Rehabilitation and Therapy Commons^™

Knowledge Translation Task Force For Core Measures Clinical Practice Guideline: A Short Report On The Process And Utilization, Marghuretta D. Bland, Jennifer Moore, Elizabeth Anderl, Megan Eikenberry, Arlene Mccarthy, Geneviève N. Olivier, Tracy Rice, Amelia Siles, Hallie Zeleznik, Wendy Romney

Physical Therapy Faculty Publications

Background

As part of the 2018 Clinical Practice Guideline (CPG): A Core Set of Outcome Measures for Adults with Neurologic Conditions Undergoing Rehabilitation, a Knowledge Translation (KT) Task Force was convened. The purpose of this short report was to (1) demonstrate the potential impact of a CPG KT Task Force through a practical example of efforts to implement a CPG into neurologic physical therapy practice and (2) describe the process to convene a KT Task Force and develop products (KT Toolkit) to facilitate implementation of the CPG.

Methods

To describe the process used by the KT Task Force to develop …

Essential Content For Teaching Implementation Practice In Healthcare: A Mixed-Methods Study Of Teams Offering Capacity-Building Initiatives, Jessica Reszel, Olivia Daub, Jenny Leese, Hanna Augustsson, Danielle Moeske Bellows, Christine E. Cassidy, Beth E. Crowner, Sandra I. Dunn, Lisa B. Goodwin, Alison M. Hoens, Sarah C. Hunter, Elizabeth A. Lynch, Jennifer Moore, Miriam R. Rafferty, Wendy Romney, Dawn Campbell, Dawn Stacey, Implementation Practice Cbi Study Team, Ian D. Graham

Physical Therapy Faculty Publications

Background

Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying implementation science in their work. One strategy to enhance individuals’ and teams’ ability to apply implementation science in practice is through training and professional development opportunities (capacity-building initiatives). Although there is an increasing demand for and offerings of implementation practice capacity-building initiatives, there is no universal agreement on what content should be included. In this study we aimed to explore what capacity-building developers and deliverers identify as essential training content …

Evidence-Based Practice Confidence And Behavior Throughout The Curriculum Of Four Physical Therapy Education Programs: A Longitudinal Study, Wendy Romney, Nancy M. Salbach, Susan B. Perry, Judith E. Deutsch

Physical Therapy Faculty Publications

Background

Evidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation.

Methods

One hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. …

Long Duration Sonophoresis Of Diclofenac To Augment Rehabilitation Of Common Musculoskeletal Injuries, Paddy Jarit, Dominic Klyve, Rod Walters

Physical Therapy Faculty Publications

Background: The use of long duration sonophoresis (LDS) for musculoskeletal injuries is a new and emerging treatment option for patients undergoing rehabilitation. The treatment is non-invasive, provides multi-hour mechanical stimulus expediating tissue regeneration and deep tissue heat along with local application of therapeutic compound for improved pain relief. The objective of this prospective case study was to evaluate real-world application of diclofenac LDS as an add-on intervention for patients non-responsive to physical therapy alone. Methods: Patient who failed to respond to at least 4 weeks of physical therapy were treated with the addition of 2.5% diclofenac LDS daily for 4 …

Initial Steps For Integrating Academic Electronic Health Records Into Clinical Curricula Of Physical And Occupational Therapy In The United States: A Survey-Based Observational Study, Stephen C. Burrows, Lola Halperin, Eric C. Nemec, Wendy Romney

Healthcare Informatics Faculty Publications

Training programs must be designed to prepare physical and occupational therapy students for using Electronic Health Records (EHR) and interprofessional collaboration. This report aims to describe physical and occupational therapy students' perceptions of integrating Academic EHR in their Problem-Based Learning (PBL) curricula in the College of Health Professions, Sacred Heart University, Fairfield, Connecticut, the United States. A paper-based case approach to PBL was adapted by creating patient cases in an Academic EHR (AEHR). Students were asked to complete chart reviews and review provider notes to enhance their learning. An online survey was conducted to determine their perceptions of using AEHR …

Doctoral Physical Therapy Students' Increased Confidence Following Exploration Of Active Video Gaming Systems In A Problem-Based Learning Curriculum In The United States: A Pre-And Post-Intervention Study, Michelle E. Wormley, Wendy Romney, Diana Veneri, Andrea Oberlander

Physical Therapy Faculty Publications

Purpose: Active video gaming (AVG) is used in physical therapy (PT) to treat individuals with a variety of diagnoses across the lifespan. The literature supports improvements in balance, cardiovascular endurance, and motor control; however, evidence is lacking regarding the implementation of AVG in PT education. This study investigated doctoral physical therapy (DPT) students' confidence following active exploration of AVG systems as a PT intervention in the United States.

Methods: This pretest-posttest study included 60 DPT students in 2017 (Cohort 1) and 55 students in 2018 (Cohort 2) enrolled in a problem-based learning curriculum. AVG systems were embedded into patient cases …

Physical Activity Interventions In Children With Juvenile Idiopathic Arthritis: A Systematic Review Of Randomized Controlled Trials, Maura D. Iversen, Marie Andre, Johan Von Heideken

Physical Therapy Faculty Publications

Introduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA.

Materials and methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and …

Reporting Of Harm In Randomized Controlled Trials Of Therapeutic Exercise For Knee Osteoarthritis: A Systematic Review, Johan Von Heideken, Sana Chowdhry, Joanna Borg, Khara James, Maura D. Iversen

Physical Therapy Faculty Publications

Objective: The Consolidated Standards of Reporting Trials (CONSORT) recommends reporting adverse events (AEs) and dropouts (DOs) with their definitions. The purpose of this study was to identify how AEs and DOs were reported in randomized controlled trials (RCTs) of therapeutic exercise for knee osteoarthritis (OA).

Methods: Data sources were the Cochrane Library, EMBASE, PUBMED, and CINAHL. Databases were searched to identify RCTs of therapeutic exercise for Knee OA published from January 1, 1980, through July 23, 2020. Researchers independently extracted participant and intervention characteristics and determined whether a clear statement of and reasons for AEs and DOs existed. The primary …

The Why, Where, And How Clinical Reasoning Model For The Evaluation And Treatment Of Patients With Low Back Pain, Sean P. Riley, Brian T. Swanson, Joshua Cleland

Physical Therapy Faculty Publications

Objective

The objective of this theoretical clinical reasoning model is to provide a framework to help clinicians integrate linear and non-linear clinical reasoning approaches to minimize clinical reasoning errors related to logically fallacious thinking and cognitive biases.

Methods

This masterclass proposes a hypothesis-driven and probabilistic approach that uses clinical reasoning for managing LBP that seeks to eliminate the challenges related to using any single diagnostic paradigm.

Conclusions

This model integrates the why (mechanism of primary symptoms), where (location of the primary driver of symptoms), and how (impact of mechanical input and how it may or may not modulate the patient's …

Physical Examination Findings In Patients With Protracted Concussion And The Impact Of An Integrative Concussion Rehabilitation Protocol, Lauren Ziaks, Chelsea Brown, Maura D. Iversen

Physical Therapy Faculty Publications

Purpose: To describe physical examination (PE) findings of individuals with protracted concussion recovery and evaluate an integrated primitive reflex (PR) disinhibition, vision, and vestibular rehabilitation intervention. Method: Retrospective study of 82 patients with protracted concussion (60.98% female) who received ≥ 2 phases of treatment. Following a baseline PE, patients completed the Post-Concussion Symptom Survey (PCSS), Activities-Based Balance Confidence Questionnaire (ABC), Dizziness Handicap Index (DHI), and Acquired Traumatic Brain Injury (aTBI) Vision Questionnaire. A subset of patients (Group 1), completed a final PE and second questionnaire administration. Descriptive statistics characterized the sample. T-tests and Wilcoxon rank sum tests compared characteristics of …

Flop To Flip: Integrating Technology And Team-Based Learning To Improve Student Engagement, Diana Veneri, Elizabeth M. Mongillo

Physical Therapy Faculty Publications

Purpose: The first attempt to develop and instruct a new course in evidence-based practice in a physical therapy curriculum proved problematic. The purpose of this paper is to describe the method of revising this traditionally taught course using a combination of flipping the classroom, team-based learning, and technology. Methods: Working with an Instructional Design Specialist, a weekly online preparatory module was created for each content topic using a variety of multimedia learning provisions including micro learning videos (PowerPoint with voiceover), transcript of the PowerPoint, a list of vocabulary words, reading, Quizlet, Flipgrids and Concept Checks. Each week’s module was introduced …

The Quality Of Intervention Reporting In Trials Of Therapeutic Exercise For Hip Osteoarthritis: A Secondary Analysis Of A Systematic Review, Louise C. Burgess, Thomas C. Wainwright, Khara A. James, Johan Von Heideken, Maura D. Iversen

Physical Therapy Faculty Publications

Background: Therapeutic exercise is recommended as a core treatment for hip osteoarthritis (HOA). Whilst it is widely accepted that exercise can improve pain and disability, optimal type and dose of exercise are yet to be agreed upon. This may, in part, be attributed to the wide variation and inadequate reporting of interventions within the literature. This study evaluates the quality of intervention reporting among trials of therapeutic exercise in HOA.

Methods: Randomised controlled trials (RCTs) were sourced in a systematic review, completed in August 2020. Two raters independently used the Template for Intervention Description and Replication (TIDieR) and Consensus on …

Measures Of Pediatric Function And Physical Activity In Arthritis, Anna E. Greer, Maura D. Iversen

Exercise Science Faculty Publications

Physical function can be assessed through physical examination with the use of performance-based measures and patient-reported outcome measures (PROMs). Each form of assessment provides a unique contribution to the understanding of the impact of rheumatologic conditions on the patient. PROMs of physical function (PF) are an important component of the assessment of children with arthritis and have been included in the recommended core set of measures for childhood arthritis and musculoskeletal conditions. These measures provide the child’s or parent’s perspective of function within the context of daily living. Measures of PF include both generic measures, which are designed for use …

Non-Thrust Cervical Manipulations Reduce Short-Term Pain And Decrease Systolic Blood Pressure During Intervention In Mechanical Neck Pain: A Randomized Clinical Trial, Emmanuel Yung, Cheongeun Oh, Michael Wong, Jason K. Grimes, Erica M. Barton, Muhammad I. Ali, Allison Breakey

Physical Therapy Faculty Publications

Objectives: To evaluate the association of resting blood pressure with pain response and evaluate the cardiovascular effects of anterior-to-posterior [AP] versus lateral [LAT] techniques of cervical spine non-thrust manipulation [NTM].

Methods: Forty-three (23 females) participants with non-chronic neck pain (mean age 29.00 ± SD 9.09 years) randomly received AP or LAT NTM to the cervical spine. Blood pressure and heart rate were measured before, during, and after the intervention. Disability and pain were measured pre- and post-intervention.

Results: Resting systolic blood pressure (SBP) was significantly associated with average pain reduction two days later on univariate and multivariate analyses (coefficients −0.029 …

Sustained Acoustic Medicine Combined With A Diclofenac Ultrasound Coupling Patch For The Rapid Symptomatic Relief Of Knee Osteoarthritis: Multi-Site Clinical Efficacy Study, Alex Madzia, Chirag Agrawal, Paddy Jarit, Stephanie Petterson, Kevin Plancher, Ralph Ortiz

Physical Therapy Faculty Publications

Background:

Sustained Acoustic Medicine (SAM) is an emerging, non-invasive, non-narcotic, home-use ultrasound therapy for the daily treatment of joint pain. The aim of this multi-site clinical study was to examine the efficacy of long-duration continuous ultrasound combined with a 1% diclofenac ultrasound gel patch in treating pain and improving function in patients with knee osteoarthritis.

Methods:

The Consolidated Standards of Reporting Trials (CONSORT) were followed. Thirty-two (32) patients (18-males, 14-females) 54 years of average age with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence (KL) grade II/III) were enrolled for treatment with the SAM device and diclofenac …

Reliability And Relationship Of The Fear-Avoidance Beliefs Questionnaire With The Shoulder Pain And Disability Index And Numeric Pain Rating Scale In Patients With Shoulder Pain, Sean P. Riley, Vincent Tafuto, Mark Cote, Jean-Michel Brismée, Alexis Wright, Chad Cook

Physical Therapy Faculty Publications

Purpose: The purpose of this study was to determine: 1) the test–retest reliability of Fear-Avoidance Beliefs Questionnaire (FABQ) Work (FABQW) subscale, FABQ Physical Activity (FABQPA) subscale, Shoulder Pain and Disability Index (SPADI) Pain subscale, SPADI Disability subscale, and Numeric Pain Rating scale (NPRS); and 2) the relationship between the FABQPA, FABQW, SPADI pain, SPADI disability, and NPRS after 4 weeks of pragmatically applied physical therapy (PT) in patients with shoulder pain. Design: Prospective, single-group observational design. Methods: Data were collected at initial evaluation, the first follow-up visit prior to the initiation of treatment, and after 4 weeks of treatment. …

Reliability Of Smartphone Inclinometry To Measure Upper Cervical Range Of Motion., Paul A. Ullucci, Frank Tudini, Matthew F. Moran

Physical Therapy Faculty Publications

Context: Assessment of upper cervical range of motion (UCROM) and mobility is commonly performed in the clinical setting for patients suffering from headache, neck pain and vestibular dysfunction. Reliable and reproducible measurement of this motion is often difficult or too expensive to perform in the clinical setting. Smartphone applications, utilizing the device's internal gyroscope, offer an easy and inexpensive means of measuring UCROM, but their reliability has not been reported in the literature.

Objective: Assess the reliability of an inclinometer application, installed on two different devices (iPhone6 (IP), Andriod (AN)), to measure UCROM in a healthy population.

Design: Two examiners …

Fms Squat Assessment And 2d Video Motion Analysis As Screening Indicators Of Low Back Pain: A Cross Sectional Case- Study, Tracy Donlon, Britanny Franklin, Courtney Machamer, Christina Mogelnicki, Jeffrey Verneus, Christopher Taber

Exercise Science Faculty Publications

Aim: Low back pain (LBP) is a disabling condition to individuals in the United States and physical therapy (PT) has been proven to be a beneficial treatment by analyzing their movement patterns. The main objective of this study was to analyze the deep squat component of the Functional Movement Screen (FMS) as an indicator of LBP while simultaneously using 2-D analysis. Method: This cross-sectional case study included 36 participants that completed a total of six deep squats. Three raters scored the FMS score of each participant. Results: The association between FMS score and the presence of LBP showed to be …

Personality Oriented Job Analysis To Identify Non-Cognitive Factors For A Doctor Of Physical Therapy Program In The United States, Maureen A. Conard, Kristin Schweizer

Psychology Faculty Publications

It aimed to conduct a personality oriented job analysis to identify non-cognitive factors that may predict successful performance or performance difficulties in doctorate in physical therapy (DPT) students. The study employed focus groups and a survey with 9 DPT subject matter experts. Focus group participants including 3 DPT faculty members and 4 recent graduates of the DPT program identified 22 non-cognitive factors. Out of them, 15 factors were possibly associated with successful performance and 7 factors were possibly associated with performance difficulties. The questionnaire employing the Combination Job Analysis Method resulted in 12 factors which could be used in selection, …

The Immediate Cardiovascular Response To Joint Mobilization Of The Neck - A Randomized, Placebo-Controlled Trial In Pain-Free Adults, Emmanuel Yung, Cheongeun Oh, Michael Wong, Jason K. Grimes, Erica M. Barton, Muhammad I. Ali, David A. Cameron

All PTHMS Faculty Publications

Background: Some normotensive patients can have a spike in resting systolic blood pressure (SBP) in response to acute neck pain. Applying the typical dosage of mobilization may potentially result in a sympatho-excitatory response, further increasing resting SBP. Therefore, there is a need to explore other dosage regimens that could result in a decrease in SBP.

Objectives: To compare the blood pressure (BP) and heart rate (HR) response of pain-free, normotensive adults when receiving unilateral posterior-to-anterior mobilization (PA) applied to the neck versus its corresponding placebo (PA-P).

Study design: Double-Blind, Randomized Clinical Trial.

Development Of The Clinical Teaching Effectiveness Questionnaire In The United States, Michelle E. Wormley, Wendy Romney, Anna E. Greer

All PTHMS Faculty Publications

The purpose of this study was to develop a single valid measure for assessing clinical teaching effectiveness within the field of physical therapy. Pilot testing with CIs from both universities were purposively sampled to complete the questionnaire. The CI databases yielded 1,001 potential respondents, recruited via e-mail. The questionnaire and two follow-up reminders were sent. Respondents consented by clicking a link which redirected them to the SurveyMonkey® questionnaire. Two hundred five CIs completed the questionnaire, a 20.5% response rate. The 205 respondents were mostly female (68.4%) with an average age of 40.54 years (SD=10.22). CI experience was distributed as follows: …

The Immediate Effects Of A Seated Versus Supine Upper Thoracic Spine Thrust Manipulation Compared To Sham Manipulation In Individuals With Subacromial Pain Syndrome – A Randomized Controlled Trial, Jason K. Grimes

Physical Therapy Faculty Publications

Background: Individuals with Subacromial Pain Syndrome (SPS) often present with a variety of contributing factors. It is possible that a subgroup exists within SPS that has primary impairments of scapular mobility and/or muscle strength. In an attempt to better identify scapular contributions in SPS, the Scapular Assistance Test (SAT) and Scapula Reposition Test (SRT) have been described. Additionally, thoracic spine thrust manipulation has been shown to be effective for shoulder pain. Problem Statement: It is currently unknown whether or not there are impairments in scapulothoracic muscle force generation or scapular mobility in individuals with SPS who have positive results on …

Improving Completeness And Transparency Of Reporting In Clinical Trials Using The Template For Intervention Description And Replication (Tidier) Checklist Will Benefit The Physiotherapy Profession, Tiê Yamato, Chris Maher, Bruno Saragiotto, Anne Moseley, Tammy Hoffmann, Mark Elkins, Shannon Petersen, Sean P. Riley, Jean-Michel Brismée

All PTHMS Faculty Publications

Incomplete reporting of interventions in physiotherapy studies is an important problem and The Journal of Manual and Manipulative Therapy endorses the use of the TIDieR checklist as a potential solution.

Health-Related Fitness For Children And Adults With Cerebral Palsy, Yvette Blanchard, Mary E. Gannotti, Wendy Romney

All PTHMS Faculty Publications

Position Statement of ACSM Sports Medicine Basics 2016: Health-related physical fitness for persons with Cerebral Palsy should be developed in the same model as fitness for all of us: start early, be easily available and continue throughout the life span.

Walking Speed: The Functional Vital Sign, Addie Middletown, Stacy Fritz, Michelle M. Lusardi

All PTHMS Faculty Publications

Walking speed (WS) is a valid, reliable, and sensitive measure appropriate for assessing and monitoring functional status and overall health in a wide range of populations. These capabilities have led to its designation as the “sixth vital sign”. By synthesizing the available evidence on WS, this scholarly review article provides clinicians with a reference tool regarding this robust measure. Recommendations on testing procedures for assessing WS, including optimal distance, inclusion of acceleration and deceleration phases, instructions, and instrumentation are given. After assessing an individual's WS, clinicians need to know what this value represents. Therefore, WS cut-off values and the corresponding …

Validity And Usability Of A Professional Association’S Web-Based Knowledge Translation Portal: American Physical Therapy Association’S Ptnow.Org, Judith E. Deutsch, Wendy Romney, Jan Reynolds, Tara Jo Manal

All PTHMS Faculty Publications

Background: PTNow.org is an evidence-based, on-line portal created by a professional membership association to promote use of evidence in practice and to help decrease unwarranted variation in practice. The site contains synthesis documents designed to promote efficient clinical reasoning. These documents were written and peer-reviewed by teams of content experts and master clinicians. The purpose of this paper is to report on the content and construct validity as well as usability of the site. Methods: Physical therapist participants used clinical summaries (available in 3 formats--as a full summary with hyperlinks, "quick takes" with hyperlinks, and a portable two-page version) on …

Health, Wellness, And The Pursuit Of Happiness: Common Ground For Adults With Cerebral Palsy And Modern Physical Therapists, Lisa Blumberg, Mary E. Gannotti, Diana J. Larocco, Yvette Blanchard

Physical Therapy Faculty Publications

Health, wellness, and happiness are important long-term goals for adulthood, especially for children with cerebral palsy (CP). Physical therapists (PTs) can assist individuals with CP realize these goals; however it requires PTs to have a greater understanding of how to apply impairment, functional, or contextual interventions to meet these goals. A critical gap in knowledge exists about perceptions of happiness and health priorities of adults with CP. The purpose of this paper is to describe the beliefs, feelings, and perceptions of happiness and health of adults with CP as compared to adults without CP, specifically PTs.

Service Learning In Guatemala: Using Qualitative Content Analysis To Explore An Interdisciplinary Learning Experience Among Students In Health Care Professional Programs, Kathleen S. Fries, Donna M. Bowers, Margo Gross, Lenore Frost

Nursing Faculty Publications

What is the experience of interprofessional collaboration as a nursing, occupational, or physical therapy health care student taking part in a weeklong service-learning experience? Interprofessional collaboration among health care professionals yields improved patient outcomes, yet many students in health care programs have limited exposure to interprofessional collaboration in the classroom and in clinical and service-learning experiences. This practice gap implies that students enter their professions without valuing interprofessional collaboration and the impact it has on promoting positive patient outcomes.

The aim of this study was to describe the interprofessional experiences of students in health care professional programs as they collaborated …

Physical Therapy News, Volume 2, Issue 1, College Of Health Professions

Physical Therapy News

No abstract provided.

Service Learning In Higher Education Exercise Science Programs, Wendy Bjerke

All PTHMS Faculty Publications

Introduction: Service learning (SL) describes teaching methods that incorporate student service activities with specific learning objectives. SL has been applied to allied health higher education programs.

Purpose: To determine the applicability of SL to exercise science courses. SL data associated with an undergraduate course in exercise physiology serving a local fire department is examined.