Physiotherapy Commons^™

From Anatomy To Safe Action: The A2d And Scope-D Frameworks For Teaching Clinical Reasoning And Referral Communication In Physical Therapist Education, Arvie Vitente, Pamela Taylor, Christopher Dela Rosa, Art Lubinski

Philippine Journal of Physical Therapy

Introduction. Physical therapist learners may accurately recall anatomy yet struggle to translate it into testable hypotheses, recognize discordant findings, select proportionate actions, and communicate uncertainty within scope. Existing frameworks address clinical reasoning or structured communication, but limited guidance connects anatomy-based hypothesis testing directly to patient-centered referral communication when findings do not fit. This theory piece pairs Anatomy-to-Decision (A2D) with SCOPE-D to address that curricular gap.

Methods. Integrative conceptual design drew on literature concerning physical therapist clinical reasoning, illness scripts, cognitive load, dual-process reasoning, hypothesis-oriented patient management, safety screening, and communication of diagnostic uncertainty. These foundations were translated into features intended …

Predictors Of Clinical Performance On The Revised Physical Therapist Clinical Performance Instrument 3.0, Derrick F. Campbell, Nancy G. Hellman, Felicity Macahilig-Rice, Sean E. Witkin, Mansoor Alameri

Internet Journal of Allied Health Sciences and Practice

Purpose: This study aimed to evaluate the impact of the 12 performance criteria from the revised American Physical Therapy Association (APTA) Physical Therapist Clinical Performance Instrument 3.0 (PT CPI 3.0) on predicting Doctor of Physical Therapy (DPT) student clinical performance outcomes during clinical education experiences. The PT CPI 3.0 was revised in 2023 to measure DPT student clinical performance. Identifying predictors for clinical performance may help flag students who struggle to meet or fall below performance expectations.

Method: A convenience sample of 693 DPT students from a large U.S. multi-campus program during Fall 2023 clinical education experiences participated. Using an …

The Effect Of Part-Time Vs Full-Time Integrated Clinical Education On Student Physical Therapists’ Self-Efficacy And Clinical Reasoning, William J. Buchala

Student Dissertations

Integrated clinical education (ICE) varies across Doctor of Physical Therapy (DPT) programs, particularly in the use of part-time and full-time clinical experiences. Limited research has examined relationships between ICE structure, self-efficacy, and clinical reasoning. The purpose of this quantitative ex post facto study was to examine relationships between part-time and full-time ICE models and self-efficacy and self-assessed clinical reasoning in DPT students. Survey responses were collected from DPT students who had participated in ICE experiences. Self-efficacy was measured using the Physical Therapist Self-Efficacy Scale, and self-assessed clinical reasoning was measured using the Self-Assessment of Clinical Reflection and Reasoning Scale. Independent-samples …

The Readiness Reset: Sleep, Stress, And Pain Management For Tactical Performance, Lauren Fried

Tactical & Occupational Performance Conference

Tactical professionals operate in high-demand environments where sleep disruption, chronic stress, and persistent pain are often normalized, but these factors significantly affect readiness, resilience, and long-term performance. This session explores how sleep, stress, and pain interact at the physiological and neurological levels to influence decision-making, recovery, injury risk, and operational effectiveness in first responders and military personnel.

Participants will gain a deeper understanding of how nervous system regulation, circadian rhythms, and pain perception affect both physical and cognitive performance under stress. Drawing on current research and applied human performance principles, this session highlights practical, field-applicable strategies that tactical professionals and …

Artificial Intelligence (Ai) In A Hybrid Dpt Program: Student Opinions On Use, Cheating, And Plagiarism, Jennifaye V. Brown, Keiba Shaw, Otis L. Owens

Internet Journal of Allied Health Sciences and Practice

Purpose: To prepare students with digital competencies needed for modern clinical practice, AI should be responsibly integrated into healthcare education programs. However, concerns exist about students misusing AI for admissions statements and academic assignments. This study examined Doctor of Physical Therapy (DPT) students' perceptions of ChatGPT use and whether they consider its use cheating or plagiarism. Method: This retrospective multi-methods analysis compared two DPT student cohorts' online essay responses to the following questions: 1) Is using AI or specifically, ChatGPT considered cheating and/or plagiarism? and 2) What are students' opinions on ChatGPT use in the DPT curriculum? One hundred forty-seven …

Effects Of Clinical Exposure On The Clinical Reasoning Skills Of Senior Pt Interns In Selected Rehabilitation Centers, Jeanelle Louise D. Atienza, Kristel Mae R. Yu, Elisha Almeda, Lance O. Panganiban, Gracyl Shane Valera, Joel Isaac B. Lorenzo, Vivebonn A. Bismonte, Martin Lorenzo Rosanes, Francis U. Santos, Danny G. Espera

Philippine Journal of Physical Therapy

Introduction. Clinical reasoning is a fundamental skill in physical therapy (PT), enabling practitioners to recognize patterns and enhance treatment decisions. It serves as a cornerstone of competence, guiding informed judgments and facilitating optimal patient care. This study aimed to examine the development of clinical reasoning skills among physical therapy interns in selected rehabilitation centers, provide baseline data for evaluating program quality, mentorship effectiveness, and impacts on clinical practice.

Methods. A cohort study design was employed in assessing clinical reasoning skills of 36 Bachelor of Science in Physical Therapy (BSPT) interns before and after a two-month clinical exposure. A validated, self-constructed …

Evaluating Forearm Strength Variability In Collegiate Tennis Players Over The Course Of A Competitive Season, Jeffrey Williams, Payton Jensen, Kevin Laudner

Clinical Practice in Athletic Training

The muscles of the forearm undergo routine, forceful, and repetitive contractions while playing tennis and may experience adaptive changes that can precede injury. An understanding of forearm strength profiles of tennis players following a competitive season would assist clinicians’ evidence-based management of the forearm’s readiness for training, competition, and return-to-sport participation. Therefore, the purpose of this study was to explore the effects of a competitive tennis season on forearm strength among collegiate tennis athletes. A prospective, case-series design was used to examine a convenience sample of 15 asymptomatic NCAA Division I tennis players (males = 10, height = 182.88 [SD …

Acute Management Of A Hamate Fracture In A Collegiate Baseball Player: A Disablement Model Case Study, Kayleigh A. De Koker, Cory E. Barton, Lindsey E. Eberman

Clinical Practice in Athletic Training

The purpose of this disablement model case study was to outline a collegiate baseball player with an isolated hamate fracture including the injury evaluation, diagnosis, and acute management. During a tournament game, the collegiate career of the patient ended abruptly following an injury sustained while at bat. The patient attempted to bat again but encountered significant difficulty due to the increasing pain in his hand. Consequently, the athletic trainer was called out for an on-field examination. The patient presented with no edema or ecchymosis but severe pain in the hypothenar eminence. This patient also presented with decreased grip strength with …

Quality Of Athletic Training Services For Lower Extremity Injuries, Katie Sniffen, Michael Rozier, Katherine Stamatakis, Paula Buchanan, Janet E. Simon, Leslie Hinyard

Clinical Practice in Athletic Training

The use of patient-reported outcomes in athletic training is inconsistent, limiting the ability to communicate service quality and value to key stakeholders. The objective of this study is to calculate meaningful quality outcome measures for athletic training services for lower extremity injuries in high school student-athletes. Data were collected from a subset of the National Athletic Treatment, Injury and Outcomes Network Surveillance Program and a convenience sample of high school student-athletes with patient-reported outcome measures for lower extremity time-loss injuries. Failure-toprogress proportions (FTPPs) were calculated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) for knee/thigh injuries and the Foot …

Recurrent Urinary Tract Infections In An Elite Level Diver: A Disablement Model Case Study, Matt O'Sullivan, Dominique M. Stevens, Lindsey E. Eberman

Clinical Practice in Athletic Training

This article presents a case of complicated and recurrent pyelonephritis, an infection of 1 or both kidneys, in an elitelevel diver. Urinary tract infections (UTIs) are among the most common outpatient infections in the United States; most are uncomplicated and resolve without significant mortality or morbidity. However, UTIs have the potential to present significant clinical challenges if the UTI becomes complicated or recurrent. Additionally, recurrent UTIs can carry a significant burden to both the individual patients and the larger healthcare system. The current paper reviews the epidemiological literature surrounding UTIs, the significant impact they have on a patient’s health-related quality …

Comfort Level Of Collegiate Student-Athletes In Opposite And Same-Gender Patient/Provider Relationships In Athletic Training, Samantha Dickie, Yashu Tang, Sydney Nelson, Emily Madrak

Clinical Practice in Athletic Training

Gender-based comfort in patient-provider relationships is a vital aspect of athletic training care. As the profession continues to evolve—particularly with a growing number of women athletic trainers (ATs) and progression of athletic training curriculum—it is essential to understand how gender dynamics influence the comfort of collegiate athletes when receiving care. This cross-sectional survey study examined how athlete comfort varies when treated by same- versus opposite-gender ATs in general patient care and in pathology-based scenarios. Ninety-six collegiate student-athletes (62.5% female) with the mean age of 20.26 (SD 1.7) years from NCAA and NAIA institutions completed the Gender Comfort with Athletic Trainer …

Prescribed Aerobic Exercise And Sport-Related Concussion Recovery: A Validation Case Series, Lacy L. Chapel, Tamara C. Valovich Mcleod

Clinical Practice in Athletic Training

Active rehabilitation, including prescribed sub-symptom threshold aerobic exercise implemented during the acute phase of recovery after sport-related concussion, has been shown to facilitate recovery and reduce the risk of persisting postconcussion symptoms. The purpose of this validation case series was to evaluate currently available external evidence regarding the effects of prescribed aerobic exercise interventions on recovery after sport-related concussion. For this study, the patient population included college athletes diagnosed with a sport-related concussion who participated in at least 5 days per week of supervised, prescribed aerobic exercise, based on graded aerobic exercise testing and heart rate threshold. Our study findings …

Suture Augmentation With Ucl Repairs In Baseball Pitchers As An Alternate To Reconstructions: An Evidence-To-Practice Review, Kayleigh A. De Koker, Kenneth E. Games

Clinical Practice in Athletic Training

An injury to the ulnar collateral ligament (UCL) is sustained through repetitive valgus motions, increasing in prevalence across all levels of baseball due to the increasing workload demands placed on the medial elbow in pitching. Traditionally, UCL tears have been managed through reconstructions followed by a lengthy rehabilitation process. In recent years, the UCL repair with suture augmentation has gained favor given the enhanced patient and clinician outcomes in return-to-play timelines, decreased medial gapping, improved Kerlan Jobe Orthopedic Clinic (KJOC) scores, and long-term functionality. Utilizing 4 databases (MEDLINE, Embase Cochrane library, Science Direct, and Scopus), literature was obtained addressing the …

Comparison Of Vibrating And Non-Vibrating Foam Roller On Hamstring Range Of Motion, Rakhoon Sung, Portia B. Resnick, Karen G. Roos, Mimi Nakajima

Clinical Practice in Athletic Training

Tightness in the distal hamstring is a common complaint among active individuals. While a foam roller is used to release muscle tension, there are limited studies about the effect using a vibrating foam roller (VFR) on hamstring flexibility and knee range of motion (ROM). For this reason, the purpose of the research was to compare the effect of a VFR and nonvibrating foam roller (NVFR) on hamstring flexibility and knee ROM in active college students. It was hypothesized that there would be more improvement in hamstring flexibility and knee ROM with a VFR than an NVFR. A randomized controlled trial …

A Review Of Mentorship And Recruitment Strategies For Minority Athletic Training Students, Dariana M. Brown

Clinical Practice in Athletic Training

The underrepresentation of minority athletic trainers remains a critical issue, affecting both the profession and the quality of patient care. While patient demographics continue to diversify, the athletic training workforce has not kept pace, leading to potential communication barriers, mistrust, and inadequate culturally competent care. This review examines whether culturally tailored mentorship programs and targeted recruitment initiatives improve retention, career satisfaction, and diversity in athletic training compared to standard methods. By analyzing studies on underrepresented minority students in athletic training, the review highlights key institutional barriers and systemic factors impacting recruitment and retention. Findings suggest that tailored mentorship and supportive …

Sacroiliac Dysfunction In A Middle-Aged Female Runner: A Case Study, Blair Bradshaw

Clinical Practice in Athletic Training

Introduction: Research has indicated an increased prevalence of low back pain (LBP) due to SIJ dysfunction, with some reports suggesting it is the main source of pain in 15- 30% of cases. Women are more prone to incidence of SIJ pain due to a wider, more uneven, less curved, and posteriorly rotated sacrum. Additionally, women have increased mobility at the SIJ which increases stress and shear loading. Repetitive loading such as running can further contribute to SIJ dysfunction. Research suggests that female runners with SIJ pain had common biomechanical patterns putting them at more risk for injury including decreased knee …

Awareness Of Native American Living Conditions Among Athletic Trainers, Laurel Trail, Brandon Warner, Rebecca Peebles, Robert French, Lynzi Warner, S. Andrew Cage

Clinical Practice in Athletic Training

Context: Native Americans and First Nations People have dealt with healthcare disparities that have been documented in previous studies. One factor that appears to have played a role in these disparities was the Indian Removal Act of 1851 which established the first Native American reservations. The foundation of these reservations led to many Native Americans being displaced from areas where the United States was establishing new population centers. This has led many individuals not understanding the conditions that Native Americans live in. Lack of knowledge of the conditions patients live in may negatively affect clinicians’ ability to provide optimal healthcare. …

Ulnar Collateral Ligament Reconstruction Compared To Common Flexor Tendon Repair With Ulnar Collateral Ligament Reconstruction: A Case Series, Amanda Dubois, Melissa Long

Clinical Practice in Athletic Training

Introduction: The ulnar collateral ligament (UCL) is found in the medial aspect of the elbow joint capsule and is commonly injured in baseball pitchers. The common flexor tendon (CFT) is also found in the medial elbow and is less commonly injured. Both structures are key in overhead throwing, repaired via surgery, and injured due to valgus stress placed on the elbow. There is research on UCL injuries but very little on CFT injuries. There is not substantial research on the return to play protocol or rehabilitation process for either of these two structures after surgery. Patient Information: The patients for …

Differences Between Genders Related To Perceived Knowledge Of And Attitudes Toward Lgbtia+ Persons Among Athletic Trainers, Brandon J. Warner, Julianne Goza, Meredith Decker, S. Andrew Cage

Clinical Practice in Athletic Training

Context: Previous literature reports that healthcare providers and student-athletes identifying as LGBTQIA+ encounter difficulties in their respective communities. A number medical professional associations have published statements affirming their commitment to providing access to patient-centered healthcare for LGBTQIA+ patients. Unfortunately, there is a lack of research related to the factors that influence perceived knowledge of and attitudes toward the LGBTQIA+ community among healthcare providers. More information on what factors impact perceived knowledge of and attitudes toward the LGBTQIA+ community would assist with creating interventions that improve perceived knowledge and attitudes toward the LGBTQIA+ community. The purpose of this study was to …

Differences Between Sexual Orientations Regarding Perceived Knowledge Of And Attitudes Toward Lgbtia+ Persons Among Athletic Trainers, Julianne Goza, S. Andrew Cage, Meredith Decker, Brandon J. Warner

Clinical Practice in Athletic Training

Context: LGBTQIA+ athletic trainers and patients encounter difficulties in their workplaces and sport communities. Several medical professional associations have produced statements claiming their commitment to fostering an patient-centered environment for healthcare for LGBTQIA+ patients. To date, there has been little research on the factors that impact perceived knowledge of and attitudes toward the LGBTQIA+ community among healthcare providers. With more information on what factors impact perceived knowledge of and attitudes toward the LGBTQIA+ community, better interventions for improving perceived knowledge and attitudes toward the LGBTQIA+ community could be created. The purpose of this study was to determine differences between sexual …

Extensor Hallucis Longus Focal Dystonia In A Patient With Parkinson’S Disease: A Case Study, Jessika Truax, Linda Bobo, Keilea Sumrall

Clinical Practice in Athletic Training

Introduction: Parkinson’s Disease (PD) is a common neurodegenerative disorder that affects a person’s ability to produce dopamine and control motion of the body. PD affects 1% of people over the age of 65, but the disease can occur earlier and later in life. The uncontrollable movement of any body part involved with PD is referred to as a tremor. Pathophysiology of PD causes the thalamus to have a decreased activation of the frontal cortex, thus decreased motor activity. Patients commonly have dystonia mostly in the foot resulting in striatal toe. Optional pain relief is a tenotomy of the extensor hallicus …

Breaking Barriers: Disparities Among Minority Collegiate Athletes In Concussion Reporting, Josette Villanueva, Melissa Long

Clinical Practice in Athletic Training

Introduction: Concussions are a serious concern in sports medicine because of their potential long-term effects on cognitive and neurological health. However, many athletes, especially those from minority groups, hesitate to report symptoms due to fears of being sidelined, pressure to keep playing, and challenges like limited access to education, language barriers, and distrust in healthcare systems. The objective of this study was to investigate the barriers to concussion reporting among Division I collegiate athletes, with a particular focus on demographic differences, particularly racial and ethnic disparities. The goal was to identify key factors that hinder self-reporting and to propose strategies …

Hyoid Bone Fracture In A Division 1 Football Player: A Conservative Management Case Study, Kynnedy Louis, Andrew Crane, Mark Knoblauch, Layci Harrison

Clinical Practice in Athletic Training

Introduction: The hyoid bone plays an important role in speaking, swallowing, and supporting the tongue. Hyoid bone fractures account for 0.002% of all fractures and are typically seen in cases dealing with strangulations or a blunt force trauma such as occurs from vehicle accidents or martial arts injuries. Signs and symptoms of hyoid fractures can include dyspnea, pharyngeal tear, or subcutaneous emphysema, and if not recognized early can significantly damage the airway. Patient Information: A 23-year-old male collegiate football player sustained blunt trauma to the anterior part of his neck due to a tackle forcing the helmet chin strap against …

Sleep And Stress Experienced By Collegiate Baseball Players During A Fall Season, Andrew R. Gallucci, Katie M. Lee, Eric Rash, Jeremy A. Bigalke, Jason R. Carter

Clinical Practice in Athletic Training

Introduction: College students are notoriously poor sleepers due to academic and social demands. Collegiate athletes have additional athletic responsibilities that can also affect sleep. During a season, baseball players experience prolonged bouts of high intensity activity that increase the need for recovery and sleep. Athletes can also experience higher perceived stress levels, a factor also known to impact sleep. Reduced sleep quality and quantity during a competitive season can impede recovery and decrease performance. The present study sought to determine the relationships between sleep [Total Sleep Time (TST), Sleep Efficiency (SE), Sleep Onset Latency (SOL), Awakenings] and stress over a …

Impressions And Gastrointestinal Tolerance Of An Electrolyte Hydration Beverage Among Individuals Participating In Collegiate Baseball, S. Andrew Cage, Alexander Jacobsen, Brandon Warner, Jessie Gibson, Derek Lege, Robert French

Clinical Practice in Athletic Training

Context: Performing physical activity in numerous environmental conditions often results in mild to moderate dehydration. Dehydration can be problematic for the physically active population, as it can lead to decreases in physical and cognitive performance. This places emphasis on making sure individuals are properly hydrated during exercise. One of the barriers to appropriate hydration behaviors that has been identified in physically active individuals is a dislike of available hydration options. This highlights the need for sports medicine professionals to provide physically active individuals with appealing hydration options. Currently there is a lack of research exploring the flavor appeal of hydration …

Overcoming Thoracic Outlet Syndrome In A Young Athlete: A Case Study, Cormia Lewis, Christina Fry, Mark Knoblauch, Layci Harrison

Clinical Practice in Athletic Training

Introduction: Thoracic Outlet Syndrome (TOS) is a rare and complex condition caused by the compression of neurovascular structures in the thoracic outlet. TOS is estimated to affect 3 to 80 individuals per 1,000,000 annually, with neurogenic TOS accounting for approximately 95% of cases. Athletes who perform repetitive overhead motions are at higher risk due to increased stress on the brachial plexus. Diagnosis can be challenging as symptoms such as pain, numbness, and weakness, often mimic other conditions such as nerve entrapment or tendon pathologies. Treatment for TOS typically begins with a conservative approach, including postural correction and strengthening, activity modification, …

Trust, Culture, And Conversation: How Athletic Training Leaders Navigate High-Stakes Interactions, Nicole A. Wilkins, Ashley B. Thrasher, Ericka P. Zimmerman

Clinical Practice in Athletic Training

Introduction: Engaging in difficult conversations is central to leadership growth and requires sustained effort to refine and strengthen these skills. Leaders not only need to navigate the complexities of their role within an organization, but also the intersectionality of interpersonal dynamics, emotional intelligence, structural hierarchies, and the nuanced environments that influence how communication occurs. Furthermore, leaders must adapt to role expectations that shift across clinical, academic, and administrative contexts, adjusting their approach to engaging in conversations based on these complexities. As part of a larger research project examining difficult conversations, this portion of the study explored how leaders in athletic …

Integrating Wearable Technologies Into Athletic Training: Bridging Innovation And Clinical Practice, Michael Douglas

Clinical Practice in Athletic Training

Athletic training is entering a transformative period driven by the convergence of wearable technologies, artificial intelligence (AI), and advanced biomechanical modeling. Historically, wearable technology in sport was primarily used for performance tracking, including workload monitoring, heart rate assessment, and movement quantification. However, advances in sensor accuracy and data analytics have expanded the clinical relevance of wearable systems, allowing athletic trainers to monitor fatigue markers, movement asymmetry, and neuromuscular control patterns that inform injury risk and rehabilitation progression. Wearable sensor technologies provide objective data that can support clinical decision-making when integrated with traditional evaluation methods.¹Despite these advancements, wearable technologies present persistent …

Performance On The Timed Single-Leg Step-Down Test Is Correlated With Hip And Knee Biomechanics As Measured By 3d Markerless Motion Capture, Ghislain Aminake, Anthony Drazick, Christ Focht, Chloe Roy, Emily Clark, Savannah Knighton, Edward Austin, Jeremy Burnham

Clinical Practice in Athletic Training

Introduction: The timed single-leg step-down (SLSD) test is widely used in clinical and sports settings to assess lower extremity function and injury risk, yet the specific biomechanical determinants of performance on this test remain poorly understood. The purpose of this study is to investigate the relationship between performance on the timed SLSD test and hip and knee biomechanics captured by a markerless 3-D motion-analysis system. Methods: Twenty (20) healthy high school athletes with no recent history of lower extremity injury completed a 60-second timed single leg step down test. The number of quality SLSD repetitions (REPS) constituted their SLSD score. …

Athletic Trainers’ Motivations For And Satisfaction With Transition To The Physician Practice Setting, Abigail G. Overstreet, Nicolette A. Harris, Cailee E. Welch Bacon

Clinical Practice in Athletic Training

An increasing number of athletic trainers are transitioning from traditional settings, such as secondary schools, colleges, universities, and professional sports, to physician practice. Although research suggests athletic trainers may be changing settings in search of better working conditions, little is known about their motivations for and satisfaction with the setting transition. The objective of this research was to explore athletic trainers’ motivations for and satisfaction with transition to the physician practice setting. A qualitative design was used to collect and interpret data. Eleven certified athletic trainers (6 women, 5 men; age 1⁄4 38.5 6 10.0 years) who transitioned from a …