knowledge, attitudes, beliefs, and barriers in addressing SDOH. Methods: Drawing on current literature, content expert feedback, identity theory, and experiential learning theory, a two-hour module on SDOH was created and delivered at two universities. The Physical Therapy Social Determinants of Health Scale (PT-SDHS) was used to assess change in students’ knowledge, attitudes, beliefs, and barriers …

The Effect Of A Therapy Dog On Pressure Pain Threshold In Healthy Individuals, Lydia L. Haak, Rhonda L. Verdegan

Internet Journal of Allied Health Sciences and Practice

Purpose: Pain is the most common reason for healthcare consultation in the United States. Pain affects every area of life; biologically, psychologically, and socially. These three constructs make up every individual and thus contribute to their perceived quality of life. The use of therapy dogs (TD) has been widely researched as a source of non-pharmacological pain management. Studies have proven that a dog can reduce perceived pain in people with a variety of comorbidities. The purpose of this study was to prove that pain is modulated biologically by dogs and not just by human perception. Methods: This was …

Virtual Lecture, Live Lecture, Flipped Classroom: Does Dpt Pain Curriculum Format Affect Student Pain Beliefs? A Preliminary Study, Jeb Helms, Jamie Ball, Kory J. Zimney Pt, Dpt, Phd

Internet Journal of Allied Health Sciences and Practice

Purpose: Currently there are multiple published examples of successful DPT delivery models for the International Association for the Study of Pain curricular guidelines. However, there are no direct comparisons between different IASP delivery models such as in-person vs hybrid or lecture vs flipped classroom. The purpose of this study was to compare 3 delivery formats for teaching a DPT pain science IASP based course (1. Virtual Lecture 2. In-person Lecture 3. Flipped in-person) for pre course and post course differences in student biomedical/biopsychosocial beliefs, and confidence to treat patients in pain.Method The instructors remained consistent throughout the study period, …

Enjoyment, Motivation, And Self-Efficacy Towards Physical Activity Among Physical Therapy Students, Lauren Butler, Amanda Thomas, Teresa Munecas, Erasmo Alvarez, David Capote, Alexa Almonte, Madeline Dawson, Jordan Hale, Mikayla Kerekes, Kaitlyn Mitchell, Mark D. Rossi

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to determine physical therapy (PT) students’ participation in and attitudes toward physical activity (PA).

Methods An electronic survey assessed demographic, academic, and sports history. Student’s PA level was assessed with the Godin Leisure-Time Exercise Questionnaire (Godin); PA enjoyment was assessed using the Physical Activity Enjoyment Scale (PACES); motivation was assessed using 4 items from the Modified Behavioral Regulation in Exercise (BREQ 3); and self-efficacy towards PA was assessed with the Exercise Self-Efficacy Scale (ESES). Descriptive statistics, Pearson correlations, and independent t-tests with 95% Confidence Interval (95% CI) were used.

Results In total, 228 …

Meeting Interprofessional Education Competencies Through A Multi-Scene Standardized Patient Simulation: A Pilot Study, Joanna Behm, Kristen Slabaugh, Karen Burket

Internet Journal of Allied Health Sciences and Practice

Purpose. Healthcare is increasingly delivered by teams of diverse disciplines. Interprofessional education for healthcare students is essential so that when students enter their respective fields, they come prepared with experience in interdisciplinary communication, teamwork, and communication. Accreditation and regulatory requirements for health professions programs have also increased the focus on interprofessional collaboration, requiring programs to be creative in finding effective and efficient integration methods. The purpose of this pilot study was to identify the perceived impact of an interprofessional collaboration event on enhancing students’ interprofessional education competency attainment. Methods. An interprofessional collaboration committee created a multi-scene, unfolding case study …

Doctor Of Physical Therapy Programs Report Teaching Telehealth With Large Discrepancies: A United States Survey, Jason Ashby, Jean-Michel Brismée, Derrick F. Campbell

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to describe the extent to which telehealth is taught in entry level Doctor of Physical Therapy (DPT) programs in the United States, and to describe where it is taught in the curriculum. Method: A survey was sent during spring 2023 to 254 United States DPT program directors using email addresses from the Commission on Accreditation in Physical Therapy Education (CAPTE) list of accredited DPT programs, with questions regarding telehealth education within the didactic and clinical portions of the programs. Results: Twenty-nine responses (11.4%) were received. Two participants did not complete the survey and …

Development Of A Scale To Evaluate Key Attributes Of Academic Advisors Essential To Physical Therapy Students, Robin M. Baker, Jamie L. Greco

Internet Journal of Allied Health Sciences and Practice

Acknowledging the crucial role of academic advising in enhancing student success, professionalism, and personal growth, this paper advocates for a shift from traditional reactive methods to proactive, personalized advising strategies that have been shown to improve retention and satisfaction rates in higher education. Our study highlights the development of a comprehensive scale through rigorous validity assessments to measure key attributes of academic advisors essential to physical therapy students (PTS). This scale, refined through extensive feedback from faculty and PTS over two development phases, consists of 18 items on a 4-point Likert scale, which together map the complex landscape of effective …

Effects Of An Educational Intervention On Firefighter Knowledge Of Cardiovascular Disease Risk Factors And Prevention, Scott Richardson, Andrew Haight, Kassandra Sanchez, Madison Jepperson, Kelsey Houston, Lauren Schembs

Internet Journal of Allied Health Sciences and Practice

Purpose: Organized firefighting began in ancient Rome in 300BC, with the first fire engines in the 17^th century. Modern firefighters face extreme personal risk, responding to emergency situations and providing life-saving public support. Cardiovascular disease events account for 45% of on-duty fatalities among firefighters. Cardiovascular health in firefighters is not only important for immediate job performance but also for long-term health. This study aimed to examine the efficacy of an educational intervention to influence firefighter knowledge of cardiovascular disease risk factors and prevention. Method: A literature review determined that cardiovascular health was the leading knowledge deficit among firefighters …

Exploring Clinical Instructors' Views On Effective Role Modeling In Physical Therapy Education: Insights From A Qualitative Study Through The Lens Of Social Cognitive Theory, Brittney M. Gunterstockman, Kellee Harper-Hanigan, Andrew Bartlett, Ian Rheault, Karen Menard

Internet Journal of Allied Health Sciences and Practice

Purpose: Acting as a role model is an essential competency and requirement for physical therapy clinical instructors. The social cognitive theory may explain how physical therapy students learn from clinical instructors during clinical education experiences. This theory suggests that individuals learn through observation of models who are competent, credible, enthusiastic, and similar to the observer. This study aimed to explore clinical instructors’ perceptions of effective role modeling. Methods: This phenomenological qualitative study used one-on-one virtual semi-structured interviews with clinical instructors (n=7) to explore effective role modeling in physical therapy clinical education. Inductive coding was used to develop codes and themes …

An Exploration Of Student Experiences And Perceptions Of A Physiotherapy Student-Led Clinic, Donna Wynne, Elizabeth Hancock Professor, Emma Stage, Kay Cooper Professor

Internet Journal of Allied Health Sciences and Practice

Purpose: Student-Led Clinics (SLCs) offer a structured, real-life learning environment for healthcare students, where they provide services under supervision. SLCs can facilitate increased confidence with clinical reasoning, improve skill development and enhance leadership skills. Existing research has generally captured students' experiences at the end of their SLC participation, lacking a longitudinal perspective and therefore, little is known about how students’ perceptions develop over time. This study aimed to explore physiotherapy students' experiences in a neurological rehabilitation SLC, with a focus on participants’ perceptions captured after attending specific SLC sessions and over the course of multiple SLC sessions. Methods: Using interpretative …

Feasibility Of A Prescribed Walking Program In Older Adults With Dizziness: Challenges And Recommendations From A Pilot Pragmatic Randomized Controlled Trial, Amie Jasper, Mary T. Blackinton, Joann Gallichio, Anne Galgon

Internet Journal of Allied Health Sciences and Practice

Purpose: Walking for endurance is a component of vestibular rehabilitation (VR); however, there is no study on increasing the physical activity of older adults with peripheral vestibular hypofunction through a prescribed walking program. This pilot study aimed to assess the feasibility of conducting a pragmatic randomized controlled trial on a prescribed walking program in a clinical environment; specifically, to determine recruitment, data collection retention, and adherence, and to estimate the variances of treatment outcomes. Method: Seventeen patients were randomly assigned into vestibular rehabilitation with walking with pedometer (VRWP), vestibular rehabilitation with walking without pedometer (VRW), and VR only. Recruitment, data …

Simulation Based Learning And Development Of Clinical Decision-Making Skills, As Perceived By Dpt Students, A Qualitative Analysis, Fabian Bizama, Kristy Demers, Mansoor Alameri, Derrick F. Campbell

Internet Journal of Allied Health Sciences and Practice

Purpose: Simulation-based learning (SBL) has been shown to help Doctor of Physical Therapy (DPT) students transfer academic skills to a range of clinical settings. However, the perceived beneficial and not beneficial elements of SBL have not been fully explored. While most research has focused on acute care settings, previously published findings demonstrated that an SBL course with outpatient-based scenarios can have a significant impact on the development of clinical decision-making (CDM) skills in DPT students; however, details on perceived successful elements were not explored. The purpose of this study was to explore what factors DPT students perceive as helpful and …

Quantifying Afo Use, Fit, And Function Via Outcome Measures By Physical Therapists, Jennifaye V. Brown, Julie Suhr

Internet Journal of Allied Health Sciences and Practice

Purpose: For individuals with cerebrovascular accident (IwCVA), there is no outcome measure considered as the gold standard to justify ankle foot orthosis (AFO) use, fit, and function and that takes into consideration inherent properties of the AFO. Data is lacking indicating AFO effectiveness, which can be used to justify insurance reimbursement for the cost of more efficient mechanisms to produce person-centered AFOs using scanning and 3D printing technology, as is commonly done for individuals with lower extremity amputation requiring a prosthesis. Methods: This study surveyed physical therapists (PTs) via electronic medium to inquire about their knowledge and use of AFO-specific …

Dysphagia And Covid-19 In Adults: A Prospective Clinical Trial With Fiberoptic Endoscopic Evaluation Of Swallowing, Gökhan Can Törpü, Müberra Tanrıverdi, Nahide Öztoprak, Ömer Faruk Çalım, Orhan Özturan

Internet Journal of Allied Health Sciences and Practice

Purpose: Coronavirus disease 2019 (COVID-19) is distinguished by its impact on various tissues and organs across the body. It is known that COVID-19-related conditions are associated with swallowing function. This prospective study aimed to investigate the correlation between COVID-19 and dysphagia in adults. Methods: Adults who applied to the swallowing disorders outpatient clinic participated in this study. According to polymerase chain reaction (PCR) testing, participants were divided into two groups: COVID-19 and non-COVID-19 group. Swallowing disorders were evaluated using fiberoptic endoscopic evaluation of swallowing and scored with the Penetration-Aspiration Scale (PAS). PAS score > 1 was considered as dysphagia. Oral …

Biopsychosocial-Based Exercise Model For Rheumatic Diseases Via Telerehabilitation: A Case Series With A One Year Follow Up, Nazlı Elif Nacar, Nur Banu Karaca, Zeynep Irem Bulut, Erkin Oguz Sarı, Senem Bulut, Yavuz Yakut, Sevim Oksüz, Sedat Kiraz, Edibe Unal

Internet Journal of Allied Health Sciences and Practice

Purpose: This study aims to examine the sustainability of the biopsychosocial exercise performed by telerehabilitation on individuals with rheumatic disease, with and without supervision, and investigate the effect of the biopsychosocial-based exercise model on biopsychosocial status, general health status, and anxiety-depression levels of individuals. Method: Twenty patients with rheumatic diseases performed a biopsychosocial-based exercise model Cognitive Exercise Therapy Approach via telerehabilitation with physiotherapist-supervised and unsupervised exercises who continued for three sessions per week for 12 months. Outcome measures were Health Assessment Questionnaire, Hospital Anxiety and Depression Scale, and Cognitive Exercise Therapy Approach -Biopsychosocial Questionnaire. Patients were assessed at baseline, 3rd, …

Therapeutic Alliance: Exploring The Patient-Clinician Relationship Through The Experiences Of Collegiate Student-Athletes With Athletic Trainers, Paulina Torres, Sean M. Stoeppel, Justin Young, John Kiesel, Lindsey E. Eberman, Matthew J. Rivera

Internet Journal of Allied Health Sciences and Practice

Purpose: The therapeutic alliance refers to the relationship between patient and provider, consisting of bonds, goals, and tasks. A positive therapeutic alliance enhances care and leads to improved outcomes. The purpose of this study is to explore the lived experiences of college student-athletes relating to the development of the therapeutic alliance with athletic trainers. Methods: Consensual Qualitative Research (CQR) with semi-structured interviews. We used a semi-structured interview to explore the therapeutic alliance and lived experiences of participants. Participants included twelve college student-athletes who were currently under the care of an athletic trainer. Participants completed a semi-structured interview. We …

Exploring Clinician Understanding Of Therapeutic Alliance, Melissa Cole, Robert Welsh, Susan Shore

Internet Journal of Allied Health Sciences and Practice

Background. Therapeutic alliance is being discussed more readily in allied health literature regarding its potential to improve functional outcomes and patient satisfaction with care. The construct was imported from psychotherapy literature, and the degree and depth of familiarity among practicing physical therapists have not been fully explored. Purpose. This study aims to gain insight into the general level of familiarity and perceptions of therapeutic alliance among practicing clinicians. Methods. A survey was designed to capture a broad professional point of view and distributed using an anonymous link. Results. 73 surveys were completed. 43.3% of respondents reported they were not familiar …

Increasing Awareness Of Burnout And Developing An Action Plan To Reduce Stress For Graduate Health Profession Students Through An Interactive Workshop, Oaklee Rogers, Zachary Baker

Internet Journal of Allied Health Sciences and Practice

Purpose: Healthcare students can experience stress and burnout before becoming practicing clinicians. Increasing education about your level of stress and understanding what burnout is are important factors in preventing burnout. Method: A 90 minute interactive workshop was developed and implemented for graduate health profession students to meet three objectives: 1) increase foundational knowledge about burnout and its impact on different health professionals, 2) assess student’s level of burnout and apply strategies to mitigate their stress, and 3) create and share a plan on how they would incorporate stress reduction strategies and/or reduce their level of burnout. Results: In total, 349 …

Mantra Meditation For Chronically Impaired Attention After Stroke: A Trial Using Single-Case Experimental Design, Cheryl Carrico, Dana Howell, John A. Patterson, Richard D. Andreatta, Camille Skubik-Peplaski

Internet Journal of Allied Health Sciences and Practice

Purpose: Impaired attention after stroke is a common problem for which rehabilitation would potentially be indicated. Systematic review evidence has revealed a lack of high-quality research that supports the effectiveness of standard-of-care cognitive rehabilitation for sustained attention, alertness, and functional impact on daily life after stroke. Standard-of-care cognitive rehabilitation does not include meditation. Meditation has been defined in contemporary scientific literature as a regime entailing voluntary self-regulation of attention. As such, meditation could potentially improve attention in keeping with tenets of neuroplasticity. The present study investigated whether mantra meditation would benefit attention for adults with chronically impaired attention after right-hemisphere …

Physiotherapists' Knowledge Of Ageing And Its Associated Factors, Unyime Jasper, Olayinka Akinrolie, Cornelius Mahdi Ishaku, Nnamdi Mgbemena

Internet Journal of Allied Health Sciences and Practice

Purpose: To evaluate knowledge of ageing and its associated factors among Nigerian physiotherapists (PTs).

Methods: We used a three-part questionnaire. Knowledge of ageing was evaluated with Palmore’s Facts on Aging Quiz (FAQ). Certain questions in the FAQ were modified to reflect the local setting. We conducted a validity and reliability check on the questionnaire using test-retest with 10 PTs. Data were analysed using descriptive statistics, t-test, ANOVA and multiple linear regression.

Resullts: Out of 204 PTs invited, 186 agreed to participate. Test-retest of the FAQ revealed a Cronbach alpha of 0.78. The age of participants ranged from …