Physical Therapy Commons^™

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

Case Report: Multifactorial Intervention For Safe Aging In Place, Ashwini Kulkarni

Rehabilitation Sciences Faculty Publications

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the …

The Landscape Of Virtual Reality Use In Mobility Rehabilitation From 2010-2023: A Scoping Review, Danielle T. Felsberg, Reza Pousti, Charlend K. Howard, Scott E. Ross, Louisa D. Raisbeck, Jared T. Mcguirt, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Significant advancements in virtual reality (VR) technology have occurred in the past decade, allowing clinical researchers to take advantage of these reduced barriers to explore the use of VR in patient populations. This scoping review on VR interventions to improve mobility in adults and children focuses on the literature from 2010-2023. A total of 2736 articles were screened and 126 articles met the inclusion criteria. Most of the studies were conducted in inpatient clinical settings (n = 41) and investigated VR interventions to improve balance (n = 118). Less immersive (n = 108) products such as Nintendo Wii or Xbox …

Athletic Trainers' Perspectives On Resources And Preparation Needed For Successful Salary Negotiation, Kimberly R. Detwiler, Cailee E. Welch Bacon, Indigo B. White, Leanne E. Jones, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context

Many athletic trainers (ATs) work under high stress, long hours, and low pay. These conditions often lead ATs and athletic training students to leave the profession. Previous studies show that over half of ATs do not negotiate salary, often because they feel the offer is fair or fear losing the job. Additional support is needed to help ATs prepare for negotiations, as current resources are limited.

Objective

This study explored ATs’ views on the resources need to prepare for salary negotiations during the hiring process.

Design

Consensual qualitative research.

Setting

Individual video interviews.

Patients or Other Participants

Twenty-eight participants …

Comparing Immersive And Nonimmersive Clinical Experiences In Athletic Training Education: Effects On Student Engagement And Confidence, Julie M. Cavallario, Shana Pribesh, S. E. Walker

Rehabilitation Sciences Faculty Publications

Context

With the shift to a graduate-level professional degree in athletic training, it was hypothesized that immersive clinical experiences (ICEs) would be more effectively integrated into curricula than non-ICEs (N-ICEs) and better prepare students for practice.

Objective

To longitudinally compare clinical engagement opportunities in ICEs versus N-ICEs and assess if these opportunities are associated with changes in student confidence in performing related tasks.

Design

Prospective, longitudinal, time-diary study using a Web-based survey. Patients or Other Participants: Fifty-three first-year, master’s-level athletic training students from 21 programs.

Main Outcome Measure(s)

Participants reported their type of clinical experience (ICE, N-ICE, or none), the …

How Many Trials Are Needed For Consistent Clinical Gait Assessment?, Charlend K. Howard, Christopher K. Rhea, Jacquelyn R. Moxey, Kyle Langerhans, Paphawee Prupetkaew, Brittany S. Samulski

Rehabilitation Sciences Faculty Publications

Background: Clinical assessment of gait typically consists of patients walking a few trials at various speeds while the clinician assesses performance. Unfortunately, there is no clear guidance on how gait changes across trials, leaving clinicians uncertain about the optimal number of trials needed to observe consistent (non-variable) performance. To address this issue, we examined gait performance from a large dataset of older adults who participated in a community-based comprehensive fall risk assessment. Methods: Community-dwelling, older adults (n = 340; 70.8 ± 7.4 years; 120 men, 220 women) performed gait trials under two conditions: preferred and maximum walking speed. …

Content Validation Of The Athletic Training Milestones: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Barton E. Anderson, Julie M. Cavallario, Bonnie Van Lunen, Lindsey E. Eberman

Rehabilitation Sciences Faculty Publications

The Athletic Training Milestones were developed as a comprehensive framework to assess athletic trainers' knowledge, skill, and behavior acquisition across the continuum of athletic training practice. However, without established content validity, it is unclear whether the Athletic Training Milestones can be used effectively as a clinical evaluation and research tool to evaluate competence and performance across multiple users and sites. We conducted a highly conservative content validity index (CVI) with data from 12 content experts. Our findings revealed an extremely high overall scale CVI of 0.99, and CVI scores of the 28 individual subcompetency items assessed ranged from 0.83 to …

Characteristics Of Patient Encounters For Athletic Training Students During Clinical Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, R.Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, athletic training students (ATSs) should experience a wide variety of clinical practice settings, interact with diverse patient populations, and engage with patients that have a wide variety of conditions. It is unclear in what ways, if any, ATSs have diverse opportunities during clinical experiences.

Objective: To describe the characteristics of patient encounters (PEs) ATSs engage in during clinical experiences. Design: Multi-site, panel design.

Setting: 12 professional athletic training programs (ATPs; 5 Bachelor, 7 Master's).

Patients or Other Participants: 363 ATSs from the ATPs that used E*Value software to document PEs during clinical …

Core Competency-Related Professional Behaviors During Patient Encounters: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, it is important that athletic trainers integrate the components of the core competencies (CCs; evidence-based practice [EBP], patient-centered care [PCC], health information technology [HIT], interprofessional education and collaborative practice [IPECP], quality improvement [QI], professionalism) as a part of routine clinical practice. In what ways, if any, athletic training students (ATSs) are currently integrating CCs into patient encounters (PEs) during clinical experiences is unclear.

Objective: To describe which professional behaviors associated with the CCs were implemented by ATSs during PEs that occurred during clinical experiences.

Design: Multisite panel design.

Setting: A total of …

Cross-Education Balance Effects After Unilateral Rehabilitation In Individuals With Chronic Ankle Instability: A Systematic Review, Briana Lawry-Popelka, Sunghoon Chung, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Objective: To conduct a systematic review of existing literature on cross-education balance effects after unilateral training in the population with chronic ankle instability (CAI).

Data Sources: PubMed, SPORTDiscus, CINAHL Plus.

Study Selection: To be included in the systematic review, studies were required to have been published in English, included participants with CAI, had participants undergo a unilateral therapeutic exercise for the lower extremity, and measured balance performance of the untrained lower extremity before and after the intervention.

Data Extraction: The certainty of evidence in each included study was assessed via the Downs and Black checklist. A score of 24 to …

The Role Mentoring Plays In The Transition To Practice Of Newly Credentialed Athletic Trainers, Stacy E. Walker, Stephanie Mazerolle Singe, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Mentoring has been identified as an important method of supporting newly credentialed athletic trainers (ATs) during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs in developing a plan to better facilitate the transition.

Objective: To examine which aspects of the mentoring relationship provided the most benefit during the transition to practice of newly certified ATs.

Design: Qualitative study.

Setting: Individual phone interviews.

Patients or Other Participants: A total of 13 ATs who graduated from a professional master's program, were certified from February through July 2016, …

Response Shift After A 4-Week Multimodal Intervention For Chronic Ankle Instability, Cameron J. Powden, Matthew C. Hoch, Beth E. Jamali, Johanna M. Hoch

Rehabilitation Sciences Faculty Publications

Context The accurate evaluation of self-reported changes in function throughout the rehabilitation process is important for determining patient progression. Currently, how a response shift (RS) may affect the accuracy of self-reported functional assessment in a population with chronic ankle instability (CAI) is unknown.

Objective To examine the RS in individuals with CAI after a 4-week multimodal rehabilitation program.

Design Controlled laboratory study.

Setting Laboratory.

Patients or Other Participants Twenty adults (5 men, 15 women; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at …

A 4-Week Multimodal Intervention For Individuals With Chronic Ankle Instability: Examination Of Disease-Oriented And Patient-Oriented Outcomes, Cameron J. Powden, Johanna M. Hoch, Beth E. Jamali, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context Individuals with chronic ankle instability (CAI) experience disease- and patient-oriented impairments that contribute to both immediate and long-term health detriments. Investigators have demonstrated the ability of targeted interventions to improve these impairments. However, the combined effects of a multimodal intervention have not been evaluated for their effects on a multidimensional profile of health.

Objective To examine the effects of a 4-week rehabilitation program on disease- and patient-oriented impairments associated with CAI.

Design Controlled laboratory study.

Setting Laboratory.

Patients or Other Participants Twenty adults (5 males, 15 females; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, …

8890: Athletic Training Student Application Of Patient-Centered Care During Clinical Education: A Report From The Athletic Training Clinical Education Network, J. M. Cavallario, C. E. Welch Bacon, S. E. Walker, R. C. Bay, B. L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Patient-centered care (PCC) is the most frequently implemented core competency by students in health care education programs, and is more likely to be included when students and preceptors are jointly treating patients during clinical education. However, past research has examined only self-identification of implementation, not the inclusion of components of the competency during patient encounters (PEs).

Objective: To assess whether athletic training students (ATSs) are integrating concepts of PCC during PEs as a part of their clinical education experiences.

Design: Multisite, panel design.

Setting: Three Commission on Accreditation of Athletic Training Education-accredited professional athletic training programs (2 baccalaureate, 1 …

Somatosensory Deficits In Post-Acl Reconstruction Patients: A Case-Control Study, Johanna M. Hoch, William O. Perkins, Jonathan R. Hartman, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Introduction: Diminished cutaneous detection thresholds have been identified in patients with multiple orthopedic conditions, and these phenomena may occur in postanterior cruciate ligament reconstructed (ACLR) patients. The purpose of this study was to determine if differences in lower extremity cutaneous detection thresholds exist in post-ACLR patients when compared with healthy controls. Methods: Fifteen individuals who were post-ACLR and 15 individuals who had no history of knee injury participated. Light touch cutaneous detection thresholds were assessed at 4 locations on the foot and ankle (first metatarsal, fifth metatarsal, medial malleolus, and lateral malleolus). Nonparametric statistics examined group differences between the …

Gait Speed And Confidence Levels In Persons Using 1 And 2 Canes While Walking A 4-M Course, Marion A. Lisenby

Rehabilitation Sciences Faculty Publications

This is the first article that the researcher is aware of that compares walking speed and confidence levels with 1 cane versus 2 canes. An observational study was conducted with 30 participants who had difficulty walking. Gait speed was assessed on a 4-m course with the participants using 1 cane, then 2 canes. Of 30 participants, 28 walked faster and demonstrated improved confidence with 2 canes. Use of 2 canes with gait might be a technique that people want to consider to improve confidence or to improve walking speed, or improve both.

Occupational Therapy And Physiotherapy Education And Workforce In Anglophone Sub-Saharan Africa Countries, Augustine O. Agho, Emmanuel B. John

Rehabilitation Sciences Faculty Publications

Background: Sub-Saharan Africa (SSA) countries are faced with the challenge of educating a critical mass of occupational therapists (OTs) and physiotherapists (PTs) to meet the growing demand for health and rehabilitation services. The World Federation of Occupational Therapy (WFOT) and World Confederation of Physical Therapy (WCPT) have argued for the need of graduate-level training for OTs and PTs for decades. However, very few studies have been conducted to determine the availability of OT and PT training programs and practitioners in SSA countries.

Methods: Initial data were collected and compiled from an extensive literature search conducted using MEDLINE and PubMed to …

Measures Of Functional Performance And Their Association With Hip And Thigh Strength, Roger Kollack, Bonnie L. Van Lunen, Stacie I. Ringleb, James M. Oñate

Rehabilitation Sciences Faculty Publications

Context: Insufficient hip and thigh strength may increase an athlete's susceptibility to injury. However, screening for strength deficits using isometric and isokinetic instrumentation may not be practical in all clinical scenarios.

Objective: To determine if functional performance tests are valid indicators of hip and thigh strength.

Design: Descriptive laboratory study.

Setting: Research laboratory.

Patients or Other Participants: Sixty-two recreationally athletic men (n = 30, age = 21.07 years, height = 173.84 cm, mass = 81.47 kg) and women (n = 32, age = 21.03 years, height = 168.77 cm, mass = 68.22 kg) participants were recruited.

Intervention(s): During session 1, …

Perceived Outcomes Of Web-Based Modules Designed To Enhance Athletic Trainers' Knowledge Of Evidence-Based Practice, Cailee E. Welch, Bonnie L. Van Lunen, Dorice A. Hankemeier, Aimee L. Wyant, Jessica M. Mutchler, William A. Pitney, Danica G. Hays

Rehabilitation Sciences Faculty Publications

Context: The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial.

Objective: To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians.

Design: Qualitative study.

Setting: Individual telephone interviews.

Patients or Other Participants: A …

Health-Related Quality Of Life In Individuals With Chronic Ankle Instability, Megan N. Houston, Bonnie L. Van Lunen, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context: Individuals with chronic ankle instability (CAI) have reported decreased global and regional function. Despite the identification of functional deficits in those with CAI, more research is required to determine the extent to which CAI influences the multidimensional profile of health-related quality of life.

Objective: To determine whether global, regional, and psychological health-related outcomes differ between individuals with and without CAI.

Design: Case-control study.

Setting: Laboratory.

Patients or Other Participants: Twenty-five participants with CAI (age = 21.9 ± 2.5 years, height = 170.8 ± 8.6 cm, mass = 69.8.0 ± 11.7 kg) were sex- and limb-matched to 25 healthy participants …

Concurrent Validity Of Accelerations Measured Using A Tri-Axial Inertial Measurement Unit While Walking On Firm, Compliant, And Uneven Surfaces, Michael H. Cole, Wolbert Van Den Hoorn, Justin K. Kavanagh, Steven Morrison, Paul W. Hodges, James E. Smeathers, Graham K. Kerr

Rehabilitation Sciences Faculty Publications

Although accelerometers are extensively used for assessing gait, limited research has evaluated the concurrent validity of these devices on less predictable walking surfaces or the comparability of different methods used for gravitational acceleration compensation. This study evaluated the concurrent validity of trunk accelerations derived from a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces and contrasted two methods used to remove gravitational accelerations; i) subtraction of the best linear fit from the data (detrending); and ii) use of orientation information (quaternions) from the inertial measurement unit. Twelve older and twelve younger adults walked at their preferred …

Future Directions Of Evidence-Based Practice In Athletic Training: Perceived Strategies To Enhance The Use Of Evidence-Based Practice, Cailee E. Welch, Dorice A. Hankemeier, Aimee L. Wyant, Danica G. Hays, William A. Pitney, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care.

Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training …

Injury Prevention With Physical Therapy, Karen Kott, Margaret F. Lemaster

Rehabilitation Sciences Faculty Publications

(First paragraph) Ergonomics is the study of human performance (positioning and movement) and workplace design, such as equipment, ambience, and placement. The purpose of ergonomics is to maximize productivity by increasing safety, improving work quality, reducing operator fatigue and discomfort, and decreasing the risk of work -related musculoskeletal disorders (MSDs).^1-3

An Evidence-Based Practice Educational Intervention For Athletic Trainers: A Randomized Controlled Trial, Cailee E. Welch, Bonnie L. Van Lunen, Dorice A. Hankemeier

Rehabilitation Sciences Faculty Publications

Context: As evidence-based practice (EBP) becomes a necessity in athletic training, Web-based modules have been developed and made available to the National Athletic Trainers' Association membership as a mechanism to educate athletic trainers (ATs) on concepts of EBP.

Objective: To assess the effect of an educational intervention on enhancing knowledge of EBP among ATs.

Design: Randomized controlled trial.

Setting: Web-based modules and knowledge assessment.

Patients or Other Participants: A total of 164 of 473 ATs (34.7% response rate), including professional athletic training students, graduate students, clinical preceptors, educators, and clinicians, were randomized into a control group (40 men, 42 women) …

Use Of Evidence-Based Practice Among Athletic Training Educators, Clinicians, And Students, Part 2: Attitudes, Beliefs, Accessibility, And Barriers, Cailee W. Mccarthy, Dorice A. Hankemeier, Jessica M. Walter, Eric J. Newton, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students.

Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students.

Design: Cross-sectional study.

Setting: Online survey instrument.

Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training …

Use Of Evidence-Based Practice Among Athletic Training Educators, Clinicians, And Students, Part 1: Perceived Importance, Knowledge, And Confidence, Dorice A. Hankemeier, Jessica M. Walter, Cailee W. Mccarty, Eric J. Newton, Stacy E. Walker, Shana L. Pribesh, Beth E. Jamali, Sarah A. Manspeaker, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context:

Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown.

Objective:

To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels.

Design:

Cross-sectional study.

Setting:

Online survey instrument.

Patients or Other Participants:

The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%.

Main Outcome Measure(s):

Demographic information and perceived importance and knowledge of and …

Instruction And Jump-Landing Kinematics In College-Aged Female Athletes Over Time, Jena Etnoyer, Nelson Cortes, Stacie I. Ringleb, Bonnie L. Van Lunen, James A. Onate

Rehabilitation Sciences Faculty Publications

Context: Instruction can be used to alter the biomechanical movement patterns associated with anterior cruciate ligament (ACL) injuries.

Objective: To determine the effects of instruction through combination (self and expert) feedback or self-feedback on lower extremity kinematics during the box–drop-jump task, running–stop-jump task, and sidestep-cutting maneuver over time in college-aged female athletes.

Design: Randomized controlled clinical trial.

Setting: Laboratory.

Patients or Other Participants: Forty-three physically active women (age = 21.47 ± 1.55 years, height = 1.65 ± 0.08 m, mass = 63.78 ± 12.00 kg) with no history of ACL or lower extremity injuries or surgery in the 2 months …

Perceptions Of Approved Clinical Instructors: Barriers In The Implementation Of Evidence-Based Practice, Dorice A. Hankemeier, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: As evidence-based practice (EBP) becomes prevalent in athletic training education, the barriers that Approved Clinical Instructors (ACIs) experience in implementing it with students need to be understood.

Objective: To investigate barriers ACIs face when implementing EBP concepts in clinical practice and in teaching EBP to professional athletic training students and to investigate the educational emphases to improve the barriers.

Design: Qualitative study.

Setting: Telephone interviews.

Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as an athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.81 ± 3.9 years) were interviewed.

Data Collection and …

Commentary On "The Motor Learning Strategy Instrument: Interrater Reliability Within Usual And Virtual Reality Physical Therapy Interventions", Karen M. Kott, Sharon Held

Rehabilitation Sciences Faculty Publications

No abstract provided.

Clinical Preceptors' Perspectives On Clinical Education In Post-Professional Athletic Training Education Programs, Kelvin Phan, Cailee W. Mccarty, Jessica M. Mutchler, Bonnie Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Clinical education is the interaction between a clinical preceptor and student within the clinical setting to help the student progress as a clinician. Post-professional athletic training clinical education is especially important to improve these students' clinical knowledge and skills. However, little research has been conducted to assess the pedagogical principles for clinical education at this level or what factors are necessary to enhance the clinical skills and decision-making abilities of post-professional students. Therefore, exploring the perspectives of clinical preceptors involved in post-professional education will help educators understand what strategies are necessary to improve post-professional athletic training education programs (PPATEPs). …