Development of education program for physical therapy assistant in Quang Tri province of Vietnam

PubMed Central

Noh, Jin Won; Cho, Sang Hyun; Kim, Min Hee; Kim, Eun Joo

2017-01-01

[Purpose] The purpose of the present study was to develop an education program for physical therapy assistants in order to provide high quality physical therapy for the province of Quang Tri in Vietnam. [Subjects and Methods] Subjects consisted of 9 professors in Quang Tri medical college and 1 physical therapist in Quang Tri General hospital. The survey research to lecturer for education of physical therapy assistant in Quang Tri medical college was conducted as pre-analysis of demand for the physical therapy assistant curriculum development. The priority rank of expectation and consciousness were measured in curriculum subjects. [Results] Results of educational expectation of the curriculum total educational expectation were presented as minimum 4 to maximum 5. In the result of educational expectation according to background variable, the differences of educational expectation on scores according to the educational experience were significant. Among the consciousness priority of each curriculum subject, the priority rank of basic kinesiology and physical therapy for international medicine & surgery were 9, the highest first rank frequency. [Conclusion] The curriculum for physical therapy assistant was developed to 5 main subjects including a total of 420 hours (120 hours of theory and 300 hours of practice). PMID:28265176

76 FR 19776 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-08

... Program to Provide Outpatient Physical Therapy and/or Speech Pathology Services, and (CMS-1893) Outpatient Physical Therapy--Speech Pathology Survey Report; Use: CMS-1856 is used as an application to be completed by providers of outpatient physical therapy and/or speech- [[Page 19777

Physical medicine and rehabilitation in the elderly arthritic patient.

PubMed

Schutt, A H

1977-02-01

The basic conservative therapy programs for elderly patients with arthritis include adequate physical rest and mental relaxation, analgesics, aspirin, and physical rehabilitation consisting of occupational and physical therapy with a good home therapy program providing appropriate balance between rest and activity. Proper protection from trauma and overuse of the involved joints, and appropriate nutrition can afford optimal improvement in health status and general resistance. Proper orientation of the patient regarding the nature of his disease and treatment program usually is required to obtain his full cooperation. A kind, encouraging, and understanding approach is most helpful in the elderly patient. Physical rehabilitation can help to relieve pain, decrease edema and deformities, improve muscle weakness and incoordination, and increase stamina. Difficulties with gait, transfers, and self-care can be solved or improved. Physical medicine and rehabilitation measures are important components of the challenging treatment of patients of all age groups who are afflicted with severe arthritis. It is most important to tailor these components of the treatment program to the problem presented by geriatric arthritic patients.

Needs, Preferences, and Functional Abilities of Veterans and Service Members with Upper-Limb Amputation

DTIC Science & Technology

2017-10-01

its Impact on Post-Acute Outcomes” has been added to active support.  “Impact of Hospital-Based Physical Therapy Services on Hospital Readmission... Physical Therapy Sponsor: Foundation for Physical Therapy Dario Dieguez, PhD Scientific Programs & Communications Manager 1033 N Fairfax St...destination and b. hospital readmission Overlap: None 11) Title: Impact of Hospital-Based Physical Therapy Services on Hospital Readmission: Implications

Employment Selections of Resident and Non-Resident Graduates of Physical Therapy Programs in Underserved Western States

ERIC Educational Resources Information Center

Swart, Kathryn D.

2011-01-01

Background and Purpose: Physical therapy (PT) is an essential component of the healthcare system in providing a comprehensive treatment plan for patients with functional limitations. The demand for physical therapy services is projected to expand in the next eight years, leading to an increased need for practicing physical therapists. The Mountain…

Embedding the IASP pain curriculum into a 3-year pre-licensure physical therapy program: redesigning pain education for future clinicians.

PubMed

Hush, Julia M; Nicholas, Michael; Dean, Catherine M

2018-03-01

Supplemental Digital Content is Available in the Text. This article describes the process and evaluation of embedding the IASP Pain Curriculum for Physical Therapy into a 3-year Doctor of Physiotherapy Program in Australia.

76 FR 22709 - Medicare and Medicaid Programs; Approval of the American Association for Accreditation of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-22

... Surgery Facilities, Inc. for Deeming Authority for Organizations That Provide Outpatient Physical Therapy... Accreditation of Ambulatory Surgery Facilities (AAAASF) for recognition as a national accreditation program for organizations that provide outpatient physical therapy and speech-language pathology services seeking to...

Academic Self-Concept, Academic Achievement, and Leadership in University Students Studying in a Physical Therapy Program.

ERIC Educational Resources Information Center

Gottlieb, Rosemary J.; Rogers, Janet L.

2002-01-01

Assessment of the academic self-concept of 32 physical therapy assistant students in a selective admission program revealed a positive correlation between grade point average in the core curriculum and their leadership and initiative scores. (Contains 20 references.) (SK)

The effectiveness of balneotherapy in chronic low back pain.

PubMed

Onat, Şule Şahin; Taşoğlu, Özlem; Güneri, Fulya Demircioğlu; Özişler, Zuhal; Safer, Vildan Binay; Özgirgin, Neşe

2014-01-01

The aim of this study is to determine the effectiveness of balneotherapy plus physical therapy versus only physical therapy in patients with chronic low back pain. In this trial, 81 patients with low back pain were followed up in two groups. Patients in group I (n = 44) were treated with physical therapy alone. Patients in group II (n = 37) were treated with balneotherapy in addition to the same physical therapy protocol in group I. Patients in both groups were given a home-based standardized exercise program. The following parameters were measured: visual analog scale (0-10 cm), fingertip-to-floor distance (cm), Oswestry Disability Index, and Short Form 36 quality of life scale. First evaluations were done at the time of enrollment, and second evaluations were done after accomplishment of a 3-week treatment program. There were no significant differences between the two groups for the sociodemographic features. All of the measured parameters improved in both groups. However, improvements in pain, functionality, and quality of life scores were found to be superior in the balneotherapy plus physical therapy group. For the patients with chronic low back pain, balneotherapy plus physical therapy is more effective, compared to physical therapy alone.

42 CFR 410.100 - Included services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... subpart B. (b) Physical therapy services. (1) These services include— (i) Testing and measurement of the... therapy program for an individual whose restoration potential has been reached is a physical therapy service; however, maintenance therapy itself is not covered as part of these services. (c) Occupational...

Patients' mental models and adherence to outpatient physical therapy home exercise programs.

PubMed

Rizzo, Jon

2015-05-01

Within physical therapy, patient adherence usually relates to attending appointments, following advice, and/or undertaking prescribed exercise. Similar to findings for general medical adherence, patient adherence to physical therapy home exercise programs (HEP) is estimated between 35 and 72%. Adherence to HEPs is a multifactorial and poorly understood phenomenon, with no consensus regarding a common theoretical framework that best guides empirical or clinical efforts. Mental models, a construct used to explain behavior and decision-making in the social sciences, may serve as this framework. Mental models comprise an individual's tacit thoughts about how the world works. They include assumptions about new experiences and expectations for the future based on implicit comparisons between current and past experiences. Mental models play an important role in decision-making and guiding actions. This professional theoretical article discusses empirical research demonstrating relationships among mental models, prior experience, and adherence decisions in medical and physical therapy contexts. Specific issues related to mental models and physical therapy patient adherence are discussed, including the importance of articulation of patients' mental models, assessment of patients' mental models that relate to exercise program adherence, discrepancy between patient and provider mental models, and revision of patients' mental models in ways that enhance adherence. The article concludes with practical implications for physical therapists and recommendations for further research to better understand the role of mental models in physical therapy patient adherence behavior.

Reduced stress and improved physical functional ability in elderly with mental health problems following a horticultural therapy program.

PubMed

Han, Ah-Reum; Park, Sin-Ae; Ahn, Byung-Eun

2018-06-01

This study aimed to determine the effects of a plant cultivation-based horticultural therapy program for elderly people with mental health problems. Pre- and post-test design with experimental and control groups. Twenty-eight elderly Korean people with mental health problems participated from April to June 2017 at a farm located in Suwon, South Korea. The participants were randomly assigned to either the control (n = 14) or horticultural therapy group (n = 14); the latter participated in once-weekly sessions of a previously designed 10-session horticultural therapy program. The pre-test occurred 1 week before starting the horticultural therapy program. The post-test was completed within 1 week after finishing the final program session. Cortisol levels were measured in saliva samples collected from both groups. The Senior Fitness Test was used to assess physical functional ability in both groups. In the horticultural therapy group, the cortisol levels decreased significantly from before to after the horticultural therapy program, and the post-test scores for six subtests of the Senior Fitness Test improved significantly. No significant improvements were seen in either measure in the control group. This study demonstrates the potential ability of horticultural therapy to improve the stress levels and physical functional abilities of elderly people with mental health problems. In future studies, it would be interesting to verify the long-term effects of this horticultural therapy program and to compare its effects with regard to sex, age, and various mental symptoms. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

PubMed Central

Van der Wees, Philip J; Hendriks, Erik JM; Custers, Jan WH; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-01-01

Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program. PMID:18036215

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

PubMed

Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-11-23

Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program.

Role of physical therapy in management of knee osteoarthritis.

PubMed

Fitzgerald, G Kelley; Oatis, Carol

2004-03-01

The purposes of this review are to: (1) describe treatments that physical therapists may use to supplement exercise programs to enhance the benefit of rehabilitation, (2) discuss current research related to the mode of delivery of physical therapy treatment, and (3) identify characteristics from recent research that may influence the responsiveness of individuals with knee osteoarthritis to physical therapy. Physical therapists provide a variety of interventions, such as manual therapy techniques, balance, coordination, and functional retraining techniques, knee taping techniques, electrical stimulation, and foot orthotics to assist in overcoming some of the barriers that make participation in exercise and physical activity difficult. Recent research implies that a number of factors may influence the responsiveness to physical therapy treatment for individuals with knee osteoarthritis. Factors such as the mode of treatment delivery, treatment compliance issues, mechanical characteristics such as joint laxity and malalignment, and radiographic severity are discussed. Future studies are needed to improve our understanding of factors that can influence the responsiveness of patients with knee osteoarthritis to exercise and physical activity programs. The question may not be which mode of therapy works best, but rather, which patient and/or disease characteristics will tell us who will and who will not respond to a given mode of therapy.

Physical Therapy Residency and Fellowship Education: Reflections on the Past, Present, and Future.

PubMed

Furze, Jennifer A; Tichenor, Carol Jo; Fisher, Beth E; Jensen, Gail M; Rapport, Mary Jane

2016-07-01

The physical therapy profession continues to respond to the complex and changing landscape of health care to meet the needs of patients and the demands of patient care. Consistent with this evolution is the rapid development and expansion of residency and fellowship postprofessional programs. With the interested number of applicants exceeding the number of residency and fellowship slots available, a "critical period" in the educational process is emerging. The purposes of this perspective article are: (1) to analyze the state of residency and fellowship education within the profession, (2) to identify best practice elements from other health professions that are applicable to physical therapy residency and fellowship education, and (3) to propose a working framework grounded in common domains of competence to be used as a platform for dialogue, consistency, and quality across all residency and fellowship programs. Seven domains of competence are proposed to theoretically ground residency and fellowship programs and facilitate a more consistent approach to curricular development and assessment. Although the recent proliferation of residency and fellowship programs attempts to meet the demand of physical therapists seeking advanced educational opportunities, it is imperative that these programs are consistently delivering high-quality education with a common focus on delivering health care in the context of societal needs. © 2016 American Physical Therapy Association.

Horticultural therapy for patients with chronic musculoskeletal pain: results of a pilot study.

PubMed

Verra, M L; Verra, Martin L; Angst, Felix; Beck, Trudi; Lehmann, Susanne; Brioschi, Roberto; Schneiter, Renata; Aeschlimann, Andre

2012-01-01

Therapists can use horticultural therapy as an adjuvant therapy in a non threatening context, with the intent of bringing about positive effects in physical health, mental health, and social interaction. Very few experimental studies exist that test its clinical effectiveness. To determine whether the addition of horticultural therapy to a pain-management program improved physical function, mental health, and ability to cope with pain. The research team designed a prospective, nonrandomized, controlled cohort study, enrolling all patients consecutively referred to the Zurzach Interdisciplinary Pain Program (ZISP) who met the studys criteria. The team divided them into two cohorts based on when medical professionals referred them: before (control group) or after (intervention group) introduction of a horticultural therapy program. The setting was the rehabilitation clinic (RehaClinic) in Bad Zurzach, Switzerland. Seventy-nine patients with chronic musculoskeletal pain (fibromyalgia or chronic, nonspecific back pain) participated in the study. The research team compared a 4-week, inpatient, interdisciplinary pain-management program with horticultural therapy (intervention, n = 37) with a pain-management program without horticultural therapy (control, n = 42). The horticultural therapy program consisted of seven sessions of group therapy, each of 1-hour duration. The research team assessed the outcome using the Medical Outcome Study Short Form-36 (SF-36), the West Haven-Yale Multidimensional Pain Inventory (MPI), the Hospital Anxiety and Depression Scale (HADS), the Coping Strategies Questionnaire (CSQ ), and two functional performance tests. The team tested participants on entry to and discharge from the 4-week pain-management program. Between-group differences in sociodemographic and outcome variables were not significant on participants entry to the pain-management program. On discharge, the research team measured small to moderate outcome effects (effect size [ES] up to 0.71) within both groups. The study found significantly larger improvements for the horticultural therapy group vs the control group in SF-36 role physical (ES = 0.71 vs 0.22; P = .018); SF-36 mental health (ES = 0.46 vs 0.16; P = .027); HADS anxiety (ES = 0.26 vs 0.03; P = .043); and CSQ pain behavior (ES = 0.30 vs -0.05; P = .032). The addition of horticultural therapy to a pain management program improved participants' physical and mental health and their coping ability with respect to chronic musculoskeletal pain.

Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: a randomized controlled trial.

PubMed

Tousignant, Michel; Corriveau, Hélène; Roy, Pierre-Michel; Desrosiers, Johanne; Dubuc, Nicole; Hébert, Réjean

2013-08-01

To compare the effectiveness of supervised Tai Chi exercises versus the conventional physical therapy exercises in a personalized rehabilitation program in terms of the incidence and severity of falls in a frail older population. The participants were frail older adults living in the community, admitted to the day hospital program in Sherbrooke, Quebec, Canada (n = 152). They were randomized to receive a 15-week intervention, either by supervised Tai Chi exercises (n = 76) or conventional physical therapy (n = 76). Fall incidence and severity were assessed using both the calendar technique and phone interviews once a month during 12 months following the end of the intervention. Other variables were collected at baseline to compare the two groups: age, comorbidity, balance, sensory interaction on balance, and self-rated health. Both interventions demonstrated a protective effect on falls but Tai Chi showed a greater one (RR = 0.74; 95% CI = 0.56-0.98) as compared to conventional physical therapy exercises. Supervised Tai Chi exercises as part of a rehabilitation program seem to be a more effective alternative to the conventional physical therapy exercises for this specific population.

Postoperative physical therapy program for latissimus dorsi and teres major tendons transfer to rotator cuff in children with obstetrical brachial plexus injury.

PubMed

Safoury, Yasser A; Eldesoky, Mohamed T; Abutaleb, Enas E; Atteya, Mohamed R; Gabr, Ahmed M

2017-04-01

The transfer of latissimus dorsi and teres major tendons to rotator cuff have been developed to rebalance the muscular dysfunction and improve shoulder range of motion in children with obstetrical brachial plexus palsy (OBPP). No previous study reported the ideal postoperative physical therapy program for these cases. The aim of the present study was to design appropriate postoperative physical therapy (PT) program after latissimus dorsi and teres major tendons transfer to rotator cuff in OBPP to improve upper limb function. Time series design. The patients were recruited from outpatient clinic of Kasr EL Aini Hospital, Cairo, Egypt. Forty seven OBPP infants (4.64±1.21 years with a range of 2.5 to 7 years, 21male and26 female) were allocated to one group. All patients had functional limitation in the involved arm due to muscle paralysis and contracture. Twenty-five patients had C5-C6 nerve root lesions while 22 had C5-C6-C7 nerve root lesions. The children underwent the surgical procedures of the transfer of latissimus dorsi and teres major tendons to rotator cuff. After the surgery the children participated in a designed physical therapy program for 6 months. Active shoulder abduction, flexion and external rotation range of motion (ROM) were assessed by electrogoniometer, and functional assessments were measured using the modified Mallet scale. All measurements were taken preoperative, 6 weeks, 3 months, and 6 months postoperatively after the application of the designed PT program. Repeated measure analysis of variance (ANOVA) followed by Bonferroni post-hoc test were used to show the improvement in all measured variables. Analysis revealed that shoulder abduction, flexion and external rotation ROM and shoulder function measured by modified Mallet scale were significantly improved (P<0.0001) after the designed postoperative PT program. It can be concluded that the combination treatment of surgical procedure and the postoperative physical therapy program seem to be effective in improving shoulder and arm functions in children with OBPP. This study describes a detailed physical therapy program after latissimus dorsi and teres major tendons transfer to rotator cuff in OBPP.

An individual rehabilitation program: evaluation by Parkinsonian patients and their physiotherapists.

PubMed

Ory Magne, F; Fabre, N; Gu, C; Pastorelli, C; Tardez, S; Marchat, J-C; Marque, P; Brefel Courbon, C

2014-11-01

The purpose of this work was to study the feasibility of an individual Parkinson disease (PD) rehabilitation program based on each patient's prevalent symptoms and to determine the effects of this program on patient's quality of life as well as the level of patient's and physiotherapist's satisfaction with the program. In association with physiotherapists with expertise in PD, a physical medicine and rehabilitation physician, we elaborated a physical therapy program based on the core areas for physical therapy in PD: transfers; posture; balance and falls; physical capacity and inactivity. Within this program, we selected exercises tailored to each patient's main impairment and proposed this selection to their local physiotherapist for three months. Quality of life was evaluated with PDQ-39 at baseline and after three months of the individualized physical therapy program. We built an anonymous satisfaction questionnaire for patients and physiotherapists that was filled out at the end of the program. One hundred and three individuals with moderately advanced but clinically stable idiopathic PD were included. Significant improvement was found for the emotional well-being, bodily discomfort and stigma domain (P ≤ 0.05). No significant improvement was found for the other PDQ-39 domains. The mean global satisfaction figures for this program were 6.0 ± 2.4 and 7.2 ± 2.1 for patients and physiotherapists respectively. Most of the patients felt improved by the physiotherapy program and especially for transfer, balance, gait, and mobility. Our study found evidence of the potential benefits of a patient-tailored physiotherapy program. Such a program was feasible and had a favorable impact on patients' quality of life and on physiotherapists' practices for PD patients. Specific physiotherapy may be effective to limit physical mobility impairment. Our results also pointed out that physiotherapy may be efficient to confine the negative impact of social isolation, pain and emotional reactions. Such a program should be associated with a therapeutic education intervention such as encouraging patients to perform physical therapy exercises alone. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

The status of temporomandibular and cervical spine education in credentialed orthopedic manual physical therapy fellowship programs: a comparison of didactic and clinical education exposure.

PubMed

Shaffer, Stephen M; Brismée, Jean-Michel; Courtney, Carol A; Sizer, Phillip S

2015-02-01

The purpose of this investigation was to establish a baseline of physical therapist education on temporomandibular disorders (TMD)-related topics during credentialed orthopedic manual physical therapy fellowship training and compare it to cervical spine disorders education. An online survey was distributed electronically to each fellowship program credentialed by the American Physical Therapy Association (APTA) and recognized by the Academy of Orthopedic Manual Physical Therapists (AAOMPT). Data were analyzed to compare overall exposure to TMD educational content, including a direct comparison of TMD and cervical spine disorders education. The response rate was 79%. Thirteen programs (87%) reported providing both didactic and clinical training on both TMD and cervical spine disorders. Didactic education for cervical spine disorders ranged from 16-20 hours to over 25 hours, whereas TMD hours ranged from 0 to 6-10 hours. Clinical education for cervical spine disorders ranged from 11-15 hours to over 25 hours, whereas TMD hours ranged from 0 to 6-10 hours. The number of hours of exposure during didactic training and the number of patients exposed to during clinical training were significantly different when comparing TMD to cervical spine disorders exposure (P<0.0001). The data indicate a lack of uniformity between credentialed fellowship programs in orthopedic manual physical therapy with respect to the extent to which programs expose trainees to evaluation and management of TMD. There is consistency in that all programs provided more training on cervical spine disorders than TMD. Despite a high level of clinical specialization, fellows-in-training receive minimal TMD education.

The Role of the Physical Therapist and the Occupational Therapist in the School Setting. TIES: Therapy in Educational Settings. Revised.

ERIC Educational Resources Information Center

Hylton, Judith; And Others

The manual aims to assist occupational and physical therapists in describing the differences between school-based therapy and clinic-based therapy, recognizing the primary role of school-based therapy in special education, identifying the therapist's responsibilities in the Individualized Education Program development process, describing the…

Follow-up of the graduates of one curriculum. 1956-1980.

PubMed

Morrison, M A; Linder, M T; Aubert, E J

1982-09-01

A questionnaire was developed to obtain information from the graduates of the Marquette University Program in Physical Therapy from 1956, the year the program was established, to 1980. The response rate was 65 percent, with 433 graduates from 25 classes returning the questionnaire. The profile derived from the responses is of a graduate who remains employed in physical therapy full time or part-time, is satisfied with the undergraduate preparation received, and is a member of the American Physical Therapy Association. Compared with other studies, this survey reveals that lower percentages of physical therapy graduates are employed in hospital settings, higher percentages are earning graduate credits, and the dropout rate from the profession has decreased significantly. Other information obtained from the questionnaire is presented relating ti demographics, continuing education, and participation in professional organizations.

Teaching Physics as a Service Subject.

ERIC Educational Resources Information Center

Lowe, T. L.; Hayes, M.

1986-01-01

Discusses the need for physics to be taught to individuals in a wide variety of areas. Argues that the understanding of physics concepts enhances other fields. Proposes various ways to integrate physics into other programs. Gives examples of incorporating physics into speech therapy, environmental health and medical technology programs. (TW)

Simultaneous feedforward recruitment of the vasti in untrained postural tasks can be restored by physical therapy.

PubMed

Cowan, Sallie M; Bennell, Kim L; Hodges, Paul W; Crossley, Kay M; McConnell, Jenny

2003-05-01

Physical therapy rehabilitation strategies are commonly directed at the alteration of muscle recruitment in functional movements. The aim of this study was to investigate whether feedforward strategies of the vasti in people with patellofemoral pain syndrome can be changed by a physical therapy treatment program in a randomised, double blind, placebo controlled trial. Forty (25 female, 15 male) subjects aged 40 yrs or less (27.2+/-7.8 yrs). Subjects were allocated to either a placebo treatment or a physical therapy intervention program. The postural challenge used as the outcome measure was not included in the training program. Electromyography (EMG) onsets of vastus medialis obliquus (VMO), vastus lateralis (VL), tibialis anterior and soleus were assessed before and after the six week standardised treatment programs. At baseline the EMG onset of VL occurred prior to that of VMO in both subject groups. Following physical therapy intervention there was a significant change in the time of onset of EMG of VMO compared to VL with the onsets occurring simultaneously. This change was associated with a reduction in symptoms. In contrast, following placebo intervention the EMG onset of VL still occurred prior to that of VMO. The results indicate that the feedforward strategy used by the central nervous system to control the patella can be restored. Importantly, the data suggest that this intervention produced a change that was transferred to a task that was not specifically included in the training program. Furthermore, the change in motor control was associated with clinical improvement in symptoms.

Helping Older Adults Sustain Their Physical Therapy Gains: A Theory-Based Intervention to Promote Adherence to Home Exercise Following Rehabilitation.

PubMed

Gallagher, Kristel M

2016-01-01

The benefits of exercise gained by older adults during physical therapy are often not maintained once the program is over. This lack of sustained benefits is thought to be partially the result of poor adherence to the prescribed home exercise program to be continued once therapy is completed. Most of what is known about older adults' adherence to physical therapy and home exercise comes from research seeking to identify and understand predictors of adherence, rather than trying to enhance adherence explicitly. The purpose of this study was to test a theoretically grounded approach to promoting adherence to home exercise programs in older adults. Sixty older adults (M age = 69.3 (6.87) years) in a program of physical therapy received 1 of 2 print messages and magnets promoting adherence to home exercise. The content of the messages was informed by the goal-specific tenets of socioemotional selectivity theory-one message described the emotional and meaningful benefits of home exercise, such as time with loved ones and independence, and one message described facts and information about physiological benefits, such as balance and strength. Adherence to home exercise was measured 2 weeks after participants were discharged from physical therapy by calculating the percentage of the prescribed exercises participants reported completing at home. An analysis of covariance indicated that there was no statistically significant difference in adherence rates between participants receiving either message. However, a 2×2 analysis of covariance did reveal a significant interaction between the type of message participants received and the time at which they received that message. Post hoc analyses separately examined the rates of adherence in participants who received the intervention message with time remaining in their therapy program and participants who received the intervention message on the day of discharge. In the subset of participants who received their intervention message with time remaining in their therapy program, those who received the emotion and meaning message were somewhat more adherent to their home exercise program than those who received the facts and information message (63.6% vs 50.8%; P = .07). Those who received the emotion and meaning message also performed on average more exercises outside of their home exercise program (2.4 vs 1.3; P = .06). Despite lacking a statistically significant difference between message groups, the results of this study suggest that highlighting the emotional and meaningful benefits of home exercise versus providing facts and information about the physiological benefits may encourage older adults to be adherent to their home exercise programs. This may especially be the case if they receive the information while still in therapy. As this was the first study to empirically test an intervention targeting adherence to post-physical therapy home exercise in older adults, future research is needed to better understand what motivates older adults to be adherent.

Differences between the family-centered "COPCA" program and traditional infant physical therapy based on neurodevelopmental treatment principles.

PubMed

Dirks, Tineke; Blauw-Hospers, Cornill H; Hulshof, Lily J; Hadders-Algra, Mijna

2011-09-01

Evidence for effectiveness of pediatric physical therapy in infants at high risk for developmental motor disorders is limited. Therefore, "Coping With and Caring for Infants With Special Needs" (COPCA), a family-centered, early intervention program, was developed. The COPCA program is based on 2 components: (1) family involvement and educational parenting and (2) the neuromotor principles of the neuronal group selection theory. The COPCA coach uses principles of coaching to encourage the family's own capacities for solving problems of daily care and incorporating variation, along with trial and error in daily activities. The purpose of this study was to evaluate whether the content of sessions of the home-based, early intervention COPCA program differs from that of traditional infant physical therapy (TIP) sessions, which in the Netherlands are largely based on neurodevelopmental treatment. The study was conducted at the University Medical Center Groningen in the Netherlands. A quantitative video analysis of therapy sessions was conducted with infants participating in a 2-arm randomized trial. Forty-six infants at high risk for developmental motor disorders were randomly assigned to receive COPCA (n=21) or TIP (n=25) between 3 and 6 months corrected age. Intervention sessions were videotaped at 4 and 6 months corrected age and analyzed with a standardized observation protocol for the classification of physical therapy actions. Outcome parameters were relative amounts of time spent on specific physical therapy actions. The content of COPCA and TIP differed substantially. For instance, in TIP sessions, more time was spent on facilitation techniques, including handling, than in COPCA sessions (29% versus 3%, respectively). During COPCA, more time was spent on family coaching and education than during TIP (16% versus 4%, respectively). The major limitation of the study was its restriction to the Netherlands, implying that findings cannot be generalized automatically to other countries. The COPCA program differs broadly from TIP as applied in the Netherlands. Studies on the effectiveness of this family-centered program are needed.

Training and Utilization of the Physical Therapy Assistant; Policy Statement Adopted by the 1967 House of Delegates.

ERIC Educational Resources Information Center

American Physical Therapy Association, New York, NY.

The physical therapy assistant is defined as a skilled technical worker who assists the professional physical therapist in patient related activities and carries out designated tasks within a service administered by a professional physical therapist. Training standards require a 2-year college level program administered by a qualified physical…

The status of temporomandibular and cervical spine education in credentialed orthopedic manual physical therapy fellowship programs: a comparison of didactic and clinical education exposure

PubMed Central

Shaffer, Stephen M; Brismée, Jean-Michel; Courtney, Carol A; Sizer, Phillip S

2015-01-01

Objective: The purpose of this investigation was to establish a baseline of physical therapist education on temporomandibular disorders (TMD)-related topics during credentialed orthopedic manual physical therapy fellowship training and compare it to cervical spine disorders education. Method: An online survey was distributed electronically to each fellowship program credentialed by the American Physical Therapy Association (APTA) and recognized by the Academy of Orthopedic Manual Physical Therapists (AAOMPT). Data were analyzed to compare overall exposure to TMD educational content, including a direct comparison of TMD and cervical spine disorders education. Results: The response rate was 79%. Thirteen programs (87%) reported providing both didactic and clinical training on both TMD and cervical spine disorders. Didactic education for cervical spine disorders ranged from 16–20 hours to over 25 hours, whereas TMD hours ranged from 0 to 6–10 hours. Clinical education for cervical spine disorders ranged from 11–15 hours to over 25 hours, whereas TMD hours ranged from 0 to 6–10 hours. The number of hours of exposure during didactic training and the number of patients exposed to during clinical training were significantly different when comparing TMD to cervical spine disorders exposure (P<0.0001). Discussion: The data indicate a lack of uniformity between credentialed fellowship programs in orthopedic manual physical therapy with respect to the extent to which programs expose trainees to evaluation and management of TMD. There is consistency in that all programs provided more training on cervical spine disorders than TMD. Despite a high level of clinical specialization, fellows-in-training receive minimal TMD education. PMID:26674266

Mobile Plant Laboratory.

ERIC Educational Resources Information Center

Carrier, Judy

1979-01-01

Describing the North Carolina Botanical Garden's horticultural therapy program, which provides activity therapy for the mental and physical well-being of people of all ages, this article details an educational training program. Journal availabillity: see RC 503 504. (SB)

Occupational and Physical Therapy Services, School Based Programs: An Organizational Manual, 1982-83.

ERIC Educational Resources Information Center

McKee, Marlene, Comp.; And Others

A 1982-83 manual on school-based occupational therapy and physical therapy (OT/PT) services in Texas is presented. Contents include: guidelines, evaluation forms, student and therapists' documentation forms, and policy/procedures manuals for a suburban independent school district and a rural independent school district. Part I provides the…

76 FR 8748 - Loan Repayment Program for Repayment of Health Professions Educational Loans

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-15

... Nurse Anesthetists.). (l) Podiatry: D.P.M. (m) Physical Rehabilitation Services: Physical Therapy... program site determined by the Secretary. Loan repayment sites are characterized by physical, cultural... allopathic medicine, family medicine, internal medicine, pediatrics, geriatric medicine, obstetrics and...

Nursing, occupational therapy, and physical therapy preparation in rheumatology in the United States and Canada.

PubMed

Jette, A M; Becker, M C

1980-11-01

Directors of undergraduate programs in nursing, physical therapy, and occupational therapy in the United States and Canada were surveyed to determine the amount and perceived adequacy of the current degree of classroom and clinical exposure to the rheumatic diseases. One hundred ninety-one (73%) of the 262 mailed questionnaires were returned. Results indicate that regardless of the actual degree of rheumatologic classroom exposure, directors in all three disciplines view current amounts as adequate. A larger proportion views levels of clinical exposure as inadequate. In general, the Canadian programs had a greater emphasis on rheumatology than their United States counterparts.

Rehabilitation Aspects of Human Sexuality

PubMed Central

Madorsky, Julie G. Botvin; Dixon, Thomas P.

1983-01-01

The PLISSIT model is a comprehensive program that combines educational strategies with behavioral intervention to integrate human sexuality into the initial rehabilitation of spinal cord-injured persons. Sexuality is treated as a health care issue as important as bowel and bladder care, skin care, psychosocial issues, mobility, self-care and vocational concerns. Patients admitted to the Spinal Cord Injury Program are surrounded by a supportive milieu and an interdisciplinary staff who comfortably incorporate sexuality into discussions about catheter care, positioning, communication styles, assistive devices and so forth. Patients are exposed to a behavioral training program that makes available didactic lectures, group and individual sessions, bibliotherapy, films and opportunities for directed overnight sexual exploration within the hospital. We advocate that sex therapy be integrated into comprehensive rehabilitation programs along with physical therapy occupational therapy, recreation therapy and psychotherapy as an integral and effective form of functional restoration for patients with major physical disabilities. PMID:6636728

A National Survey of School-Based Physical Therapists and Secondary Transition Practices

ERIC Educational Resources Information Center

Doty, Antonette

2010-01-01

Researchers in the fields of physical therapy and special education transition have stated the need to explore how therapy programs impact the outcomes for transition-age students. Limited information exists to determine the level of involvement and role of physical therapists in secondary transition. In what transition activities are physical…

Curricular Integration and Measurement of Cultural Competence Development in a Group of Physical Therapy Students

ERIC Educational Resources Information Center

Palombaro, Kerstin M.; Dole, Robin L.; Black, Jill D.

2015-01-01

Introduction and Background: The link between cultural competence and effective physical therapy encounters is established. Physical therapist educational programs face the challenge of fostering the cultural competence of students in effective and meaningful ways within the curriculum. They also face the challenge of measuring the development of…

38 CFR 52.160 - Specialized rehabilitative services.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., but not limited to, physical therapy, speech therapy, occupational therapy, and mental health services for mental illness are required in the participant's comprehensive plan of care, program management...

Meeting the Challenge of Instructor Shortages: A Blended Teaching and Learning Model for a Neuroscience Course in a Doctor of Physical Therapy Program.

PubMed

Ge, Weiqing

2018-01-01

Physical therapy workforce shortages are expected to increase for all 50 states through 2030. There is a recognized nationwide unprecedented shortage of well-prepared physical therapy instructors. One practical solution can be to share instructors among Doctor of Physical Therapy (DPT) programs using a blended teaching and learning model. The purpose of this project was to evaluate the effectiveness of a blended teaching and learning model for a neuroscience course in a DPT program. Faculty members from two DPT programs collaborated to develop, implement, and evaluate a blended teaching and learning model. The Blackboard Learning Management System (LMS) was available at both institutions and chosen as the learning platform. The design of this research study was retrospective nonexperimental observational. The overall feedback from the students was positive. Most students (91.6%) strongly agreed or agreed that the content of the course was appropriate for learning neuroscience. The students taking this blended course performed slightly better than the students taking the traditional course, though there was no significant difference (p=0.06). The results support the use of a blended teaching and learning model to meet faculty shortage challenges. Future research with a larger sample size is necessary.

Investigating elementary education and physical therapy majors' perceptions of an inquiry-based physics content course

NASA Astrophysics Data System (ADS)

Hilton, John Martin

This study investigates why physical therapy assistant majors engage and perform better than elementary education majors in an inquiry-based conceptual physics course at Mid-Atlantic Community College. The students from each major are demographically similar, both courses are similar in depth and structure, and each course supports the students' program. However, there is an observed difference in the levels of engagement with the curriculum and performance on writing-based assessments between the two groups. To explore possible explanations for the difference, I examine students' affinity for science, their beliefs about the nature of science and scientific knowledge in the classroom, and their perception of the usefulness of science to their program. During semi-structured interviews, students from both majors displayed nearly identical weak affinities for science, epistemological beliefs, and uncertainty about the usefulness of the class. However, the physical therapy majors' ability to see the relevance of the physics course experience to their program enhanced their interest and motivation. In contrast, the elementary education students do not see connections between the course and their program, and do not see a purpose for their learning of physics content. To improve the program, I propose a two-pronged approach - designing a faded-scaffolded-inquiry approach for both classes, and developing a field-based/seminar class for the elementary education majors. The scaffolded inquiry will help both groups develop better orientations toward lab activities, and the structured observations and reflection will help the elementary group connect the material to their program.

Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.

PubMed

Archer, Kristin R; Devin, Clinton J; Vanston, Susan W; Koyama, Tatsuki; Phillips, Sharon E; George, Steven Z; McGirt, Matthew J; Spengler, Dan M; Aaronson, Oran S; Cheng, Joseph S; Wegener, Stephen T

2016-01-01

The purpose of this study was to determine the efficacy of a cognitive-behavioral-based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia. Randomization to either CBPT or an education program occurred at 6 weeks after surgery. Assessments were completed pretreatment, posttreatment and at 3-month follow-up. The primary outcomes were pain and disability measured by the Brief Pain Inventory and Oswestry Disability Index. Secondary outcomes included general health (SF-12) and performance-based tests (5-Chair Stand, Timed Up and Go, 10-Meter Walk). Multivariable linear regression analyses found that CBPT participants had significantly greater decreases in pain and disability and increases in general health and physical performance compared with the education group at the 3-month follow-up. Results suggest a targeted CBPT program may result in significant and clinically meaningful improvement in postoperative outcomes. CBPT has the potential to be an evidence-based program that clinicians can recommend for patients at risk for poor recovery after spine surgery. This study investigated a targeted cognitive-behavioral-based physical therapy program for patients after lumbar spine surgery. Findings lend support to the hypothesis that incorporating cognitive-behavioral strategies into postoperative physical therapy may address psychosocial risk factors and improve pain, disability, general health, and physical performance outcomes. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Community Travel for Physically Impaired Students.

ERIC Educational Resources Information Center

Millet Learning Center, Saginaw, MI.

The community travel program for physically impaired children at the Millet Learning Center (Saginaw, Michigan) blends skills from two professions: orientation and mobility, and physical therapy. Program goals include enabling students to overcome travel fears, to learn travel skills, to learn to make adaptations necessary for successful travel,…

Treatment-Based Classification versus Usual Care for Management of Low Back Pain

DTIC Science & Technology

2014-08-01

Doctoral Fellowship in Orthopaedic Manual Physical Therapy , San Antonio Military Medical Center, Fort Sam Hous- ton, Texas. N.W. Gill, PT, DSc, OCS, FAAOMPT...US Army–Baylor Uni- versity Doctor of Physical Therapy Program, Fort Sam Houston, Texas. [Rhon DI, Deyle GD, Gill NW. Clin- ical reasoning and...1234–1243.] © 2013 American Physical Therapy Association Published Ahead of Print: February 7, 2013 Accepted: February 4, 2013 Submitted: March 30, 2012

Effectiveness of Manual Therapy Combined With Physical Therapy in Treatment of Patellofemoral Pain Syndrome: Systematic Review.

PubMed

Espí-López, Gemma Victoria; Arnal-Gómez, Anna; Balasch-Bernat, Mercè; Inglés, Marta

2017-06-01

The purpose of this study was to conduct a review of randomized controlled trials (RCTs) to determine the treatment effectiveness of the combination of manual therapy (MT) with other physical therapy techniques. Systematic searches of scientific literature were undertaken on PubMed and the Cochrane Library (2004-2014). The following terms were used: "patellofemoral pain syndrome," "physical therapy," "manual therapy," and "manipulation." RCTs that studied adults diagnosed with patellofemoral pain syndrome (PFPS) treated by MT and physical therapy approaches were included. The quality of the studies was assessed by the Jadad Scale. Five RCTs with an acceptable methodological quality (Jadad ≥ 3) were selected. The studies indicated that MT combined with physical therapy has some effect on reducing pain and improving function in PFPS, especially when applied on the full kinetic chain and when strengthening hip and knee muscles. The different combinations of MT and physical therapy programs analyzed in this review suggest that giving more emphasis to proximal stabilization and full kinetic chain treatments in PFPS will help better alleviation of symptoms.

Inclusion of Medical-Legal Issues in Entry-Level Occupational and Physical Therapy Curricula.

ERIC Educational Resources Information Center

Ekelman, Beth A.; Goodman, Glenn; Dal Bello-Haas, Vanina

2000-01-01

Directors of 47 occupational therapy (OT) and 65 physical therapy (PT) accredited entry-level programs responded to a survey by indicating their support for inclusion of medical-legal issues in the curriculum. Only 40% of OT and 52% of PT directors believed lawyers should deliver instruction; most felt their faculty were qualified to teach these…

Graduate Education.

ERIC Educational Resources Information Center

Eng, Jacqueline; And Others

1991-01-01

Discusses the advantages of getting graduate degrees in pharmaceutical sciences, physical therapy, occupational therapy, nursing, and respiratory therapy. Looks at the cost of education, degrees offered, research and clinical options, availability of programs, and career options. (JOW)

Manual physical therapy and perturbation exercises in knee osteoarthritis.

PubMed

Rhon, Daniel; Deyle, Gail; Gill, Norman; Rendeiro, Daniel

2013-11-01

Knee osteoarthritis (OA) causes disability among the elderly and is often associated with impaired balance and proprioception. Perturbation exercises may help improve these impairments. Although manual physical therapy is generally a well-tolerated treatment for knee OA, perturbation exercises have not been evaluated when used with a manual physical therapy approach. The purpose of this study was to observe tolerance to perturbation exercises and the effect of a manual physical therapy approach with perturbation exercises on patients with knee OA. This was a prospective observational cohort study of 15 patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), global rating of change (GROC), and 72-hour post-treatment tolerance were primary outcome measures. Patients received perturbation balance exercises along with a manual physical therapy approach, twice weekly for 4 weeks. Follow-up evaluation was done at 1, 3, and 6 months after beginning the program. Mean total WOMAC score significantly improved (P = 0.001) after the 4-week program (total WOMAC: initial, 105; 4 weeks, 56; 3 months, 54; 6 months, 57). Mean improvements were similar to previously published trials of manual physical therapy without perturbation exercises. The GROC score showed a minimal clinically important difference (MCID)≥+3 in 13 patients (87%) at 4 weeks, 12 patients (80%) at 3 months, and 9 patients (60%) at 6 months. No patients reported exacerbation of symptoms within 72 hours following each treatment session. A manual physical therapy approach that also included perturbation exercises was well tolerated and resulted in improved outcome scores in patients with knee OA.

Development and outcomes of a program to translate the evidence for spinal manipulation into physical therapy practice

PubMed Central

Kramer, Christopher D; Koch, William H; Fritz, Julie M

2013-01-01

Objectives: To describe a program to translate evidence into practice for the use of manipulation with a sub-group of patients with low back pain and report the program's outcomes following implementation. We compared outcomes based on appropriate inclusion in the program and compliance with the evidence being translated. Methods: The evidence translation program was based on evidence that patients meeting two criteria (duration of symptoms <16 days, no symptoms distal to knee) were likely to respond to a physical therapy that included manipulation in the first two visits. Implementation addressed potential barriers with referring physicians, physical therapists, and scheduling staff to this evidence. Outcomes for patients in the program were tracked following implementation. Process outcomes were appropriateness of inclusion (met both criteria), compliance with evidence for providing thrust manipulation in the first two visits, and number of physical therapy visits. Clinical outcomes were based on Oswestry scores from the first, interim (after two to three visits), and final visit. Results: A total of 577 patients entered the evidence translation program (mean age  =  43.0, 56.8% female); 79.5% were appropriate inclusions and 83.0% received manipulation. The use of manipulation was associated with fewer visits (mean difference  =  0.54 visits, 95% CI: 0.037, 1.04, P  =  0.035), and appropriate inclusion was associated with greater Oswestry change (mean difference at the final visit  =  6.6 points, 95% CI: 1.6, 11.6; P  =  0.010). Discussion: Implementing evidence into practice is difficult; however, barriers can be anticipated and overcome. Tracking the outcomes of an implementation program is critical to evaluating its benefit to patients. Additional research using experimental designs are necessary to evaluate the effectiveness of various treatments implemented in physical therapy practice. PMID:24421630

Rehabilitation program for children with brachial plexus and peripheral nerve injury.

PubMed

Ramos, L E; Zell, J P

2000-03-01

An aggressive and integrated physical and occupational therapy program is essential in the treatment of congenital brachial plexus injuries and other severe upper extremity nerve injuries. This article addresses the evaluation, identification of needs, establishment of goals, and the approaches to rehabilitation treatment for patients with brachial plexus palsy and other peripheral nerve injuries. Rehabilitative therapy can preserve and build on gains made possible by medical or surgical interventions; however, therapy is vital to these children regardless of whether surgery is indicated. The therapist uses a problem-solving approach to evaluate the patient and select appropriate occupational and physical therapy treatment modalities. Therapy is continually adjusted based on each child's unique needs. An understanding of the therapy principles aids in making appropriate referrals and prescriptions, and helps to coordinate care between the therapist, pediatrician, neurologist, and surgeon.

Enhanced Exercise Therapy in Parkinson’s disease: A comparative effectiveness trial

PubMed Central

Ridgel, Angela L.; Walter, Benjamin L.; Tatsuoka, Curtis; Walter, Ellen M.; Colón-Zimmermann, Kari; Welter, Elisabeth; Sajatovic, Martha

2015-01-01

Objectives Exercise can improve motor function in people with Parkinson’s disease but depression reduces the motivation to participate in regular exercise. The aim of this study was to develop a novel Enhanced Exercise Therapy program that uses manual-driven guided exercise and peer-facilitated psychoeducation for individuals with Parkinson’s disease and depression. Design 24 week randomized controlled design. Methods Thirty individuals were randomized to Enhanced Exercise Therapy or self-guided therapy, and evaluated at baseline, 12-weeks and at 24-weeks. Enhanced Exercise Therapy included group exercise and group psychoeducation for 12 weeks. Between 13–24 weeks, individuals had access to the fitness facility but group sessions were not held. Self-guided therapy included written guidelines for a self-paced exercise program and psychoeducation. Primary outcome measures included the number of exercise sessions and International Physical Activity Questionnaire score. Secondary measures included resting heart rate, supine blood pressure, estimated VO2max and incidence of orthostatic hypotension. Results Twenty four individuals completed the study (80% retention) and both groups attended similar number of exercise sessions. There were no significant changes in cardiovascular fitness measures but there was a significant increase in the amount of physical activity in the Enhanced Exercise Therapy group and a decrease in the self-guided therapy group during the post-intervention period. Conclusions Enhanced exercise therapy appears to promote engagement in an exercise program and more physical activity, even after group sessions were concluded in individuals with Parkinson’s disease and depression. PMID:25709055

Comparing conventional physical therapy rehabilitation with neuromuscular electrical stimulation after TKA.

PubMed

Levine, Michael; McElroy, Karen; Stakich, Valerie; Cicco, Jodie

2013-03-01

Rehabilitation following total knee arthroplasty (TKA) is a costly, cumbersome, and often painful process. Physical therapy contributes to the successful outcome of TKA but can be expensive. Alternative methods of obtaining good functional results that help minimize costs are desirable. Neuromuscular electrical stimulation (NMES) is a potential option. Neuromuscular electrical stimulation has been shown to increase quadriceps muscle strength and activation following TKA. Functional scores also improve following TKA when NMES is added to conventional therapy protocols vs therapy alone. The authors hypothesized that rehabilitation managed by a physical therapist would not result in a functional advantage for patients undergoing TKA when compared with NMES and an unsupervised at-home range of motion exercise program and that patient satisfaction would not differ between the 2 groups. Seventy patients were randomized into a postoperative protocol of conventional physical therapy with a licensed therapist, including range of motion exercises and strengthening exercises, or into a program of NMES and range of motion exercises performed at home without therapist supervision. Noninferiority of the NMES program was obtained 6 weeks postoperatively (Knee Society pain/function scores, Western Ontario and McMaster Universities Osteoarthritis Index, flexion). Noninferiority was shown 6 months postoperatively for all parameters. The results suggest that rehabilitation managed by a physical therapist results in no functional advantage or difference in patient satisfaction when compared with NMES and an unsupervised at-home range of motion program. Neuromuscular electrical stimulation and unsupervised at-home range of motion exercises may provide an option for reducing the cost of the postoperative TKA recovery process without compromising quadriceps strength or patient satisfaction. Copyright 2013, SLACK Incorporated.

78 FR 7787 - Loan Repayment Program for Repayment of Health Professions Educational Loans

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

...: Physical Therapy, Occupational Therapy, Speech-Language Pathology, and Audiology: M.S. and D.P.T. (q... site determined by the Secretary. Loan repayment sites are characterized by physical, cultural, and..., internal medicine, pediatrics, geriatric medicine, obstetrics and gynecology, podiatric medicine, nursing...

Effect of Home Exercise Program Performance in Patients with Osteoarthritis of the Knee or the Spine on the Visual Analog Scale after Discharge from Physical Therapy

ERIC Educational Resources Information Center

Chen, Hamilton; Onishi, Kentaro

2012-01-01

The aim of our study was to assess the effect of the frequency of home exercise program (HEP) performance on pain [10-point visual analog scale (VAS)] in patients with osteoarthritis of the spine or knee after more than 6 months discharge from physical therapy (PT). We performed a retrospective chart review of 48 adult patients with a clinical…

Feasibility and safety of early combined cognitive and physical therapy for critically ill medical and surgical patients: the Activity and Cognitive Therapy in ICU (ACT-ICU) trial.

PubMed

Brummel, N E; Girard, T D; Ely, E W; Pandharipande, P P; Morandi, A; Hughes, C G; Graves, A J; Shintani, A; Murphy, E; Work, B; Pun, B T; Boehm, L; Gill, T M; Dittus, R S; Jackson, J C

2014-03-01

Cognitive impairment after critical illness is common and debilitating. We developed a cognitive therapy program for critically ill patients and assessed the feasibility and safety of administering combined cognitive and physical therapy early during a critical illness. We randomized 87 medical and surgical ICU patients with respiratory failure and/or shock in a 1:1:2 manner to three groups: usual care, early once-daily physical therapy, or early once-daily physical therapy plus a novel, progressive, twice-daily cognitive therapy protocol. Cognitive therapy included orientation, memory, attention, and problem-solving exercises, and other activities. We assessed feasibility outcomes of the early cognitive plus physical therapy intervention. At 3 months, we also assessed cognitive, functional, and health-related quality of life outcomes. Data are presented as median (interquartile range) or frequency (%). Early cognitive therapy was a delivered to 41/43 (95%) of cognitive plus physical therapy patients on 100% (92-100%) of study days beginning 1.0 (1.0-1.0) day following enrollment. Physical therapy was received by 17/22 (77%) of usual care patients, by 21/22 (95%) of physical therapy only patients, and 42/43 (98%) of cognitive plus physical therapy patients on 17% (10-26%), 67% (46-87%), and 75% (59-88%) of study days, respectively. Cognitive, functional, and health-related quality of life outcomes did not differ between groups at 3-month follow-up. This pilot study demonstrates that early rehabilitation can be extended beyond physical therapy to include cognitive therapy. Future work to determine optimal patient selection, intensity of treatment, and benefits of cognitive therapy in the critically ill is needed.

Feasibility and safety of early combined cognitive and physical therapy for critically ill medical and surgical patients: the Activity and Cognitive Therapy in ICU (ACT-ICU) trial

PubMed Central

Brummel, N.E.; Girard, T.D.; Ely, E.W.; Pandharipande, P.P.; Morandi, A.; Hughes, C.G.; Graves, A.J.; Shintani, A.K.; Murphy, E.; Work, B.; Pun, B.T.; Boehm, L.; Gill, T.M.; Dittus, R.S.; Jackson, J.C.

2013-01-01

PURPOSE Cognitive impairment after critical illness is common and debilitating. We developed a cognitive therapy program for critically ill patients and assessed the feasibility and safety of administering combined cognitive and physical therapy early during a critical illness. METHODS We randomized 87 medical and surgical ICU patients with respiratory failure and/or shock in a 1:1:2 manner to three groups: usual care, early once-daily physical therapy, or early once-daily physical therapy plus a novel, progressive, twice-daily cognitive therapy protocol. Cognitive therapy included orientation, memory, attention, and problem solving exercises, and other activities. We assessed feasibility outcomes of the early cognitive plus physical therapy intervention. At 3-months, we also assessed cognitive, functional and health-related quality of life outcomes. Data are presented as median [interquartile range] or frequency (%). RESULTS Early cognitive therapy was a delivered to 41/43 (95%) of cognitive plus physical therapy patients on 100% [92–100%] of study days beginning 1.0 [1.0–1.0] day following enrollment. Physical therapy was received by 17/22 (77%) of usual care patients, by 21/22 (95%) of physical therapy only patients and 42/43 (98%) of cognitive plus physical therapy patients on 17% [10–26%], 67% [46–87%] and 75% [59–88%] of study days, respectively. Cognitive, functional and health-related quality of life outcomes did not differ between groups at 3-month follow-up. CONCLUSIONS This pilot study demonstrates that early rehabilitation can be extended beyond physical therapy to include cognitive therapy. Future work to determine optimal patient selection, intensity of treatment and benefits of cognitive therapy in the critically ill is needed. PMID:24257969

THE LINDA CRANE MEMORIAL LECTURE: Striving for Excellence

PubMed Central

Hayes, Sherrill H

2010-01-01

Historically, invited lecturers have often challenged us to define excel lence in physical therapy practice, or in our academic programs. While some have addressed different char acteristics of excellence, our profession has not really come together to address 2 very important questions: what does “quality” mean in physical therapist education? And how do we measure it? Using 3 elements of Friendship, Leadership, and Mentoring, and Defining Excellence and juxtaposing these with Linda Crane and her life, a vision of excellence in physical therapy educational programs was explored in this invited lecture. The text of that lecture ensues. PMID:20520760

Art Therapy: A Creative Approach to the Care of Mentally Handicapped People.

ERIC Educational Resources Information Center

Males, Jeanne; Males, Bruce

1979-01-01

The article describes the art therapy program for the mentally handicapped at St. Lawrence's Hospital in England. The program, which also serves those retarded patients who are physically handicapped, functions as a diagnosic and assessment aid, direct therapeutic aid, part of an integrated treatment program, means of employment for some patients,…

Characteristics, perceptions, and other factors influencing physical therapist assistant program directors in 2001.

PubMed

Page, Catherine G

2003-01-01

Little is known about program directors in physical therapist assistant (PTA) programs. This study describes the characteristics of program directors in PTA programs, such as time spent on responsibilities, influences on decision making, perceptions of current working relationships, and satisfaction with decision making. Program directors of 153 (57.5%) accredited PTA programs responded to the survey. The self-reported data were generated by a mail survey developed by the investigator that included 32 demographic items and 58 Likert-scale items to meet the purpose of the study. The data suggest that PTA program directors have average to extremely good levels of satisfaction with their positions and spend more time on student-related and accreditation/long range planning activities than they do on other activities. Information on years of experience and types of degrees suggest that respondents have a great deal of physical therapy experience but much less experience in teaching and administration within community colleges. This information may be valuable for people who seek, or who are recruited for, PTA program director positions. It provides a foundational database for periodic studies of PTA program directors. As enrollments and new programs stabilize and as new program directors are appointed, their impact on physical therapy education and the profession must be reevaluated.

Physical Therapy for an Adult with Chronic Stroke after Botulinum Toxin Injection for Spasticity: A Case Report

PubMed Central

Phadke, Chetan P.; Ismail, Farooq; Boulias, Chris

2015-01-01

ABSTRACT Purpose: In this case report, we describe the type and duration of a physical therapy and botulinum toxin type A (BoNTA) intervention directed at lower limb spasticity and the gait and balance improvement in a patient post-stroke. Treatment of focal spasticity with BoNTA intramuscular injections combined with physical therapy is recommended by rehabilitation experts. However, the optimal type and duration of physical therapy intervention to optimize any functional gains that follow chemodenervation induced by BoNTA has not been established. Method: One individual with chronic stroke who received BoNTA injections for upper and lower extremity spasticity was included. Physical therapy intervention consisted of 45- to 60-min sessions twice weekly for 12 weeks, based on the Bobath–neurodevelopmental therapy approach, and an activity-based home program. Results: After BoNTA injections and physical therapy, the patient made clinically significant improvements in balance and gait speed and became more independent with his ambulation. Conclusions: This case report demonstrates that physical therapy after BoNTA injections can result in significant functional improvements for individuals with spasticity after chronic stroke that may not be possible with BoNTA injections alone. PMID:25931655

Manual therapy intervention for a patient with a total hip arthroplasty revision.

PubMed

Howard, Paul D; Levitsky, Beth

2007-12-01

Case report. A 73-year-old active woman with a total hip arthroplasty, who later had revision surgery, developed left hip and buttock pain 2 years after the revision surgery, subsequent to lifting her foot while seated. This movement was performed so that her spouse could assist her in putting on her sock and shoe. During the first physical therapy session, the patient exhibited a forward-flexed trunk posture and difficulty weight bearing on the involved lower limb. The patient was successfully treated with manual therapy techniques and a home exercise program. The manual therapy techniques included long-axis hip distraction, lateral hip distraction, posterior-to-anterior hip joint mobilization, and a contract-relax proprioceptive neuromuscular facilitation technique. The patient's home program consisted of long-axis hip distraction, performed by her spouse, and standing lower limb pendular movements into flexion and extension. Pain scale ratings, posture and gait observations, strength, range of motion, and return to functional activities served as outcome measures. After 1 physical therapy visit, in which manual therapy techniques were utilized, the patient had a significant decrease in hip symptoms. The patient and spouse were compliant with the home exercise program and continued with physical therapy for 3 more visits, and the patient ultimately became symptom free. The patient returned to all previous activities, including household chores, cooking, and a walking program. The patient was contacted at 6 months, 1 year, and 4 years, and reported no recurrences of hip or buttock symptoms. Manual therapy techniques and home exercises described in this case report were apparently effective in eliminating symptoms and returning this patient, who had total hip arthroplasty and revision surgery 2 years earlier, to all previous functional activities after a dressing incident produced hip and buttock symptoms.

Physical Therapy Machine

NASA Technical Reports Server (NTRS)

1989-01-01

Loredan Biomedical, Inc.'s LIDO, a computerized physical therapy system, was purchased by NASA in 1985 for evaluation as a Space Station Freedom exercise program. In 1986, while involved in an ARC muscle conditioning project, Malcom Bond, Loredan's chairman, designed an advanced software package for NASA which became the basis for LIDOSOFT software used in the commercially available system. The system employs a "proprioceptive" software program which perceives internal body conditions, induces perturbations to muscular effort and evaluates the response. Biofeedback on a screen allows a patient to observe his own performance.

The Relationship between the Physical Therapist Clinical Performance Instrument Scores and Doctor of Physical Therapy Student Learning Styles

ERIC Educational Resources Information Center

Courtright, Joachim

2017-01-01

INTRODUCTION. The learning style of a student is an important factor in their ability to gain knowledge. This is especially important in challenging curriculums such as the Doctor of Physical Therapy (DPT) program. A common tool to assess one's learning style is The Kolb Learning Styles Inventory (LSI). A common tool used to measure the…

Oral anatomy laboratory examinations in a physical therapy program.

PubMed

Fabrizio, Philip A

2013-01-01

The process of creating and administering traditional tagged anatomy laboratory examinations is time consuming for instructors and limits laboratory access for students. Depending on class size and the number of class, sections, creating, administering, and breaking down a tagged laboratory examination may involve one to two eight-hour days. During the time that a tagged examination is being created, student productivity may be reduced as the anatomy laboratory is inaccessible to students. Further, the type of questions that can be asked in a tagged laboratory examination may limit student assessment to lower level cognitive abilities and may limit the instructors' ability to assess the students' understanding of anatomical and clinical concepts. Anatomy is a foundational science in the Physical Therapy curriculum and a thorough understanding of anatomy is necessary to progress through the subsequent clinical courses. Physical therapy curricula have evolved to reflect the changing role of physical therapists to primary caregivers by introducing a greater scope of clinical courses earlier in the curriculum. Physical therapy students must have a thorough understanding of clinical anatomy early in the education process. However, traditional anatomy examination methods may not be reflective of the clinical thought processes required of physical therapy students. Traditional laboratory examination methods also reduce student productivity by limiting access during examination set-up and breakdown. To provide a greater complexity of questions and reduced overall laboratory time required for examinations, the Physical Therapy Program at Mercer University has introduced oral laboratory examinations for the gross anatomy course series. © 2012 American Association of Anatomists.

Smart watch-based coaching with tiotropium and olodaterol ameliorates physical activity in patients with chronic obstructive pulmonary disease

PubMed Central

Hataji, Osamu; Nishii, Yoichi; Ito, Kentaro; Sakaguchi, Tadashi; Saiki, Haruko; Suzuki, Yuta; D'Alessandro-Gabazza, Corina; Fujimoto, Hajime; Kobayashi, Tetsu; Gabazza, Esteban C.; Taguchi, Osamu

2017-01-01

Combined therapy with tiotropium and olodaterol notably improves parameters of lung function and quality of life in patients with chronic obstructive pulmonary disease (COPD) compared to mono-components; however, its effect on physical activity is unknown. The present study evaluated whether combination therapy affects daily physical performance in patients with COPD under a smart watch-based encouragement program. This was a non-blinded clinical trial with no randomization or placebo control. A total of 20 patients with COPD were enrolled in the present study. The patients carried an accelerometer for 4 weeks; they received no therapy during the first 2 weeks but they were treated with combined tiotropium and olodaterol under a smart watch-based encouragement program for the last 2 weeks. The pulmonary function test, COPD assessment test, 6-min walk distance and parameters of physical activity were significantly improved (P<0.05) by combination therapy under smart watch-based coaching compared with values prior to treatment. To the best of our knowledge, the present study for the first time provides evidence that smart watch-based coaching in combination with tiotropium and olodaterol may improve daily physical activity in chronic obstructive pulmonary disease. PMID:29104624

Smart watch-based coaching with tiotropium and olodaterol ameliorates physical activity in patients with chronic obstructive pulmonary disease.

PubMed

Hataji, Osamu; Nishii, Yoichi; Ito, Kentaro; Sakaguchi, Tadashi; Saiki, Haruko; Suzuki, Yuta; D'Alessandro-Gabazza, Corina; Fujimoto, Hajime; Kobayashi, Tetsu; Gabazza, Esteban C; Taguchi, Osamu

2017-11-01

Combined therapy with tiotropium and olodaterol notably improves parameters of lung function and quality of life in patients with chronic obstructive pulmonary disease (COPD) compared to mono-components; however, its effect on physical activity is unknown. The present study evaluated whether combination therapy affects daily physical performance in patients with COPD under a smart watch-based encouragement program. This was a non-blinded clinical trial with no randomization or placebo control. A total of 20 patients with COPD were enrolled in the present study. The patients carried an accelerometer for 4 weeks; they received no therapy during the first 2 weeks but they were treated with combined tiotropium and olodaterol under a smart watch-based encouragement program for the last 2 weeks. The pulmonary function test, COPD assessment test, 6-min walk distance and parameters of physical activity were significantly improved (P<0.05) by combination therapy under smart watch-based coaching compared with values prior to treatment. To the best of our knowledge, the present study for the first time provides evidence that smart watch-based coaching in combination with tiotropium and olodaterol may improve daily physical activity in chronic obstructive pulmonary disease.

Building Successes out of At-Risk Students: The Role of a Biology Foundations Course

ERIC Educational Resources Information Center

Beeber, Carla; Biermann, Carol A.

2007-01-01

The majority of students arriving at Kingsborough Community College with hopes of entering the nursing, physical therapist assistant, and other allied health programs (concentrations in pre-physical therapy, pre-occupational therapy, pre-pharmacy, and pre-physician's assistant) are at-risk students. A Foundations of Human Anatomy and Physiology…

Physical therapy for a child with sudden-onset choreoathetosis: a case report.

PubMed

Smith, Hilary J

2014-01-01

This case report describes the physical therapy examination, intervention, and outcomes for a 5-year-old girl who developed choreoathetosis following mitral valve repair. This child was admitted to an inpatient short-term rehabilitation program with marked choreoathetosis and dependence for all functional mobility. She received physical therapy twice a day for 5 weeks. Physical therapy intervention included therapeutic exercise emphasizing stabilization and closed chain exercises, aquatic therapy, and functional training to improve gross motor skills and mobility. Tests and measures included the Selective Control Assessment of the Lower Extremity, 66-item Gross Motor Function Measure, and Pediatric Evaluation of Disability Inventory. At discharge, this child demonstrated improvements in her Selective Control Assessment of the Lower Extremity, Gross Motor Function Measure, and Pediatric Evaluation of Disability Inventory scores. She was independent in all functional mobility tasks. This case study describes physical therapy tests and measures, intervention, and positive outcomes for a child with sudden-onset choreoathetosis.

Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

PubMed

Harnish, Andrew; Dieter, William; Crawford, Albert; Shubert, Tiffany E

2016-01-01

Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. The purpose of this study was to translate research findings into a "real world" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a "proof of concept" model for future programing. Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s ( p  = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 ( p  = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s ( p  < 0.0001). Participants did not experience any falls or hospitalizations, and two participants required physical therapy episodes of care. Implementing an evidence-based fall reduction program into a senior living program has a positive effect on strength, balance, fall risk, gait speed, fall rate, hospitalizations, and amount of physical therapy intervention.

Improving the Self-Image of the Socially Disabled

ERIC Educational Resources Information Center

Matthews, Lillian B.

1975-01-01

Reviewing the literature on physical attractiveness' relationship to selself-image and social acceptability, the author points out the need for self-care courses as "social therapy," gives a step-by-step procedure to develop such programs for the institutionalized, and tells how to become a teacher in a social therapy program. (AJ)

The use of objective measurements in the evaluation of therapy programs

NASA Technical Reports Server (NTRS)

Chaplin, H.

1974-01-01

The importance of objective measurements is discussed as a means of assessing the efficacy of physical and occupational therapy programs applied to patients recovering from neurological diseases. Considered are three primary categories of neurologically injured patients: patients with hemiplegia, patients with spinal cord injuries, and the heterogeneous group of cerebral palsy patients.

Do Differences in Programmatic Resource Investments Result in Different 3-Year Pass Rates on the U.S. National Physical Therapy Examination?

PubMed

Covington, Kyle; McCallum, Christine; Engelhard, Chalee; Landry, Michel D; Cook, Chad

2016-01-01

The rising cost of health professions education is well documented and a growing concern among educators; however, little is known about the implications of resource investment on student success. The objective of this study was to determine whether programs with higher National Physical Therapist Exam (NPTE) pass rates invested significantly more on programmatic resources. This observational study used data from the Commission on Accreditation in Physical Therapy Education's (CAPTE) Annual Accreditation Report including all accredited physical therapist programs from the United States who graduated physical therapist students in 2011. Resource expenditures were recorded as both raw and as an index variable (resources per student). Descriptive statistics and comparisons (using chi-square and t-tests) among programs with <100% and 100% pass rates were analyzed from 2009-2011. An ANCOVA was used to determine differences in raw resource expenditures and resource expenditures per student. There were no differences in raw resource expenditures between programs with <100% and 100% pass rates. Programs with 100% pass rates were provided more resource expenditures per student for personnel, overall budget, and core faculty. The results of this study suggest programs with 100% pass rates invested significantly more per student for selected resources.

Student Perceptions of Factors Influencing Success in Hybrid and Traditional DPT Programs: A Q-Sort Analysis

ERIC Educational Resources Information Center

Cherry, Lance; Blackinton, Mary

2017-01-01

There is a dearth of literature in physical therapy education regarding factors students believe to influence success, and little to no literature describing such beliefs related to hybrid education in the health professions or specific to physical therapy. The overarching purpose of this investigation was to determine students' perceptions of…

Theoretical Frames and Teaching Styles of Physical Therapy Faculty Who Lead International Service-Learning Experiences

ERIC Educational Resources Information Center

Audette, Jennifer Gail

2011-01-01

Purpose: International service-learning (ISL) is popular in higher education, and many physical therapy educational programs are adding ISL opportunities to their curricula because doing so aligns with student interest and the increasingly global nature of the profession. The faculty leading these experiences have not been studied. Nearly all…

Task Lists for Health Occupations. Radiologic Aide. Activity Aide. Optometric Assistant. Physical Therapy Aide. Education for Employment Task Lists.

ERIC Educational Resources Information Center

Lathrop, Janice

These task lists contain employability skills and tasks for the following health occupations: radiologic aide, activity aide, physical therapy aide, and optometric assistant. The duties and tasks found in these lists form the basis of instructional content for secondary, postsecondary, and adult occupational training programs. Employability skills…

Use of a pretest strategy for physical therapist assistant programs to predict success rate on the national physical therapy exam.

PubMed

Sloas, Stacey B; Keith, Becky; Whitehead, Malcolm T

2013-01-01

This study investigated a pretest strategy that identified physical therapist assistant (PTA) students who were at risk of failure on the National Physical Therapy Examination (NPTE). Program assessment data from five cohorts of PTA students (2005-2009) were used to develop a stepwise multiple regression formula that predicted first-time NPTE licensure scores. Data used included the Nelson-Denny Reading Test, grades from eight core courses, grade point average upon admission to the program, and scores from three mock NPTE exams given during the program. Pearson correlation coefficients were calculated between each of the 15 variables and NPTE scores. Stepwise multiple regression analysis was performed using data collected at the ends of the first, second, and third (final) semesters of the program. Data from the class of 2010 were then used to validate the formula. The end-of-program formula accounted for the greatest variance (57%) in predicted scores. Those students scoring below a predicted scaled score of 620 were identified to be at risk of failure of the licensure exam. These students were counseled, and a remedial plan was developed based on regression predictions prior to them sitting for the licensure exam.

A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy.

PubMed

Franki, Inge; Van den Broeck, Christine; De Cat, Josse; Tijhuis, Wieke; Molenaers, Guy; Vanderstraeten, Guy; Desloovere, Kaat

2014-10-01

A pilot study to compare the effectiveness of an individual therapy program with the effects of a general physical therapy program. A randomized, single-blind cross-over design. Ten ambulant children with bilateral spastic cerebral palsy, age four to nine years. Participants were randomly assigned into a ten-week individually defined, targeted or a general program, followed by a cross-over. Evaluation was performed using the Gross Motor Function Measure-88 and three-dimensional gait analysis. General outcome parameters were Gross Motor Function Measure-88 scores, time and distance parameters, gait profile score and movement analysis profiles. Individual goal achievement was evaluated using z-scores for gait parameters and Goal Attainment Scale for gross motor function. No significant changes were observed regarding gross motor function. Only after individualized therapy, step- and stride-length increased significantly (p = 0.022; p = 0.017). Change in step-length was higher after the individualized program (p = 0.045). Within-group effects were found for the pelvis in transversal plane after the individualized program (p = 0.047) and in coronal plane after the general program (p = 0.047). Between-program differences were found for changes in the knee in sagittal plane, in the advantage of the individual program (p = 0.047). A median difference in z-score of 0.279 and 0.419 was measured after the general and individualized program, respectively. Functional goal attainment was higher after the individual therapy program compared with the general program (48 to 43.5). The results indicate slightly favorable effects towards the individualized program. To detect clinically significant changes, future studies require a minimal sample size of 72 to 90 participants. © The Author(s) 2014.

The Influence of Patient Choice of First Provider on Costs and Outcomes: Analysis From a Physical Therapy Patient Registry.

PubMed

Denninger, Thomas R; Cook, Chad E; Chapman, Cole G; McHenry, Timothy; Thigpen, Charles A

2018-02-01

Study Design Retrospective study. Background Alternative models of care that allow patients to choose direct access to physical therapy have shown promise in terms of cost reduction for neck and back pain. However, real-world exploration within the US health care system is notably limited. Objectives To compare total claims paid and patient outcomes for patients with neck and back pain who received physical therapy intervention via direct access versus medical referral. Methods Data were accessed for patients seeking care for neck or back pain (n = 603) between 2012 and 2014, who chose to begin care either through traditional medical referral or direct access to a physical therapy- led spine management program. All patients received a standardized, pragmatic physical therapy approach, with patient-reported measures of pain and disability assessed before and after treatment. Patient demographics and outcomes data were obtained from the medical center patient registry and combined with total claims paid calculated for the year after the index claim. Linear mixed-effects modeling was used to analyze group differences in pain and disability, visits/time, and annualized costs. Results Patients who chose to enter care via the direct-access physical therapy-led spine management program displayed significantly lower total costs (mean difference, $1543; 95% confidence interval: $51, $3028; P = .04) than those who chose traditional medical referral. Patients in both groups showed clinically important improvements in pain and disability, which were similar between groups (P>.05). Conclusion The initial patient choice to begin care with a physical therapist for back or neck pain resulted in lower cost of care over the next year, while resulting in similar improvements in patient outcomes at discharge from physical therapy. These findings add to the emerging literature suggesting that patients' choice to access physical therapy through direct access may be associated with lower health care expenditures for patients with neck and back pain. Level of Evidence Economic and decision analyses, level 4. J Orthop Sports Phys Ther 2018;48(2):63-71. Epub 26 Oct 2017. doi:10.2519/jospt.2018.7423.

Academicians and Neurologic Physical Therapy Residents Partner to Expand Clinical Reflection Using the SOLO Taxonomy: A Novel Approach.

PubMed

Pinto Zipp, Genevieve; Maher, Catherine; Donnelly, Erin; Fritz, Brian; Snowdon, Lauren

2016-01-01

Creating curriculums that develop physical therapy (PT) students into evidenced-based, critically reflective, entry-level practitioners is one of the primary goals for PT programs. Academic faculty partnering with neurologic residency programs to design learning environments that capitalize upon the strengths of both can create insightful educational experiences for students during their didactic training. These partnerships support the development of critical thinking skills and provide mentorship for residents transitioning from their role as a clinician to that of an educator. Using the SOLO (structure of observed learning outcomes) taxonomy as a framework for developing learning experiences, Seton Hall University neurologic academic faculty and program directors from the Kessler Institute for Rehabilitation Residency in Neurologic Physical Therapy have built a partnership that seeks to develop critical reflection skills in both the neurologic resident and entry-level PT students. While integration of residents into entry-level PT curriculum may not be novel, we believe that utilizing the SOLO model within this partnership is unique. This paper describes the partnership and learning experiences rooted in the SOLO taxonomy theoretical framework and discusses perceived benefits of this learning experience across professional health science programs.

38 CFR 52.160 - Specialized rehabilitative services.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., but not limited to, physical therapy, speech therapy, occupational therapy, and mental health services for mental illness are required in the participant's comprehensive plan of care, program management... AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.160...

Diagnostic and procedural imaging curricula in physical therapist professional degree programs.

PubMed

Boissonnault, William G; White, Douglas M; Carney, Sara; Malin, Brittany; Smith, Wayne

2014-08-01

Descriptive survey. To describe the status of diagnostic and procedural imaging curricula within United States physical therapist professional degree programs. As patient direct access to physical therapy services increases, the ability to refer patients directly for diagnostic imaging could promote more efficient delivery of care. Appropriate patient referral is contingent on physical therapists having the requisite knowledge base and skills. While evidence describing imaging competence of physical therapists with advanced training in military institutions exists, evidence is lacking for other physical therapists, including new graduates of physical therapist professional degree programs. Faculty members teaching imaging at 206 United States physical therapist professional degree programs recognized by the Commission on Accreditation in Physical Therapy Education were recruited via e-mail correspondence. An e-mail attachment included the survey on which faculty reported imaging curricula and faculty qualifications, attitudes, and experiences. Faculty from 155 (75.2%) programs responded to the survey, with imaging being included in the curriculum of 152 programs. Content was integrated by required standalone courses or clinical science track courses, and/or through elective courses. The average reported estimate of imaging contact hours was 24.4 hours (range, 2-75 hours). Emphasis was on the musculoskeletal system, including 76.3% of the required standalone course content. Student competence was assessed in 147 (96.7%) programs, primarily by written (66.7%) and practical (19.7%) examinations. Faculty rated student competence on a scale of 1 (not competent) to 5 (competent), with ratings ranging from a high of 4.0 (identifying normal anatomy on plain-film radiography) to a low of 1.9 (identifying common tissue pathological processes/injuries on ultrasound). While a majority of programs reported including imaging curricula, variability was noted in all curricular aspects. These results may serve as a benchmark for faculty to assess existing curricula, allow for further development of imaging curricula, and provide a benchmark for the profession regarding current level of training for recent graduates of entry-level physical therapist professional degree programs.

Group physical therapy for veterans with knee osteoarthritis: study design and methodology.

PubMed

Allen, Kelli D; Bongiorni, Dennis; Walker, Tessa A; Bartle, John; Bosworth, Hayden B; Coffman, Cynthia J; Datta, Santanu K; Edelman, David; Hall, Katherine S; Hansen, Gloria; Jennings, Caroline; Lindquist, Jennifer H; Oddone, Eugene Z; Senick, Margaret J; Sizemore, John C; St John, Jamie; Hoenig, Helen

2013-03-01

Physical therapy (PT) is a key component of treatment for knee osteoarthritis (OA) and can decrease pain and improve function. Given the expected rise in prevalence of knee OA and the associated demand for treatment, there is a need for models of care that cost-effectively extend PT services for patients with this condition. This manuscript describes a randomized clinical trial of a group-based physical therapy program that can potentially extend services to more patients with knee OA, providing a greater number of sessions per patient, at lower staffing costs compared to traditional individual PT. Participants with symptomatic knee OA (n = 376) are randomized to either a 12-week group-based PT program (six 1 h sessions, eight patients per group, led by a physical therapist and physical therapist assistant) or usual PT care (two individual visits with a physical therapist). Participants in both PT arms receive instruction in an exercise program, information on joint care and protection, and individual consultations with a physical therapist to address specific functional and therapeutic needs. The primary outcome is the Western Ontario and McMasters Universities Osteoarthritis Index (self-reported pain, stiffness, and function), and the secondary outcome is the Short Physical Performance Test Protocol (objective physical function). Outcomes are assessed at baseline and 12-week follow-up, and the primary outcome is also assessed via telephone at 24-week follow-up to examine sustainability of effects. Linear mixed models will be used to compare outcomes for the two study arms. An economic cost analysis of the PT interventions will also be conducted. Published by Elsevier Inc.

Sport Skills for Students with Disabilities: A Collaborative Effort.

ERIC Educational Resources Information Center

Kasser, Susan L.; And Others

1997-01-01

Provides justification for a cross-disciplinary approach to program delivery in physical education for students with physical and cognitive disabilities. Details the positive outcomes possible through a bidirectional relationship between physical education and physical therapy and presents guidelines for collaboration and for sport skill…

Recipe for Success.

ERIC Educational Resources Information Center

Kimeldorf, Martin; Strawn, Laura

1983-01-01

Describes a special curriculum devised to teach cooking to a physically disabled high school student, a program which also served as physical therapy. Key ingredients included individualization, kitchen accessibility, and peer tutoring. (SK)

The Art Studio: A Studio-Based Art Therapy Program.

ERIC Educational Resources Information Center

McGraw, Mary K.

1995-01-01

Describes the history and development of the Art Studio, a studio-based art therapy program in Cleveland, Ohio, and discusses specific patient needs that are uniquely addressed by the Art Studio model. The Art Studio was developed for use by medically ill and physically disabled persons, and is the result of a unique cooperative relationship…

Implementing an Evidence Based Preceptorship Program in a Military Center

DTIC Science & Technology

2014-11-05

included 34 interdisciplinary staff (Rehab, Education, Respiratory Therapy , and Clinic Staff), Staff Nurses (n=43) and 100% of identified preceptors (n...program. VNIP training (n=110) included 34 interdisciplinary staff (Rehab, Education, Respiratory Therapy , and Clinic Staff), Staff Nurses (n=43...disciplines (Administrative Leaders, Specialties to include: burn clinic, respiratory, occupational, and physical therapists). -VNIP Course Evaluation

Comparing the effects of manual therapy versus electrophysical agents in the management of knee osteoarthritis.

PubMed

Ali, Syed Shahzad; Ahmed, Syed Imran; Khan, Muhammad; Soomro, Rabail Rani

2014-07-01

To evaluate the effectiveness of Manual Therapy in comparison to Electrophysical agents in Knee Osteoarthritis. Total 50 patients with knee osteoarthritis were recruited from OPD of orthopedics civil hospital and Institute Of Physical Medicine & Rehabilitation, Dow University of Health Sciences Karachi. All those patients who fulfilled inclusion criteria were selected on voluntary basis. Selected patients were equally divided and randomly assigned into two groups with age and gender matching. The Manual therapy group received program of Maitland joint mobilization whereas Electrophysical Agent group received a program of TENS and cold pack. Both group received a program of exercise therapy as well. Patients received 3 treatment sessions per week for 4 successive weeks. Clinical assessment was performed using WOMAC index at baseline and on 12th treatment session. Both study groups showed clinically and statistically considerable improvements in WOMAC index. However, Related 2 sample t-test showed better clinical results in Manual Therapy group (p = 0.000) than Electrophysical Agents group (p = 0.008). The mean improvement in total WOMAC index was relatively higher in Manual Therapy group (22.36 ± 13.91) than Electrophysical Agent group (9.72 ± 6.10). This study concluded that manual therapy is clinically more effective in decreasing pain, stiffness and improving physical function in knee osteoarthritis.

Conventional physical therapy and physical therapy based on reflex stimulation showed similar results in children with myelomeningocele.

PubMed

Aizawa, Carolina Y P; Morales, Mariana P; Lundberg, Carolina; Moura, Maria Clara D Soares de; Pinto, Fernando C G; Voos, Mariana C; Hasue, Renata H

2017-03-01

We aimed to investigate whether infants with myelomeningocele would improve their motor ability and functional independence after ten sessions of physical therapy and compare the outcomes of conventional physical therapy (CPT) to a physical therapy program based on reflex stimulation (RPT). Twelve children were allocated to CPT (n = 6, age 18.3 months) or RPT (n = 6, age 18.2 months). The RPT involved proprioceptive neuromuscular facilitation. Children were assessed with the Gross Motor Function Measure and the Pediatric Evaluation of Disability Inventory before and after treatment. Mann-Whitney tests compared the improvement on the two scales of CPT versus RPT and the Wilcoxon test compared CPT to RPT (before vs. after treatment). Possible correlations between the two scales were tested with Spearman correlation coefficients. Both groups showed improvement on self-care and mobility domains of both scales. There were no differences between the groups, before, or after intervention. The CPT and RPT showed similar results after ten weeks of treatment.

Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial.

PubMed

Hoeksma, Hugo L; Dekker, Joost; Ronday, H Karel; Heering, Annet; van der Lubbe, Nico; Vel, Cees; Breedveld, Ferdinand C; van den Ende, Cornelia H M

2004-10-15

To determine the effectiveness of a manual therapy program compared with an exercise therapy program in patients with osteoarthritis (OA) of the hip. A single-blind, randomized clinical trial of 109 hip OA patients was carried out in the outpatient clinic for physical therapy of a large hospital. The manual therapy program focused on specific manipulations and mobilization of the hip joint. The exercise therapy program focused on active exercises to improve muscle function and joint motion. The treatment period was 5 weeks (9 sessions). The primary outcome was general perceived improvement after treatment. Secondary outcomes included pain, hip function, walking speed, range of motion, and quality of life. Of 109 patients included in the study, 56 were allocated to manual therapy and 53 to exercise therapy. No major differences were found on baseline characteristics between groups. Success rates (primary outcome) after 5 weeks were 81% in the manual therapy group and 50% in the exercise group (odds ratio 1.92, 95% confidence interval 1.30, 2.60). Furthermore, patients in the manual therapy group had significantly better outcomes on pain, stiffness, hip function, and range of motion. Effects of manual therapy on the improvement of pain, hip function, and range of motion endured after 29 weeks. The effect of the manual therapy program on hip function is superior to the exercise therapy program in patients with OA of the hip.

Attitudes of students in medicine, nursing, occupational therapy, and physical therapy toward interprofessional education.

PubMed

Rose, Molly A; Smith, Kellie; Veloski, J Jon; Lyons, Kevin J; Umland, Elena; Arenson, Christine A

2009-01-01

With the growing interest in interprofessional education and practice, methods to evaluate the effectiveness of related curricular activities are essential. The purpose of this study was twofold: (1) to assess the attitudes of students in medicine, nursing, occupational therapy, and physical therapy toward interprofessional education using the Interdisciplinary Education Perception Scale and Readiness for Interprofessional Learning Scale and (2) to compare data with normative data previously reported. The two instruments were administered to 474 first-year students in medicine, nursing, occupational therapy, and physical therapy who completed the forms in the context of a workshop at the conclusion of the first year of an interprofessional health mentor program. Differences among professions were reported. Students in medicine and physical therapy rated members of their own professions significantly higher in the areas of competence/autonomy and need for cooperation as compared with those in nursing and occupational therapy. Along with reporting similarities and differences, the results provide additional normative data on these tools that can be used when choosing tools to evaluate interprofessional education attitudes.

"Our Hands Will Know": The Development of Tactile Diagnostic Skill--Teaching, Learning, and Situated Cognition in a Physical Therapy Program.

ERIC Educational Resources Information Center

Rose, Mike

1999-01-01

Examines, within a situated-cognition framework, the teaching and learning of a concept in biomechanics, the manual techniques and tactile discrimination skills that accompany it, and the diagnostic frame of mind that informs concept, technique, and skill. Draws on observations of a class of physical-therapy students. (Author/SLD)

Case Report Writing in a Doctor of Physical Therapy Education Program: A Case Study

ERIC Educational Resources Information Center

Fillyaw, Michael J.

2011-01-01

Case reports are an established form of scholarship used for teaching and learning in medicine and health care, but there are few examples of the teaching and learning activities used to prepare students to write a case report. This report describes the implementation of two courses that prepare physical therapy students to write and disseminate a…

Brain and Nerves of the Human Body: A Programmed Text and Plate Booklet for Physical Therapy Aides.

ERIC Educational Resources Information Center

Kristy, Jean; McDaniel, Lucy V.

Designed by physical therapists on the basis of results of job analysis and tested with several individual and two small groups, this programed text and plate booklet are intended for either individual or group use in a hospital or junior college program. It is suggested that some discussion, demonstration, and application sessions be arranged in…

The Stoplight Program: A Proactive Physical Therapy Intervention for Children With Acute Lymphoblastic Leukemia.

PubMed

Tanner, Lynn; Sencer, Susan; Hooke, Mary C

Chemotherapy may cause neuromuscular impairments that can have life-long effects. The Stoplight Program (SLP) was developed as a proactive physical therapy (PT) intervention directed at impairments in children with acute lymphoblastic leukemia (ALL). In this program evaluation, we assessed the feasibility of the SLP delivered as part of standard care and identified body function and activity patterns in patients who received the intervention. Children ages 1 to 22 years, diagnosed with ALL, received an assessment by a physical therapist as part of usual care. The SLP intervention used 3 levels to categorize the impairment levels and intensity of PT. Of the children (n = 135) screened, 46% completed 5 intervention visits and 32% completed the program and met discharge criteria. At initial assessment, 46% of children ages 1 to 5 years and 67% of children ages 6 to 22 years had abnormal motor function. Those completing the program tested within the healthy norms. Research is needed on variables that influence adherence to a PT program and the range of functional impairment and activity limitations in this population.

Role of conceptual models in a physical therapy curriculum: application of an integrated model of theory, research, and clinical practice.

PubMed

Darrah, Johanna; Loomis, Joan; Manns, Patricia; Norton, Barbara; May, Laura

2006-11-01

The Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada, recently implemented a Master of Physical Therapy (MPT) entry-level degree program. As part of the curriculum design, two models were developed, a Model of Best Practice and the Clinical Decision-Making Model. Both models incorporate four key concepts of the new curriculum: 1) the concept that theory, research, and clinical practice are interdependent and inform each other; 2) the importance of client-centered practice; 3) the terminology and philosophical framework of the World Health Organization's International Classification of Functioning, Disability, and Health; and 4) the importance of evidence-based practice. In this article the general purposes of models for learning are described; the two models developed for the MPT program are described; and examples of their use with curriculum design and teaching are provided. Our experiences with both the development and use of models of practice have been positive. The models have provided both faculty and students with a simple, systematic structured framework to organize teaching and learning in the MPT program.

Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program.

PubMed

Deyle, Gail D; Allison, Stephen C; Matekel, Robert L; Ryder, Michael G; Stang, John M; Gohdes, David D; Hutton, Jeremy P; Henderson, Nancy E; Garber, Matthew B

2005-12-01

Manual therapy and exercise have not previously been compared with a home exercise program for patients with osteoarthritis (OA) of the knee. The purpose of this study was to compare outcomes between a home-based physical therapy program and a clinically based physical therapy program. One hundred thirty-four subjects with OA of the knee were randomly assigned to a clinic treatment group (n=66; 61% female, 39% male; mean age [+/-SD]=64+/-10 years) or a home exercise group (n=68, 71% female, 29% male; mean age [+/-SD]=62+/-9 years). Subjects in the clinic treatment group received supervised exercise, individualized manual therapy, and a home exercise program over a 4-week period. Subjects in the home exercise group received the same home exercise program initially, reinforced at a clinic visit 2 weeks later. Measured outcomes were the distance walked in 6 minutes and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Both groups showed clinically and statistically significant improvements in 6-minute walk distances and WOMAC scores at 4 weeks; improvements were still evident in both groups at 8 weeks. By 4 weeks, WOMAC scores had improved by 52% in the clinic treatment group and by 26% in the home exercise group. Average 6-minute walk distances had improved about 10% in both groups. At 1 year, both groups were substantially and about equally improved over baseline measurements. Subjects in the clinic treatment group were less likely to be taking medications for their arthritis and were more satisfied with the overall outcome of their rehabilitative treatment compared with subjects in the home exercise group. Although both groups improved by 1 month, subjects in the clinic treatment group achieved about twice as much improvement in WOMAC scores than subjects who performed similar unsupervised exercises at home. Equivalent maintenance of improvements at 1 year was presumably due to both groups continuing the identical home exercise program. The results indicate that a home exercise program for patients with OA of the knee provides important benefit. Adding a small number of additional clinical visits for the application of manual therapy and supervised exercise adds greater symptomatic relief.

Restoration of physical performance capacity of athletes after prolonged restriction of their motor activity

NASA Technical Reports Server (NTRS)

Soldatov, A. D.; Finogeyev, V. I.

1980-01-01

The effects of different regimens of treatment following prolonged hypokinesia were studied in order to determine the most effective program. The types of programs considered were passive means, consisting of physical therapy; active means, consisting of athletic training; and a combined program. In the first stage of the experiment, the effects of a 10 day period of hypokinesia were studied. It was determined that the restoration programs must address the problems of: (1) increasing defense function and general tone of the body; (2) restore orthostatic stability; and (3) increase general endurance. In later stages, groups of athletes and nonathletes underwent 30 day periods of hypokinesia. Restoration was carefully monitored for groups treated with the various regimens. It was determined that the most effective treatment was a comprehensive program of passive and active therapy.

A comparison of two manual physical therapy approaches and electrotherapy modalities for patients with knee osteoarthritis: A randomized three arm clinical trial.

PubMed

Kaya Mutlu, Ebru; Ercin, Ersin; Razak Ozdıncler, Arzu; Ones, Nadir

2018-08-01

A broad spectrum of physical therapy exercise programs provides symptom relief and functional benefit for patients with knee OA. Manual physical therapy, including tailored exercise programs provide relatively higher level benefit that persists to one year. It is currently unknown if there are important differences in the effects of different manual physical therapy techniques for patients with knee OA and there are virtually no studies comparing manual physical therapy and electrotherapy modalities. The aim of the study was to compare long-term results between three treatment groups (mobilization with movements [MWMs], passive joint mobilization [PJM], and electrotherapy) to determine which treatment is most effective in patients with knee OA. A single-blind randomized clinical trial with parallel design was conducted in patients with knee OA. Seventy-two consecutive patients (mean age 56.11 ± 6.80 years) with bilateral knee OA were randomly assigned to one of three treatment groups: MWMs, PJM, and electrotherapy. All groups performed an exercise program and received 12 sessions. The primary outcome measures of the functional assessment were the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and Aggregated Locomotor Function (ALF) test scores. The secondary outcome measures were pain level, measured using a pressure algometer and a visual analogue scale (VAS), range of motion (ROM), measured using a digital goniometer, and muscle strength, evaluated with a handheld dynamometer. Patients were assessed before treatment, after treatment and after 1 year of follow-up. Patients receiving the manual physical therapy interventions consisting of either MWM or PJM demonstrated a greater decrease in VAS scores at rest, during functional activities, and during the night compared to those in the electrotherapy group from baseline to after the treatment (p < 0.05). This improvement continued at the 1-year follow-up (p < 0.05). The MWMs and PJM groups also showed significantly improved WOMAC and ALF scores, knee ROM and quadriceps muscle strength compared to those in the electrotherapy group from baseline to 1-year follow-up (p < 0.05). In the treatment of patients with knee OA, manual physical therapy consisting of either MWM or PJM provided superior benefit over electrotherapy in terms of pain level, knee ROM, quadriceps muscle strength, and functional level.

Opportunities for Regenerative Rehabilitation and Advanced Technologies in Physical Therapy: Perspective From Academia.

PubMed

Norland, Ryan; Muchnick, Matthew; Harmon, Zachary; Chin, Tiffany; Kakar, Rumit Singh

2016-04-01

As rehabilitation specialists, physical therapists must continue to stay current with advances in technologies to provide appropriate rehabilitation protocols, improve patient outcomes, and be the preferred clinician of choice. To accomplish this vision, the physical therapy profession must begin to develop a culture of lifelong learning at the early stages of education and clinical training in order to embrace cutting-edge advancements such as stem cell therapies, tissue engineering, and robotics, to name a few. The purposes of this article are: (1) to provide a current perspective on faculty and graduate student awareness of regenerative rehabilitation concepts and (2) to advocate for increased integration of these emerging technologies within the doctor of physical therapy (DPT) curriculum. An online survey was designed to gauge awareness of principles in regenerative rehabilitation and to determine whether the topic was included and assessed in doctoral curricula. The survey yielded 1,006 responses from 82 DPT programs nationwide and indicated a disconnect in familiarity with the term "regenerative rehabilitation" and awareness of the inclusion of this material in the curriculum. To resolve this disconnect, the framework of the curriculum can be used to integrate new material via guest lecturers, interdisciplinary partnerships, and research opportunities. Successfully mentoring a generation of clinicians and rehabilitation scientists who incorporate new medical knowledge and technology into their own clinical and research practice depends greatly on sharing the responsibility among graduate students, professors, the American Physical Therapy Association (APTA), and DPT programs. Creating an interdisciplinary culture and integrating regenerative medicine and rehabilitation concepts into the curriculum will cultivate individuals who will be advocates for interprofessional behaviors and will ensure that the profession meets the goals stated in APTA Vision 2020. © 2016 American Physical Therapy Association.

42 CFR 484.4 - Personnel qualifications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... successful completion of a physical therapist education program approved by one of the following: (i) The Commission on Accreditation in Physical Therapy Education (CAPTE). (ii) Successor organizations of CAPTE... physical therapist entry-level education in the United States by a credentials evaluation organization...

A comparison of home-based exercise programs with and without self-manual therapy in individuals with knee osteoarthritis in community.

PubMed

Cheawthamai, Kornkamon; Vongsirinavarat, Mantana; Hiengkaew, Vimonwan; Saengrueangrob, Sasithorn

2014-07-01

The present study aimed to compare the effectiveness of the treatment programs of home-based exercise with and without self-manual therapy in individuals with knee osteoarthritis (knee OA) in community. Forty-three participants with knee OA were randomly assigned in groups. All participants received the same home-based exercise program with or without self-manual therapy over 12 weeks. Outcome measures were pain intensity, range of motions, six-minute walk test distance, the knee injury and osteoarthritis outcome score (KOOS), short-form 36 (SF-36) and satisfaction. The results showed that the self-manual therapy program significantly decreased pain at 4 weeks, increased flexion and extension at 4 and 12 weeks, and improved the KOOS in pain item and SF-36 in physical function and mental health items. The home-based exercise group showed significant increase of the six-minute walk distance at 4 and 12 weeks, improvements in the KOOS in pain and symptom items and SF-36 in the physical function and role-emotional items. Overall, the results favored a combination of self-manual therapy and home-based exercise for patients with knee OA, which apparently showed superior benefits in decreasing pain and improving active knee range of motions.

Tobacco Cessation Counseling Training in US Entry-Level Physical Therapist Education Curricula: Prevalence, Content, and Associated Factors

PubMed Central

Gurka, Matthew J.; Jones, Dina L.; Kershner, Ruth E.; Ohtake, Patricia J.; Stauber, William T.; Swisher, Anne K.

2014-01-01

Background The US Public Health Service (USPHS) recommends tobacco cessation counseling (TCC) training for all health care professionals. Within physical therapist practice, smoking can have adverse effects on treatment outcomes in all body systems. In addition, people with physical disabilities have a higher smoking prevalence than the general population, creating a strong need for tobacco cessation among physical therapy clientele. Therefore, TCC training is an important component of entry-level physical therapist education. Objective The aims of this study were: (1) to determine need for TCC training within entry-level physical therapist education and (2) to identify potential barriers to implementation of USPHS guidelines in the academic environment. Design A descriptive cross-sectional survey was conducted. Methods Directors or academic coordinators of clinical education from entry-level physical therapist programs (N=204) were surveyed using an online instrument designed specifically for this study. Data regarding program and faculty characteristics, tobacco-related training content, and faculty opinions toward TCC in both physical therapist practice and education were analyzed descriptively. Results The response rate was 71%. A majority (60%) of programs indicated inclusion of tobacco-related training, most commonly 1 to 2 hours in duration, and of these programs, 40% trained students in the implementation of USPHS clinical guidelines for TCC. Limitations Data analyses were constrained by limited or missing data in some areas. A single faculty member completed the survey for each program. Conclusions There is a need for TCC training in entry-level physical therapist education. Inclusion may be facilitated by addressing perceived barriers toward TCC as a component of physical therapist practice and promoting the relevance of TCC as it relates to intended outcomes of physical therapy interventions. PMID:24830717

A combined treatment approach emphasizing impairment-based manual physical therapy for plantar heel pain: a case series.

PubMed

Young, Brian; Walker, Michael J; Strunce, Joseph; Boyles, Robert

2004-11-01

Case series. To describe an impairment-based physical therapy treatment approach for 4 patients with plantar heel pain. There is limited evidence from clinical trials on which to base treatment decision making for plantar heel pain. Four patients completed a course of physical therapy based on an impairment-based model. All patients received manual physical therapy and stretching. Two patients were also treated with custom orthoses, and 1 patient received an additional strengthening program. Outcome measures included a numeric pain rating scale (NPRS) and self-reported functional status. Symptom duration ranged from 6 to 52 weeks (mean duration+/-SD, 33+/-19 weeks). Treatment duration ranged from 8 to 49 days (mean duration+/-SD, 23+/-18 days), with number of treatment sessions ranging from 2 to 7 (mode, 3). All 4 patients reported a decrease in NPRS scores from an average (+/-SD) of 5.8+/-2.2 to 0 (out of 10) during previously painful activities. Additionally, all patients returned to prior activity levels. In this case series, patients with plantar heel pain treated with an impairment-based physical therapy approach emphasizing manual therapy demonstrated complete pain relief and full return to activities. Further research is necessary to determine the effectiveness of impairment-based physical therapy interventions for patients with plantar heel pain/plantar fasciitis.

Effectiveness of Physical Therapy as an Adjunctive Treatment for Trauma-induced Chronic Torticollis in Raptors.

PubMed

Nevitt, Benjamin N; Robinson, Narda; Kratz, Gail; Johnston, Matthew S

2015-03-01

Management of trauma-induced chronic torticollis in raptors has historically been challenging. Euthanasia is common in affected birds because of their inability to maintain normal cervical position, although they may be able to function normally. To assess effectiveness of physical therapy of the neck and head as an adjunct treatment for this condition, a case-control study was done in raptors admitted to the Rocky Mountain Raptor Program from 2003 to 2010. Eleven cases were identified with a diagnosis of chronic torticollis resulting from traumatic brain injury. Five cases were treated with physical therapy of the head and neck, and 6 control cases did not receive any physical therapy for the torticollis. Of the control cases, 0 of 6 had resolution of the torticollis, 0 of 6 were released, and 5 of 6 were euthanatized. Of the treated cases, 4 of 5 had complete resolution of the torticollis and 5 of 5 were released. Resolution of torticollis differed significantly between cases receiving physical therapy and controls. These results indicate that physical therapy should be used as an adjunctive therapy in cases of chronic torticollis induced by trauma in raptors because it results in better resolution of the torticollis and increased likelihood of release.

Adapting Animal-Assisted Therapy Trials to Prison-Based Animal Programs.

PubMed

Allison, Molly; Ramaswamy, Megha

2016-09-01

Prison-based animal programs have shown promise when it comes to increased sociability, responsibility, and levels of patience for inmates who participate in these programs. Yet there remains a dearth of scientific research that demonstrates the impact of prison-based animal programs on inmates' physical and mental health. Trials of animal-assisted therapy interventions, a form of human-animal interaction therapy most often used with populations affected by depression/anxiety, mental illness, and trauma, may provide models of how prison-based animal program research can have widespread implementation in jail and prison settings, whose populations have high rates of mental health problems. This paper reviews the components of prison-based animal programs most commonly practiced in prisons today, presents five animal-assisted therapy case studies, evaluates them based on their adaptability to prison-based animal programs, and discusses the institutional constraints that act as barriers for rigorous prison-based animal program research implementation. This paper can serve to inform the development of a research approach to animal-assisted therapy that nurses and other public health researchers can use in working with correctional populations. © 2016 Wiley Periodicals, Inc.

Comprehensive rehabilitation of the child with osteogenesis imperfecta.

PubMed

Binder, H; Conway, A; Hason, S; Gerber, L H; Marini, J; Berry, R; Weintrob, J

1993-01-15

Children with osteogenesis imperfecta (OI) that results in considerable deformity are often viewed as poor candidates for aggressive physical therapy and rehabilitation. To determine if this view is realistic, we have entered almost 50 children with OI type III and OI type IV into a comprehensive graduated rehabilitation program, based at the National Institutes of Health, but designed to be implemented by continuing involvement of community resources. Children are begun in the program early with emphasis on gain of head and trunk control and progression to sitting and walking, if possible, with the aid of a variety of physical supports, including internal and external bracing. Although not conducted in a randomized fashion, the program's success in bringing children into graded exercise regimes and fostering their increased involvement in school and social situations suggest that aggressive physical therapy and rehabilitation have a major place in the overall care of the infants and children with OI.

Educating Patient Educators: Enhancing Instructional Effectiveness in Physical Therapy for Low Back Pain Patients.

ERIC Educational Resources Information Center

Kerssens, Jan J.; Sluijs, Emmy M.; Verhaak, Peter F. M.; Knibbe, Hanneke J.; Hermans, Irma M. J.

1999-01-01

Examines the effectiveness of a training program designed for physical therapists (N=19) to aid them in the enhancement of patient education. Five therapist-skills were tested. After the training only a minority of the trained skills appeared to have improved. Results show that the training program was not very effective. (Author/MKA)

Behavioral and Psychosocial Outcomes of a 16-Week Rebound Therapy-Based Exercise Program for People with Profound Intellectual Disabilities

ERIC Educational Resources Information Center

Jones, Martyn C.; Walley, Robert M.; Leech, Amanda; Paterson, Marion; Common, Stephanie; Metcalf, Charlotte

2007-01-01

People with profound intellectual disabilities rarely experience a physically active lifestyle, and their long-term physical inactivity likely contributes to poor health. The authors developed and implemented a pilot exercise program for persons with a profound intellectual disability and conducted a study to evaluate the effort. The development…

Evaluating the professional libraries of practicing physical therapists.

PubMed

Brown, Suzanne R; Roush, James R; Lamkin, Alyson R; Perrakis, Rena; Kronenfeld, Michael R

2007-01-01

The primary objective of this study was to explore the use of information resources by a sample of physical therapists. A qualitatively designed study using structured individual interviews, examination of professional libraries, and identification of information resources was initiated in three sites (Southern California, Arizona, and Georgia). Participants included forty physical therapists with between five and twenty years of experience. The Internet and continuing education activities appeared to be the primary information sources for the physical therapists surveyed. The personal professional libraries of participants were limited in scope and contained titles copyrighted more than ten years ago. Access to peer-reviewed journals in the sample was limited primarily to those received as a benefit of professional association membership. Participants did not maintain current print professional information resources. The majority of books in the personal and workplace professional libraries held copyrights dating from the time of the participants' enrollment in an entry-level physical therapy program. Medical librarians may play an important role in shifting physical therapy towards evidence-based practice by collaborating in professional development for this group. Physical therapy educators and professional leaders should support current public collections of physical therapy-related information resources to encourage the movement towards an evidence-based practice model in physical therapy.

Evaluating the professional libraries of practicing physical therapists

PubMed Central

Brown, Suzanne R.; Roush, James R.; Lamkin, Alyson R.; Perrakis, Rena; Kronenfeld, Michael R.

2007-01-01

Background and Purpose: The primary objective of this study was to explore the use of information resources by a sample of physical therapists. Methods: A qualitatively designed study using structured individual interviews, examination of professional libraries, and identification of information resources was initiated in three sites (Southern California, Arizona, and Georgia). Participants included forty physical therapists with between five and twenty years of experience. Results: The Internet and continuing education activities appeared to be the primary information sources for the physical therapists surveyed. The personal professional libraries of participants were limited in scope and contained titles copyrighted more than ten years ago. Access to peer-reviewed journals in the sample was limited primarily to those received as a benefit of professional association membership. Discussion and Conclusions: Participants did not maintain current print professional information resources. The majority of books in the personal and workplace professional libraries held copyrights dating from the time of the participants' enrollment in an entry-level physical therapy program. Medical librarians may play an important role in shifting physical therapy towards evidence-based practice by collaborating in professional development for this group. Physical therapy educators and professional leaders should support current public collections of physical therapy-related information resources to encourage the movement towards an evidence-based practice model in physical therapy. PMID:17252068

Physical Therapy Interventions for Degenerative Lumbar Spinal Stenosis: A Systematic Review

PubMed Central

Macedo, Luciana Gazzi; Hum, Abraham; Kuleba, Laura; Mo, Joey; Truong, Linda; Yeung, Mankeen

2013-01-01

Background Physical therapy is commonly prescribed for patients with lumbar spinal stenosis (LSS); however, little is known about its effectiveness. Purpose The purpose of this study was to systematically review randomized controlled trials (RCTs), controlled trials, and cohort studies evaluating the effectiveness of physical therapy for LSS. Data Sources Studies were searched on electronic databases to January 2012. Study Selection Inclusion criteria were: clinical diagnosis of LSS with confirmatory imaging, evaluation of physical therapy treatment, presence of a comparison group, and outcomes of pain, disability, function, or quality of life. Data Extraction Outcomes were extracted and, when possible, pooled using RevMan 5, a freely available review program from the Cochrane Library. Data Synthesis Ten studies were included: 5 RCTs, 2 controlled trials, 2 mixed-design studies, and 1 longitudinal cohort study. Pooled effects of 2 studies revealed that the addition of a physical therapy modality to exercise had no statistically significant effect on outcome. Pooled effects results of RCTs evaluating surgery versus physical therapy demonstrated that surgery was better than physical therapy for pain and disability at long term (2 years) only. Other results suggested that exercise is significantly better than no exercise, that cycling and body-weight–supported treadmill walking have similar effects, and that corsets are better than no corsets. Limitations The limitations of this review include the low quality and small number of studies, as well as the heterogeneity in outcomes and treatments. Conclusions No conclusions could be drawn from the review regarding which physical therapy treatment is superior for LSS. There was low-quality evidence suggesting that modalities have no additional effect to exercise and that surgery leads to better long-term (2 years) outcomes for pain and disability, but not walking distance, than physical therapy in patients with LSS. PMID:23886845

The PEREGRINETM program: using physics and computer simulation to improve radiation therapy for cancer

NASA Astrophysics Data System (ADS)

Hartmann Siantar, Christine L.; Moses, Edward I.

1998-11-01

When using radiation to treat cancer, doctors rely on physics and computer technology to predict where the radiation dose will be deposited in the patient. The accuracy of computerized treatment planning plays a critical role in the ultimate success or failure of the radiation treatment. Inaccurate dose calculations can result in either insufficient radiation for cure, or excessive radiation to nearby healthy tissue, which can reduce the patient's quality of life. This paper describes how advanced physics, computer, and engineering techniques originally developed for nuclear weapons and high-energy physics research are being used to predict radiation dose in cancer patients. Results for radiation therapy planning, achieved in the Lawrence Livermore National Laboratory (LLNL) 0143-0807/19/6/005/img2 program show that these tools can give doctors new insights into their patients' treatments by providing substantially more accurate dose distributions than have been available in the past. It is believed that greater accuracy in radiation therapy treatment planning will save lives by improving doctors' ability to target radiation to the tumour and reduce suffering by reducing the incidence of radiation-induced complications.

77 FR 3269 - Loan Repayment Program for Repayment of Health Professions Educational Loans; Announcement Type...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... Anesthetists.). (o) Podiatry: D.P.M. (p) Physical Rehabilitation Services: Physical Therapy, Occupational... by the Secretary. Loan repayment sites are characterized by physical, cultural, and professional... medicine, internal medicine, pediatrics, geriatric medicine, obstetrics and gynecology, podiatric medicine...

Utilizing the "Plan, Do, Study, Act" Framework to Explore the Process of Curricular Assessment and Redesign in a Physical Therapy Education Program in Suriname.

PubMed

Audette, Jennifer Gail; Baldew, Se-Sergio; Chang, Tony C M S; de Vries, Jessica; Ho A Tham, Nancy; Janssen, Johanna; Vyt, Andre

2017-01-01

To describe how a multinational team worked together to transition a physical therapy (PT) educational program in Paramaribo, Suriname, from a Bachelor level to a Master of Science in Physical Therapy (MSPT) level. The team was made up of PT faculty from Anton De Kom Universiteit van Suriname (AdeKUS), the Flemish Interuniversity Council University Development Cooperation (VLIR-UOS) leadership, and Health Volunteers Overseas volunteers. In this case study, the process for curricular assessment, redesign, and upgrade is described retrospectively using a Plan, Do, Study, Act (PDSA) framework. PT educational programs in developing countries are eager for upgrade to meet international expectations and to better meet community health-care needs. An ongoing process which included baseline assessment of all aspects of the existing bachelor's program in PT, development of a plan for a MSPT, implementation of the master's program, and evaluation following implementation is described. Curricular assessment and upgrade in resource-limited countries requires the implementation of process-oriented methods. The PDSA process is a useful tool to explore curricular development. The international collaboration described in this paper provides an example of the diligence, consistency, and dedication required to see a project through and achieve success while providing adequate support to the host site. This project might provide valuable insights for those involved in curricular redesign in similar settings.

Job satisfaction among academic coordinators of clinical education in physical therapy.

PubMed

Harris, M J; Fogel, M; Blacconiere, M

1987-06-01

The Academic Coordinator of Clinical Education is the physical therapy faculty member who is responsible for the clinical component of the curriculum. The responsibilities involved in the ACCE's job are such that ACCEs seem to be at risk for job dissatisfaction and burnout. The purpose of this descriptive study was to investigate the levels and patterns of job satisfaction among ACCEs in physical therapy. A questionnaire, including a 32-item job satisfaction inventory, was sent to the ACCE at each accredited entry-level education program for physical therapists and physical therapist assistants (N = 169). One hundred twelve (66.3%) responses were received and analyzed. Demographic characteristics of the respondents are reported. The results of the study showed that ACCEs, in general, expressed low levels of occupational dissatisfaction and burnout. Satisfaction with the aspects of the job involving self-esteem, achievement, and creativity seems to outweight dissatisfaction with the time available, the work load, and organizational efficiency. Those ACCEs with doctoral degrees expressed the highest levels of dissatisfaction and burnout. Those ACCEs working in entry-level master's degree programs expressed the lowest level of dissatisfaction; those in tenure-track positions expressed the lowest level of burnout. Factors contributing to job satisfaction and dissatisfaction are discussed.

75 FR 1384 - Indian Health Professions Preparatory, Indian Health Professions Pregraduate and Indian Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-11

.... undergraduate years). D. Pre-Nursing. E. Pre-Occupational Therapy. F. Pre-Pharmacy. G. Pre-Physical Therapy (Jr..., Geriatric, Women's Health, Pediatric Nursing, Nurse Anesthetist, and Nurse Practitioner. (Priority...) and its amendments; or in a program assisted under Title V of the IHCIA.) L. Occupational Therapy: B.S...

A prehabilitation program for physically frail community-living older persons.

PubMed

Gill, Thomas M; Baker, Dorothy I; Gottschalk, Margaret; Gahbauer, Evelyne A; Charpentier, Peter A; de Regt, Paul T; Wallace, Sarah J

2003-03-01

To describe the development and implementation of a preventive, home-based physical therapy program (PREHAB) and to provide evidence for the safety and interrater reliability of the PREHAB protocol. Demonstration study. General community. Ninety-four physically frail, community-living persons, aged 75 years or older, who were randomized to the PREHAB program in a clinical trial. The PREHAB program built on the physical therapy component of 2 previous home-based protocols. A total of 223 assessment items were linked to 28 possible interventions, including progressive balance and conditioning exercises, by using detailed algorithms and decisions rules that were automated on notebook computers. The percentages of participants who were eligible for and who completed each intervention, the extent of progress noted in the balance and conditioning exercises, adherence to the training program, and adverse events. Participants who completed the PREHAB program and those who ended it prematurely received an average of 9.7 and 7.2 interventions during an average of 14.9 and 9.5 home visits, respectively. With few exceptions, the completion rate and interrater reliability for the specific interventions were high. Despite high self-reported adherence to the training program, the majority of participants did not advance beyond the initial Thera-Band level for the upper- and lower-extremity conditioning exercises, and only about a third advanced to the highest 2 levels of the balance exercises. Adverse events were no more common in the PREHAB group than in the educational control group. Our results support the feasibility and safety of the PREHAB program, but also show the special challenges and pitfalls of such a strategy when it is implemented among persons of advanced age and physical frailty. Copyright 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Systematic Clinical Reasoning in Physical Therapy (SCRIPT): Tool for the Purposeful Practice of Clinical Reasoning in Orthopedic Manual Physical Therapy.

PubMed

Baker, Sarah E; Painter, Elizabeth E; Morgan, Brandon C; Kaus, Anna L; Petersen, Evan J; Allen, Christopher S; Deyle, Gail D; Jensen, Gail M

2017-01-01

Clinical reasoning is essential to physical therapist practice. Solid clinical reasoning processes may lead to greater understanding of the patient condition, early diagnostic hypothesis development, and well-tolerated examination and intervention strategies, as well as mitigate the risk of diagnostic error. However, the complex and often subconscious nature of clinical reasoning can impede the development of this skill. Protracted tools have been published to help guide self-reflection on clinical reasoning but might not be feasible in typical clinical settings. This case illustrates how the Systematic Clinical Reasoning in Physical Therapy (SCRIPT) tool can be used to guide the clinical reasoning process and prompt a physical therapist to search the literature to answer a clinical question and facilitate formal mentorship sessions in postprofessional physical therapist training programs. The SCRIPT tool enabled the mentee to generate appropriate hypotheses, plan the examination, query the literature to answer a clinical question, establish a physical therapist diagnosis, and design an effective treatment plan. The SCRIPT tool also facilitated the mentee's clinical reasoning and provided the mentor insight into the mentee's clinical reasoning. The reliability and validity of the SCRIPT tool have not been formally studied. Clinical mentorship is a cornerstone of postprofessional training programs and intended to develop advanced clinical reasoning skills. However, clinical reasoning is often subconscious and, therefore, a challenging skill to develop. The use of a tool such as the SCRIPT may facilitate developing clinical reasoning skills by providing a systematic approach to data gathering and making clinical judgments to bring clinical reasoning to the conscious level, facilitate self-reflection, and make a mentored physical therapist's thought processes explicit to his or her clinical mentor. © 2017 American Physical Therapy Association

The Dis-Art Creative Journey, Art Therapy for Persons with Disabilities: Adaptation of the Creative Journey

ERIC Educational Resources Information Center

Luzzatto, Paola; Bruno, Teresa; Cosco, Marianna; Del Curatolo, Annamaria; Frigenti, Franca; Macchioni, Silvia

2017-01-01

This article describes a 10-session group art therapy program for people with physical and neurological disabilities. This program, the DIS-ART Creative Journey, was adapted from the Creative Journey used with cancer patients, and was tested in Italy by 4 art therapists. The 5-step structure of each session and the 10 facilitating techniques used…

Hyperbaric oxygen therapy as treatment for bilateral arm compartment syndrome after CrossFit: case report and literature review.

PubMed

Mendes, Adriano Fernando; Neto, José da Mota; Heringer, Erica Maciel; de Simoni, Leandro Furtado; Pires, Diego Demolinari; Labronici, Pedro José

2018-01-01

CrossFit is a physical fitness program characterized by high-intensity workouts that can be associated with serious injury. Acute compartment syndrome in the upper limbs is a rare occurrence. It may occur after intense physical exercise, and its usual treatment is surgical. Hyperbaric oxygen therapy is a treatment described as adjunctive in cases of compartmental syndrome. We describe the case of a CrossFit practitioner who, after intense training, developed progressive symptoms of rhabdomyolysis and acute bilateral arm compartment syndrome, who was successfully treated with hyperbaric oxygen therapy and required no fasciotomy as surgical treatment. Acute compartment syndrome in the arms after intense physical exercise is a rare occurrence that should be suspected by practitioners of physical activity experiencing intense, disproportionate and progressive pain. In the case presented, hyperbaric oxygen therapy was successfully used in the treatment of the disorder, with satisfactory progress, and without the need for a surgical fasciotomy as therapy. Copyright© Undersea and Hyperbaric Medical Society.

University faculty preparation of students in using natural environment practices with young children.

PubMed

Dunst, Carl J; Bruder, Mary Beth

2005-02-01

155 university faculty teaching students in physical therapy, occupational therapy, speech and language pathology, early childhood special education, or multidisciplinary studies programs were surveyed to assess how the students were taught how to use everyday family and community activities as natural learning opportunities for young children. Analysis showed that the faculty provided very little training in using community activity settings as contexts for children's learning and that physical therapy faculty provided less training in using natural environments as sources of children's learning opportunities than faculty in the other disciplines.

Meeting the Demands of Professional Education: A Study of Mind Mapping in a Professional Doctoral Physical Therapy Education Program

ERIC Educational Resources Information Center

Pollard, Elicia L.

2010-01-01

The purposes of this study are to investigate whether the quiz scores of physical therapy students who integrated mind mapping in their learning strategies are significantly different than the quiz scores of students who did not use mind mapping to learn in a lecture-based research course and examine the students' perceptions of mind mapping as a…

Cognitive behavioral therapy and physical exercise for climacteric symptoms in breast cancer patients experiencing treatment-induced menopause: design of a multicenter trial.

PubMed

Duijts, Saskia F A; Oldenburg, Hester S A; van Beurden, Marc; Aaronson, Neil K

2009-06-06

Premature menopause is a major concern of younger women undergoing adjuvant therapy for breast cancer. Hormone replacement therapy is contraindicated in women with a history of breast cancer. Non-hormonal medications show a range of bothersome side-effects. There is growing evidence that cognitive behavioral therapy (CBT) and physical exercise can have a positive impact on symptoms in naturally occurring menopause. The objective of this study is to investigate the efficacy of these interventions among women with breast cancer experiencing treatment-induced menopause. In a randomized, controlled, multicenter trial, we are evaluating the effectiveness of CBT/relaxation, of physical exercise and of these two program elements combined, in reducing menopausal symptoms, improving sexual functioning, reducing emotional distress, and in improving the health-related quality of life of younger breast cancer patients who experience treatment-induced menopause. 325 breast cancer patients (aged < 50) are being recruited from hospitals in the Amsterdam region, and randomly allocated to one of the three treatment groups or a 'waiting list' control group. Self-administered questionnaires are completed by the patients at baseline, and at 12 weeks (T1) and 6 months (T2) post-study entry. Upon completion of the study, women assigned to the control group will be given the choice of undergoing either the CBT or physical exercise program. Cognitive behavioral therapy and physical exercise are potentially useful treatments among women with breast cancer undergoing treatment-induced, premature menopause. For these patients, hormonal and non-hormonal therapies are contraindicated or have a range of bothersome side-effects. Hence, research into these interventions is needed, before dissemination and implementation in the current health care system can take place.

Physics for Occupational Therapy Majors Program

NASA Astrophysics Data System (ADS)

Singh Aurora, Tarlok

1998-03-01

In Spring 1996, a one semester course - "Survey of Physics" - was taught for students majoring in Occupational Therapy (O. T.), in contrast to the two semester physics sequence for all other health science majors. The course was designed to expose the students to the concept of physics, develop problem solving skills and to emphasize the importance of physics to O.T. In developing the course content, students' preparedness in mathematics and the perceived future applications of physics in O. T. was taken in to consideration, and steps were taken to remedy the deficiencies in students' background. The course was comprised of lecture, laboratory, and considerable self study due to the time constraints, and these will be described.

Parents and Young Children with Disabilities: The Effects of a Home-Based Music Therapy Program on Parent-Child Interactions.

PubMed

Yang, Yen-Hsuan

2016-01-01

Responsive parenting style and synchronous parent-child interactions have a positive impact on children in terms of language, cognitive, and social-emotional development. Despite widely documented benefits of music therapy on parent-child interactions, empirical evidence for the effects of music therapy on parent-child synchrony is lacking. To examine effects of parent-child dyads' participation in a six-week home-based music therapy program on parent response, child initiation, and parent-child synchrony, as well as parents' daily use of musical activities with their child. Twenty-six parent-child dyads participated in this pretest-posttest within-subject single-group design study. Participating dyads included parents and their child with disabilities or developmental delays (ages 1-3 years inclusive). Parent-child dyads participated in a home-based music therapy program that included six weekly 40-minute sessions, and incorporated five responsive teaching strategies (i.e., affect, match, reciprocity, shared control, and contingency). Observational data were recorded for parent-child interactions and parent-child synchrony. Parents' positive physical and verbal responses, as well as children's positive verbal initiations, increased significantly pre- to post-intervention; however, children's positive physical initiations did not increase significantly. Parent-child synchrony also improved significantly pre- to post-intervention. Findings support the use of home-based music therapy programs to facilitate parent-child interactions in the areas of parental responsiveness and child-initiated communication, as well as parent-child synchrony. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Institutional Variation in Traumatic Brain Injury Acute Rehabilitation Practice.

PubMed

Seel, Ronald T; Barrett, Ryan S; Beaulieu, Cynthia L; Ryser, David K; Hammond, Flora M; Cullen, Nora; Garmoe, William; Sommerfeld, Teri; Corrigan, John D; Horn, Susan D

2015-08-01

To describe institutional variation in traumatic brain injury (TBI) inpatient rehabilitation program characteristics and evaluate to what extent patient factors and center effects explain how TBI inpatient rehabilitation services are delivered. Secondary analysis of a prospective, multicenter, cohort database. TBI inpatient rehabilitation programs. Patients with complicated mild, moderate, or severe TBI (N=2130). Not applicable. Mean minutes; number of treatment activities; use of groups in occupational therapy, physical therapy, speech therapy, therapeutic recreation, and psychology inpatient rehabilitation sessions; and weekly hours of treatment. A wide variation was observed between the 10 TBI programs, including census size, referral flow, payer mix, number of dedicated beds, clinician experience, and patient characteristics. At the centers with the longest weekday therapy sessions, the average session durations were 41.5 to 52.2 minutes. At centers with the shortest weekday sessions, the average session durations were approximately 30 minutes. The centers with the highest mean total weekday hours of occupational, physical, and speech therapies delivered twice as much therapy as the lowest center. Ordinary least-squares regression modeling found that center effects explained substantially more variance than patient factors for duration of therapy sessions, number of activities administered per session, use of group therapy, and amount of psychological services provided. This study provides preliminary evidence that there is significant institutional variation in rehabilitation practice and that center effects play a stronger role than patient factors in determining how TBI inpatient rehabilitation is delivered. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Continuing education in physical rehabilitation and health issues of agricultural workers.

PubMed

Wilhite, Carla S; Jaco, Linda

2014-01-01

Limited attention has been devoted to the cultural and practice competencies needed by occupational therapy and physical therapy professionals who provide services to farming families impacted by chronic health or disability issues. Agricultural occupational safety and health should represent a continuum of services responsive to individuals, families, and agricultural communities across a life span and range of health status changes. Physical rehabilitation professionals have a key role in impacting an agricultural producer's sense of self-efficacy and capacities for returning to agricultural living and work. However, demonstration of competency is essential in providing person-centered rehabilitation services of assessment, evaluation, treatment planning, interventions, referrals, and discharge issues. The paper highlights methods utilized by a state AgrAbility program and a former National AgrAbility Project to develop a model of continuing education programming for occupational and physical therapists that evaluate and treat agricultural workers after acute injury or exacerbation of chronic health conditions.

Motions and functional performance after supervised physical therapy program versus home-based program after arthroscopic anterior shoulder stabilization: a randomized clinical trial.

PubMed

Ismail, M M; El Shorbagy, K M

2014-01-01

To compare the effects of a standardized supervised physical therapy versus a controlled home-based programs on the rate of shoulder motion and functional recovery after arthroscopic anterior shoulder stabilization. Twenty-seven patients (18-35years) underwent arthroscopic anterior shoulder stabilization. Patients were randomized into two groups. A supervised group (n=14) received a rehabilitation program, 3 sessions/week for 24 weeks and a controlled home treated group (n=13) who followed a home-based program for same period. Range of motion (ROM) of the shoulder was assessed 4 times after each phase of rehabilitation and function was assessed after the 3rd and 4th phase of rehabilitation. Both groups achieved a significant progressive increase in all shoulder motions throughout the study period. Patients in the supervised group achieved 92.6% and 94.2% of the contralateral side in abduction and forward elevation respectively. The controlled home-based group achieved 87.1% and 94.7% of abduction and forward elevation respectively. For external rotation, the percentage ROM achieved was 81.1% for the supervised group and 76.4% for the controlled home-based group. For function assessment, the two groups showed a significant improvement. However, the two groups were not significantly different from each other in all measured variables. A controlled home-based physical therapy program is as effective as a supervised program in increasing shoulder range of motion and function after arthroscopic anterior shoulder stabilization. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Dance program for physical rehabilitation and participation in children with cerebral palsy.

PubMed

López-Ortiz, Citlali; Gladden, Kim; Deon, Laura; Schmidt, Jennifer; Girolami, Gay; Gaebler-Spira, Deborah

2012-02-01

Objective : This pilot study aimed to examine a classical ballet program created for children with cerebral palsy (CP) as an emerging physical rehabilitation modality. The main program goals were to promote participation and to provide an artistic, physically therapeutic activity. Methods : The study was conducted in collaboration with a tertiary rehabilitation hospital, one outpatient physical therapy clinic, and one community center. As a pilot exploratory study, the research design included questionnaires to assess the participants' (children ( n  = 16), parents ( n  = 16), and therapists ( n  = 13)) perceptions on the therapeutic benefit of the dance program. A binomial statistical model was adopted for the analysis of the results. Results : Main results were that the children reported high enjoyment level ( p  < .0001) and desire for more classes (.0001); the parents reported perceived therapeutic benefit ( p  < .0001); and the therapists viewed the class as a positive adjunct to therapy ( p  < .0001). Conclusions : The main limitation of this work was the utilization of subjective outcome measures. However, this is the first step toward the development of objective measures of an intervention that, to our knowledge, has not been analyzed in the past. We conclude that the program has the potential of developing into an evidence based rehabilitation resource for children with CP.

Alcohol use disorder

MedlinePlus

... help you stop drinking completely. These programs usually offer: Education about alcohol use and its effects Counseling and therapy to discuss how to control your thoughts and behaviors Physical ... programs offer housing options for people with alcohol problems. Depending ...

Early Incorporation of an Evidence-Based Aquatic-Assisted Approach to Arthroscopic Rotator Cuff Repair Rehabilitation: Prospective Case Study.

PubMed

Burmaster, Chris; Eckenrode, Brian J; Stiebel, Matthew

2016-01-01

Both traditional and progressive rotator cuff repair rehabilitation protocols often delay active motion of the shoulder for 6 weeks or more. The early inclusion of a comprehensive aquatic-assisted exercise program presents a unique approach to postoperative management. The purpose of this case study is to describe a comprehensive evidence-based, aquatic-assisted rehabilitation program following arthroscopic rotator cuff repair. A 73-year-old woman with a nonretracted, medium-size, full-thickness tear (2.5 cm) of the supraspinatus tendon underwent arthroscopic rotator cuff repair and was referred for postoperative physical therapy. The rehabilitation program was initiated at 2 weeks postoperatively and consisted of concurrent land- and aquatic-based interventions over 6 weeks for a total of 18 physical therapy visits. Improvements were made in all 5 patient-reported outcome measures that were recorded weekly over the course of care. Improvements reached or exceeded minimal detectable change levels for the Shoulder Pain and Disability Index and the Penn Shoulder Score. Her numeric pain rating scale score at rest decreased from 4/10 at the initial evaluation to 2/10 at 8 weeks postoperatively and with activity decreased from 9/10 to 6/10. Shoulder strength and range of motion values also exhibited improvement over the course of care. No adverse events occurred during the case study. This case study illustrates the safe inclusion of low-stress aquatic exercises as an early adjunct to traditional land-based rotator cuff repair rehabilitation programs in small- to medium-size repairs. Further studies are needed to determine the long-term effectiveness of adding aquatic therapy to traditional postoperative programs. © 2016 American Physical Therapy Association.

Aquatic Physical Therapy for Children with Developmental Coordination Disorder: A Pilot Randomized Controlled Trial

ERIC Educational Resources Information Center

Hillier, Susan; McIntyre, Auburn; Plummer, Leanne

2010-01-01

Aquatic therapy is an intervention for children with Developmental Coordination Disorder (DCD) that has not been investigated formally. This was a pilot randomized controlled trial to investigate the feasibility and preliminary effectiveness of an aquatic therapy program to improve motor skills of children with DCD. Thirteen children (mean age 7…

Continuous passive motion and physical therapy (CPM) versus physical therapy (PT) versus delayed physical therapy (DPT) after surgical release for elbow contractures; a study protocol for a prospective randomized controlled trial.

PubMed

Viveen, Jetske; Doornberg, Job N; Kodde, Izaak F; Goossens, Pjotr; Koenraadt, Koen L M; The, Bertram; Eygendaal, Denise

2017-11-22

The elbow is prone to stiffness after trauma. To regain functional elbow motion several conservative- and surgical treatment options are available. Conservative treatment includes physical therapy, intra-articular injections with corticosteroids and a static progressive or dynamic splinting program. If conservative treatment fails, an operative release of the posttraumatic stiff elbow is often performed. The best Evidence-Based rehabilitation protocol for patients after an operative release is unknown to date and differs per surgeon, hospital and country. Options include early- or delayed motion supervised by a physical therapist, immediate continuous passive motion (CPM), (night) splinting and a static progressive or dynamic splinting program. The SET-Study (Stiff Elbow Trial) is a single-centre, prospective, randomized controlled trial. The primary objective of this study is to compare the active Range of Motion (ROM) (flexion arc and rotational arc) twelve months after surgery between three groups. The first group will receive in-hospital CPM in combination with early motion Physical Therapy (PT) supervised by a physical therapist, the second group will receive only in-hospital early motion PT supervised by a physical therapist and the third group will receive outpatient supervised PT from postoperative day seven till ten. Secondary outcome measures will be Patient Reported Outcome Measures (PROMs) including the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES), the quick Disabilities of Arm, Shoulder and Hand (qDASH) score, Visual Analogue pain Scale in rest and activity (VAS), Pain Catastrophizing Scale (PCS), the Short Form (SF)-36, the Centre for Epidemiological Studies Depression Scale Revised (CESD-R) and the Work Rehabilitation Questionnaire (WORQ) for the upper limb. A successful completion of this trial will provide evidence on the best rehabilitation protocol in order to (re)gain optimal motion after surgical release of the stiff elbow. The trial is registered at the Dutch Trial Register: NTR6067 , 31-8-2016.

International Disability Educational Alliance (IDEAnet)

DTIC Science & Technology

2008-03-01

Rehabilitation in Amman, Jordan. ....................34 Page 5 of 213 D2: Deliver professional education to 70 Iraqi physical therapists and 20...and Orthotic Center P&O: prosthetics and orthotics PT: physical therapists /physiotherapists PWDs: people with disabilities QI/QA: Quality...training program for physical therapists /physiotherapists (PTs) with previous clinical experience (see Appendix N for physical therapy modules). The

Physiotherapy interventions for ankylosing spondylitis.

PubMed

Dagfinrud, H; Kvien, T K; Hagen, K B

2008-01-23

Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease. Physiotherapy is considered an important part of the overall management of AS. To summarise the available scientific evidence on the effectiveness of physiotherapy interventions in the management of AS. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, CINAHL and PEDro up to January 2007 for all relevant publications, without any language restrictions. We checked the reference lists of relevant articles and contacted the authors of included articles. We included randomised and quasi-randomised studies with AS patients and where at least one of the comparison groups received physiotherapy. The main outcomes of interest were pain, stiffness, spinal mobility, physical function and patient global assessment. Two reviewers independently selected trials for inclusion, extracted data and assessed trial quality. Investigators were contacted to obtain missing information. Eleven trials with a total of 763 participants were included in this updated review. Four trials compared individualised home exercise programs or a supervised exercise program with no intervention and reported low quality evidence for effects in spinal mobility (Relative percentage differences (RPDs) from 5-50%) and physical function (four points on a 33-point scale). Three trials compared supervised group physiotherapy with an individualised home-exercise program and reported moderate quality evidence for small differences in spinal mobility (RPDs 7.5-18%) and patient global assessment (1.46 cm) in favour of supervised group exercises. In one study, a three-week inpatient spa-exercise therapy followed by 37 weeks of weekly outpatient group physiotherapy (without spa) was compared with weekly outpatient group physiotherapy alone; there was moderate quality evidence for effects in pain (18%), physical function (24%) and patient global assessment (27%) in favour of the combined spa-exercise therapy. One study compared daily outpatient balneotherapy and an exercise program with only exercise program, and another study compared balneotherapy with fresh water therapy. None of these studies showed significant between-group differences. One study compared an experimental exercise program with a conventional program; statistically significant change scores were reported on nearly all spinal mobility measures and physical function in favour of the experimental program. The results of this review suggest that an individual home-based or supervised exercise program is better than no intervention; that supervised group physiotherapy is better than home exercises; and that combined inpatient spa-exercise therapy followed by group physiotherapy is better than group physiotherapy alone.

Increasing Fathers' Participation in Therapeutic Intervention Programs for Exceptional Children.

ERIC Educational Resources Information Center

Revelj, Elizabeth O.

In response to a research review indicating that few programs address the father's role in early intervention and preschool programs for the young exceptional child, a three-month practicum was designed which included fathers in physical therapy sessions and in daily home exercise programming for their developmentally disabled children. Practicum…

The efficacy of self-directed modules for clinical learning: advanced competencies in entry-level physical therapy education.

PubMed

Peck, Kirk; Paschal, Karen; Black, Lisa; Nelson, Kelly

2014-01-01

Prior to graduation, students often express an interest to advance clinical and professional skills in teaching, research, administration, and various niche practice areas. The acquisition of advanced education in selected areas of practice is believed to improve employment opportunities, accelerate career advancement including eligibility for professional certifications, and contribute to personal satisfaction in the profession. The purpose of this paper is to (1) describe an innovative model of education, the Directed Practice Experience (DPE) elective, that incorporates a student-initiated learning process designed to achieve student-identified professional goals, and (2) report the outcomes for graduates who have completed the DPE in an entry-level program in physical therapy education. Students who met select criteria were eligible to complete a DPE. Applicants designed a 4- to 6-week clinical education experience consisting of stated rationale for personal and professional growth, examples of leadership and service, and self-directed objectives that are beyond entry-level expectations as measured by the revised Physical Therapist Clinical Performance Instrument, version 2006. Twenty-six students have completed DPEs since 2005. Fifty percent resulted in new academic partnerships. At least 25% of graduates now serve as clinical instructors for the entry-level program. Those who participated in DPEs have also completed post-graduate residencies, attained ABPTS Board certifications, authored peer-reviewed publications, and taught in both PT and residency programs. The DPE model allows qualified students to acquire advanced personal skills and knowledge prior to graduation in areas of professional practice that exceed entry-level expectations. The model is applicable to all CAPTE accredited physical therapy education programs and is especially beneficial for academic programs desiring to form new community partnerships for student clinical education.

Developing Integrated Programs: A Transdisciplinary Approach for Early Intervention.

ERIC Educational Resources Information Center

Coling, Marcia Cain

This book presents an amalgam of early intervention ideas from the fields of education, occupational therapy, and physical therapy for children with developmental delays. An introductory chapter describes the approach's three theoretical bases: neurodevelopmental treatment (NDT), sensory integration, and Piagetian theory. Chapter 1 considers…

Design of the Quality of Life in Motion (QLIM) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of a combined physical exercise and psychosocial training program to improve physical fitness in children with cancer.

PubMed

Braam, Katja I; van Dijk, Elisabeth M; Veening, Margreet A; Bierings, Marc B; Merks, Johannes H M; Grootenhuis, Martha A; Chinapaw, Mai J M; Sinnema, Gerben; Takken, Tim; Huisman, Jaap; Kaspers, Gertjan J L; van Dulmen-den Broeder, Eline

2010-11-11

Childhood cancer and its treatment have considerable impact on a child's physical and mental wellbeing. Especially long-term administration of chemotherapy and/or radiotherapy impairs physical fitness both during and after therapy, when children often present with muscle weakness and/or low cardiorespiratory fitness. Physical exercise can improve these two elements of physical fitness, but the positive effects of physical exercise might be further increased when a child's wellbeing is simultaneously enhanced by psychosocial training. Feeling better may increase the willingness and motivation to engage in sports activities. Therefore, this multi-centre study evaluates the short and long-term changes in physical fitness of a child with a childhood malignancy, using a combined physical exercise and psychosocial intervention program, implemented during or shortly after treatment. Also examined is whether positive effects on physical fitness reduce inactivity-related adverse health problems, improve quality of life, and are cost-effective. This multi-centre randomized controlled trial compares a combined physical and psychosocial intervention program for children with cancer, with care as usual (controls). Children with cancer (aged 8-18 years) treated with chemotherapy and/or radiotherapy, and who are no longer than 1 year post-treatment, are eligible for participation. A total of 100 children are being recruited from the paediatric oncology/haematology departments of three Dutch university medical centres. Patients are stratified according to pubertal stage (girls: age ≤10 or >10 years; boys: ≤11 or >11 years), type of malignancy (haematological or solid tumour), and moment of inclusion into the study (during or after treatment), and are randomly assigned to the intervention or control group. Childhood cancer patients undergoing long-term cancer therapy may benefit from a combined physical exercise and psychosocial intervention program since it may maintain or enhance their physical fitness and increase their quality of life. However, the feasibility, patient need, and effectiveness of such a program should be established before the program can be implemented as part of standard care. NTR1531 (The Netherlands National Trial Register).

Slippery Rock University

ERIC Educational Resources Information Center

Arnhold, Robert W.

2008-01-01

Slippery Rock University (SRU), located in western Pennsylvania, is one of 14 state-owned institutions of higher education in Pennsylvania. The university has a rich tradition of providing professional preparation programs in special education, therapeutic recreation, physical education, and physical therapy for individuals with disabilities.…

CARL: a LabVIEW 3 computer program for conducting exposure therapy for the treatment of dental injection fear.

PubMed

Coldwell, S E; Getz, T; Milgrom, P; Prall, C W; Spadafora, A; Ramsay, D S

1998-04-01

This paper describes CARL (Computer Assisted Relaxation Learning), a computerized, exposure-based therapy program for the treatment of dental injection fear. The CARL program operates primarily in two different modes; in vitro, which presents a video-taped exposure hierarchy, and in vivo, which presents scripts for a dentist or hygienist to use while working with a subject. Two additional modes are used to train subjects to use the program and to administer behavioral assessment tests. The program contains five different modules, which function to register a subject, train subjects to use physical and cognitive relaxation techniques, deliver an exposure hierarchy, question subjects about the helpfulness of each of the therapy components, and test for memory effects of anxiolytic medication. Nine subjects have completed the CARL therapy program and 1-yr follow-up as participants in a placebo-controlled clinical trial examining the effects of alprazolam on exposure therapy for dental injection phobia. All nine subjects were able to receive two dental injections, and all reduced their general fear of dental injections. Initial results therefore indicate that the CARL program successfully reduces dental injection fear.

Managing a patient's constipation with physical therapy.

PubMed

Harrington, Kendra L; Haskvitz, Esther M

2006-11-01

Constipation is a prevalent condition in the United States, with typical treatment consisting of diet modification, stool softeners, and laxatives. These interventions, however, are not always effective. The purpose of this case report is to describe the use of abdominal massage in physical therapist management for a patient with constipation. An 85-year-old woman with constipation was referred for physical therapy following unsuccessful treatment with stool softeners. The patient was instructed in bowel management as well as a daily, 10-minute home abdominal massage program. Upon re-examination, the patient reported a return of normal bowel frequency and function without the need to strain or use digital evacuation. Physical therapy incorporating abdominal massage appeared to be helpful in resolving this patient's constipation. Unlike medical management of constipation, no known side effects have been identified with abdominal massage.

The influence of ageism, experience, and relationships with older adults on physical therapy students' perception of geriatrics.

PubMed

Blackwood, Jennifer; Sweet, Christina

2017-01-01

Increased exposure to geriatrics throughout a student's professional education has been reported to improve the desire to work in this area; however, factors that influence the perception of geriatric physical therapy may prohibit students from actively seeking those experiences. The purpose of this study was to examine the perceptions of geriatric physical therapy by first-year graduate physical therapy students. A qualitative case study research approach was performed. Three focus groups were completed using students enrolled in their second semester of a graduate-level physical therapy program. Dialogue was reviewed and coded by three raters. Twenty-five subcategories of open-coding terms were triangulated and grouped into 4 themes via axial coding. Four themes emerged: (1) ageism exists in health care, (2) personal and professional experiences serve as a framework for students' perception of geriatrics, (3) interpersonal relationships formed within geriatric practice are highly valued, and (4) additional contextual barriers exist in geriatrics. To meet the needs of a highly skilled geriatric workforce, students should participate in enhanced geriatric experiences in didactic coursework as well as within interprofessional geriatric clinics throughout their education.

Incorporating yoga into an intense physical therapy program in someone with Parkinson's disease: a case report.

PubMed

Moriello, Gabriele; Denio, Christopher; Abraham, Megan; DeFrancesco, Danielle; Townsley, Jill

2013-10-01

The purpose of this case report was to document outcomes following an intense exercise program integrating yoga with physical therapy exercise in a male with Parkinson's disease. The participant performed an intense 1½-hour program (Phase A) incorporating strengthening, balance, agility and yoga exercises twice weekly for 12 weeks. He then completed a new home exercise program developed by the researchers (Phase B) for 12 weeks. His score on the Parkinson's Disease Questionnaire improved 16 points while his score on the High Level Mobility Assessment tool improved 11 points. There were also improvements in muscle length of several lower extremity muscles, in upper and lower extremity muscle strength, in dynamic balance and he continues to work full time 29 months later. There were no improvements in thoracic posture or aerobic power. This intense program was an effective dose of exercise for someone with Parkinson's disease and allowed him to continue to participate in work, leisure, and community activities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparison between Kinesio Taping and a Traditional Physical Therapy Program in Treatment of Nonspecific Low Back Pain.

PubMed

Kachanathu, Shaji John; Alenazi, Aqeel M; Seif, Hamada Eid; Hafez, Ashraf Ramadan; Alroumim, Meshari Abdulmohsen

2014-08-01

[Purpose] Nonspecific low back pain (NSLBP) is a very common but largely self-limiting condition. Several types of tape and their associated application methods are available for different conditions. The aim of the present study was to observe the effect of Kinesio taping (KT) compared with traditional management of NSLBP. [Subjects and Methods] Forty male and female patients with a mean age of 34.8±7.54 years were randomly divided into two groups; group 1 (n=20) which underwent conventional physical therapy with KT, and group 2 (n=20), which underwent only conventional physical therapy. The intervention sessions for both groups were three times per week for four weeks. Outcomes were assessed for activities of daily living (ADL) using the Roland-Morris Disability Questionnaire, pain severity using a visual analogue scale, and ranges of motion (ROMs) of trunk flexion and extension using the modified Schober's test. [Results] Significant differences in measures of pain, ADL, and trunk flexion and extension ROMs were observed post intervention within each group. In comparison, there were no significant differences in measures of pain, ADL, and trunk flexion and extension ROMs post intervention between groups. [Conclusion] A physical therapy program involving strengthening exercises for abdominal muscles and stretching exercises for back, hamstring, and iliopsoas muscles with or without Kinesio taping was beneficial in the treatment of chronic low back pain.

Balneotherapy for chronic low back pain: a randomized, controlled study.

PubMed

Kesiktas, Nur; Karakas, Sinem; Gun, Kerem; Gun, Nuran; Murat, Sadiye; Uludag, Murat

2012-10-01

A large number of treatments were used for patients with chronic low back pain. Frequent episodes have been reported very high. Although balneotherapy was found effective in this disease, there are not well-designed studies. We aimed to determine the effectiveness of balneotherapy versus physical therapy in patients with chronic low back pain. Exercise was added to both treatment programs. Sixty patients with chronic low back pain were randomly divided into two groups. Physical modalities plus exercise were applied to group 1, and group 2 was received balneotherapy plus exercise for ten sessions. The following parameters were measured: visual analogue scale at rest and movement for pain, paracetamol dose, manual muscle test for lumber muscles, modified Schoeber' test, Oswestry disability index, and Short-Form 36 at the beginning and end of the therapies and at the 3 months follow-up. The statistical analyses were performed using the SPSS 10.0 program. Both groups achieved significant improvements within themselves. But balneotherapy groups were improved at back extensor muscle test (P < 0.05), modified Schoeber's test (P < 0.03), Oswestry disability index, and the some scores of SF 36 (energy vitality, social function, role limitations related to physical problems, and general health P < 0.05). Balneotherapy combined with exercise therapy had advantages than therapy with physical modalities plus exercise in improving quality of life and flexibility of patients with chronic low back pain.

A National Survey on the Use of Immersive Simulation for Interprofessional Education in Physical Therapist Education Programs.

PubMed

Stockert, Brad; Ohtake, Patricia J

2017-10-01

There is growing recognition that collaborative practice among healthcare professionals is associated with improved patient outcomes and enhanced team functioning, but development of collaborative practitioners requires interprofessional education (IPE). Immersive simulation, a clinically relevant experience that deeply engages the learner in realistic clinical environments, is used increasingly for IPE. The purpose of this study was to assess the use of immersive simulation as a strategy for IPE in physical therapist (PT) education programs. During fall 2014 and spring 2015, we contacted all 214 Commission on Accreditation in Physical Therapy Education accredited PT education programs in the United States and invited a faculty member to participate in our online survey. One hundred fourteen PT programs responded (53% response rate). Eighty responding programs (70%) identified themselves as users of immersive simulation, and 45 programs (39%) used simulation for IPE. Of these 45 programs, more than 90% included Interprofessional Education Collaborative competency learning objectives of roles/responsibilities, interprofessional communication, and teams/teamwork and 51% reported learning objectives for values/ethics for interprofessional practice. Interprofessional simulations with PT students commonly included nursing (91%). In programs using immersive simulation for IPE, 91% included debriefing and 51% included debriefing by interprofessional teams. Eighty accredited PT programs (70%) that responded to the survey use immersive simulation, and 45 programs (39%) use simulation for IPE. Most programs conduct simulations consistent with recognized best practice, including debriefing and Interprofessional Education Collaborative competency learning objectives for promoting interprofessional collaborative practice. We anticipate an increase in the use of immersive simulation for IPE as an educational strategy to comply with the revised Commission on Accreditation in Physical Therapy Education accreditation standards related to interprofessional collaborative practice that will become effective on January 1, 2018.

Strength and Conditioning for the Person with Cystic Fibrosis.

ERIC Educational Resources Information Center

Waller, Mike

2001-01-01

Discusses how a strength and conditioning program can be safety incorporated into the daily life of people with cystic fibrosis as a complementary therapy to medications, regular checkups, bronchial drainage, and respiratory therapy, examining physical restrictions and guidelines, exercise prescriptions, and exercise applications, and explaining…

Professional Socialisation of Valuers: Program Directors Perspective

ERIC Educational Resources Information Center

Page, Geoff

2007-01-01

An examination of the professional socialisation process is critical in changing the way graduates are trained and how they are supported post graduation. This article summarises key mechanisms to facilitate socialisation from recent socialisation studies undertaken in the fields of medicine, physical therapy nursing, occupational therapy, and…

Effectiveness of Physical Therapy in Treating Atraumatic Full Thickness Rotator Cuff Tears. A Multicenter Prospective Cohort Study

PubMed Central

Kuhn, John E.; Dunn, Warren R.; Sanders, Rosemary; An, Qi; Baumgarten, Keith M.; Bishop, Julie Y.; Brophy, Robert H.; Carey, James L.; Holloway, Brian G.; Jones, Grant L.; Ma, C. Benjamin; Marx, Robert G.; McCarty, Eric C.; Poddar, Sourav K.; Smith, Matthew V.; Spencer, Edwin E.; Vidal, Armando F.; Wolf, Brian R.; Wright, Rick W.

2013-01-01

Purpose To assess the effectiveness of a specific non-operative physical therapy program in treating atraumatic full thickness rotator cuff tears using a multicenter prospective cohort study design. Methods Patients with atraumatic full thickness rotator cuff tears who consented to enroll provided data via questionnaire on demographics, symptom characteristics, co-morbidities, willingness to undergo surgery, and patient related outcome assessments (SF-12, ASES, WORC, SANE score, Shoulder Activity Scale). Physicians recorded physical examination and imaging data. Patients began a physical therapy program developed from a systematic review of the literature and returned for evaluation at 6 and 12 weeks. At those visits patients could chose one of three courses: 1.) Cured (no formal follow up scheduled), 2.) Improved (continue therapy with scheduled reassessment in 6 weeks), or 3.) No better (offered surgery). Patients were contacted by telephone at 1 and 2 years to determine if they had undergone surgery since their last visit. A Wilcoxon signed rank test with continuity correction was used to compare initial, 6 week, and 12 week outcome scores. Results The cohort consists of 452 patients. Patient reported outcomes improved significantly at 6 and 12 weeks. Patients elected to undergo surgery less than 25% of the time. Patients who decided to have surgery generally did so between 6 and 12 weeks, and few had surgery between 3 and 24 months. Conclusion Non-operative treatment using this physical therapy protocol is effective for treating atraumatic full thickness rotator cuff tears in approximately 75% of patients followed for two years. Level of evidence Level IV, Case Series, Treatment Study PMID:23540577

Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay.

PubMed

Souza Possa, S; Braga Amador, C; Meira Costa, A; Takahama Sakamoto, E; Seiko Kondo, C; Maida Vasconcellos, A L; Moran de Brito, C M; Pereira Yamaguti, W

2014-01-01

The aim of this study was to evaluate the effectiveness of implementing a physical therapy guideline for patients undergoing upper abdominal surgery (UAS) in reducing the incidence of atelectasis and length of hospital stay in the postoperative period. A "before and after" study design with historical control was used. The "before" period included consecutive patients who underwent UAS before guideline implementation (intervention). The "after" period included consecutive patients after guideline implementation. Patients in the pre-intervention period were submitted to a program of physical therapy in which the treatment planning was based on the individual experience of each professional. On the other hand, patients who were included in the post-intervention period underwent a standardized program of physical therapy with a focus on the use of additional strategies (EPAP, incentive spirometry and early mobilization). There was a significant increase in the use of incentive spirometry and positive expiratory airway pressure after guideline implementation. Moreover, it was observed that early ambulation occurred in all patients in the post-intervention period. No patient who adhered totally to the guideline in the post-intervention period developed atelectasis. Individuals in the post-intervention period presented a shorter length of hospital stay (9.2±4.1 days) compared to patients in the pre-intervention period (12.1±8.3 days) (p<0.05). The implementation of a physical therapy guideline for patients undergoing UAS resulted in reduced incidence of atelectasis and reduction in length of hospital stay in the postoperative period. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

A systematic review on reminder systems in physical therapy

PubMed Central

Jangi, Majid; Ferandez-de-las-Penas, Cesar; Tara, Mahmoud; Moghbeli, Fateme; Ghaderi, Fariba; Javanshir, Khodabakhsh

2018-01-01

Background: The main goal of physical therapy is to help the patient gain a better health status. Several studies have investigated the use of reminders to prevent such failures on the patients’ side. This article presents a systematic review of the literature concerning reminders in physical therapy. Methods: Databases were searched until May 2017 and literatures were found from April 1992 until 2017. The literature recruitment strategy was based on applying several keywords and Medical Subject Heading (MeSH) combination running against title and abstract, including concepts such as reminder, physical therapy. The finally selected articles were categorized through reminder aspects such as how, who feedback. Data were extracted according to PRISMA guidelines. Results: In 47% of studies, the reminder was sent to the patients, 29% to the physical therapists and 12% to the caretaker team. In 24% of the studies, paper-based letters were main medium for reminders while the rest were various types of media like emails and SMS mobile text messages. 35% of the articles showed positive effects of the reminders. Conclusions: Many reminder methods consisted of SMS, phone calls, letters, emails and notices on the wall were used in physical therapy. Reminders may be used to improve patients' adherence to exercise programs. PMID:29387313

Dance program for physical rehabilitation and participation in children with cerebral palsy

PubMed Central

López-Ortiz, Citlali; Gladden, Kim; Deon, Laura; Schmidt, Jennifer; Girolami, Gay; Gaebler-Spira, Deborah

2012-01-01

Objective: This pilot study aimed to examine a classical ballet program created for children with cerebral palsy (CP) as an emerging physical rehabilitation modality. The main program goals were to promote participation and to provide an artistic, physically therapeutic activity. Methods: The study was conducted in collaboration with a tertiary rehabilitation hospital, one outpatient physical therapy clinic, and one community center. As a pilot exploratory study, the research design included questionnaires to assess the participants' (children (n = 16), parents (n = 16), and therapists (n = 13)) perceptions on the therapeutic benefit of the dance program. A binomial statistical model was adopted for the analysis of the results. Results: Main results were that the children reported high enjoyment level (p < .0001) and desire for more classes (.0001); the parents reported perceived therapeutic benefit (p < .0001); and the therapists viewed the class as a positive adjunct to therapy (p < .0001). Conclusions: The main limitation of this work was the utilization of subjective outcome measures. However, this is the first step toward the development of objective measures of an intervention that, to our knowledge, has not been analyzed in the past. We conclude that the program has the potential of developing into an evidence based rehabilitation resource for children with CP. PMID:25431617

Effect of forced use of the lower extremity on gait performance and mobility of post-acute stroke patients

PubMed Central

Yu, Wen-Hsiu; Liu, Wen-Yu; Wong, Alice May-Kuen; Wang, Tzu-Chi; Li, Yen-Chen; Lien, Hen-Yu

2015-01-01

[Purpose] The purpose of this study was to investigate the effects of a forced-use training program on gait, mobility and quality of life of post-acute stroke patients. [Subjects] Twenty-one individuals with unilateral stroke participated in this study. All participants had suffered from first-ever stroke with time since onset of at least 3 months. [Methods] A single-blinded, non-equivalent, pre-post controlled design with 1-month follow-up was adopted. Participants received either a forced-use or a conventional physical therapy program for 2 weeks. The main outcomes assessed were preferred and fastest walking velocities, spatial and temporal symmetry indexes of gait, the timed up and go test, the Rivermead Mobility Index, and the Stroke-Specific Quality of Life Scale (Taiwan version). [Results] Forced-use training induced greater improvements in gait and mobility than conventional physical therapy. In addition, compared to pre-training, patients in the conventional physical therapy group walked faster but more asymmetrically after training. However, neither program effectively improved in-hospital quality of life. [Conclusion] The forced-use approach can be successfully applied to the lower extremities of stroke patients to improve mobility, walking speeds and symmetry of gait. PMID:25729182

Evaluation of the effectiveness of robotic gait training and gait-focused physical therapy programs for children and youth with cerebral palsy: a mixed methods RCT.

PubMed

Wiart, Lesley; Rosychuk, Rhonda J; Wright, F Virginia

2016-06-02

Robot assisted gait training (RAGT) is considered to be a promising approach for improving gait-related gross motor function of children and youth with cerebral palsy. However, RAGT has yet to be empirically demonstrated to be effective. This knowledge gap is particularly salient given the strong interest in this intensive therapy, the high cost of the technology, and the requirement for specialized rehabilitation centre resources. This is a research protocol describing a prospective, multi-centre, concurrent mixed methods study comprised of a randomized controlled trial (RCT) and an interpretive descriptive qualitative design. It is a mixed methods study designed to determine the relative effectiveness of three physical therapy treatment conditions (i.e., RAGT, a functional physical therapy program conducted over-ground (fPT), and RAGT + fPT) on gait related motor skills of ambulatory children with cerebral palsy. Children with cerebral palsy aged 5-18 years who are ambulatory (Gross Motor Function Classification System Levels II and III) will be randomly allocated to one of four treatment conditions: 1) RAGT, 2) fPT, 3) RAGT and fPT combined, or 4) a maintenance therapy only control group. The qualitative component will explicate child and parent experiences with the interventions, provide insight into the values that underlie their therapy goals, and assist with interpretation of the results of the RCT. n/a. NCT02391324 Registered March 12, 2015.

Formal Physical Therapy After Total Hip Arthroplasty Is Not Required: A Randomized Controlled Trial.

PubMed

Austin, Matthew S; Urbani, Brian T; Fleischman, Andrew N; Fernando, Navin D; Purtill, James J; Hozack, William J; Parvizi, Javad; Rothman, Richard H

2017-04-19

The value of formal physical therapy after total hip arthroplasty is unknown. With substantial changes that have occurred in surgical and anesthesia techniques, self-directed therapy may be efficacious in restoring function to patients undergoing total hip arthroplasty. We conducted a single-center, randomized trial of 120 patients undergoing primary, unilateral total hip arthroplasty who were eligible for direct home discharge. The experimental group followed a self-directed home exercise program for 10 weeks. The control group received the standard protocol for physical therapy that included in-home visits with a physical therapist for the first 2 weeks followed by formal outpatient physical therapy for 8 weeks. Functional outcomes were measured using validated instruments including the Harris hip score (HHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form-36 Health Survey (SF-36) preoperatively, at 1 month postoperatively, and at 6 to 12 months postoperatively. Of 120 randomized patients, 108 were included in the final analysis. Ten patients (19%) were randomized to unsupervised home exercise and 20 patients (37%) were randomized to formal outpatient therapy crossed over between groups. There was no significant difference in any of the measured functional outcomes between patients receiving formal therapy (n = 54) and those participating in unsupervised home exercise (n = 54) at any time point (HHS, p = 0.82; WOMAC, p = 0.80; and SF-36 physical health, p = 0.90). This randomized trial suggests that unsupervised home exercise is both safe and efficacious for a majority of patients undergoing total hip arthroplasty, and formal physical therapy may not be required. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Development and Evaluation of an Implementation Strategy for Collecting Data in a National Registry and the Use of Patient-Reported Outcome Measures in Physical Therapist Practices: Quality Improvement Study.

PubMed

Meerhoff, Guus A; van Dulmen, Simone A; Maas, Marjo J M; Heijblom, Karin; Nijhuis-van der Sanden, Maria W G; Van der Wees, Philip J

2017-08-01

In 2013, the Royal Dutch Society for Physical Therapy launched the program "Quality in Motion." This program aims to collect data from electronic health record systems in a registry that is fed back to physical therapists, facilitating quality improvement. The purpose of this study was to describe the development of an implementation strategy for the program and to evaluate the feasibility of building a registry and implementing patient-reported outcome measures (PROMs) in physical therapist practices. A stepwise approach using mixed methods was established in 3 consecutive pilots with 355 physical therapists from 66 practices. Interim results were evaluated using quantitative data from a self-assessment questionnaire and the registry and qualitative data from 21 semistructured interviews with physical therapists. Descriptive statistics and McNemar's symmetry chi-squared test were used to summarize the feasibility of implementing PROMs. PROMs were selected for the 5 most prevalent musculoskeletal conditions in Dutch physical therapist practices. A core component of the implementation strategy was the introduction of knowledge brokers to support physical therapists in establishing the routine use of PROMs in clinical practice and to assist in executing peer assessment workshops. In February 2013, 30.3% of the physical therapist practices delivered 4.4 completed treatment episodes per physical therapist to the registry; this increased to 92.4% in November 2014, delivering 54.1 completed patient episodes per physical therapist. Pre- and posttreatment PROM use increased from 12.2% to 39.5%. It is unclear if the participating physical therapists reflect a representative sample of Dutch therapists. Building a registry and implementing PROMs in physical therapist practices are feasible. The routine use of PROMs needs to increase to ensure valid feedback of outcomes. Using knowledge brokers is promising for implementing the program via peer assessment workshops. © 2017 American Physical Therapy Association

Improving student-perceived benefit of academic advising within education of occupational and physical therapy in the United States: a quality improvement initiative.

PubMed

Barnes, Lisa J; Parish, Robin

2017-01-01

Academic advising is a key role for faculty in the educational process of health professionals; however, the best practice of effective academic advising for occupational and physical therapy students has not been identified in the current literature. The purpose of this quality improvement initiative was to assess and improve the faculty/student advisor/advisee process within occupational and physical therapy programs within a school of allied health professions in the United States in 2015. A quality improvement initiative utilizing quantitative and qualitative information was gathered via survey focused on the assessment and improvement of an advisor/advisee process. The overall initiative utilized an adaptive iterative design incorporating the plan-do-study-act model which included a three-step process over a one year time frame utilizing 2 cohorts, the first with 80 students and the second with 88 students. Baseline data were gathered prior to initiating the new process. A pilot was conducted and assessed during the first semester of the occupational and physical therapy programs. Final information was gathered after one full academic year with final comparisons made to baseline. Defining an effective advisory program with an established framework led to improved awareness and participation by students and faculty. Early initiation of the process combined with increased frequency of interaction led to improved student satisfaction. Based on student perceptions, programmatic policies were initiated to promote advisory meetings early and often to establish a positive relationship. The policies focus on academic advising as one of proactivity in which the advisor serves as a portal which the student may access leading to a more successful academic experience.

Clinical Performance and Admission Variables as Predictors of Passage of the National Physical Therapy Examination.

PubMed

Meiners, Kelly M; Rush, Douglas K

2017-01-01

Prior studies have explored variables that had predictive relationships with National Physical Therapy Examination (NPTE) score or NPTE failure. The purpose of this study was to explore whether certain variables were predictive of test-takers' first-time score on the NPTE. The population consisted of 134 students who graduated from the university's Professional DPT Program in 2012 to 2014. This quantitative study used a retrospective design. Two separate data analyses were conducted. First, hierarchical linear multiple regression (HMR) analysis was performed to determine which variables were predictive of first-time NPTE score. Second, a correlation analysis was performed on all 18 Physical Therapy Clinical Performance Instrument (PT CPI) 2006 category scores obtained during the first long-term clinical rotation, overall PT CPI 2006 score, and NPTE passage. With all variables entered, the HMR model predicted 39% of the variance seen in NPTE scores. The HMR results showed that physical therapy program first-year GPA (1PTGPA) was the strongest predictor and explained 24% of the variance in NPTE scores (b=0.572, p<0.001). The correlational analysis found no statistically significant correlation between the 18 PT CPI 2006 category scores, overall PT CPI 2006 score, and NPTE passage. As 1PTGPA had the most significant contribution to prediction of NPTE scores, programs need to monitor first-year students who display academic difficulty. PT CPI version 2006 scores were significantly correlated with each other, but not with NPTE score or NPTE passage. Both tools measure many of the same professional requirements but use different modes of assessment, and they may be considered complementary tools to gain a full picture of both the student's ability and skills.

Making Decisions about Service Delivery in Early Childhood Programs

ERIC Educational Resources Information Center

Case-Smith, Jane; Holland, Terri

2009-01-01

Purpose: This article presents a rationale for specialized services personnel to use fluid models of service delivery and explains how specialized services personnel make decisions about the blend of service delivery methods that will best serve a child. Method: The literature on occupational therapy, physical therapy, and speech-language…

75 FR 40039 - Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... external defibrillator AFROC Association of Freestanding Radiation Oncology Centers AHA American Heart... Procedure Coding System HCRIS Healthcare Cost Report Information System HDRT High dose radiation therapy HH... rule with comment period IMRT Intensity-Modulated Radiation Therapy IPPE Initial preventive physical...

Emotional Safety in Adventure Therapy Programs: Can It Be Defined?

ERIC Educational Resources Information Center

Vincent, Suzanne M.

1995-01-01

Ninety-eight adventure therapy professionals analyzed a proposed definition of emotional safety and rated 26 factors hypothesized to affect an individual's level of emotional safety during adventure activities. Factors were related to specific techniques used by instructors, instructor skills and abilities, the physical environment, and group…

Clinical Reasoning: Survey of Teaching Methods, Integration, and Assessment in Entry-Level Physical Therapist Academic Education.

PubMed

Christensen, Nicole; Black, Lisa; Furze, Jennifer; Huhn, Karen; Vendrely, Ann; Wainwright, Susan

2017-02-01

Although clinical reasoning abilities are important learning outcomes of physical therapist entry-level education, best practice standards have not been established to guide clinical reasoning curricular design and learning assessment. This research explored how clinical reasoning is currently defined, taught, and assessed in physical therapist entry-level education programs. A descriptive, cross-sectional survey was administered to physical therapist program representatives. An electronic 24-question survey was distributed to the directors of 207 programs accredited by the Commission on Accreditation in Physical Therapy Education. Descriptive statistical analysis and qualitative content analysis were performed. Post hoc demographic and wave analyses revealed no evidence of nonresponse bias. A response rate of 46.4% (n=96) was achieved. All respondents reported that their programs incorporated clinical reasoning into their curricula. Only 25% of respondents reported a common definition of clinical reasoning in their programs. Most respondents (90.6%) reported that clinical reasoning was explicit in their curricula, and 94.8% indicated that multiple methods of curricular integration were used. Instructor-designed materials were most commonly used to teach clinical reasoning (83.3%). Assessment of clinical reasoning included practical examinations (99%), clinical coursework (94.8%), written examinations (87.5%), and written assignments (83.3%). Curricular integration of clinical reasoning-related self-reflection skills was reported by 91%. A large number of incomplete surveys affected the response rate, and the program directors to whom the survey was sent may not have consulted the faculty members who were most knowledgeable about clinical reasoning in their curricula. The survey construction limited some responses and application of the results. Although clinical reasoning was explicitly integrated into program curricula, it was not consistently defined, taught, or assessed within or between the programs surveyed-resulting in significant variability in clinical reasoning education. These findings support the need for the development of best educational practices for clinical reasoning curricula and learning assessment. © 2017 American Physical Therapy Association

Nuclear Physics Laboratory technical progress report, November 1, 1972-- November 1, 1973

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1973-11-01

The experimental program was divided into the areas of nuclear physics (charged-particle experiments, gamma-ray experiments andd beta decay, neutron time-of-flight experiments, x-ray fluorescence analysis, other activities), intermediate enengy physics, and apparatus and facility development. The energy- loss spectrograph, rotating-beam neutron time-of-flight spectrometer, and cyclotron and the rearch done using these facilities are described. The theoretical program has concentrated on the effects of two-step processes in nuclear reactions. The trace element analysis program continued, and a neutron beam for cancer therapy is being developed. Lists of publications and personnel are also included. (RWR)

Factors Influencing Texas Physical Therapy Students' Membership in the American Physical Therapy Association and the Texas Physical Therapy Association: Implications for Academicians, Clinicians, and Professional Associations.

PubMed

Hughes, Lynne C; Book, Ashley; Lewis, Harriet

2016-01-01

To determine the factors impacting the decisions of student physical therapists (PTs) and physical therapist assistants (PTAs) to join and maintain membership in the American Physical Therapy Association and the Texas Physical Therapy Association, in light of a membership initiative of Reach 100 that was adopted in Texas. Survey, descriptive. An online membership survey invitation was distributed to Texas PT and PTA students. A total of 479 students responded to the survey. A majority of participants (67%) reported being members, while 33% reported being non-members. The primary reason students (74%) reported for being a member was that they were encouraged by their academic program. Students who are not members (87%) cited the high cost of national dues. A majority of participants (n=379, 83%) rated faculty promotion of membership as somewhat high to high. In contrast, only 26% rated the promotion of membership by their clinical education sites as somewhat high to high. Professional growth and development was cited as the main reason to maintain membership. Although students are being encouraged to join, a third of the respondents still do not belong. It is imperative that clinical mentors model and support membership activities. Association leadership may use this information to develop strategic plans to be inclusive of the student and new professional.

Treatment of ankylosing spondylitis with biologics and targeted physical therapy: positive effect on chest pain, diminished chest mobility, and respiratory function.

PubMed

Gyurcsik, Z; Bodnár, N; Szekanecz, Z; Szántó, S

2013-12-01

Biologics are highly effective in ankylosing spondylitis (AS). In this self-controlled study, we assessed the additive value of complex physiotherapy in decreasing chest pain and tenderness and improving respiratory function in AS patients treated with tumor necrosis factor α (TNF-α) inhibitors. The trial consisted of 2 parts. In study I, clinical data of AS patients with (n=55) or without biological therapy (n=20) were retrospectively analyzed and compared. Anthropometrical data, duration since diagnosis and patient assessment of disease activity, pain intensity, tender points, sacroiliac joint involvement determined by X-ray, functional condition, and physical activity level were recorded. Subjective, functional, and physical tests were performed. In study II, 10 voluntary patients (6 men and 4 women, age 52.4 ± 13.6 years) with definite AS and receiving anti-TNF therapy were recruited. It was a prospective, non-randomized physiotherapeutic trial. BASFI (Bath Ankylosing Spondylitis Functional Index), BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), modified Schober Index, occiput-to-wall distance, and fingertip-to-floor distance were evaluated. Forced vital capacity, forced 1-s expiratory volume, peak expiratory flow, and maximum voluntary ventilation were recorded. Furthermore, typical tender points were recorded. A targeted physiotherapy program was conducted twice a week for 12 weeks and all above parameters were recorded at baseline and after 12 weeks. Differences in patient assessment of disease activity (p=0.019) and pain intensity (p=0.017) were found in study I. Pain and tenderness of the thoracic spine were observed in both groups. Back pain without biologic therapy was slightly higher than other group. In study II, we found that patient assessment of disease activity and pain intensity significantly improved after the physical therapy program (p=0.002 and p<0.001). BASFI and BASDAI increased after treatment (p=0.004 and p<0.001). The finger-to-floor distance, chest expansion, and modified Schober index increased (p=0.008, p<0.001, and p=0.031, respectively). The respiratory functional parameters showed a tendency towards improvement. AS patients already receiving biological therapy may benefit from additional targeted physiotherapy. Physical therapy may be of important additive value in AS patients being treated with biological. The exercise program presented here showed an improvement in functional parameters as well as spine and chest mobility, thereby enhancing the favorable effects of biological therapy.

Native Americans in Physical Therapy.

ERIC Educational Resources Information Center

Westberg, Jane

2003-01-01

Three Native American physical therapists share stories of their careers, including educational background; motivation to enter the field; and experiences as a volunteer in Vietnam and working with the Indian Health Service and various rehabilitation programs. Advice on appropriate preparation in the sciences is offered to Native students…

Decisions on Implementing Service-Learning: Perceptions of Physical Therapist Assistant Faculty within a State Technical College System

ERIC Educational Resources Information Center

Herlitzke, Mary Ann

2012-01-01

The Commission on Accreditation of Physical Therapy Education (CAPTE) requires that graduates of physical therapist assistant programs demonstrate a commitment to social responsibility. Service-learning, a method of instruction in which students apply knowledge and skills learned in the classroom to a community need, can assist in the development…

The impact of a service learning experience to enhance curricular integration in a physical therapist education program.

PubMed

Gazsi, Claudia C; Oriel, Kathryn N

2010-01-01

A goal when designing the Physical Therapy Program at Lebanon Valley College (LVC) was to maximize vertical and horizontal integration of course content related to (a) medical Spanish, (b) geriatrics, and (c) health promotion through a service learning engagement. Seventeen Doctor of Physical Therapy students from LVC participated in a fall risk screening at a local senior center in a Spanish-speaking neighborhood. The screen included the single leg stance, timed-up-and-go (TUG), and functional reach tests. The students screened 30 participants over a 3-hour time period. Following the screening event, students were asked to reflect on their experience. Reflections revealed that the activity supported integration of concurrent didactic course material and Core Values, reinforced cultural issues presented the previous year, and convinced students that physical therapists have a distinct and important role in primary and secondary prevention in meeting the needs of the Spanish-speaking elderly community.

The Physiotherapy for Femoroacetabular Impingement Rehabilitation STudy (physioFIRST): A Pilot Randomized Controlled Trial.

PubMed

Kemp, Joanne L; Coburn, Sally L; Jones, Denise M; Crossley, Kay M

2018-04-01

Study Design A pilot double-blind randomized controlled trial (RCT). Background The effectiveness of physical therapy for femoroacetabular impingement syndrome (FAIS) is unknown. Objectives To determine the feasibility of an RCT investigating the effectiveness of a physical therapy intervention for FAIS. Methods Participants were 17 women and 7 men (mean ± SD age, 37 ± 8 years; body mass index, 25.4 ± 3.4 kg/m 2 ) with FAIS who received physical therapy interventions provided over 12 weeks. The FAIS-specific physical therapy group received personalized progressive strengthening and functional retraining. The control group received standardized stretching exercises. In addition, both groups received manual therapy, progressive physical activity, and education. The primary outcome was feasibility, including integrity of the protocol, recruitment and retention, outcome measures, randomization procedure, and sample-size estimate. Secondary outcomes included hip pain and function (international Hip Outcome Tool-33 [iHOT-33]) and hip muscle strength. Poststudy interviews were conducted to determine potential improvements for future studies. Results Twenty-four (100%) patients with known eligibility agreed to participate. Four patients (17%) were lost to follow-up. All participants and the tester remained blinded, and the control intervention was acceptable to participants. The between-group mean differences in change scores were 16 (95% confidence interval [CI]: -9, 38) for the iHOT-33 and 0.24 (95% CI: 0.02, 0.47) Nm/kg for hip adduction strength, favoring the FAIS-specific physical therapy group. Using an effect size of 0.61, between-group improvements for the iHOT-33 suggest that 144 participants are required for a full-scale RCT. Conclusion A full-scale RCT of physical therapy for FAIS is feasible. A FAIS-specific physical therapy program has the potential for a moderate to large positive effect on hip pain, function, and hip adductor strength. Level of Evidence Therapy, level 2b. J Orthop Sports Phys Ther 2018;48(4):307-315. doi:10.2519/jospt.2018.7941.

Physical conditioning and mental stress reduction - a randomised trial in patients undergoing cardiac surgery

PubMed Central

2011-01-01

Background Preoperative anxiety and physical unfitness have been shown to have adverse effects on recovery from cardiac surgery. This study involving cardiac surgery patients was primarily aimed at assessing the feasibility of delivering physical conditioning and stress reduction programs within the public hospital setting. Secondary aims were to evaluate the effect of these programs on quality of life (QOL), rates of postoperative atrial fibrillation (AF) and length of stay (LOS) in hospital. Methods Elective patients scheduled for coronary artery bypass graft and/or valve surgery at a public hospital in Melbourne, Australia were enrolled. Patients were randomized to receive either holistic therapy (HT) or usual care (UC). HT consisted of a series of light physical exercise sessions together with a mental stress reduction program administered in an outpatient setting for the first two weeks after placement on the waiting list for surgery. A self-administered SF-36 questionnaire was used to measure QOL and hospital records to collect data on LOS and rate of postoperative AF. Results The study population comprised 117 patients of whom 60 received HT and 57 received UC. Both programs were able to be delivered within the hospital setting but ongoing therapy beyond the two week duration of the program was not carried out due to long waiting periods and insufficient resources. HT, as delivered in this study, compared to UC did not result in significant changes in QOL, LOS or AF incidence. Conclusions Preoperative holistic therapy can be delivered in the hospital setting, although two weeks is insufficient to provide benefits beyond usual care on QOL, LOS or postoperative AF. Further research is now required to determine whether a similar program of longer duration, or targeted to high risk patients can provide measurable benefits. Trial registration This trial was conducted as part of a larger study and according to the principles contained in the CONSORT statement 2001. PMID:21385466

Peer Mentoring Program in an Interprofessional and Interdisciplinary Curriculum in Brazil

ERIC Educational Resources Information Center

de Oliveira, Camila Aparecida Machado; de França Carvalho, Carolina Prado; Céspedes, Isabel Cristina; de Oliveira, Flávia; Le Sueur-Maluf, Luciana

2015-01-01

The Federal University of São Paulo, Baixada Santista Campus was founded in 2006 with five degree-granting programs in physical education, physiotherapy, nutrition, psychology, and occupational therapy. The guiding principle behind the programs' educational mission was centered on the development of health care professionals capable of working in…

A Data Set of Human Body Movements for Physical Rehabilitation Exercises.

PubMed

Vakanski, Aleksandar; Jun, Hyung-Pil; Paul, David; Baker, Russell

2018-03-01

The article presents University of Idaho - Physical Rehabilitation Movement Data (UI-PRMD) - a publically available data set of movements related to common exercises performed by patients in physical rehabilitation programs. For the data collection, 10 healthy subjects performed 10 repetitions of different physical therapy movements, with a Vicon optical tracker and a Microsoft Kinect sensor used for the motion capturing. The data are in a format that includes positions and angles of full-body joints. The objective of the data set is to provide a basis for mathematical modeling of therapy movements, as well as for establishing performance metrics for evaluation of patient consistency in executing the prescribed rehabilitation exercises.

RCT - subjective physical performance and quality of life after a 6-month programmed sports therapy (PST) in patients with haemophilia.

PubMed

Runkel, B; Von Mackensen, S; Hilberg, T

2017-01-01

Musculoskeletal bleedings lead to limitations in the locomotor system and consequently, in health-related quality of life (HRQoL) in patients with haemophilia (PwH). Sports therapy is increasingly recommended to improve their physical performance. Until today, randomised controlled studies investigating changes in physical performance in PwH are rare. This study investigates the impact of programmed sports therapy on the subjective physical performance and the HRQoL in PwH. A randomised controlled trial (RCT) was conducted with a training intervention for over 6 months. For this purpose, 64 PwH with moderate (n = 5) or severe (n = 59) haemophilia A (n = 57) or B (n = 7) were randomised into two groups - intervention (IG) or control group (CG). The HRQoL was assessed with the SF-36 questionnaire and the disease-specific Haem-A-QoL before and after the intervention. The subjective physical performance was tested by the HEP-Test-Q. After the 6-month training intervention, PwH in the IG subjectively reported significant better 'endurance' (P = 0.000) in the HEP-Test-Q compared to the CG. In the SF-36, a significant difference in the domains 'general health perceptions' (P = 0.005) and 'mental health' (P = 0.001) was detected. The haemophilia-specific HRQoL questionnaire showed a significant improvement in the dimensions 'feeling' (P = 0.049), 'work' (P = 0.046) and 'family' (P = 0.040). In the first RCT evaluating the impact of a 6-month training intervention on the subjective perception of PwH, an increase in subjective physical performance and some domains of HRQoL was demonstrated in the IG. Specific sports therapy should be included into the comprehensive treatment under supervision and monitoring by experienced staff. © 2016 John Wiley & Sons Ltd.

Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome: Randomized Controlled Trial.

PubMed

Christiansen, David Høyrup; Frost, Poul; Falla, Deborah; Haahr, Jens Peder; Frich, Lars Henrik; Andrea, Linda Christie; Svendsen, Susanne Wulff

2016-06-01

Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery. A multicenter randomized controlled trial was conducted. The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region. One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated. A standardized exercise program consisting of physical therapist-supervised individual training sessions and home training was used. The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire. At 3 and 12 months, follow-up data were obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95% confidence interval=-0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures. The nature of the exercise intervention did not allow blinding of patients and care providers. The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and function at 12 months compared with usual care. © 2016 American Physical Therapy Association.

Perceptions of a Videogame-Based Dance Exercise Program Among Individuals with Parkinson's Disease.

PubMed

Natbony, Lauren R; Zimmer, Audra; Ivanco, Larry S; Studenski, Stephanie A; Jain, Samay

2013-08-01

Physical therapy, including exercise, improves gait and quality of life in Parkinson's disease (PD). Many programs promoting physical activity have generated significant short-term gains, but adherence has been a problem. A recent evidence-based analysis of clinical trials using physical therapy in PD patients produced four key treatment recommendations: cognitive movement strategies, physical capacity, balance training, and cueing. We have attempted to incorporate all four of these features together through a dance exercise program using the dance videogame "Dance Dance Revolution" (DDR) (Konami Digital Entertainment, El Segundo, CA). Sixteen medically stable participants with mild to moderate PD were given the opportunity to try DDR with supervision by a research staff member. Feedback about the advantages and disadvantages of DDR as a form of physical activity was elicited through focus groups using the nominal group technique. Of 21 advantages and 17 disadvantages elicited, the most frequently cited advantages were "fun" and "easy to use," followed by "improves balance or coordination," "challenging," and "full body aerobic activity." Common concerns were the distracting or confusing interface, cost, and possible technical issues. Interactive dance exercise was appealing to participants with PD and may help promote adherence to physical activity. Concerns regarding familiarity with the technology may be addressed with simplification of the interface or additional training for participants. Results support a larger longitudinal study of DDR in PD.

Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

PubMed

Kash, Bita A; Deshmukh, A A

2013-01-01

The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.

Overcoming Content-Associated Challenges Using Attention-Focused Methods

ERIC Educational Resources Information Center

Lebec, Michael T.; Kesteloot, Lauren

2015-01-01

A common challenge in higher education is teaching required content for which students traditionally have lower levels of interest. Physical therapist education programs experience this challenge when training entry-level students to document in the medical record. The authors compared learning outcomes among physical therapy students taught…

Effectiveness and cost-effectiveness of a blended exercise intervention for patients with hip and/or knee osteoarthritis: study protocol of a randomized controlled trial.

PubMed

Kloek, Corelien J J; Bossen, Daniël; Veenhof, Cindy; van Dongen, Johanna M; Dekker, Joost; de Bakker, Dinny H

2014-08-08

Exercise therapy in patients with hip and/or knee osteoarthritis is effective in reducing pain, increasing physical activity and physical functioning, but costly and a burden for the health care budget. A web-based intervention is cheap in comparison to face-to-face exercise therapy and has the advantage of supporting in home exercises because of the 24/7 accessibility. However, the lack of face-to-face contact with a professional is a disadvantage of web-based interventions and is probably one of the reasons for low adherence rates. In order to combine the best of two worlds, we have developed the intervention e-Exercise. In this blended intervention face-to-face contacts with a physical therapist are partially replaced by a web-based exercise intervention. The aim of this study is to investigate the short- (3 months) and long-term (12 months) (cost)-effectiveness of e-Exercise compared to usual care physical therapy. Our hypothesis is that e-Exercise is more effective and cost-effective in increasing physical functioning and physical activity compared to usual care. This paper presents the protocol of a prospective, single-blinded, multicenter cluster randomized controlled trial. In total, 200 patients with OA of the hip and/or knee will be randomly allocated into either e-Exercise or usual care (physical therapy). E-Exercise is a 12-week intervention, consisting of maximum five face-to-face physical therapy contacts supplemented with a web-based program. The web-based program contains assignments to gradually increase patients' physical activity, strength and stability exercises and information about OA related topics. Primary outcomes are physical activity and physical functioning. Secondary outcomes are health related quality of life, self-perceived effect, pain, tiredness and self-efficacy. All measurements will be performed at baseline, 3 and 12 months after inclusion. Retrospective cost questionnaires will be sent at 3, 6, 9 and 12 months and used for the cost-effectiveness and cost-utility analysis. This study is the first randomized controlled trial in the (cost)-effectiveness of a blended exercise intervention for patients with osteoarthritis of the hip and/or knee. The findings will help to improve the treatment of patients with osteoarthritis. NTR4224.

Effects of dance therapy on the selected hematological and rheological indicators in older women.

PubMed

Filar-Mierzwa, Katarzyna; Marchewka, Anna; Bac, Aneta; Kulis, Aleksandra; Dąbrowski, Zbigniew; Teległów, Aneta

2017-01-01

The aim of this study was to analyze the effects of dance therapy on selected hematological and rheological indicators in older women. The study included 30 women (aged 71.8±7.4), and the control group comprised of 10 women of corresponding age. Women from the experimental group were subjected to a five-month dance therapy program (three 45-minute sessions per week); women from the control group were not involved in any regular physical activity. Blood samples from all the women were examined for hematological, rheological, and biochemical parameters prior to the study and five months thereafter. The dance therapy program was reflected by a significant improvement of erythrocyte count and hematocrit. Furthermore, the dance therapy resulted in a significant increase in the plasma viscosity, while no significant changes in glucose and fibrinogen levels were noted. Dance therapy modulates selected hematological parameters of older women; it leads to increase in erythrocyte count and hematocrit level. Dance therapy is reflected by higher plasma viscosity. Concentrations of fibrinogen and glucose are not affected by the dance therapy in older women, suggesting maintenance of homeostasis. Those findings advocate implementation of dance therapy programs in older women.

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

PubMed Central

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain.

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

2014-01-15

Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

Essential competencies in entry-level pediatric physical therapy education.

PubMed

Rapport, Mary Jane; Furze, Jennifer; Martin, Kathy; Schreiber, Joe; Dannemiller, Lisa A; Dibiasio, Paula A; Moerchen, Victoria A

2014-01-01

The Section on Pediatrics (SoP) convened an Education Summit in July 2012 to examine, discuss, and respond to documented inconsistencies and challenges in teaching pediatric physical therapy (PT) content in entry-level professional education programs. Despite previous attempts by the SoP to provide guidance around teaching pediatric PT, variability continued to be extensive across programs. This article presents the core competencies developed out of the Summit to inform pediatric content in the entry-level PT curriculum. In addition, the core competencies were linked to teaching strategies, learning activities, assessment outcomes, and curricular structures. Consensus was reached on 5 core competencies that represent a knowledge base essential to all graduates of PT programs. In contrast to prior SoP documents, these competencies were specifically designed to focus on knowledge and skills unique to pediatric practice but essential for all graduates of accredited entry-level PT education programs. For more insights from the authors, see Supplemental Digital Content 1, at http://links.lww.com/PPT/A50.

Therapeutic horse back riding of a spinal cord injured veteran: a case study.

PubMed

Asselin, Glennys; Penning, Julius H; Ramanujam, Savithri; Neri, Rebecca; Ward, Constance

2012-01-01

To determine an incomplete spinal cord injured veteran's experience following participation in a therapeutic horseback riding program. Following the establishment of a nationwide therapeutic riding program for America's wounded service veterans in 2007, a Certified Rehabilitation Registered Nurse from the Michael E. DeBakey Veteran Affairs Medical Center worked with an incomplete spinal cord injured veteran who participated in the Horses for Heroes program. This program resulted in many benefits for the veteran, including an increase in balance, muscle strength, and self-esteem. A physical, psychological, and psychosocial benefit of therapeutic horseback riding is shown to have positive results for the spinal cord injured. Therapeutic riding is an emerging field where the horse is used as a tool for physical therapy, emotional growth, and learning. Veterans returning from the Iraq/Afghanistan war with traumatic brain injuries, blast injuries, depression, traumatic amputations, and spinal cord injuries may benefit from this nurse-assisted therapy involving the horse. © 2012 Association of Rehabilitation Nurses.

Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease: A Randomized Clinical Trial.

PubMed

King, Laurie A; Wilhelm, Jennifer; Chen, Yiyi; Blehm, Ron; Nutt, John; Chen, Zunqiu; Serdar, Andrea; Horak, Fay B

2015-10-01

Comparative studies of exercise interventions for people with Parkinson disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by (1) home exercise program, (2) individualized physical therapy, or (3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention. Fifty-eight people (age = 63.9 ± 8 years) with PD participated. People were randomized into (1) home exercise program, (2) individual physical therapy, or (3) group class intervention. All arms were standardized and based on the Agility Boot Camp exercise program for PD, 3 times per week for 4 weeks. The primary outcome measure was the 7-item Physical Performance Test. Other measures of balance, gait, mobility, quality of life, balance confidence, depressions, apathy, self-efficacy and UPDRS-Motor, and activity of daily living scores were included. Only the individual group significantly improved in the Physical Performance Test. The individual exercise showed the most improvements in functional and balance measures, whereas the group class showed the most improvements in gait. The home exercise program improved the least across all outcomes. Several factors effected success, particularly for the home group. An unsupervised, home exercise program is the least effective way to deliver exercise to people with PD, and individual and group exercises have differing benefits. Furthermore, people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist.Video Abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A112).

A randomized controlled trial of an enhanced interdisciplinary community based group program for people with Parkinson's disease: study rationale and protocol.

PubMed

Peters, Catherine; Currin, Michelle; Tyson, Sara; Rogers, Anthea; Healy, Susan; McPhail, Steven; Brauer, Sandra G; Heathcote, Katharine; Comans, Tracy

2012-01-09

Parkinson's disease (PD) is a progressive, chronic neurodegenerative disorder for which there is no known cure. Physical exercise programs may be used to assist with the physical management of PD. Several studies have demonstrated that community based physical therapy programs are effective in reducing physical aspects of disability among people with PD. While multidisciplinary therapy interventions may have the potential to reduce disability and improve the quality of life of people with PD, there is very limited clinical trial evidence to support or refute the use of a community based multidisciplinary or interdisciplinary programs for people with PD. A two group randomized trial is being undertaken within a community rehabilitation service in Brisbane, Australia. Community dwelling adults with a diagnosis of Idiopathic Parkinson's disease are being recruited. Eligible participants are randomly allocated to a standard exercise rehabilitation group program or an intervention group which incorporates physical, cognitive and speech activities in a multi-tasking framework. Outcomes will be measured at 6-week intervals for a period of six months. Primary outcome measures are the Montreal Cognitive Assessment (MoCA) and the Timed Up and Go (TUG) cognitive test. Secondary outcomes include changes in health related quality of life, communication, social participation, mobility, strength and balance, and carer burden measures. This study will determine the immediate and long-term effectiveness of a unique multifocal, interdisciplinary, dual-tasking approach to the management of PD as compared to an exercise only program. We anticipate that the results of this study will have implications for the development of cost effective evidence based best practice for the treatment of people with PD living in the community.

Interprofessional Collaboration and Turf Wars How Prevalent Are Hidden Attitudes?*

PubMed Central

Chung, Chadwick L. R.; Manga, Jasmin; McGregor, Marion; Michailidis, Christos; Stavros, Demetrios; Woodhouse, Linda J.

2012-01-01

Purpose: Interprofessional collaboration in health care is believed to enhance patient outcomes. However, where professions have overlapping scopes of practice (eg, chiropractors and physical therapists), "turf wars" can hinder effective collaboration. Deep-rooted beliefs, identified as implicit attitudes, provide a potential explanation. Even with positive explicit attitudes toward a social group, negative stereotypes may be influential. Previous studies on interprofessional attitudes have mostly used qualitative research methodologies. This study used quantitative methods to evaluate explicit and implicit attitudes of physical therapy students toward chiropractic. Methods: A paper-and-pencil instrument was developed and administered to 49 individuals (students and faculty) associated with a Canadian University master's entry-level physical therapy program after approval by the Research Ethics Board. The instrument evaluated explicit and implicit attitudes toward the chiropractic profession. Implicit attitudes were determined by comparing response times of chiropractic paired with positive versus negative descriptors. Results: Mean time to complete a word association task was significantly longer (t = 4.75, p =.00) when chiropractic was associated with positive rather than negative words. Explicit and implicit attitudes were not correlated (r = 0.13, p =.38). Conclusions: While little explicit bias existed, individuals associated with a master's entry-level physical therapy program appeared to have a significant negative implicit bias toward chiropractic PMID:22778528

Interprofessional collaboration and turf wars how prevalent are hidden attitudes?

PubMed

Chung, Chadwick L R; Manga, Jasmin; McGregor, Marion; Michailidis, Christos; Stavros, Demetrios; Woodhouse, Linda J

2012-01-01

Interprofessional collaboration in health care is believed to enhance patient outcomes. However, where professions have overlapping scopes of practice (eg, chiropractors and physical therapists), "turf wars" can hinder effective collaboration. Deep-rooted beliefs, identified as implicit attitudes, provide a potential explanation. Even with positive explicit attitudes toward a social group, negative stereotypes may be influential. Previous studies on interprofessional attitudes have mostly used qualitative research methodologies. This study used quantitative methods to evaluate explicit and implicit attitudes of physical therapy students toward chiropractic. A paper-and-pencil instrument was developed and administered to 49 individuals (students and faculty) associated with a Canadian University master's entry-level physical therapy program after approval by the Research Ethics Board. The instrument evaluated explicit and implicit attitudes toward the chiropractic profession. Implicit attitudes were determined by comparing response times of chiropractic paired with positive versus negative descriptors. Mean time to complete a word association task was significantly longer (t = 4.75, p =.00) when chiropractic was associated with positive rather than negative words. Explicit and implicit attitudes were not correlated (r = 0.13, p =.38). While little explicit bias existed, individuals associated with a master's entry-level physical therapy program appeared to have a significant negative implicit bias toward chiropractic.

A multimodal physical therapy approach utilizing the Maitland concept in the management of a patient with cervical and lumbar radiculitis and Ehlers-Danlos syndrome-hypermobility type: A case report.

PubMed

Pennetti, Adelina

2018-07-01

The purpose of this case report is to present a multimodal approach for patient management using the Maitland concept framework for cervical and lumbar radiculitis with an underlying diagnosis of Ehlers-Danlos Syndrome-Hypermobility Type (EDS-HT). This case presents care guided by evidence, patient values, and rationale for the selected course of physical therapy treatment provided by therapist experience. A 35-year-old female with a 2-year history of worsening lumbar and cervical pain was referred to physical therapy to address these musculoskeletal issues concurrent with diagnostic testing for EDS. A multimodal approach including manual therapy, therapeutic exercise, postural and body mechanics education, and a home exercise program was used. The patient specific functional scale (PSFS) was used to gauge patient's perceived improvements which were demonstrated by increased scores at reevaluation and at discharge. Following the Maitland concept framework, the physical therapist was able to make sound clinical decisions by tracking the logical flow of constant patient assessment. A 10-month course of treatment designed to maximize recovery of function was successful with a chronic history of pain and the EDS-HT diagnosis. The role of education and empowering the patient is shown to be of utmost importance. Optimizing therapeutic outcomes long-term for this patient population requires maintaining a home exercise program, adaptation and modifications of work and lifestyle activities.

Cerebral Palsy Symptoms in Children Decreased Following Massage Therapy

ERIC Educational Resources Information Center

Hernandez-Reif, Maria; Field, Tiffany; Largie, Shay; Diego, Miguel; Manigat, Natasha; Seoanes, Jacqueline; Bornstein, Joan

2005-01-01

Twenty young children (mean age = 32 months) with cerebral palsy (CP) recruited from early intervention programs received 30 minutes of massage or reading twice weekly for 12 weeks. The children receiving massage therapy showed fewer physical symptoms including reduced spasticity, less rigid muscle tone overall and in the arms, and improved fine…

Measuring Professional Behaviour in Canadian Physical Therapy Students' Objective Structured Clinical Examinations: An Environmental Scan

PubMed Central

Ellerton, Cindy; Evans, Cathy

2015-01-01

ABSTRACT Purpose: To identify professional behaviours measured in objective structured clinical examinations (OSCEs) by Canadian university physical therapy (PT) programs. Method: A cross-sectional telephone survey was conducted to review current practice and determine which OSCE items Canadian PT programs are using to measure PT students' professional behaviours. Telephone interviews using semi-structured questions were conducted with individual instructors responsible for courses that included an OSCE as part of the assessment component. Results: Nine PT programmes agreed to take part in the study, and all reported conducting at least one OSCE. The number and characteristics of OSCEs varied both within and across programs. Participants identified 31 professional behaviour items for use in an OSCE; these items clustered into four categories: communication (n=14), respect (n=10), patient safety (n=4), and physical therapists' characteristics (n=3). Conclusions: All Canadian entry-level PT programmes surveyed assess professional behaviours in OSCE-type examinations; however, the content and style of assessment is variable. The local environment should be considered when determining what professional behaviours are appropriate to assess in the OSCE context in individual programmes. PMID:25931656

From Nothing to Something: The Nuts and Bolts of Building a Mentoring Program in a Health Sciences College

ERIC Educational Resources Information Center

Franko, Debra L.

2016-01-01

In this paper, I report the development of a mentoring program in a College of Health Sciences comprised of schools of nursing, pharmacy, and health professions (which include physical therapy, speech pathology and audiology, applied psychology, and physician assistant programs) at a large private university. Although university-wide mentoring…

Great Careers in Two Years: The Associate Degree Option. High Skill and High Wage Jobs Available through Two-Year Programs.

ERIC Educational Resources Information Center

Phifer, Paul

This book explores high-skill and high-wage jobs available through two-year programs. It identifies 100 high-need occupational areas, and discusses "hot" programs and starting salaries for graduates of dental hygiene, manufacturing, process technology, telecommunications, physical therapy assisting, and registered nursing. Each career article…

A multimodal physical therapy approach to the management of a patient with temporomandibular dysfunction and head and neck lymphedema: a case report

PubMed Central

Crane, Patricia; Feinberg, Lauren; Morris, John

2015-01-01

Objective and importance: There is a paucity of research that investigates therapeutic interventions of patients with concurrent head and neck lymphedema and temporomandibular dysfunction (TMD). The purpose of this case report is to describe the management and outcomes of a patient with head and neck lymphedema and TMD using a multimodal physical therapy approach. Clinical presentation: A 74-year-old male with a past medical history of head and neck lymphedema and TMD was referred to physical therapy with chief complaints of inability to open his mouth in order to eat solid food, increased neck lymphedema, temporomadibular joint pain, and inability to speak for prolonged periods of time. Interventions: The patient was treated for three visits over 4 weeks. Treatment included complete decongestive therapy (CDT), manual therapy, therapeutic exercise, and a home exercise program. Upon discharge, the patient had improved mandibular depression, decreased head and neck lymphedema, improved deep neck flexor endurance, decreased pain, and improved function on the Patient Specific Functional Scale (PSFS). Conclusion: Utilization of a multimodal physical therapy approach to treat a patient with a complex presentation yielded positive outcomes. Further research on outcomes and treatment approaches in patients with TMD and head and neck lymphedema is warranted. PMID:26309380

A multimodal physical therapy approach to the management of a patient with temporomandibular dysfunction and head and neck lymphedema: a case report.

PubMed

Crane, Patricia; Feinberg, Lauren; Morris, John

2015-02-01

There is a paucity of research that investigates therapeutic interventions of patients with concurrent head and neck lymphedema and temporomandibular dysfunction (TMD). The purpose of this case report is to describe the management and outcomes of a patient with head and neck lymphedema and TMD using a multimodal physical therapy approach. A 74-year-old male with a past medical history of head and neck lymphedema and TMD was referred to physical therapy with chief complaints of inability to open his mouth in order to eat solid food, increased neck lymphedema, temporomadibular joint pain, and inability to speak for prolonged periods of time. The patient was treated for three visits over 4 weeks. Treatment included complete decongestive therapy (CDT), manual therapy, therapeutic exercise, and a home exercise program. Upon discharge, the patient had improved mandibular depression, decreased head and neck lymphedema, improved deep neck flexor endurance, decreased pain, and improved function on the Patient Specific Functional Scale (PSFS). Utilization of a multimodal physical therapy approach to treat a patient with a complex presentation yielded positive outcomes. Further research on outcomes and treatment approaches in patients with TMD and head and neck lymphedema is warranted.

Conceptual design project: Accelerator complex for nuclear physics studies and boron neutron capture therapy application at the Yerevan Physics Institute (YerPhI) Yerevan, Armenia

NASA Astrophysics Data System (ADS)

Avagyan, R. H.; Kerobyan, I. A.

2015-07-01

The final goal of the proposed project is the creation of a Complex of Accelerator Facilities at the Yerevan Physics Institute (CAF YerPhI) for nuclear physics basic researches, as well as for applied programs including boron neutron capture therapy (BNCT). The CAF will include the following facilities: Cyclotron C70, heavy material (uranium) target/ion source, mass-separator, LINAC1 (0.15-1.5 MeV/u) and LINAC2 (1.5-10 MeV/u). The delivered by C70 proton beams with energy 70 MeV will be used for investigations in the field of basic nuclear physics and with energy 30 MeV for use in applications.

A pilot study of maudsley family therapy with group dialectical behavior therapy skills training in an intensive outpatient program for adolescent eating disorders.

PubMed

Johnston, Jennifer A Y; O'Gara, Jesine S X; Koman, Stuart L; Baker, Christina Wood; Anderson, Drew A

2015-06-01

The goal of this study was to provide pilot clinical data on the effectiveness of an intensive outpatient treatment model for adolescent eating disorders that combines Maudsley-based family therapy and group dialectical behavior therapy skills training. Measures of physical and psychological status were gathered upon admission, discharge, and at 3 follow-up intervals. Adolescents who completed the program gained a significant amount of weight and experienced a significant decrease in eating disorder psychopathology. At the 1-year follow-up, 64% of adolescents were weight restored and menstruating normally. Measures of eating disorder psychopathology continued to improve up to a year after treatment. This pilot, multimodal program warrants further investigation and may be an effective intermediate level of care treatment option for adolescent eating disorders. © 2015 Wiley Periodicals, Inc.

Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students' perceptions of geriatrics and geriatric education in the United States.

PubMed

Reneker, Jennifer C; Weems, Kyra; Scaia, Vincent

2016-01-01

This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT) students, 21-33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center in Akron, Ohio, USA. Student perceptions were collected before and after participation in the 8-week balance class. The Wilcoxon sign-ranked test was used to identify differences in perceptions after participation in the group balance class. Cohen's d values were calculated to measure the size of the pre-participation to post-participation effect for each measure. At the conclusion of the group class, the DPT students demonstrated an increase in positive perceptions of geriatric physical therapy in 8 measures, with small effect sizes (d=0.15-0.30). Two perceptions of geriatric physical therapy demonstrated a significant positive increase (P<.05) with moderate effect sizes (d=0.47 and d=0.50). The students' perceptions of geriatric education in the curriculum demonstrated a large positive effect for quality (d=1.68) and enjoyment (d=1.96). Positive changes were found in most of the perceptions of geriatrics and geriatric education after participation, suggesting that integrated clinical experiences with geriatric patients are an effective way to positively influence perceptions of physical therapist practice with older adults.

Effects of conventional neurological treatment and a virtual reality training program on eye-hand coordination in children with cerebral palsy.

PubMed

Shin, Ji-Won; Song, Gui-Bin; Hwangbo, Gak

2015-07-01

[Purpose] The purpose of the study was to evaluate the effects of conventional neurological treatment and a virtual reality training program on eye-hand coordination in children with cerebral palsy. [Subjects] Sixteen children (9 males, 7 females) with spastic diplegic cerebral palsy were recruited and randomly assigned to the conventional neurological physical therapy group (CG) and virtual reality training group (VRG). [Methods] Eight children in the control group performed 45 minutes of therapeutic exercise twice a week for eight weeks. In the experimental group, the other eight children performed 30 minutes of therapeutic exercise and 15 minutes of a training program using virtual reality twice a week during the experimental period. [Results] After eight weeks of the training program, there were significant differences in eye-hand coordination and visual motor speed in the comparison of the virtual reality training group with the conventional neurological physical therapy group. [Conclusion] We conclude that a well-designed training program using virtual reality can improve eye-hand coordination in children with cerebral palsy.

The influence of physical therapy and anti-botulinum toxin antibody on the efficacy of botulinum toxin-A injections in children with spastic cerebral palsy.

PubMed

Jang, Dae-Hyun; Sung, In Young

2014-12-01

To identify factors associated with the efficacy of botulinum toxin-A (BoNT-A) injections. Thirty-eight children with spastic cerebral palsy (CP) received BoNT-A injections into the gastrocnemius. The baseline anti-botulinum antibodies were checked. The Static dorsiflexion range of motion (ROM), Modified Tardieu Scale (MTS) and Physician Rating Scale (PRS) were assessed at pre-injection as well as 4- and 12-week post-injection. No samples contained anti-botulinum antibodies. Greater baseline MTS dynamic range was associated with greater changes in MTS dynamic ranges at 4-week post-injection. More frequent physical therapy was associated with greater changes in static dorsiflexion ROM at 4-week post-injection and greater changes in PRS at 4- and 12-week post-injection. The improvement in PRS at 12-week post-injection was associated with the frequency of physical therapy. Therefore, intensive physical therapy programs may be necessary to maintain the beneficial effects of BoNT-A injections in children with CP.

Multidimensional Patient Impression of Change Following Interdisciplinary Pain Management.

PubMed

Gagnon, Christine M; Scholten, Paul; Atchison, James

2018-04-20

To assess patient impression of change following interdisciplinary pain management utilizing a newly developed Multidimensional Patient Impression of Change (MPIC) questionnaire. A heterogeneous group of chronic pain patients (N = 601) participated in an interdisciplinary treatment program. Programs included individual and group therapies (pain psychology, physical therapy, occupational therapy, relaxation training/biofeedback, aerobic conditioning, patient education and medical management). Patients completed measures of pain, mood, coping, physical functioning and pain acceptance both prior to and at completion of their treatment programs. The newly developed MPIC is an expansion to the Patient Global Impression of Change (PGIC) including seven additional domains (Pain, Mood, Sleep, Physical Functioning, Cope with Pain, Manage Pain Flare-ups, and Medication Effectiveness). The MPIC was administered to the patients post-treatment. There were statistically significant pre- to post-treatment improvements found on all outcome measures. The majority of these improvements were significantly correlated with all domains of the MPIC. The original PGIC item was significantly associated with all of the new MPIC domains and the domains were significantly associated with each other; but there were variations in the distribution of responses highlighting variation of perceived improvements among the domains. Our results support the use of the MPIC as a quick and easy post-treatment assessment screening tool. Future research is needed to examine relevant correlates to Medication Effectiveness. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Selectivity of physiotherapist programs in the United States does not differ by institutional funding source or research activity level.

PubMed

Riley, Sean P; Covington, Kyle; Landry, Michel D; McCallum, Christine; Engelhard, Chalee; Cook, Chad E

2016-01-01

This study aimed to compare selectivity characteristics among institution characteristics to determine differences by institutional funding source (public vs. private) or research activity level (research vs. non-research). This study included information provided by the Commission on Accreditation in Physical Therapy Education (CAPTE) and the Federation of State Boards of Physical Therapy. Data were extracted from all students who graduated in 2011 from accredited physical therapy programs in the United States. The public and private designations of the institutions were extracted directly from the classifications from the 'CAPTE annual accreditation report,' and high and low research activity was determined based on Carnegie classifications. The institutions were classified into four groups: public/research intensive, public/non-research intensive, private/research intensive, and private/non-research intensive. Descriptive and comparison analyses with post hoc testing were performed to determine whether there were statistically significant differences among the four groups. Although there were statistically significant baseline grade point average differences among the four categorized groups, there were no significant differences in licensure pass rates or for any of the selectivity variables of interest. Selectivity characteristics did not differ by institutional funding source (public vs. private) or research activity level (research vs. non-research). This suggests that the concerns about reduced selectivity among physiotherapy programs, specifically the types that are experiencing the largest proliferation, appear less warranted.

Tailored Behavioral Intervention for Insomnia in Children with Autism Spectrum Disorder

DTIC Science & Technology

2015-09-01

children with attention deficit/hyperactivity disorder. Journal of Physical Therapy Science, 24, 1-6. 15 9. Quietly Reading a Book Reading is a common...Journal of Occupational Therapy . 63(4):423-432. Silva, L., Schalock, M., Gabrielsen, K. (20 II). Early intervention for autism with a parent- delivered...Qigong massage program: A randomized controlled trial. American Journal of Occupational Therapy , 65(5):550-559. doi: 10.5014/ajoty.2011.000661. 9 4

76 FR 64429 - Advisory Committee on Prosthetics and Special-Disabilities Programs; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-18

... research services available to the Committee. Additionally, the Committee will discuss future agenda topics... state-of-the art prosthetics and the associated rehabilitation research, development, and evaluation of... will be briefed by the Chief Disability and Medical Assessment Officer; Physical Therapy Program...

LATIS3D: The Goal Standard for Laser-Tissue-Interaction Modeling

NASA Astrophysics Data System (ADS)

London, R. A.; Makarewicz, A. M.; Kim, B. M.; Gentile, N. A.; Yang, T. Y. B.

2000-03-01

The goal of this LDRD project has been to create LATIS3D-the world's premier computer program for laser-tissue interaction modeling. The development was based on recent experience with the 2D LATIS code and the ASCI code, KULL. With LATIS3D, important applications in laser medical therapy were researched including dynamical calculations of tissue emulsification and ablation, photothermal therapy, and photon transport for photodynamic therapy. This project also enhanced LLNL's core competency in laser-matter interactions and high-energy-density physics by pushing simulation codes into new parameter regimes and by attracting external expertise. This will benefit both existing LLNL programs such as ICF and SBSS and emerging programs in medical technology and other laser applications. The purpose of this project was to develop and apply a computer program for laser-tissue interaction modeling to aid in the development of new instruments and procedures in laser medicine.

Clinical Guide to Music Therapy in Physical Rehabilitation Settings

ERIC Educational Resources Information Center

Wong, Elizabeth

2004-01-01

Elizabeth Wong, MT-BC presents tools and information designed to arm the entry-level music therapist (or an experienced MT-BC new to rehabilitation settings) with basic knowledge and materials to develop or work in a music therapy program treating people with stroke, brain injury, and those who are ventilator dependent. Ms. Wong offers goals and…

Evidence-based exercise prescription for balance and falls prevention: a current review of the literature.

PubMed

Shubert, Tiffany E

2011-01-01

Falls are the leading cause of emergency department visits, hospital admissions, and unintentional death for older adults. Balance and strength impairments are common falls risk factors for community-dwelling older adults. Though physical therapists commonly treat balance and strength, standardized falls screening has not been fully incorporated into physical therapy practice and there is much variation in the frequency, intensity, and duration of therapy prescribed to achieve optimal results. For community-dwelling older adults, a progressive exercise program that focuses on moderate to high-intensity balance exercises appears to be one of the most effective interventions to prevent falls. For more frail older adults in institutional settings, exercise programs in addition to multifactorial interventions appear to show promise as effective falls prevention interventions. The minimum dose of exercise to protect an older adult against falls is 50 hours. This article describes the current best practices for physical therapists to effectively improve balance and manage falls risk in patients. The unique challenges and opportunities for physical therapists to incorporate evidence-based fall-prevention strategies are discussed. Innovative practice models incorporating evidence-based fall-prevention programs and partnerships with public health and aging service providers to create a continuum of care and achieve the optimal dose of balance training are presented.

Perceptions of a Videogame-Based Dance Exercise Program Among Individuals with Parkinson's Disease

PubMed Central

Natbony, Lauren R.; Zimmer, Audra; Ivanco, Larry S.; Studenski, Stephanie A.

2013-01-01

Abstract Objective Physical therapy, including exercise, improves gait and quality of life in Parkinson's disease (PD). Many programs promoting physical activity have generated significant short-term gains, but adherence has been a problem. A recent evidence-based analysis of clinical trials using physical therapy in PD patients produced four key treatment recommendations: cognitive movement strategies, physical capacity, balance training, and cueing. We have attempted to incorporate all four of these features together through a dance exercise program using the dance videogame “Dance Dance Revolution” (DDR) (Konami Digital Entertainment, El Segundo, CA). Subjects and Methods Sixteen medically stable participants with mild to moderate PD were given the opportunity to try DDR with supervision by a research staff member. Feedback about the advantages and disadvantages of DDR as a form of physical activity was elicited through focus groups using the nominal group technique. Results Of 21 advantages and 17 disadvantages elicited, the most frequently cited advantages were “fun” and “easy to use,” followed by “improves balance or coordination,” “challenging,” and “full body aerobic activity.” Common concerns were the distracting or confusing interface, cost, and possible technical issues. Discussion Interactive dance exercise was appealing to participants with PD and may help promote adherence to physical activity. Concerns regarding familiarity with the technology may be addressed with simplification of the interface or additional training for participants. Results support a larger longitudinal study of DDR in PD. PMID:24761325

Medical Management

MedlinePlus

... org Close Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

[Resource management: ICF-oriented exercise programs for patients with diabetes mellitus type 2. Chronic illnesses and biopsychosocial status].

PubMed

Pfeifer, K; Huber, G; Baldus, A; Pöthig, D; Schüle, K

2012-02-01

Common health problems are increasing due to the combination of decreased physical activity demands in everyday life and demographic changes; thus, the importance of exercise therapy is increasing. The incidence and prevalence of today's predominant chronic diseases are directly related to physical activity. However, daily clinical routine does not stay abreast with these changes. The education of physicians, and thus their scope of action, is dominated by biomedical therapy concepts, predominantly drug therapy concepts. Differential and consolidated findings of modern exercise and sport science are astonishingly rare in the counselling and treatment portfolio of medical care. The present disease management program for persons with diabetes mellitus type 2 is a good example. Referring to this background, the authors address the new approach of "ICF-oriented exercise programs and biopsychosocial status." They present resource-related interventional strategies and health care concepts for chronic health disorders like the metabolic syndrome or diabetes mellitus type 2. The relevance and use of active health promotion and care - due to lifestyle- and age-related health problems of the population - will increase in importance and be more commonly recommended.

New framework for rehabilitation – fusion of cognitive and physical rehabilitation: the hope for dancing

PubMed Central

Dhami, Prabhjot; Moreno, Sylvain; DeSouza, Joseph F. X.

2015-01-01

Neurorehabilitation programs are commonly employed with the goal to help restore functionality in patients. However, many of these therapies report only having a small impact. In response to the need for more effective and innovative approaches, rehabilitative methods that take advantage of the neuroplastic properties of the brain have been used to aid with both physical and cognitive impairments. Following this path of reasoning, there has been a particular interest in the use of physical exercise as well as musical related activities. Although such therapies demonstrate potential, they also have limitations that may affect their use, calling for further exploration. Here, we propose dance as a potential parallel to physical and music therapies. Dance may be able to aid with both physical and cognitive impairments, particularly due to it combined nature of including both physical and cognitive stimulation. Not only does it incorporate physical and motor skill related activities, but it can also engage various cognitive functions such as perception, emotion, and memory, all while done in an enriched environment. Other more practical benefits, such as promoting adherence due to being enjoyable, are also discussed, along with the current literature on the application of dance as an intervention tool, as well as future directions required to evaluate the potential of dance as an alternative therapy in neurorehabilitation. PMID:25674066

Recommendations for physical and occupational therapy practice from the perspective of clients undergoing therapy for breast cancer-related impairments.

PubMed

Lattanzi, Jill B; Giuliano, Susan; Meehan, Caitlin; Sander, Beth; Wootten, Rachel; Zimmerman, Amanda

2010-01-01

Evidence points to the efficacy of physical and occupational therapy intervention for the management of impairments and functional limitations related to the treatment of breast cancer. However, few studies give voice to the women participating in the physical rehabilitation programs intended to ameliorate their deficits. The purpose of this qualitative investigation was to explore the experience of physical rehabilitation as well as to identify recommendations for physical and occupational therapy practice from the perspective of the client undergoing therapy for breast cancer-related impairments. A phenomenological design was chosen and included a purposive sample of women (n = 10) undergoing physical rehabilitation for impairments related to breast cancer treatment. Data included semistructured interviews and artifact examination. Ten semistructured interviews were conducted at a setting of the participants' choice. Data collection continued until saturation was reached. Data analysis was cyclical and ongoing and involved all six researchers in analyzing and triangulating all pieces of data. Member checks and a peer review were conducted to confirm relevance and validity. Five themes emerged: 1) challenges with obtaining referrals, 2) challenges with patient education, 3) improvements in functional impairments, 4) emotional support, and 5) benefits of a specialized clinic environment. Consideration of the five themes led to four recommendations for physical and occupational therapist practice from the perspective of the client: 1) advocate for presurgical therapy consultations, 2) be competent in the management of all impairments and functional limitations associated with breast cancer treatment, 3) be aware of the emotional support the therapist has the capacity to provide or not provide, and 4) as much as possible, create an inviting, nonclinical environment.

Short- and long-term effects of a six-week clinical Pilates program in addition to physical therapy on postmenopausal women with chronic low back pain: a randomized controlled trial.

PubMed

Cruz-Díaz, David; Martínez-Amat, Antonio; Osuna-Pérez, M C; De la Torre-Cruz, M J; Hita-Contreras, Fidel

2016-01-01

To determine the short- and long-term effectiveness of the application of Clinical Pilates in addition to physical therapy versus a physical therapy treatment alone in a population of postmenopausal women with chronic low back pain (CLBP). A single-blind randomized controlled trial with repeated measures and a follow-up period. One hundred and one patients were randomly allocated to a Pilates + physical therapy (PPT) group or to a physical therapy (PT) only group for six weeks. Pain and disability were measured by visual analog scale (VAS) and the Oswestry disability index respectively preintervention, after 6 weeks of treatment and after 1-year follow-up. There were significant differences between groups in pain and disability after 6 weeks of treatment, with better results in the PPT group with an effect size of d = 3.14 and d = 2.33 for pain and disability. After 1-year follow-up, only PPT group showed better results compared with baseline with an effect size of d = 2.49 and d = 4.98 for pain and disability. The results suggest that using Clinical Pilates in addition to physical therapy provides improved results on pain management and functional status for postmenopausal woman with CLBP and that its benefits still linger after one year. Chronic Low Back Pain could benefit from the Pilates practice in postmenopausal women. Improvement in pain and disability derived from CLBP seem to be maintained over time due to Pilates practice. Pilates constitutes a safe tool to be applied in older population with CLBP due to its ability to be adapted to every performance and physical level.

Integrating professional behavior development across a professional allied health curriculum.

PubMed

Tsoumas, Linda J; Pelletier, Deborah

2007-01-01

Professional behaviors are an integral part of clinical practice in all allied health and medical fields. A systematic process for instruction, the education, and development of professional behaviors, cannot be taught in the same way that memorization of human anatomy or medical terminology is taught. One cannot expect professional behaviors to just appear in an individual upon graduation and entry into a health care field. Professional behavior development is an essential component of physical therapy professional education and is clearly defined through the guiding documents of the American Physical Therapy Association, which include 'A Normative Model of Physical Therapist Professional Education,' 'Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists,' and the 'Guide to Physical Therapist Practice.' Building a comprehensive and progressive curricular thread for professional behaviors can pose a challenge for a professional program and the core faculty. This paper will present a curricular model of weaving professional behaviors into a core entry-level professional curriculum using a specific curricular thread, activities for different levels of students, and assessment at each point in the path. This paper will demonstrate the potential for universal application of a professional behaviors.

Cognitive-behavioral based physical therapy for patients with chronic pain undergoing lumbar spine surgery: a randomized controlled trial

PubMed Central

Archer, Kristin R.; Devin, Clinton J.; Vanston, Susan W.; Koyama, Tatsuki; Phillips, Sharon; George, Steven Z.; McGirt, Matthew J.; Spengler, Dan M.; Aaronson, Oran S.; Cheng, Joseph S.; Wegener, Stephen T.

2015-01-01

The purpose of this study was to determine the efficacy of a cognitive-behavioral based physical therapy (CBPT) program for improving outcomes in patients following lumbar spine surgery. A randomized controlled trial was conducted in 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia. Randomization to either CBPT or an Education program occurred at 6 weeks after surgery. Assessments were completed pre-treatment, post-treatment and at 3 month follow-up. The primary outcomes were pain and disability measured by the Brief Pain Inventory and Oswestry Disability Index. Secondary outcomes included general health (SF-12) and performance-based tests (5-Chair Stand, Timed Up and Go, 10 Meter Walk). Multivariable linear regression analyses found that CBPT participants had significantly greater decreases in pain and disability and increases in general health and physical performance compared to the Education group at 3 month follow-up. Results suggest a targeted CBPT program may result in significant and clinically meaningful improvement in postoperative outcomes. CBPT has the potential to be an evidence-based program that clinicians can recommend for patients at-risk for poor recovery following spine surgery. PMID:26476267

Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report.

PubMed

Farrell, Elizabeth; Naber, Erin; Geigle, Paula

2010-01-01

This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.

A personalized, intense physical rehabilitation program improves walking in people with multiple sclerosis presenting with different levels of disability: a retrospective cohort.

PubMed

Kalron, Alon; Nitzani, Dalia; Magalashvili, David; Dolev, Mark; Menascu, Shay; Stern, Yael; Rosenblum, Uri; Pasitselsky, Diana; Frid, Lior; Zeilig, Gabi; Barmatz, Caroline; Givon, Uri; Achiron, Anat

2015-03-04

People with multiple sclerosis (PwMS) endure walking limitations. To address this restriction, various physical rehabilitation programs have been implemented with no consensus regarding their efficacy. Our objective was to report on the efficacy of an integrated tailored physical rehabilitation program on walking in people with multiple sclerosis categorized according to their level of neurological disability. Retrospective data were examined and analyzed. Specifically, data obtained from all patients who participated in the Multiple Sclerosis Center's 3 week rehabilitation program were extracted for in depth exploration. The personalized rehabilitation program included three major components modified according to the patient's specific impairments and functional needs: (a) goal directed physical therapy (b) moderately intense aerobic exercise training on a bicycle ergometer and (c) aquatic therapy chiefly oriented to body structures appropriate to movement. Gait outcome measurements included the 10 meter, 20 meter, Timed up and go and 2 minute walking tests measured pre and post the rehabilitation program. Three hundred and twelve people with relapsing-remitting multiple sclerosis were included in the final analysis. Patients were categorized into mild (n = 87), moderate (n = 104) and severely (n = 121) disabled groups. All clinical walking outcome measurements demonstrated statistically significant improvements, however, only an increase in the 2 minute walking test was above the minimal clinical difference value. The moderate and severe groups considerably improved compared to the mild gait disability group. Mean change scores (%) of the pre-post intervention period of the 2 minute walking test were 19.0 (S.E. = 3.4) in the moderate group, 16.2 (S.E. = 5.4) in the severe group and 10.9 (S.E. = 2.3) in the mild gait disability group. We presented comprehensive evidence verifying the effects of an intense goal-directed physical rehabilitation program on ambulation in people with multiple sclerosis presenting with different neurological impairment levels.

Physical therapy treatment in patients suffering from cervicogenic somatic tinnitus: study protocol for a randomized controlled trial

PubMed Central

2014-01-01

Background Tinnitus occurs in a large part of the general population with prevalences ranging from 10% to 15% in an adult population. One subtype is cervicogenic somatic tinnitus, arising from cervical spine dysfunctions, justifying cervical spine assessment and treatment. This study aims to investigate the effect of a standardized physical therapy treatment, directed to the cervical spine, on tinnitus. Additionally, a second aim is to identify a subgroup within the tinnitus population that benefits from physical therapy treatment. Methods and design This study is designed as a randomized controlled trial with delayed treatment design. Patients with severe subjective tinnitus (Tinnitus Functional Index (TFI) between 25 and 90 points), in combination with neck complaints (Neck Bournemouth Questionnaire (NBQ) >14 points) will be recruited from the University Hospital of Antwerp. Patients suffering from tinnitus with clear otological etiologies, severe depression, traumatic cervical spine injury, tumors, cervical spine surgery, or conditions in which physical therapy is contra-indicated, will be excluded. After screening for eligibility, baseline data such as TFI, NBQ, and a set of cervical biomechanical and sensorimotor tests will be collected. Patients are randomized in an immediate therapy group and in a group with a delayed start of therapy by 6 weeks. Patients will receive physical therapy with a maximum of 12 sessions of 30 min for a 6-week program. Data from the TFI and NBQ will be collected at baseline (week 0), at the start of therapy (weeks 0 or 6), at the end of therapy (weeks 6 or 12), 6 weeks after therapy (weeks 12 or 18), and 3 months after therapy (weeks 18 or 24). Secondary outcome measures will be collected at baseline and 6 weeks after the therapy (weeks 12 or 18), as the maximal therapy effect on the cervical spine dysfunctions is expected at that moment. Discussion This study is the first to investigate the effect of a standardized physical therapy treatment protocol on somatic tinnitus with a prospective comparative delayed design and with blinded evaluator for baseline, end of therapy, and 6 and 12 weeks after therapy. Trial registration 12 September 2013, ClinicalTrials.gov: NCT02016313 PMID:25056151

Physical therapy as conservative management for cervical pain and headaches in an adolescent with neurofibromatosis type 1: a case study.

PubMed

Helmers, Kristin M; Irwin, Kent E

2009-12-01

: Neurofibromatosis is a group of genetic disorders that affect the development and growth of nerve cell tissues. These disorders include tumors of myelin-producing supportive cells that grow on nerves and can cause changes in bone formation, skin integrity, and nerve transmission. Common musculoskeletal impairments associated with neurofibromatosis type 1 (NF 1) include cervical pain, muscle weakness, muscle stiffness, headaches, and postural deviations. : This case study describes successful physical therapy management and outcomes for cervical pain and headaches in a 17-year-old girl with a 16-year history of NF 1. Difficulties in driving, studying, lifting, and participating in recreational activities were all associated with the patient's pain, decreased cervical range of motion, decreased scapular strength, and postural deviations. : Physical therapy interventions included posture training, dynamic shoulder/scapular strengthening, cervical stabilization, stretching, ultrasound, interferential current, and a progressive home exercise program. : By the end of 13 weeks (20 sessions) of physical therapy, the patient was completely pain free, demonstrated increased cervical range of motion, and had improvements in scapular strength. She returned to full and unrestricted recreational activities, driving, studying, and household chores. Furthermore, scores on the Neck Disability Index improved from 44 of 50 (complete disability) to 2 of 50 (no disability). : Physical therapy may be a viable option for conservative management of musculoskeletal dysfunction and functional limitations resulting from NF 1.

Student Outcomes of School-Based Physical Therapy as Measured by Goal Attainment Scaling.

PubMed

Chiarello, Lisa A; Effgen, Susan K; Jeffries, Lynn; McCoy, Sarah Westcott; Bush, Heather

2016-01-01

The main purposes were to describe individualized outcomes of students receiving school-based physical therapy and determine if goal attainment differed by gross motor ability and age. One hundred nine physical therapists and 296 students participated. At the beginning of the school year, therapists translated students' Individualized Education Program goals into subgoals using Goal Attainment Scaling and determined students' Gross Motor Functional Classification System level. Researchers categorized goals (posture/mobility, recreation/fitness, self-care, or academics), and therapists identified students' primary goal. At the end of the school year, therapists scored the goals. Descriptive statistics and 2-way analyses of variance were conducted. Students exceeded their expected goal level for primary goals and goals categorized as posture/mobility, recreation/fitness, and self-care and made progress on academic goals. No differences were found by gross motor ability. Younger students had higher goal attainment for primary and recreation goals. Students achieve individualized outcomes addressed by school-based physical therapy.

Advances in boron neutron capture therapy (BNCT) at kyoto university - From reactor-based BNCT to accelerator-based BNCT

NASA Astrophysics Data System (ADS)

Sakurai, Yoshinori; Tanaka, Hiroki; Takata, Takushi; Fujimoto, Nozomi; Suzuki, Minoru; Masunaga, Shinichiro; Kinashi, Yuko; Kondo, Natsuko; Narabayashi, Masaru; Nakagawa, Yosuke; Watanabe, Tsubasa; Ono, Koji; Maruhashi, Akira

2015-07-01

At the Kyoto University Research Reactor Institute (KURRI), a clinical study of boron neutron capture therapy (BNCT) using a neutron irradiation facility installed at the research nuclear reactor has been regularly performed since February 1990. As of November 2014, 510 clinical irradiations were carried out using the reactor-based system. The world's first accelerator-based neutron irradiation system for BNCT clinical irradiation was completed at this institute in early 2009, and the clinical trial using this system was started in 2012. A shift of BCNT from special particle therapy to a general one is now in progress. To promote and support this shift, improvements to the irradiation system, as well as its preparation, and improvements in the physical engineering and the medical physics processes, such as dosimetry systems and quality assurance programs, must be considered. The recent advances in BNCT at KURRI are reported here with a focus on physical engineering and medical physics topics.

Critical Thinking and Disposition Toward Critical Thinking Among Physical Therapy Students.

PubMed

Domenech, Manuel A; Watkins, Phillip

2015-01-01

Students who enter a physical therapist (PT) entry-level program with weak critical thinking skills may not be prepared to benefit from the educational training program or successfully engage in the future as a competent healthcare provider. Therefore, assessing PT students' entry-level critical thinking skills and/or disposition toward critical thinking may be beneficial to identifying students with poor, fair, or good critical thinking ability as one of the criteria used in the admissions process into a professional program. First-year students (n=71) from the Doctor of Physical Therapy (DPT) program at Texas Tech University Health Sciences Center completed the California Critical Thinking Skills Test (CCTST), the California Critical Thinking Dispositions Inventory (CCTDI), and demographic survey during orientation to the DPT program. Three students were lost from the CCTST (n=68), and none lost from the CCTDI (n=71). Analysis indicated that the majority of students had a positive disposition toward critical thinking, yet the overall CCTST suggested that these students were somewhat below the national average. Also, individuals taking math and science prerequisites at the community-college level tended to have lower overall CCTST scores. The entering DPT class demonstrated moderate or middle range scores in critical thinking and disposition toward critical thinking. This result does not indicate, but might suggest, the potential for learning challenges. Assessing critical thinking skills as part of the admissions process may prove advantageous.

The effect of exercise therapy on knee adduction moment in individuals with knee osteoarthritis: A systematic review.

PubMed

Ferreira, Giovanni E; Robinson, Caroline Cabral; Wiebusch, Matheus; Viero, Carolina Cabral de Mello; da Rosa, Luis Henrique Telles; Silva, Marcelo Faria

2015-07-01

Exercise therapy is an evidence-based intervention for the conservative management of knee osteoarthritis. It is hypothesized that exercise therapy could reduce the knee adduction moment. A systematic review was performed in order to verify the effects of exercise therapy on the knee adduction moment in individuals with knee osteoarthritis in studies that also assessed pain and physical function. A comprehensive electronic search was performed on MEDLINE, Cochrane CENTRAL, EMBASE, Google scholar and OpenGrey. Inclusion criteria were randomized controlled trials with control or sham groups as comparator assessing pain, physical function, muscle strength and knee adduction moment during walking at self-selected speed in individuals with knee osteoarthritis that underwent a structured exercise therapy rehabilitation program. Two independent reviewers extracted the data and assessed risk of bias. For each study, knee adduction moment, pain and physical function outcomes were extracted. For each outcome, mean differences and 95% confidence intervals were calculated. Due to clinical heterogeneity among exercise therapy protocols, a descriptive analysis was chosen. Three studies, comprising 233 participants, were included. None of the studies showed significant differences between strengthening and control/sham groups in knee adduction moment. In regards to pain and physical function, the three studies demonstrated significant improvement in pain and two of them showed increased physical function following exercise therapy compared to controls. Muscle strength and torque significantly improved in all the three trials favoring the intervention group. Clinical benefits from exercise therapy were not associated with changes in the knee adduction moment. The lack of knee adduction moment reduction indicates that exercise therapy may not be protective in knee osteoarthritis from a joint loading point of view. Alterations in neuromuscular control, not captured by the knee adduction moment measurement, may contribute to alter dynamic joint loading following exercise therapy. To conclude, mechanisms other than the reduction in knee adduction moment might explain the clinical benefits of exercise therapy on knee osteoarthritis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cultural competence education in university rehabilitation programs.

PubMed

Matteliano, Mary A; Stone, John H

2014-01-01

The Center of International Rehabilitation Research, Information, and Exchange (CIRRIE) has prepared curriculum guides for rehabilitation professionals in occupational therapy, physical therapy, speech language pathology, and rehabilitation counseling. The objective is to provide a resource to faculty who wish to include or strengthen cultural competency education in their program and courses. CIRRIE assessed students'cultural needs, and solicited assistance from experts in the field to assist with the development of the guides. After the guides were published CIRRIE conducted surveys to assess their usefulness. Survey responses were highest among occupational therapy faculty. Among faculty who responded, most intended to use the cultural competence activities, case studies, and resources that the guides offer throughout their curriculum.

CONSERVATIVE MANAGEMENT OF AN ISOLATED GRADE III LATERAL COLLATERAL LIGAMENT INJURY IN AN ADOLESCENT MULTI-SPORT ATHLETE: A CASE REPORT

PubMed Central

Haddad, M. Alex; Budich, Justin M.; Eckenrode, Brian J.

2016-01-01

ABSTRACT Study design Case report Background Isolated, grade III lateral collateral ligament knee injuries are an uncommon traumatic injury with little guidance available in the literature for conservative management and prognosis for return to sport. The purpose of this case report is to describe the clinical decision-making in both differential diagnosis and physical therapy management of an isolated grade III lateral collateral ligament sprain in an adolescent multi-sport high school athlete. Case Description A 16 year-old male, high school, multi-sport athlete (cross country, wrestling, track and field) sustained a traumatic knee injury during a wrestling match when his involved lower extremity was forcefully externally rotated by his opponent. Initial clinical presentation revealed pain and increased laxity with varus stress testing of the left knee, which was subsequently identified via MRI as a complete lateral collateral ligament rupture (grade III). A conservative physical therapy program was developed targeting the active and neuromuscular subsystems, theorized to compensate for the lack of an intact lateral collateral ligament. Outcomes The subject attended 18 visits of physical therapy over a period of 12 weeks. His rehabilitation program focused on functional strengthening of the posterolateral corner, enhancement of neuromuscular control, and graded progression to sports specific drills. Return to play decisions were based on a combination of lower extremity functional performance measures, condition specific outcome measures and subjective performance on sports specific tasks. At discharge from physical therapy, he reported 0/10 pain, scored a 76/80 on the Lower Extremity Functional Scale, and was able to return to competitive track and field events. Discussion Few descriptions in the literature exist for the conservative management of isolated, grade III lateral collateral ligament injuries. A program of selective functional strengthening, proprioceptive training, and graded sport specific activities may allow these individuals to return to sport with conservative management. Levels of Evidence 4 (Single Case Report) PMID:27525183

Quality and Variability of Online Physical Therapy Protocols for Isolated Meniscal Repairs.

PubMed

Trofa, David P; Parisien, Robert L; Noticewala, Manish S; Noback, Peter C; Ahmad, Christopher S; Moutzouros, Vasilios; Makhni, Eric C

2018-05-31

The ideal meniscal repair postoperative rehabilitation protocol has yet to be determined. Further, patients are attempting to access health care content online at a precipitously increasing rate given the efficiency of modern search engines. The purpose of this investigation was to assess the quality and variability of meniscal repair rehabilitation protocols published online with the hypothesis that there would be a high degree of variability found across available protocols. To this end, Web-based meniscal repair physical therapy protocols from U.S. academic orthopaedic programs as well as the first 10 protocols identified by the Google search engine for the term "meniscal repair physical therapy protocol" were reviewed and assessed via a custom scoring rubric. Twenty protocols were identified from 155 U.S. academic orthopaedic programs for a total of 30 protocols. Twenty-six protocols (86.6%) recommended immediate postoperative bracing. Twelve (40.0%) protocols permitted immediate weight-bearing as tolerated (WBAT) postoperatively, while the remaining protocols permitted WBAT at an average of 4.0 (range, 1-7) weeks. There was considerable variation in range of motion (ROM) goals, with most protocols (73.3%) initiating immediate passive ROM to 90°. The types and timing of strength, proprioception, agility, and pivoting exercises advised were extremely diverse. Only five protocols (16.7%) employed functional testing as a marker for return to athletics. The results of this study indicate that only a minority of academic orthopaedic programs publish meniscal repair physical therapy protocols online and that within the most readily available online protocols there are significant disparities in regards to brace use, ROM, weight-bearing, and strengthening and proprioception exercises. These discrepancies reflect the fact that the best rehabilitation practices after a meniscal repair have yet to be elucidated. This represents a significant area for improved patient care through standardization. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effectiveness of a Blended Multidisciplinary Intervention for Patients with Moderate Medically Unexplained Physical Symptoms (PARASOL): Protocol for a Cluster Randomized Clinical Trial.

PubMed

van Westrienen, Paula Elisabeth; Pisters, Martijn F; Toonders, Suze Aj; Gerrits, Marloes; Veenhof, Cindy; de Wit, Niek J

2018-05-08

Medically unexplained physical symptoms are an important health problem in primary care, with a spectrum from mild to chronic. The burden of chronic medically unexplained physical symptoms is substantial for patients, health care professionals, and society. Therefore, early identification of patients with moderate medically unexplained physical symptoms is needed in order to prevent chronicity. The preventive screening of medically unexplained physical symptoms (PRESUME) screening method was developed using data from the electronic medical record of the patients' general practitioner and demonstrated its prognostic accuracy to identify patients with moderate medically unexplained physical symptoms. In the next step, we developed a proactive blended and integrated mental health and physical therapy intervention program (PARASOL) to reduce complaints of moderate medically unexplained physical symptoms, stimulate self-management, and prevent chronicity. The primary objective of this study is to investigate the effectiveness of the blended PARASOL intervention on the impact of symptoms and quality of life in patients with moderate medically unexplained physical symptoms compared with usual care. Secondary objectives are to study the effect on severity of physical and psychosocial symptoms, general health, physical behavior, illness perception, and self-efficacy in patients with moderate medically unexplained physical symptoms as well as to determine the cost-effectiveness of the program. This paper presents the study protocol of a multicenter cluster randomized clinical trial. Adult patients with moderate medically unexplained physical symptoms will be identified from electronic medical record data using the PRESUME screening method and proactively recruited for participation in the study. Cluster randomization will be performed at the level of the participating health care centers. In total 248 patients with moderate medically unexplained physical symptoms (124 patients per arm) are needed. The PARASOL intervention is a 12-week blended primary care program consisting of 4 face-to-face consultations with the mental health nurse and 5 physical therapy sessions, supplemented with a Web-based program. The Web-based program contains (1) information modules and videos on self-management and educative themes, (2) videos and instructions on prescribed home exercises, and (3) assignments to gradually increase the physical activity. The program is directed at patients' perception of symptoms as well as modifiable prognostic risk factors for chronicity using therapeutic neuroscience education. It encourages self-management, as well as an active lifestyle using a cognitive behavioral approach and graded activity. Primary outcomes are impact of symptoms and quality of life. Secondary outcomes are severity of physical and psychosocial symptoms, general health, physical behavior, illness perceptions, self-efficacy, and cost-effectiveness. All measurements will be performed at baseline, 3 and 12 months after baseline. Retrospective cost questionnaires will also be sent at 6 and 9 months after baseline and these will be used for the cost-effectiveness analysis. The intervention has been developed, and the physical therapists and mental health nurses in the participating experimental health care centers have received two days of training on the content of the blended PARASOL intervention. The recruitment of health care centers started in June 2016 and inclusion of patients began in March 2017. Follow-up assessments of patients are expected to be completed in March 2019. This study is the first randomized clinical trial to determine the effectiveness (including cost-effectiveness) of a proactive, blended, and integrated mental health and physical therapy care program for patients with moderate medically unexplained physical symptoms. The findings will help to improve the treatment for patients with moderate medically unexplained physical symptoms and prevent chronicity. Netherlands Trial Register NTR6755; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6755 (Archived by WebCite at http://www.webcitation.org/6ywporY7u). ©Paula Elisabeth van Westrienen, Martijn F Pisters, Suze AJ Toonders, Marloes Gerrits, Cindy Veenhof, Niek J de Wit. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 08.05.2018.

University of Connecticut School of Allied Health Professions: Program Evaluation for the 1979-1980 Academic Year.

ERIC Educational Resources Information Center

Rovezzi-Carroll, Susan

The vocational curricular evaluation model (MCC) developed by the Division of Planning and Development at the Metropolitan Community College Administration Center is used to evaluate the University of Connecticut's School of Allied Health Professions. The three undergraduate programs focused on are physical therapy, clinical dietetics and medical…

Learning of Musculoskeletal Ligament Stress Testing in a Gross Anatomy Laboratory

ERIC Educational Resources Information Center

Krause, David A.; Youdas, James W.; Hollman, John H.

2011-01-01

Human anatomy in physical therapy programs is a basic science course serving as a foundation for subsequent clinical courses. Integration of anatomy with a clinical emphasis throughout a curriculum provides opportunities for reinforcement of previously learned material. Considering the human cadaver laboratory as a fixed cost to our program, we…

Comparison of Physical Therapy Anatomy Performance and Anxiety Scores in Timed and Untimed Practical Tests

ERIC Educational Resources Information Center

Schwartz, Sarah M.; Evans, Cathy; Agur, Anne M.R.

2015-01-01

Students in health care professional programs face many stressful tests that determine successful completion of their program. Test anxiety during these high stakes examinations can affect working memory and lead to poor outcomes. Methods of decreasing test anxiety include lengthening the time available to complete examinations or evaluating…

Navy-ASEE Summer Faculty Research Program. Navy-ASEE Sabbatical Leave Program.

DTIC Science & Technology

1994-09-01

University Arnall Physical Therapy N. Arizona Univ. I Azimi-Sadjadi Elec. Eng. Colorado St. Univ. Baird Chem. Univ. of Alabama in Huntsville I Bandy Mech...provide the framework for the analysis of data in magneto -optics and on tunneling structures for a number of years. Dr. Bilal M. Ayyub Associate

Effectiveness of physical therapy for patients with neck pain: an individualized approach using a clinical decision-making algorithm.

PubMed

Wang, Wendy T J; Olson, Sharon L; Campbell, Anne H; Hanten, William P; Gleeson, Peggy B

2003-03-01

The purpose of this study was to determine the effectiveness of an individualized physical therapy intervention in treating neck pain based on a clinical reasoning algorithm. Treatment effectiveness was examined by assessing changes in impairment, physical performance, and disability in response to intervention. One treatment group of 30 patients with neck pain completed physical therapy treatment. The control group of convenience was formed by a cohort group of 27 subjects who also had neck pain but did not receive treatment for various reasons. There were no significant differences between groups in demographic data and the initial test scores of the outcome measures. A quasi-experimental, nonequivalent, pretest-posttest control group design was used. A physical therapist rendered an eclectic intervention to the treatment group based on a clinical decision-making algorithm. Treatment outcome measures included the following five dependent variables: cervical range of motion, numeric pain rating, timed weighted overhead endurance, the supine capital flexion endurance test, and the Patient Specific Functional Scale. Both the treatment and control groups completed the initial and follow-up examinations, with an average duration of 4 wk between tests. Five mixed analyses of variance with follow-up tests showed a significant difference for all outcome measures in the treatment group compared with the control group. After an average 4 wk of physical therapy intervention, patients in the treatment group demonstrated statistically significant increases of cervical range of motion, decrease of pain, increases of physical performance measures, and decreases in the level of disability. The control group showed no differences in all five outcome variables between the initial and follow-up test scores. This study delineated algorithm-based clinical reasoning strategies for evaluating and treating patients with cervical pain. The algorithm can help clinicians classify patients with cervical pain into clinical patterns and provides pattern-specific guidelines for physical therapy interventions. An organized and specific physical therapy program was effective in improving the status of patients with neck pain.

Dance Therapy with Physical Therapy for Children with Down Syndrome.

ERIC Educational Resources Information Center

Dupont, Blanche Burt; Schulmann, Diana

This study sought to investigate effects of a dance program on bilateral toe-standing balance and single-point static balance skills of a group of children with Down Syndrome. Thirteen experimental and 10 control group students between the ages of 3 and 13 years were assessed on toe-standing balance and single-point standing balance on the right…

A conceptual framework for international service-learning course planning: promoting a foundation for ethical practice in the physical therapy and occupational therapy professions.

PubMed

Lattanzi, Jill Black; Pechak, Celia

2011-01-01

As physical therapy (PT) and occupational therapy (OT) educational programs endeavor to foster core values of social responsibility, justice, and altruism in an increasingly global community, the incorporation of local and international service-learning (ISL) into the curriculum is growing. Much of the research has focused on the measurement of student learning, with little written about the impact on the host community. Proponents of global health initiatives are calling for consideration of all stakeholders to ensure ethical practice. This paper explores the current literature related to PT and OT ISL and builds a conceptual framework for ISL course planning. The essential phases in the framework include: 1) pre-experience planning/preparation stage, 2) field immersion experience stage, and 3) postexperience stage. The essential elements are: 1) cultural competency training, 2) communication and coordination with community, 3) comprehensive assessment, and 4) strategic planning. The authors suggest this framework as a practical tool to structure ISL courses with an explicit emphasis on ethical concerns. Additionally, they seek to foster more dialogue and action related to the promotion of ethical practices in ISL in PT and OT education programs.

The development of clinical reasoning and interprofessional behaviors: service-learning at a student-run free clinic.

PubMed

Seif, Gretchen; Coker-Bolt, Patty; Kraft, Sara; Gonsalves, Wanda; Simpson, Kit; Johnson, Emily

2014-11-01

This article examines the benefits of a student run free clinic (SRFC) as a service learning experience for students in medicine, pharmacy, occupational therapy, physical therapy and physician assistant programs. We hypothesized that students who participate in an interprofessional service learning course and volunteer at a SRFC would demonstrate significant increases in perceptions and attitudes for working in interprofessional health care teams and clinical reasoning skills compared to students who did not participate. Three assessments were administered to an experimental and control group of pre-clinical students from medical, occupational therapy, physical therapy, pharmacy and physician assistant programs before and after participation in an interprofessional service-learning course and volunteering at the SRFC. The tools were the Interdisciplinary Education Perception Scale (IEPS), Readiness for Interprofessional Learning Scale (RIPLS) and the Self-Assessment of Clinical Reflection and Reasoning (SACRR). Students who completed the course had improvements in interprofessional perceptions and attitudes (p = 0.03) and perceptions of clinical reasoning skills when compared to the control group (p = 0.002). This study is novel as it examined students' perceptions of interprofessional attitudes and clinical reasoning following participation in an interprofessional service-learning course and participation in a SRFC.

Does Group, Individual or Home Exercise Best Improve Mobility for People With Parkinson's Disease?

PubMed Central

King, LA; Wilhelm, J; Chen, Y; Blehm, R; Nutt, J; Chen, Z; Serdar, A; Horak, FB

2016-01-01

Background and Purpose Comparative studies of exercise interventions for people with Parkinson Disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by 1) home exercise program, 2) individualized physical therapy, or 3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention. Methods Fifty-eight people (age 63.9 ± 8) with PD participated. People were randomized into: 1) home exercise program 2) individual physical therapy or 3) group class intervention. All arms were standardized and based on the Agility Boot Camp exercise program for PD, 3 times per week for 4 weeks. The primary outcome measure was the 7-item Physical Performance Test (PPT). Other measures of balance, gait, mobility, quality of life, balance confidence, depressions, apathy, self-efficacy and UPDRS motor and ADL scores were included. Results Only the individual group significantly improved in PPT. The individual exercise showed the most improvements in functional and balance measures, while the group class showed the most improvements in gait. The home exercise program improved the least across all outcomes. Several factors effected success, particularly for the home group. Discussion and Conclusions An unsupervised, home exercise program is the least effective way to deliver exercise to people with PD and individual and group exercises have differing benefits. Furthermore, people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist. Video Abstract available for additional insights from the authors (See Supplemental Digital Content 1, http://links.lww.com/JNPT/A112). PMID:26308937

High-dose-rate intraoperative radiation therapy: the nuts and bolts of starting a program

PubMed Central

Moningi, Shalini; Armour, Elwood P.; Terezakis, Stephanie A.; Efron, Jonathan E.; Gearhart, Susan L.; Bivalacqua, Trinity J.; Kumar, Rachit; Le, Yi; Kien Ng, Sook; Wolfgang, Christopher L.; Zellars, Richard C.; Ellsworth, Susannah G.; Ahuja, Nita

2014-01-01

High-dose-rate intraoperative radiation therapy (HDR-IORT) has historically provided effective local control (LC) for patients with unresectable and recurrent tumors. However, IORT is limited to only a few specialized institutions and it can be difficult to initiate an HDR-IORT program. Herein, we provide a brief overview on how to initiate and implement an HDR-IORT program for a selected group of patients with gastrointestinal and pelvic solid tumors using a multidisciplinary approach. Proper administration of HDR-IORT requires institutional support and a joint effort among physics staff, oncologists, surgeons, anesthesiologists, and nurses. In order to determine the true efficacy of IORT for various malignancies, collaboration among institutions with established IORT programs is needed. PMID:24790628

Cerebral Palsy Not Necessary: Maxi-Move. Do It Yourself for Parents with Movement Delayed Children under Eight.

ERIC Educational Resources Information Center

Lotz, H. Winky

Written for parents to use in the home environment, this illustrated handbook describes the Maxi-Move program, an intensive one-year program of exercise for children of one to eight years of age, who have cerebral palsy. The program does not use physical therapy, patterning, or specific movement goals, but focuses on having fun, creating…

The efficacy of Sustained Natural Apophyseal Glides with and without Isometric Exercise Training in Non-specific Neck Pain.

PubMed

Ali, Abid; Shakil-Ur-Rehman, Syed; Sibtain, Fozia

2014-07-01

To determine the efficacy of Sustained Natural Apophyseal Glides (SNAGs) with and without Isometric Exercise Training Program (IETP) in Non-specific Neck Pain (NSNP) Methods: This randomized control trial of one year duration was conducted at out-patient department of Physiotherapy and Rehabilitation, Khyber Teaching Hospital (KTH) Peshawar, Pakistan from July 2012 to June 2013. The sample of 102 patients of NSNP were randomly selected through simple random sampling technique, and placed into two groups. The SNAGs manual physical therapy technique with IETP was applied on 51 patients in group A and SNAGs manual physical therapy techniques was applied alone on 51 patients in group B. The duration of intervention was 6 weeks, at 4 times per week. The Neck Disability Index (NDI) and Visual Analog Scale (VAS) for neck pain were assessment tools used for all patients before and after 6 weeks of physical therapy intervention. All the patients were assessed through NDI and VAS before intervention and at the completion of 6 weeks program. The data of all 102 was analyzed by SPSS-20 and statistical test was applied at 95% level of significance determine the efficacy of both the treatments interventions and compare with each other. The patients in group A, treated with SNAGs and followed by IETP for 6 weeks, demonstrated more improvement in pain and physical activity as assessed by VAS (p=0.013) and NDI (p=0.003), as compared to the patients treated with SNAGS alone, as pain and function assessed by VAS (p=0.047) and NDI (p=0.164). In group A the NDI score improved from 40 to 15 and VAS from 7 to 4, while in group B the NDI score improved from 42 to 30 and VAS from 7 to 4. Patients with non-specific neck pain treated with SNAGs manual physical therapy techniques and followed by IETP was more effective in reduction of pain and enhancement of function, as compared to those patients treated with SNAGs manual physical therapy techniques alone.

Postoperative treatment of metacarpal fractures-Classical physical therapy compared with a home exercise program.

PubMed

Gülke, Joachim; Leopold, Barbara; Grözinger, Daniel; Drews, Björn; Paschke, Stephan; Wachter, Nikolaus J

Prospective cohort randomized controlled trial. Is either a home exercise (HE) program or traditional physical therapy (PT) more effective in the postoperative management of metacarpal fractures? Sixty patients suffering from nonthumb metacarpal fractures who received mobilization-stable open reduction and internal fixation were included. All patients were prospectively randomized into either the PT group or the HE group. Follow-up examinations at 2, 6 and 12 weeks postoperatively. After 2 weeks, the range of motion (ROM) in both groups was still severely reduced. Twelve weeks after surgery the ROM improved to 245° (PT) and 256° (HE). Grip strength after 6 weeks was 68% (PT) and 71% (HE) when compared to the non-injured hand, improving to 91% (PT) and 93% (HE) after 12 weeks. Study results show that both HE program and traditional PT are effective in the postoperative management of metacarpal fractures. II. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Antigravity treadmill training during the early rehabilitation phase following unicompartmental knee arthroplasty: A case series.

PubMed

Huang, Chun-Hao; Schroeder, E Todd; Powers, Christopher

2018-02-26

Patients who have undergone unicompartmental knee arthroplasty (UKA) have been reported to exhibit altered gait 19-25 months post-surgery. The most common gait impairment in this population is inadequate knee flexion and a corresponding decrease in the knee extensor moment during loading response (i.e., quadriceps avoidance). The purpose of this case series was to determine whether incorporation of antigravity treadmill training into a standard physical therapy program can eliminate quadriceps avoidance gait during the early rehabilitation phase following UKA. Four females who underwent UKA were recruited for this study. Participants completed antigravity treadmill training three times per week for 12 weeks in addition to their standard physical therapy program. Instrumented gait analysis was performed at baseline (pre-intervention), week 6 (mid-intervention), and week 12 (post-intervention). We found that peak knee flexion and the peak knee extensor moment during the weight acceptance phase of gait increased to normal values following the 12-week intervention period (14.1 ± 6.5° to 20.6 ± 1.5° and 0.4 ± 0.3 to 0.7 ± 0.2 Nm/kg respectively). The findings of this case series suggest that a standard physical therapy program that incorporates early gait training using an antigravity treadmill may be beneficial in eliminating "quadriceps avoidance" during the early rehabilitation phase following UKA.

Randomized Controlled Trial of Screening, Risk Modification, and Physical Therapy to Prevent Falls Among the Elderly Recently Discharged From the Emergency Department to the Community: The Steps to Avoid Falls in the Elderly Study.

PubMed

Matchar, David B; Duncan, Pamela W; Lien, Christopher T; Ong, Marcus Eng Hock; Lee, Mina; Gao, Fei; Sim, Rita; Eom, Kirsten

2017-06-01

To evaluate the effectiveness of a multifactorial, tailored program of physical therapy to reduce the occurrence of falls among a heterogeneous group of high-risk elderly Singaporeans recently discharged from the emergency department (ED). Randomized controlled trial. Communities. Adults (N=354) aged ≥65 years who were seen in the ED for a fall or fall-related injuries and discharged home. The intervention primarily consisted of a tailored program of physical therapy focused on progressive training in strength, balance, and gait for a period of 3 months. Participants in the intervention group also received screening and follow-up for vision, polypharmacy, and environmental hazards. Participants in the control group received usual care prescribed by a physician and educational materials on falls prevention. The primary outcome measure was experiencing at least 1 fall during the 9-month study period (a 3-mo active intervention phase and a 6-mo maintenance phase). Secondary outcome measures were the occurrence of at least 1 injurious fall during the study period and a change in the Short Physical Performance Battery (SPPB) score. Participants were assessed both after 3 and 9 months. During the 9-month study period, 37.8% of the control group and 30.5% of the intervention group fell at least once, which was not statistically significantly different (odds ratio [OR]=.72; 95% confidence interval [CI], .46-1.12; P=.146). The intervention group had statistically significantly fewer individuals with injurious falls (OR=.56; 95% CI, .32-.98; P=.041) and less deterioration in physical performance, reflected by a mean difference of 0.6 in SPPB scores (P=.029). Multivariate analyses indicated a strong interaction effect between the intervention and the presence of 2 or more major comorbidities; after accounting for this effect, the intervention program reduced the number of people experiencing at least 1 fall (OR=.34; 95% CI, .17-.67; P=.002). We observed that in this heterogeneous population, the proportion of participants experiencing at least 1 fall during the study period was not statistically significantly lower in the intervention group compared with the control group. Secondary analyses strongly suggest that individuals with 2 or more major comorbidities do not benefit from a tailored physical therapy program; however, individuals with less comorbidity may substantially benefit. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Visual Biofeedback Balance Training Using Wii Fit after Stroke: A Randomized Controlled Trial

PubMed Central

Barcala, Luciana; Grecco, Luanda André Collange; Colella, Fernanda; Lucareli, Paulo Roberto Garcia; Salgado, Afonso Shiguemi Inoue; Oliveira, Claudia Santos

2013-01-01

[Purpose] The aim of the present study was to investigate the effect of balance training with visual biofeedback on balance, body symmetry, and function among individuals with hemiplegia following a stroke. [Subjects and Methods] The present study was performed using a randomized controlled clinical trial with a blinded evaluator. The subjects were twenty adults with hemiplegia following a stroke. The experimental group performed balance training with visual biofeedback using Wii Fit® together with conventional physical therapy. The control group underwent conventional physical therapy alone. The intervention lasted five weeks, with two sessions per week. Body symmetry (baropodometry), static balance (stabilometry), functional balance (Berg Balance Scale), functional mobility (Timed Up and Go test), and independence in activities of daily living (Functional Independence Measure) were assessed before and after the intervention. [Results] No statistically significant differences were found between the experimental and control groups. In the intragroup analysis, both groups demonstrated a significant improvement in all variables studied. [Conclusion] The physical therapy program combined with balance training involving visual biofeedback (Wii Fit®) led to an improvement in body symmetry, balance, and function among stroke victims. However, the improvement was similar to that achieved with conventional physical therapy alone. PMID:24259909

Microwave resonance therapy in medical practice

NASA Astrophysics Data System (ADS)

Sumskoy, L. L.

1994-08-01

Consideration is being given to the problems of organizing treatment of patients with quantum medicine methods by Prof. S.P. Sit'ko at 660 hospitals of Ukraine and Russia. Analyzed are teaching of doctors and treatment of 250,000 patients for 82 nozologic cases in 1990 through 1993. In the State of Ukraine, the Government has adopted a State Target-oriented Program of Large- scale Promotion of Microwave Resonance Therapy Into Medical Practice as presented by the Ministry of Health care in 1989. According to the Program, it was planned, during the three year period, to provide MRT rooms in 325 medical institutions. The Program was based on a discovery by Prof. S.P. Sit'ko DSc (Physics & Mathematics), of a new non-morphological structure of man, i.e. an electromagnetic framework that is manifested by eigenfrequencies in the millimeter range and disturbance of which results in disease while repair returns the organism to health. This idea was subjected to national and international expert evaluation. This evaluation was done by a panel of 12 universally acknowledged scientists headed by the founder of the theory of superconductivity, professor of the Liverpool University (Great Britain) h. Frohlich and director of the Madrid medical center Prof. Alzina. The USA was represented by Dr. W. Rogers, chief of the Center of Radiation, Institute of Bioinformation Research. The stated that Professor S.P. Sit'ko and his coworkers had established a new line of inquiry in medicine, i.e. microwave resonance therapy. To implement the State Target-oriented Program, the Government chose the Interbranch Scientific and Engineering Center on Physics of the Alive and Microwave Resonance Therapy 'Vidhuk'.

Facilitating Community-Based Exercise for People With Stroke: Cross-Sectional e-Survey of Physical Therapist Practice and Perceived Needs.

PubMed

Lau, Carrie; Chitussi, Danielle; Elliot, Sarah; Giannone, Jennifer; McMahon, Mary-Katherine; Sibley, Kathryn M; Tee, Alda; Matthews, Julie; Salbach, Nancy M

2016-04-01

Educating people with stroke about community-based exercise programs (CBEPs) is a recommended practice that physical therapists are well positioned to implement. The aim of this study was to evaluate the provision of education about CBEPs to people with stroke, barriers to providing education, and preferences for resources to facilitate education among physical therapists in neurological practice. A cross-sectional e-survey of physical therapists treating adults with stroke in Ontario, Canada, was conducted. A link to the questionnaire was emailed to physical therapists in a provincial stroke network, a provincial physical therapy association, and on hospital and previous research lists. Responses from 186 physical therapists were analyzed. The percentage of respondents who reported providing CBEP education was 84.4%. Only 36.6% reported typically providing education to ≥7 out of 10 patients with stroke. Physical (90.5%) and preventative (84.6%) health benefits of exercise were most frequently discussed. Therapists reported most commonly delivering education at discharge (73.7%). Most frequently cited barriers to educating patients were a perceived lack of suitable programs (53.2%) and a lack of awareness of local CBEPs (23.8%). Lists of CBEPs (94.1%) or brochures (94.1%) were considered to be facilitators. The percentage of physical therapists providing CBEP education varied across acute, rehabilitation, and public outpatient settings. The percentage of physical therapists providing education may have been overestimated if respondents who deliver CBEP education were more likely to participate and if participants answered in a socially desirable way. Even though a high proportion of physical therapists provide CBEP education, education is not consistently delivered to the majority of patients poststroke. Although a CBEP list or brochure would facilitate education regarding existing CBEPs, efforts to implement CBEPs are needed to help overcome the lack of suitable programs. © 2016 American Physical Therapy Association.

Physical therapy vs. internet-based exercise training (PATH-IN) for patients with knee osteoarthritis: study protocol of a randomized controlled trial.

PubMed

Williams, Quinn I; Gunn, Alexander H; Beaulieu, John E; Benas, Bernadette C; Buley, Bruce; Callahan, Leigh F; Cantrell, John; Genova, Andrew P; Golightly, Yvonne M; Goode, Adam P; Gridley, Christopher I; Gross, Michael T; Heiderscheit, Bryan C; Hill, Carla H; Huffman, Kim M; Kline, Aaron; Schwartz, Todd A; Allen, Kelli D

2015-09-28

Physical activity improves pain and function among individuals with knee osteoarthritis (OA), but most people with this condition are inactive. Physical therapists play a key role in helping people with knee OA to increase appropriate physical activity. However, health care access issues, financial constraints, and other factors impede some patients from receiving physical therapy (PT) for knee OA. A need exists to develop and evaluate other methods to provide physical activity instruction and support to people with knee OA. This study is examining the effectiveness of an internet-based exercise training (IBET) program designed for knee OA, designed by physical therapists and other clinicians. This is a randomized controlled trial of 350 participants with symptomatic knee OA, allocated to three groups: IBET, standard PT, and a wait list (WL) control group (in a 2:2:1 ratio, respectively). The study was funded by the Patient Centered Outcomes Research Institute, which conducted a peer review of the proposal. The IBET program provides patients with a tailored exercise program (based on functional level, symptoms, and current activity), video demonstrations of exercises, and guidance for appropriate exercise progression. The PT group receives up to 8 individual visits with a physical therapist, mirroring standard practice for knee OA and with an emphasis on a home exercise program. Outcomes are assessed at baseline, 4 months (primary time point) and 12 months (to assess maintenance of treatment effects). The primary outcome is the Western Ontario and McMaster Universities Osteoarthritis Index, and secondary outcomes include objective physical function, satisfaction with physical function, physical activity, depressive symptoms and global assessment of change. Linear mixed models will be used to compare both the IBET and standard PT groups to the WL control group, examine whether IBET is non-inferior to PT (a treatment that has an established evidence base for knee OA), and explore whether participant characteristics are associated with differential effects of IBET and/or standard PT. This research is in compliance with the Helsinki Declaration and was approved by the Institutional Review Board of the University of North Carolina at Chapel Hill. The IBET program could be disseminated widely at relatively low cost and could be an important resource for helping patients with knee OA to adopt and maintain appropriate physical activity. This trial will provide an important evaluation of the effectiveness of this IBET program for knee OA. NCT02312713.

An evaluator-blinded randomized controlled trial evaluating therapy effects and prognostic factors for a general and an individually defined physical therapy program in ambulant children with bilateral spastic cerebral palsy.

PubMed

Franki, I; Desloovere, K; De Cat, J; Tijhuis, W; Molenaers, G; Feys, H; Vanderstraeten, G; Van Den Broeck, C

2015-12-01

Cerebral palsy (CP) is characterized by a heterogeneous nature with a variety of problems. Therefore, individualized physical therapy might be more appropriate to address the needs for these children. The first aim was to compare the effectiveness of an individually-defined therapy program (IT) and a general therapy program (GT) on gait and gross motor function in children with CP. The second aim was to evaluate interaction-effects, time-effects, treatment with botulinum toxin A, age, gross Motor Function Classification Scale (GMFCS), treatment frequency and quality as factors influencing outcome. An evaluator-blinded, randomized controlled trial. Outpatient rehabilitation unit. Forty ambulant children with spastic bilateral CP (mean age 6 years 1 month). All children were randomly assigned to receive either IT or GT over a 10 week period. Nineteen of these children were enrolled into a second and/or third program, resulting in 60 interventions. Primary outcome was assessed with the Goal Attainment Scale (GAS) for gross motor function goals and z-scores for goals based on specific 3D gait parameters. Secondary outcome included the Gross Motor Function Measure-88 (GMFM-88) scores, time and distance gait parameters, Gait Profile Score, Movement Analysis Profiles and time needed to complete Timed-Up-and-Go and Five-Times-Sit-To-Stand tests. There were higher, but non-significant GAS and z-score changes following the IT program compared to the GT program (GAS: 46.2 for the IT versus 42.2 for the GT group, P=0.332, ES 0.15; z-score: 0.135 for the IT compared to 0.072 for the GT group, P=0.669, ES 0.05). Significant time-effects could be found on the GAS (P<0.001) and the GMFM-88 total score (P<0.001). Age was identified as a predictor for GAS and GMFM-88 improvement (P=0.023 and P=0.044). No significant differences could be registered between the effects of the IT and the GT. The favorable outcome after the IT program was only a trend and needs to be confirmed on larger groups and with programs of longer duration. Both programs had a positive impact on the children's motor functioning. It is useful to involve older children more actively in the process of goal setting.

Yoga-Based Rehabilitation Program in Reducing Physical and Emotional Side Effects in Patients With Cancer

ClinicalTrials.gov

2017-01-23

Alopecia; Anxiety; Breast Carcinoma; Cognitive Side Effects of Cancer Therapy; Colorectal Carcinoma; Depression; Fatigue; Lung Carcinoma; Nausea and Vomiting; Pain; Psychological Impact of Cancer; Sleep Disorder; Weight Change

A Healthy Investment: Building the Facilities to Train the Next Generation of Nursing and Allied Health Professionals

ERIC Educational Resources Information Center

Woods, Bob

2013-01-01

A growing number of community colleges are investing in new facilities and programs to train health care workers in a variety of professions, including nursing, radiology, health information technology, physical therapy, dentistry, and surgical technology. Community colleges have historically offered job training programs in health care, but with…

Student Recruitment in Allied Health Educational Programs: The Importance of Initial Source of Contact.

ERIC Educational Resources Information Center

Baldwin, Alphonso; Agho, Augustine O.

2003-01-01

A survey of 1,809 students found that information influencing their decision to enroll in allied health programs came from a variety of sources. Practicing health professionals were the most influential. Only physical therapy and dental hygiene students identified high school counselors as an important source. (Contains 20 references.) (JOW)

Lower extremity thrust and non-thrust joint mobilization for patellofemoral pain syndrome: a case report.

PubMed

Simpson, Brad G; Simon, Corey B

2014-05-01

A 40-year old female presented to physical therapy with a one-year history of insidious right anteromedial and anterolateral knee pain. Additionally, the patient had a history of multiple lateral ankle sprains bilaterally, the last sprain occurring on the right ankle 1 year prior to the onset of knee pain. The patient was evaluated and given a physical therapy diagnosis of patellofemoral pain syndrome (PFPS), with associated talocrural and tibiofemoral joint hypomobility limiting ankle dorsiflexion and knee extension, respectively. Treatment included a high-velocity low amplitude thrust manipulation to the talocrural joint, which helped restore normal ankle dorsiflexion range of motion. The patient also received tibiofemoral joint non-thrust manual therapy to regain normal knee extension mobility prior to implementing further functional progression exercises to her home program (HEP). This case report highlights the importance of a detailed evaluation of knee and ankle joint mobility in patients presenting with anterior knee pain. Further, manual physical therapy to the lower extremity was found to be successful in restoring normal movement patterns and pain-free function in a patient with chronic anterior knee pain.

Increased Compliance With Supervised Rehabilitation Improves Functional Outcome and Return to Sport After Anterior Cruciate Ligament Reconstruction in Recreational Athletes

PubMed Central

Han, Fucai; Banerjee, Anirban; Shen, Liang; Krishna, Lingaraj

2015-01-01

Background: Successful return to sport is an important outcome measure after anterior cruciate ligament (ACL) reconstruction and a reason for patients’ decisions to elect surgery. Rehabilitation programs supervised by physical therapists are routinely prescribed after ACL reconstruction surgery. However, the added advantage of supervised physical therapy after ACL reconstruction is still debatable. Hypothesis: Attending more supervised physical therapy sessions after arthroscopic ACL reconstruction in recreational athletes increases their chance of successful return to sport. Study Design: Cohort study; Level of evidence, 3. Methods: The authors analyzed 93 recreational athletes who underwent arthroscopic ACL reconstruction. After arthroscopic single-bundle ACL reconstruction, patients were advised to attend 20 supervised physical therapy sessions. Patients’ demographics, surgical details, and outcome measures (Knee injury and Osteoarthritis Outcome Score [KOOS], Lysholm scale, and Short Form–36 Health Survey [SF-36]) were recorded presurgery and at 1-year follow-up. Ability to return to sports was documented through patients’ self-report. The attendance at physical therapy by each patient was obtained by examining database records and assessed as fully compliant (>15 sessions), moderately compliant (6-15 sessions), or noncompliant (<6 sessions). Results: Patients in the fully compliant group had significantly greater odds (odds ratio [OR], 18.5; 95% CI, 1.9-184.5; P = .013) of a successful return to sport as compared with the noncompliant group. Patients in the moderately compliant group also had greater odds of returning to sport as compared with the noncompliant group (OR, 4.2; 95% CI, 1.0-16.6; P = .043). Patients in the fully compliant group had significantly greater scores on the Lysholm (P < .001), KOOS Sports and Recreation subscale (P = .021), KOOS Symptoms subscale (P = .040), and SF-36 physical component summary (PCS) (P = .012) as compared with the noncompliant group. Moderately compliant patients had significantly greater scores on the Lysholm (P = .004), KOOS Sports and Recreation (P = .026), KOOS Symptoms (P = .041), KOOS Quality of Life (P = .022), and SF-36 PCS (P = .004) as compared with noncompliant patients. Conclusion: In recreational athletes, moderate to full compliance with a supervised physical therapy program predicts improved knee function and a greater chance of returning to sport 1 year after ACL reconstruction. PMID:26740958

National Study of Excellence and Innovation in Physical Therapist Education: Part 1-Design, Method, and Results.

PubMed

Jensen, Gail M; Nordstrom, Terrence; Mostrom, Elizabeth; Hack, Laurita M; Gwyer, Janet

2017-09-01

The Carnegie Foundation for the Advancement of Teaching commissioned the Preparation for the Professions Program, a qualitative study of professional education in 5 professions: medicine, nursing, law, engineering, and clergy. These studies identified curricular structures, instructional practices, assessment approaches, and environmental characteristics that support the preparation of professionals and led to educational reforms. The physical therapy profession has not had any in-depth, national investigation of physical therapist education since the Catherine Worthingham studies conducted more than 50 years ago. This research was a Carnegie-type study, investigating elements of excellence and innovation in academic and clinical physical therapist education in the United States. Five physical therapist education researchers from across the United States used a qualitative multiple-case study design. Six academic and 5 clinical programs were selected for the study. The academic institutions and clinical agencies studied were diverse in size, institutional setting, geography, and role in residency education. Qualitative case studies were generated from review of artifacts, field observations, and interviews (individual and focus group), and they provided the data for the study. A conceptual framework grounded in 3 major dimensions was generated, with 8 supporting elements: (1) culture of excellence (shared beliefs and values, leadership and vision, drive for excellence, and partnerships), (2) praxis of learning (signature pedagogy, practice-based learning, creating adaptive learners, and professional formation), and (3) organizational structures and resources. Building on the work of the Carnegie Foundation's Preparation for the Professions Program, a conceptual model was developed, representing the dimensions and elements of excellence in physical therapist education that is centered on the foundational importance of a nexus of linked and highly valued aims of being learner centered and patient centered in all learning environments, both academic and clinical. © 2017 American Physical Therapy Association

Physical agents used in the management of chronic pain by physical therapists.

PubMed

Allen, Roger J

2006-05-01

Evidence supporting the use of specific physical agents in the management of chronic pain conditions is not definitive; it is largely incomplete and sometimes contradictory. However, the use of agents in chronic pain management programs is common. Within the broad use of physical agents, they are rarely the sole modality of treatment. A 1995 American Physical Therapy Association position statement asserts that "Without documentation which justifies the necessity of the exclusive use of physical agents/modalities, the use of physical agents/modalities, in the absence of other skilled therapeutic or educational intervention, should not be considered physical therapy". Physical agents may serve as useful adjunctive modalities of pain relief or to enhance the effectiveness of other elements in therapy geared toward resolution of movement impairments and restoration of physical function. Given that a conclusive aggregate of findings is unlikely to exist for all permutations of patient conditions, combined with interacting therapeutic modalities, an evidence-based approach to pain management is not always possible or beneficial to the patient. In the face of inconclusive evidence, a theory-based approach may help determine if the therapeutic effect ofa given physical agent has the possibility of being a useful clinical tool in the context of treating a particular patient's mechanism of pain generation. Until controlled efficacy findings are definitive, careful individual patient response monitoring of thoughtful theoretical application of adjunctive physical agents may be a prudent approach to the management of chronic pain.

Effectiveness of postoperative physical therapy for upper-limb impairments after breast cancer treatment: a systematic review.

PubMed

De Groef, An; Van Kampen, Marijke; Dieltjens, Evi; Christiaens, Marie-Rose; Neven, Patrick; Geraerts, Inge; Devoogdt, Nele

2015-06-01

To systematically review the effectiveness of various postoperative physical therapy modalities and timing of physical therapy after treatment of breast cancer on pain and impaired range of motion (ROM) of the upper limb. We searched the following databases: PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Physiotherapy Evidence Database, and Cochrane. Articles published until October 2012 were included. Only (pseudo) randomized controlled trials and nonrandomized experimental trials investigating the effectiveness of passive mobilization, manual stretching, myofascial therapy, and/or exercise therapy and timing of physical therapy after treatment for breast cancer are reviewed. Primary outcomes are pain of the upper limb and/or ROM of the shoulder. Secondary outcomes are decreased shoulder strength, arm lymphedema, limitations in activities of daily living, decreased quality of life, and wound drainage volume. Physical therapy modalities had to be started in the first 6 weeks after surgery. Articles were selected by 2 independent researchers in 3 phases and compared for consensus. First the titles were analyzed, and then the selected abstracts and finally the full texts were reviewed. Eighteen randomized controlled trials were included in the review. Three studies investigated the effect of multifactorial therapy: 2 studies confirmed that the combination of general exercises and stretching is effective for the treatment of impaired ROM another study showed that passive mobilization combined with massage had no beneficial effects on pain and impaired ROM. Fifteen studies investigated the effectiveness of a single physical therapy modality. One study of poor quality found evidence supporting the beneficial effects of passive mobilization. The only study investigating the effect of stretching did not find any beneficial effects. No studies were found about the effectiveness of myofascial therapy in the postoperative phase. Five studies found that active exercises were more effective than no therapy or information on the treatment of impairments of the upper limb. Three studies supported the early start of exercises for recovery of shoulder ROM, whereas 4 studies supported the delay of exercises to avoid prolonged wound healing. Multifactorial physical therapy (ie, stretching, exercises) and active exercises were effective to treat postoperative pain and impaired ROM after treatment for breast cancer. High-quality studies are necessary to determine the effectiveness of passive mobilization, stretching, and myofascial therapy as part of the multifactorial treatment. In addition, the appropriate timing and content of the exercise programs need to be further investigated. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

RCT of a 6-month programmed sports therapy (PST) in patients with haemophilia - Improvement of physical fitness.

PubMed

Runkel, B; Czepa, D; Hilberg, T

2016-09-01

Physical fitness is of major importance for patients with haemophilia (PwH) but is highly influenced by bleeding episodes. Although some cohort studies describe an improvement of physical fitness after training intervention, randomized controlled studies (RCT) in PwH are still rare. The aim of this study was to prove the enhancement of physical work capacity in PwH by programmed sports therapy (PST). This RCT includes a training period over six months. Sixty-four PwH with moderate (n = 5) to severe (n = 59) haemophilia A (n = 57) and B (n = 7) were randomized into two groups - training intervention group (IG) and control group (CG) by block randomization. Complex strength measurements, joint score, coordination check and a 12-min walking test were carried out before and after training intervention. Significant differences were tested in M. triceps brachii (Δ+0.62 N kg(-1) ), biceps brachii (Δ+1.25 N kg(-1) ), latissimus dorsi (Δ+0.59 N kg(-1) ), rectus abdominis (Δ+0.51 N kg(-1) ), biceps femoris (right: Δ+0.68 N kg(-1) ; left: Δ+0.59 N kg(-1) ) and the quadriceps femoris (right: Δ+0.71 N kg(-1) ; left: Δ+0.55 N kg(-1) ) after intervention between the two groups (all p ≤ 0.003). Furthermore, an increase in distance (Δ+171.5 m) covered in the 12-min walking test (P = 0.011) was observed. Regarding one-leg stand, a significant improvement (P = 0.037) in the IG (Δ+2.2 s right leg) after intervention could be determined. For the first time, a study with a corresponding number of adult PwH in a RCT-design showed that programmed sport therapy with specific instructions over 6 months has a positive effect on physical performance of PwH, independent of constitution and disease process. © 2016 John Wiley & Sons Ltd.

Peer Teaching among Physical Therapy Students during Human Gross Anatomy: Perceptions of Peer Teachers and Students

ERIC Educational Resources Information Center

Youdas, James W.; Hoffarth, Brianna L.; Kohlwey, Scott R.; Kramer, Christine M.; Petro, Jaime L.

2008-01-01

Despite nearly 200 accredited entry-level physical therapist education programs in the United States that culminate in a doctoral degree, only a paucity of reports have been published regarding the efficacy of peer teaching in gross anatomy. No one has described the usefulness of peer teaching from the viewpoint of the peer teacher. An organized…

78 FR 15726 - Cellular, Tissue and Gene Therapies Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

.... In open session, the committee will hear updates of research programs in the Laboratory of Chemistry... advisory committee meetings and will make every effort to accommodate persons with physical disabilities or...

WE-D-204-02: Errors and Process Improvements in Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fontenla, D.

2016-06-15

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

Contributions of a group-based exercise program for coping with fibromyalgia: a qualitative study giving voice to female patients.

PubMed

Beltrán-Carrillo, Vicente J; Tortosa-Martínez, Juan; Jennings, George; Sánchez, Elena S

2013-01-01

Numerous quantitative studies have illustrated the potential usefulness of exercise programs for women with fibromyalgia. However, a deeper understanding of the physical and especially psychosocial benefits of exercise therapy from the subjective perspective of this population is still needed. This study was conducted with 25 women who had fibromyalgia and were participating in a nine-month, group-based exercise program. The aim was to provide an in-depth description and analysis of the perceived physical and psychosocial benefits of participation. Qualitative data were collected through observation, interviews, and focus groups. The exercise program not only alleviated the physical symptoms of fibromyalgia, but social interactions within the group helped to counteract the isolation, frustration, and depression often associated with this chronic condition. The data from this study may contribute to a deeper understanding of the benefits of exercise for women with fibromyalgia and might be useful for the improvement of future exercise programs for this population.

Staff Attitudes Regarding the Impact of a Therapy Dog Program on Military Behavioral Health Patients.

PubMed

Brisson, Sara; Dekker, Anthony H

Human-animal interactions in the form of animal-assisted therapy (AAT) have become common in both civilian and military health care facilities. Evidence supports AAT as a beneficial therapeutic alternative for patients with physical disabilities and psychological disorders. Few studies have been conducted in the civilian health care setting to evaluate staff attitudes regarding the impact of an AAT program on behavioral health (BH) patients. To our knowledge, no research has examined staff attitudes on the impact and effectiveness of AAT on active-duty Servicemembers in a BH program at a military facility. At the completion of a year-long AAT dog program and after institutional review board exemption, an anonymous, six-question survey was used to examine staff attitudes (n = 29) regarding the impact and continuation of the program with military BH patients. Most staff members (86%) believed the AAT dog program had a positive impact on the BH patients, including improved patient mood, greater patient relaxation, improved patient attitude toward therapy, and increased social interactions among patients. All the staff reported a desire to continue the program at the military facility. Most BH staff thought the year-long AAT dog program had a positive impact on patients. All staff supported continuation of the program. 2017.

Early rehabilitation exercise program for inpatients during an acute exacerbation of chronic obstructive pulmonary disease: a randomized controlled trial.

PubMed

Tang, Clarice Y; Blackstock, Felicity C; Clarence, Michael; Taylor, Nicholas F

2012-01-01

To determine whether an early rehabilitation program was safe and feasible for patients during an acute exacerbation of chronic obstructive pulmonary disease (COPD). In this phase 1 randomized controlled trial, patients with an acute exacerbation of COPD admitted to the hospital were randomly allocated to a low-intensity exercise group, a moderate- to high-intensity exercise group, or a control group, who received routine physical therapy. In addition to routine physical therapy, patients in the exercise group had to participate in an exercise program. The program consisted of twice-daily aerobic and resistance exercise sessions. Primary outcomes were the number and classification of adverse events and program adherence. In 174 exercise sessions, there was 1 serious adverse event of arrhythmia in the low-intensity exercise group that resolved within 1 hour. There were 12 other minor adverse events involving 5 patients with no significant differences between groups. Patients completed an average of 80% of their scheduled sessions with no significant between-group differences. The exercise groups improved significantly in walking distance; however, no significant between-group differences were observed. There was preliminary evidence that it was safe and feasible to implement an exercise program for patients during an acute exacerbation of COPD. Additional studies with larger sample sizes are required to accurately evaluate program effectiveness.

Physical Therapy Considerations for Chronic Kidney Disease and Secondary Sarcopenia

PubMed Central

Hernandez, Haniel J.; Obamwonyi, Gideon; Harris-Love, Michael O.

2018-01-01

Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance. Given the consequences of both low muscle mass and low bone mineral density, appropriate and timely physical therapy is important for fall risk assessment and intervention to minimize the susceptibility to bone fracture. While strength training has been studied less frequently than aerobic training for the management of secondary CKD conditions, evidence suggests that this patient population benefits from participation in strength training programs. However, the provision of a formal exercise prescription by a health care professional, along with formal implementation of an exercise program, may need to be more fully integrated into the standard plan of care for individuals with CKD. PMID:29376141

Medical Applications of the PHITS Code (3): User Assistance Program for Medical Physics Computation.

PubMed

Furuta, Takuya; Hashimoto, Shintaro; Sato, Tatsuhiko

2016-01-01

DICOM2PHITS and PSFC4PHITS are user assistance programs for medical physics PHITS applications. DICOM2PHITS is a program to construct the voxel PHITS simulation geometry from patient CT DICOM image data by using a conversion table from CT number to material composition. PSFC4PHITS is a program to convert the IAEA phase-space file data to PHITS format to be used as a simulation source of PHITS. Both of the programs are useful for users who want to apply PHITS simulation to verification of the treatment planning of radiation therapy. We are now developing a program to convert dose distribution obtained by PHITS to DICOM RT-dose format. We also want to develop a program which is able to implement treatment information included in other DICOM files (RT-plan and RT-structure) as a future plan.

Do occupational therapy and physical therapy curricula teach critical thinking skills?

PubMed

Vogel, Kimberly A; Geelhoed, Michael; Grice, Kimatha O; Murphy, Douglas

2009-01-01

This study evaluated whether critical thinking ability can be improved through participation in occupational therapy (OT) and physical therapy (PT) curricula. The researchers compared levels of the critical thinking skills of OT and PT students at the beginning and end of their programs to determine whether changes occurred and to examine facets of the curricula that may have caused the differences. The curricula include teaching strategies of problem-based learning modules, small group discussion and problem-solving, case studies, clinical observation, and evidence-based practice assignments, as well as teaching about critical thinking as a process in itself. Fifty OT and PT students completed the Watson-Glaser Critical Thinking Appraisal at the beginning and end of 20 mos of the academic phase of their master's degree programs. Researchers analyzed the data using a one-way repeated-measures ANOVA. Results showed no differences between OT and PT students on the pretest or post-test and no differences for PT students between the pretest and post-test. OT students' scores increased significantly from pretest to post-test. The influence of the timing of teaching critical thinking skills in the resulting differences between the two curricula, as well as the validity of the Watson-Glaser Critical Thinking Appraisal is a valid measure of critical thinking changes in allied health students are discussed.

Diabetes prevention program in a Mediterranean environment: individual or group therapy? An effectiveness evaluation.

PubMed

Endevelt, R; Peled, R; Azrad, A; Kowen, G; Valinsky, L; Heymann, A D

2015-04-01

Diabetes as a multifactorial disorder requires prevention measures based upon the modification of several risk factors simultaneously; otherwise, there is insufficient potential for prevention. Following the success of the American Diabetes Prevention Program (DPP), we implemented an intervention program in a large Israeli healthcare organization with an emphasize on Mediterranean Diet (MedDiet) and physical activity. The objective was to evaluate the effectiveness of two types of intervention, individual and group therapies, in reducing risk factors and in preventing or delaying the development of type 2 diabetes. Out of 180 primary care physicians, 85 who agreed to participate, were randomly assigned, between the years 2005 and 2006, into two groups: those who would refer pre-diabetes adult patients for individual therapy and those who would refer for group therapy. The two groups of patients consisted of 111 and 112 in each group. The intervention lasted for 6 months and discussed: the benefits of MedDiet, planning nutritional behavior and mindful eating, and the importance of physical activity. All patients were invited to participate in walking groups. Follow up lasted for 24 months and logistic, mixed models, and Cox regressions were employed. No statistically significant differences were detected between the two intervention groups in age; gender and clinical measurements at recruitment. Thirty nine percent of both groups developed diabetes (entered the DR by 2012), including 38.7% from the individual therapy and 39.3% from the group therapy (P=0.933). The mean time from 2005 until entry to the Diabetes Registry (DR) was 2.9 and 2.5 years for the individual and group therapy respectively (P=0.542). Both interventions were equally effective in achieving the desired outcomes and time until entry to the DR. For large health organizations with a high number of pre-diabetes patients and scarce resources, group therapy, where 12 people are reached out by one team member are preferable and more costly effective, than a one on one therapy. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Teaching dementia care to physical therapy doctoral students: A multimodal experiential learning approach.

PubMed

Lorio, Anne K; Gore, Jane B; Warthen, Lindsey; Housley, Stephen N; Burgess, Elisabeth O

2017-01-01

As the population aged 65 and older grows, it becomes imperative for health care providers to expand their knowledge regarding geriatric conditions and concerns. Dementia is a devastating degenerative disease process that is affecting millions of individuals in the United States, with significant economic and emotional burden on family and caregivers. The need for further dementia education in physical therapy school is essential to improve attitudes and treatment that affect patient outcomes and quality of care. This physical therapy program implemented a 12-hour multimodal experiential learning module designed to educate their students on the challenges associated with dementia to increase knowledge and confidence when treating these patients. The results of this study showed statistically significant improvements in overall confidence and knowledge of treating patients with dementia. The study finds the addition of experiential learning to traditional didactic coursework improves students' reported confidence in working with patients with dementia and understanding the challenges associated with treating patients with dementia.

A distance learning model in a physical therapy curriculum.

PubMed

English, T; Harrison, A L; Hart, A L

1998-01-01

In response to the rural health initiative established in 1991, the University of Kentucky has developed an innovative distance learning program of physical therapy instruction that combines classroom lecture and discussion via compressed video technology with laboratory experiences. The authors describe the process of planning, implementing, and evaluating a specific distance learning course in pathomechanics for the professional-level master's-degree physical therapy students at the University of Kentucky. This presentation may serve as a model for teaching distance learning. Descriptions of optimal approaches to preclass preparation, scheduling, course delivery, use of audiovisual aids, use of handout material, and video production are given. Special activities that may enhance or deter the achievement of the learning objectives are outlined, and a problem-solving approach to common problems encountered is presented. An approach to evaluating and comparing course outcomes for the distance learnere is presented. For this particular course, there was no statistically significant difference in the outcome measures utilized to compare the distance learners with the on-site learners.

Effects of compound music program on cognitive function and QOL in community-dwelling elderly

PubMed Central

Fujita, Takaaki; Ito, Akemi; Kikuchi, Nana; Kakinuma, Tomohiro; Sato, Yoshihisa

2016-01-01

[Purpose] Interventions using music, physical exercise, and reminiscence therapy are widely used both for rehabilitation and care of the elderly. This study aimed to investigate the effect of structured interventions comprising music, physical exercise, and reminiscence therapy on cognitive function and quality of life of the community-dwelling elderly. [Subjects and Methods] The study included 15 community-dwelling elderly people who used a day-care center. Participants underwent sessions comprising the following three factors: 1) singing songs familiar to the elderly; 2) physical exercise to music; and 3) observation of historical pictures. Sessions were conducted once or twice per week, 30 to 40 min per day, for 10 weeks. Pre and post interventions of the Mini Mental State Examination, the Behavioral Rating Scale for the Elderly, and the SF-8 were compared. [Results] No significant difference was observed between pre- and post-intervention scores on the Mini Mental State Examination and the Behavioral Rating Scale for the Elderly. However, the post intervention physical component summary of SF-8 was significantly higher than the pre intervention summary. [Conclusion] This study suggests that interventions comprising music, physical exercise, and reminiscence therapy may contribute toward the improvement of elderly individuals’ health-related quality of life, especially physical health. PMID:27942151

Outpatient physical therapy utilization for children and adolescents with intellectual disabilities in Taiwan: a population-based nationwide study.

PubMed

Chang, Yu-Chia; Lin, Jin-Ding; Tung, Ho-Jui; Chiang, Po-Huang; Hsu, Shang-Wei

2014-02-01

This study analyzed the utilization and utilization determinants of outpatient physical therapy (PT) among children and adolescents with intellectual disabilities (ID) in Taiwan. A cross-sectional study was conducted to analyze 2007 national health insurance (NHI) claim data from 35,802 eighteen-year-old and younger persons with intellectual disabilities. A total of 3944 (11.02%) claimants received outpatient physical therapy. Variables that affected PT utilization included age, residence urbanization level, ID level, copayment status and major co-morbidity. The average annual PT visit frequency was 25.4 ± 33.0; pre-school children, claimants suffering from catastrophic disease and ID co-occurring with cerebral palsy had a higher mean cost per visit. Age, ID level, copayment status and co-morbidity were factors that influenced expenditure. Pre-school children, males, individuals who resided in the lowest urbanization areas and individuals with a catastrophic disease tended to use hospital services. The point prevalence of epilepsy and cerebral palsy were 12.10% and 19.80%, respectively. Despite the NHI program and government regulations to provide special services, the use of physical therapy for children and adolescents with intellectual disabilities was low, and the utilization decreased as the subjects aged. Copyright © 2013 Elsevier Ltd. All rights reserved.

Physical therapy approaches to reduce fall and fracture risk among older adults.

PubMed

Karinkanta, Saija; Piirtola, Maarit; Sievänen, Harri; Uusi-Rasi, Kirsti; Kannus, Pekka

2010-07-01

Falls and fall-related injuries, such as fractures, are a growing problem among older adults, often causing longstanding pain, functional impairments, reduced quality of life and excess health-care costs and mortality. These problems have led to a variety of single component or multicomponent intervention strategies to prevent falls and subsequent injuries. The most effective physical therapy approach for the prevention of falls and fractures in community-dwelling older adults is regular multicomponent exercise; a combination of balance and strength training has shown the most success. Home-hazard assessment and modification, as well as assistive devices, such as canes and walkers, might be useful for older people at a high risk of falls. Hip protectors are effective in nursing home residents and potentially among other high-risk individuals. In addition, use of anti-slip shoe devices in icy conditions seems beneficial for older people walking outdoors. To be effective, multifactorial preventive programs should include an exercise component accompanied by individually tailored measures focused on high-risk populations. In this Review, we focus on evidence-based physical therapy approaches, including exercise, vibration training and improvements of safety at home and during periods of mobility. Additionally, the benefits of multifaceted interventions, which include risk factor assessment, dietary supplements, elements of physical therapy and exercise, are addressed.

Physical Therapists, Telephone Coaches, and Patients With Knee Osteoarthritis: Qualitative Study About Working Together to Promote Exercise Adherence.

PubMed

Hinman, Rana S; Delany, Clare M; Campbell, Penelope K; Gale, Janette; Bennell, Kim L

2016-04-01

Integrated models of care are recommended for people with knee osteoarthritis (OA). Exercise is integral to management, yet exercise adherence is problematic. Telephone-based health coaching is an attractive adjunct to physical therapist-prescribed exercise that may improve adherence. Little is known about the perceptions and interpretations of physical therapists, telephone coaches, and patients engaged in this model of care. The purpose of this study was to explore how stakeholders (physical therapists, telephone coaches, and patients) experienced, and made sense of, being involved in an integrated program of physical therapist-supervised exercise and telephone coaching for people with knee OA. A cross-sectional qualitative design drawing from symbolic interactionism was used. Semistructured interviews with 10 physical therapists, 4 telephone coaches, and 6 patients with painful knee OA. Interviews were audiorecorded, transcribed, and analyzed using thematic analysis informed by grounded theory. Four themes emerged: (1) genuine interest and collaboration, (2) information and accountability, (3) program structure, and (4) roles and communication in teamwork. Patients reported they appreciated personalized, genuine interest from therapists and coaches and were aware of their complementary roles. A collaborative approach, with defined roles and communication strategies, was identified as important for effectiveness. All participants highlighted the importance of sharing information, monitoring, and being accountable to others. Coaches found the lack of face-to-face contact with patients hampered relationship building. Therapists and coaches referred to the importance of teamwork in delivering the intervention. The small number of physical therapists and telephone coaches who delivered the intervention may have been biased toward favorable experiences with the intervention and may not be representative of their respective professions. Integrated physical therapy and telephone coaching was perceived as beneficial by most stakeholders. Programs should be structured but have some flexibility to give therapists and coaches some freedom to adjust treatment to individual patient needs as required. Opportunities for visual communication between telephone coaches and patients could facilitate relationship building. © 2016 American Physical Therapy Association.

Physical activity in anorexia nervosa: How relevant is it to therapy response?

PubMed

Sauchelli, S; Arcelus, J; Sánchez, I; Riesco, N; Jiménez-Murcia, S; Granero, R; Gunnard, K; Baños, R; Botella, C; de la Torre, R; Fernández-García, J C; Fernández-Real, J M; Frühbeck, G; Gómez-Ambrosi, J; Tinahones, F J; Casanueva, F F; Menchón, J M; Fernandez-Aranda, F

2015-11-01

Elevated physical activity has been observed in some patients with anorexia nervosa (AN) despite their emaciated condition. However, its effects on treatment outcome remain unclear. This study aimed to examine objectively measured physical activity in this clinical population and how it might be related to a partial hospitalization therapy response, after considering potential confounders. The sample comprised 88 AN patients consecutively enrolled in a day hospital treatment program, and 116 healthy-weight controls. All participants were female and a baseline assessment took place using an accelerometer (Actiwatch AW7) to measure physical activity, the Eating Disorders Inventory-2 and the Depression subscale of the Symptom Checklist-Revised. Outcome was evaluated upon the termination of the treatment program by expert clinicians. Although AN patients and controls did not differ in the average time spent in moderate-to-vigorous physical activity (MVPA) (P=.21), nor daytime physical activity (P=.34), fewer AN patients presented a high physical activity profile compared to the controls (37% vs. 61%, respectively; P=.014). Both lower levels of MVPA and greater eating disorder severity had a direct effect on a poor treatment outcome. Depression symptoms in the patients were associated with lower MVPA, as well as with an older age, a shorter duration of the disorder and greater eating disorder psychopathology. There is a notable variation in the physical activity profile of AN patients, characterized by either low or very high patterns. Physical activity is a highly relevant issue in AN that must be taken into account during the treatment process. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Factors influencing the use of outcome measures in physical therapy practice.

PubMed

Wedge, Frances M; Braswell-Christy, Jennifer; Brown, Cynthia J; Foley, Kathleen T; Graham, Cecilia; Shaw, Sharon

2012-02-01

Use of outcome measures in physical therapy practice is central to evaluating the effectiveness of treatment interventions, providing accountability and addressing quality of physical therapy programs. There is limited discussion on barriers and facilitators to using outcome measures in physical therapy practice. The purpose of this study was to identify factors that influence a physical therapist when deciding to use outcome measures in clinical practice. Participants were 21 physical therapists, seven each from skilled nursing facilities, outpatient clinics, and inpatient rehabilitation facilities. A grounded theory approach was used for interview and data collection. Common themes were determined from the data and a theory developed to explain the rationale behind physical therapists' decisions to use or not use outcome measures in clinical practice. Three overlapping themes related to (1) concepts of time, (2) knowledge, and (3) facility culture were indentified as factors influencing the use of outcome measures. A fourth encompassing theme, professionalism, identified the value placed on the use of outcome measures in practice. Data revealed that therapists require more information on the outcome measures available, and this information needs to be easily accessible within the workplace. Therapists value information generated by using outcome measures in the clinical setting, but need information on what measures are available and psychometric properties. Information must be easily accessible and measures easy to use. Newer graduates and recent learners have a foundation in the use of outcome measures, but more needs to be done in the clinic and through continuing education to promote increased use and understanding.

Postdoctoral Opportunities in Medical Physics

NASA Astrophysics Data System (ADS)

Hogstrom, Kenneth

2006-04-01

The medical physicist is a professional who specializes in the application of the concepts and methods of physics to the diagnosis and treatment of human disease. Medical physicists identify their primary discipline to be radiation therapy (78%), medical imaging (16%), nuclear medicine (3%), or radiation safety (2%). They state their primary responsibility to be clinical (78%), academic (9%), research (4%), etc. Correspondingly, medical physicists reveal their primarily employment to be a private hospital (42%), university hospital (32%), physicist's service group (9%), physician's service group (9%), industry (5%), and government (3%). The most frequent job of medical physicists is clinical radiation therapy physicist, whose clinical duties include: equipment acquisition, facility design, commissioning, machine maintenance, calibration and quality assurance, patient treatment planning, patient dose calculation, management of patient procedures, development of new technology, radiation safety, and regulatory compliance. The number of medical physicists in the United States can be estimated by the number of members of the American Association of Physicists in Medicine (AAPM), which has increased 5.5% annually since 1969, currently being 5,000. New positions plus retirements create a current need >300 new medical physicists per year, which exceeds supply. This is supported by the steady growth in average salaries, being 100,000 for PhDs entering the field and reaching 180,000. Graduate programs alone cannot meet demand, and physicists entering the field through postdoctoral training in medical physics remain important. Details of postdoctoral research programs and medical physics residency programs will provide direction to physics PhD graduates interested in medical physics. [The AAPM, its annual Professional Information Report, and its Public Education Committee are acknowledged for information contributing to this presentation.

Physical and Occupational Therapy for a Teenager with Acute Flaccid Myelitis: A Case Report.

PubMed

Kornafel, Tracy; Tsao, Elaine Y; Sabelhaus, Emily; Surges, Lori; Apkon, Susan D

2017-10-20

The purpose of this case report is to describe the inpatient rehabilitation program of a 13-year-old boy with acute flaccid myelitis (AFM), specific to physical and occupational therapy examination, treatment, and outcomes. AFM is a rare, acute neurologic illness in children and young adults who present with weakness and/or paralysis of unknown etiology. The teenager was admitted to the program, dependent for all mobility and self-care. Interventions focused on range of motion, transfer training, self-care, power wheelchair mobility, and environmental adaptations. Weekly re-evaluations and the WeeFIM were used at admission and discharge to measure the teenager's progress. At discharge, the teenager had made small gains in his passive and active range of motion. He was independent in directing his care and able to drive his power wheelchair with supervision. Due to the scarcity of published data describing AFM, this report describes an individual's response to a rehabilitation program and will hopefully add to future research in order to provide patients and families with expectations for their recovery and ultimate level of function.

Teaching evidence based practice in physical therapy in a developing country: a national survey of Philippine schools

PubMed Central

2013-01-01

Background Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP. Methods A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively. Results The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students’ inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively). Conclusions Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective ‘educating the educators’ strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice. PMID:24267512

Teaching evidence based practice in physical therapy in a developing country: a national survey of Philippine schools.

PubMed

Gorgon, Edward James R; Basco, Mark David S; Manuel, Almira T

2013-11-22

Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP. A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively. The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students' inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively). Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective 'educating the educators' strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice.

Progress in sensorimotor rehabilitative physical therapy programs for stroke patients

PubMed Central

Chen, Jia-Ching; Shaw, Fu-Zen

2014-01-01

Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into “a training package”, based on the patient’s functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients. PMID:25133141

Design of the Physical exercise during Adjuvant Chemotherapy Effectiveness Study (PACES): a randomized controlled trial to evaluate effectiveness and cost-effectiveness of physical exercise in improving physical fitness and reducing fatigue.

PubMed

van Waart, Hanna; Stuiver, Martijn M; van Harten, Wim H; Sonke, Gabe S; Aaronson, Neil K

2010-12-07

Cancer chemotherapy is frequently associated with a decline in general physical condition, exercise tolerance, and muscle strength and with an increase in fatigue. While accumulating evidence suggests that physical activity and exercise interventions during chemotherapy treatment may contribute to maintaining cardiorespiratory fitness and strength, the results of studies conducted to date have not been consistent. Additional research is needed to determine the optimal intensity of exercise training programs in general and in particular the relative effectiveness of supervised, outpatient (hospital- or physical therapy practice-based) versus home-based programs. This multicenter, prospective, randomized trial will evaluate the effectiveness of a low to moderate intensity, home-based, self-management physical activity program, and a high intensity, structured, supervised exercise program, in maintaining or enhancing physical fitness (cardiorespiratory fitness and muscle strength), in minimizing fatigue and in enhancing the health-related quality of life (HRQoL). Patients receiving adjuvant chemotherapy for breast or colon cancer (n = 360) are being recruited from twelve hospitals in the Netherlands, and randomly allocated to one of the two treatment groups or to a 'usual care' control group. Performance-based and self-reported outcomes are assessed at baseline, at the end of chemotherapy and at six month follow-up. This large, multicenter, randomized clinical trial will provide additional empirical evidence regarding the effectiveness of physical exercise during adjuvant chemotherapy in enhancing physical fitness, minimizing fatigue, and maintaining or enhancing patients' quality of life. If demonstrated to be effective, exercise intervention programs will be a welcome addition to the standard program of care offered to patients with cancer receiving chemotherapy. This study is registered at the Netherlands Trial Register (NTR 2159).

Impact of physical exercise in cancer survivors during and after antineoplastic treatments

PubMed Central

Ferioli, Martina; Zauli, Giorgio; Martelli, Alberto M.; Vitale, Marco; McCubrey, James A.; Ultimo, Simona; Capitani, Silvano; Neri, Luca M.

2018-01-01

Cancer patients experience symptoms and adverse effects of treatments that may last even after the end of treatments. Exercise is a safe, non-pharmacological and cost-effective therapy that can provide several health benefits in cancer patient and survivors, reducing cancer symptoms and cancer treatment side effects. The purpose of this review is to describe how the physical exercise is capable to reduce cancer symptoms and cancer treatment side effects. We realized a pragmatic classification of symptoms, dividing them into physical, psychological and psycho-physical aspects. For each symptom we discuss causes, therapies, we analyse the effects of physical exercise and we summarize the most effective type of exercise to reduce the symptoms. This review also points out what are the difficulties that patients and survivors face during the practice of physical activity and provides some solutions to overcome these barriers. Related to each specific cancer, it emerges that type, frequency and intensity of physical exercise could be prescribed and supervised as a therapeutic program, like it occurs for the type, dose and duration of a drug treatment. PMID:29568412

Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial.

PubMed

Akhtar, Muhammad Waseem; Karimi, Hossein; Gilani, Syed Amir

2017-01-01

Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain. This is single blinded randomized control trial that was conducted at the department of physical therapy Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain participated. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after giving an informed consent. Participants were randomly assigned to two treatment groups A & B which were treated with core stabilization exercise and routine physical therapy exercise respectively. TENS and ultrasound were given as therapeutic modalities to both treatment groups. Outcomes of the treatment were recorded using Visual Analogue Scale (VAS) pretreatment, at 2 nd , 4 th and 6 th week post treatment. The results of this study illustrate that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. This study found significant reduction in pain across the two groups at 2 nd , 4 th and 6 th week of treatment with p value less than 0.05. There was a mean reduction of 3.08 and 1.71 on VAS across the core stabilization group and routine physical therapy exercise group respectively. Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in patients with non-specific low back pain.

Evaluating the effectiveness of psychosocial resilience training for heart health, and the added value of promoting physical activity: a cluster randomized trial of the READY program.

PubMed

Burton, Nicola W; Pakenham, Kenneth I; Brown, Wendy J

2009-11-23

Depression and poor social support are significant risk factors for coronary heart disease (CHD), and stress and anxiety can trigger coronary events. People experiencing such psychosocial difficulties are more likely to be physically inactive, which is also an independent risk factor for CHD. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program (READY) to promote psychosocial well-being for heart health, and the added value of integrating physical activity promotion. In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 x 2.5 hour group resilience training program (READY) over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action) and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial well-being and depression. Secondary outcome measures will include self-reported indicators of stress, anxiety and physical activity, and objective indicators of CHD risk (blood glucose, cholesterol [mmol.L-1], triglycerides, blood pressure). Process measures of attendance, engagement and fidelity will also be conducted. Linear analyses will be used to examine group differences in the outcome measures, and the product of coefficients method will be used to examine mediated effects. If successful, this program will provide an innovative means by which to promote psychosocial well-being for heart health in the general population. The program could also be adapted to promote well-being in other at risk population subgroups. ACTRN12608000017325.

Patient education and rehabilitation after hip arthroplasty in an Italian spa center: a pilot study on its feasibility.

PubMed

Musumeci, Alfredo; Pranovi, Giulia; Masiero, Stefano

2018-05-11

Nowadays, some spa centers are suitable for providing rehabilitative and preventive treatment in association with traditional spa therapy. This study aims to evaluate the feasibility and the effectiveness of an intensive rehabilitation program after hip arthroplasty in an Italian spa center. Early after total hip arthroplasty for severe osteoarthritis (≤ 10 days after the intervention), 12 consecutive patients (5 males and 7 females) aged between 50 and 85 years were enrolled for this study. All the patients performed a 2-week thermal multimodal rehabilitation program, which consisted of education and physical rehabilitative measures. Patients had 2-h and half/day session of land-based and hydrokinesitherapy (aquatic therapy) consisted in active and passive joint mobilization, respiratory and functional re-education exercises, gait and balance training, resistance exercise, and power training mainly for the upper limb associated to physical therapy modalities (electrotherapy and low-level laser therapy). An educational program was performed to both patients and families. Both before and after the rehabilitation treatment, patients underwent clinical evaluation, hip flexion/abduction range of motion, and Numeric Pain Rating Scale. Harris Hip Score (HHS) and SF-12 questionnaires (physical-PCS-12-and mental health component-MCS-12) were also administered. After the 2-week thermal spa treatment, hip flexion/abduction improved significantly (p < 0.05), but there was no statistically significant reduction in pain (p = 0.350). The HHS score improved significantly from 62.6 ± 12.8 to 82.15 ± 12.7 (p < 0.05), and the PCS-12 score from 36.37 ± 8.4 to 43.61 ± 8.95 (p < 0.05). There was no adverse event during spa treatment. After total hip arthroplasty, patients who underwent an intensive post-acute multimodal rehabilitation program showed an improvement in motor and functional recovery and a positive impact on quality of life. Therefore, we believe that the thermal setting is a suitable place for providing intensive rehabilitative treatment in orthopedic musculoskeletal disability.

Mirror book therapy for the treatment of idiopathic facial palsy.

PubMed

Barth, Jodi Maron; Stezar, Gincy L; Acierno, Gabriela C; Kim, Thomas J; Reilly, Michael J

2014-09-01

We conducted a retrospective chart review to determine the effectiveness of treating idiopathic facial palsy with mirror book therapy in conjunction with facial physical rehabilitation. We compared outcomes in 15 patients who underwent mirror book therapy in addition to standard therapy with those of 10 patients who underwent standard rehabilitation therapy without the mirror book. Before and after treatment, patients in both groups were rated according to the Facial Grading System (FGS), the Facial Disability Index-Physical (FDIP), and the Facial Disability Index-Social (FDIS). Patients in the mirror therapy group had a mean increase of 24.9 in FGS score, 22.0 in FDIP score, and 25.0 in FDIS score, all of which represented statistically significant improvements over their pretreatment scores. Those who did not receive mirror book therapy had mean increases of 20.8, 19.0, 14.6, respectively; these, too, represented significant improvements over baseline, and thus there was no statistically significant difference in improvement between the two groups. Nevertheless, our results show that patients who used mirror book therapy in addition to standard facial rehabilitation therapy experienced significant improvements in the treatment of idiopathic facial palsy. While further studies are necessary to determine if it has a definitive, statistically significant advantage over standard therapy, we recommend adding this therapy to the rehabilitation program in view of its ease of use, low cost, and lack of side effects.

Telehealth, Wearable Sensors, and the Internet: Will They Improve Stroke Outcomes Through Increased Intensity of Therapy, Motivation, and Adherence to Rehabilitation Programs?

PubMed

Burridge, Jane H; Lee, Alan Chong W; Turk, Ruth; Stokes, Maria; Whitall, Jill; Vaidyanathan, Ravi; Clatworthy, Phil; Hughes, Ann-Marie; Meagher, Claire; Franco, Enrico; Yardley, Lucy

2017-07-01

Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors. This article addresses the need for cost-effective increased intensity of practice and suggests potential benefits of telehealth (TH) as an innovative model of care in physical therapy. We provide an overview of TH and present evidence that a web-supported program, used in conjunction with constraint-induced therapy (CIT), can increase intensity and adherence to a rehabilitation regimen. The design and feasibility testing of this web-based program, "LifeCIT," is presented. We describe how wearable sensors can monitor activity and provide feedback to patients and therapists. The methodology for the development of a wearable device with embedded inertial and mechanomyographic sensors, algorithms to classify functional movement, and a graphical user interface to present meaningful data to patients to support a home exercise program is explained. We propose that wearable sensor technologies and TH programs have the potential to provide most-effective, intensive, home-based stroke rehabilitation.

Relationship between Improvements in Physical Measures and Patient Satisfaction in Rehabilitation after Total Knee Arthroplasty

ERIC Educational Resources Information Center

Nazzal, Mahmoud I.; Bashaireh, Khaldoon H.; Alomari, Mahmoud A.; Nazzal, Mohammad S.; Maayah, Mikhled F.; Mesmar, Mohammad

2012-01-01

The aim of this study was to examine patient satisfaction with rehabilitation after total knee arthroplasty (TKA). Fifty-six patients, aged 45-77 years, were enrolled in a post-TKA comprehensive therapy program focusing on knee strengthening and functional activities. The program lasted 3 months and was conducted for 1 h, twice a day, 5 days per…

NCI support for particle therapy: past, present, future.

PubMed

Deye, James A

2012-11-01

In light of the rising worldwide interest in particle therapy, and proton therapy specifically in the United States, the National Cancer Institute (NCI) is being asked more often about funding for such research and facilities. Many of the questions imply that NCI is naive to the exciting possibilities inherent in particle therapies, and thus they wish to encourage NCI to initiate and underwrite such programs. In fact, NCI has a long track record of support for the translation of hadrons from the physics laboratory to the therapy clinic by way of technology development and scientific investigations of physical and biological processes as well as clinical outcomes. Early work has included continuous funding since 1961 of proton treatments for more than 15,000 patients and facility construction at the Harvard/Massachusetts General Hospital (MGH) site; treatment of 227 patients with the pi-meson facility at Los Alamos between 1974 and 1981; funding of more than $69M for seven neutron therapy centers between 1971 and 1989; many funded projects in boron neutron capture radiation therapy through the present time; and numerous radiobiology projects over the past 50 y. NCI continues to play an active role in the incorporation of protons into randomized clinical trials through the Children's Oncology Group, Radiation Therapy Oncology Group, and the Program Project Grant (P01), which is co-directed by the MGH and MD Anderson Cancer Center. This has required funding development and implementation of guidelines that enable intercomparison of dosimetry and treatment between facilities. NCI has also funded recent efforts to develop new physical processes for the production of particles such as protons. With regard to the future, while it is true that there are no specific funding opportunity announcements directed to particle therapy research, it is also true that NCI remains open to reviewing any research that is compatible with an established mechanism. However, given the very substantial resources that these facilities currently require along with the highly competitive economic environment that now exists, it is clear that scientific review of such grant applications will look to leverage the scientific pursuits that are the NCI mandate with the reality of the clinical practices, just as is the case for photon radiation research. Such leveraging should be enhanced by the growing opportunities and need for international collaborations. On the other hand, these collaborations are complicated by the fact that these particle therapies are now fully reimbursable modalities, which makes it difficult to separate research (the NCI mission) from clinical practice development. This paper seeks to illuminate these new realities in order to encourage the pursuit and funding of the scientific underpinnings of physical methods, radiobiology, and clinical practice with particle therapy.

The status of temporomandibular and cervical spine education in post-professional physical therapy training programs recognized by Member Organizations of IFOMPT: an investigation of didactic and clinical education.

PubMed

Shaffer, Stephen M; Stuhr, Sarah H; Sizer, Phillip S; Courtney, Carol A; Brismée, Jean-Michel

2018-05-01

The purpose of this investigation was to establish an international baseline of the quantity of physical therapist education on temporomandibular disorders (TMD) during post-professional Orthopedic Manual Physical Therapy (OMPT) education. An electronically distributed survey was sent to programs and data analyzed for trends, including a comparison of TMD and cervical spine disorders education. Current data were compared to pre-existing data from the United States. For the current data-set, the Mann-Whitney U test demonstrated statistical significance when comparing TMD and cervical spine disorders education for both the hours of didactic training provided ( p  < 0.0001) and the number of patients seen during clinical training ( p  < 0.006). When comparing the United States and international data, statistically significant greater exposure was reported for both didactic ( p  < 0.0001) and clinical education ( p  < 0.006) of TMD topics in the United States but not for didactic ( p  = 0.23) or clinical education ( p  = 0.15) of cervical spine topics. These data again indicate a lack of uniformity between post-professional training programs in OMPT with respect to TMD education. There is, however, consistency in that most programs provided more training on cervical spine disorders than TMD. Based on these findings, further investigations are appropriate to determine if TMD education is adequate during post-professional OMPT education.

Lower extremity thrust and non-thrust joint mobilization for patellofemoral pain syndrome: a case report

PubMed Central

Simpson, Brad G; Simon, Corey B

2014-01-01

A 40-year old female presented to physical therapy with a one-year history of insidious right anteromedial and anterolateral knee pain. Additionally, the patient had a history of multiple lateral ankle sprains bilaterally, the last sprain occurring on the right ankle 1 year prior to the onset of knee pain. The patient was evaluated and given a physical therapy diagnosis of patellofemoral pain syndrome (PFPS), with associated talocrural and tibiofemoral joint hypomobility limiting ankle dorsiflexion and knee extension, respectively. Treatment included a high-velocity low amplitude thrust manipulation to the talocrural joint, which helped restore normal ankle dorsiflexion range of motion. The patient also received tibiofemoral joint non-thrust manual therapy to regain normal knee extension mobility prior to implementing further functional progression exercises to her home program (HEP). This case report highlights the importance of a detailed evaluation of knee and ankle joint mobility in patients presenting with anterior knee pain. Further, manual physical therapy to the lower extremity was found to be successful in restoring normal movement patterns and pain-free function in a patient with chronic anterior knee pain. PMID:24976753

Riding light in the minority communities and how K-12 students can shine in physics

NASA Astrophysics Data System (ADS)

Gueye, Paul

2010-03-01

The National Society of Black Physicists, along with the National Society of Hispanic Physicists, has been reaching out to the minority K-12 population by revolutionizing its Science Ambassador program under its Pre-College Program Committee. Since 2005, both societies have been providing unique interactive physics demonstrations to predominantly minority schools to expose them to the exciting world of physics. In a four year span, the population of targeted students went from 25 (2005) to 400 (2009). During the 2009 joint annual meeting, a Physics Day camp was introduced during which eight physics societies combined their efforts to reach to a larger group of students in a short time period. This initiative has now tackled the unique feature to expand nationally by reaching out to the members of all physics societies. While the world of optics has been an integral part of the demonstrations being performed on stage or at individual booths, physics concepts and its applications in medical physics (such as imaging or therapy) is the focus of the 2010 effort as part of LaserFest. This talk will review the impact of this program in the minority community and the importance of physics department at minority institutions in changing the conception of science in K-12 arenas.

Rehabilitation Aids.

ERIC Educational Resources Information Center

National Center on Educational Media and Materials for the Handicapped, Columbus, OH.

Selected from the National Instructional Materials Information System (NIMIS)--a computer based on-line interactive retrieval system on special education materials--the bibliography covers 40 equipment items for rehabilitation and physical therapy programs for all levels of handicapped children. Described are such items as a handygym, a suspension…

Patellar Tendinopathy

PubMed Central

Schwartz, Aaron; Watson, Jonathan N.; Hutchinson, Mark R.

2015-01-01

Context: Patellar tendinopathy is a common condition. There are a wide variety of treatment options available, the majority of which are nonoperative. No consensus exists on the optimal method of treatment. Evidence Acquisition: PubMed spanning 1962-2014. Study Design: Clinical review. Level of Evidence: Level 4. Results: The majority of cases resolve with nonoperative therapy: rest, physical therapy with eccentric exercises, cryotherapy, anti-inflammatories, corticosteroid injections, extracorporeal shockwave therapy, glyceryl trinitrate, platelet-rich plasma injections, and ultrasound-guided sclerosis. Refractory cases may require either open or arthroscopic debridement of the patellar tendon. Corticosteroid injections provide short-term pain relief but increase risk of tendon rupture. Anti-inflammatories and injectable agents have shown mixed results. Surgical treatment is effective in many refractory cases unresponsive to nonoperative modalities. Conclusion: Physical therapy with an eccentric exercise program is the mainstay of treatment for patellar tendinopathy. Platelet-rich plasma has demonstrated mixed results; evidence-based recommendations on its efficacy cannot be made. In the event that nonoperative treatment fails, surgical intervention has produced good to excellent outcomes in the majority of patients. PMID:26502416

Virtual patient care: an interprofessional education approach for physician assistant, physical therapy and occupational therapy students.

PubMed

Shoemaker, Michael J; Platko, Christina M; Cleghorn, Susan M; Booth, Andrew

2014-07-01

The purpose of this retrospective qualitative case report is to describe how a case-based, virtual patient interprofessional education (IPE) simulation activity was utilized to achieve physician assistant (PA), physical therapy (PT) and occupational therapy (OT) student IPE learning outcomes. Following completion of a virtual patient case, 30 PA, 46 PT and 24 OT students were required to develop a comprehensive, written treatment plan and respond to reflective questions. A qualitative analysis of the submitted written assignment was used to determine whether IPE learning objectives were met. Student responses revealed three themes that supported the learning objectives of the IPE experience: benefits of collaborative care, role clarification and relevance of the IPE experience for future practice. A case-based, IPE simulation activity for physician assistant and rehabilitation students using a computerized virtual patient software program effectively facilitated achievement of the IPE learning objectives, including development of greater student awareness of other professions and ways in which collaborative patient care can be provided.

Comparison of Ai Chi and Impairment-Based Aquatic Therapy for Older Adults With Balance Problems: A Clinical Study.

PubMed

Covill, Laura G; Utley, Cynthia; Hochstein, Cheryl

Older adults with balance deficits often fear falling and limit their mobility. Poor balance is multifactorial, influenced by medication interactions, musculoskeletal and sensory system changes, and poor neuromuscular response to changes in body positions. Aquatic physical therapy (APT) is an intervention used to improve balance and decrease falls. Ai Chi is a water-based exercise program. It incorporates slow movements of progressive difficulty utilizing the upper and lower extremities and trunk coordinated with deep breathing. It is used for relaxation, strengthening, and balance training. The purpose of this study was to determine whether Ai Chi provides better results than conventional impairment-based aquatic therapy (IBAT) for older adults with balance deficits. Thirty-two community-dwelling adults, 65 to 85 years old, were referred to 2 different community pools for APT. Fifteen participants received Ai Chi-based aquatic interventions and 17 participants received an IBAT program. Physical therapists trained in both programs completed interventions and determined discharge. Physical balance measures, which included the Berg Balance Scale (BBS) and Timed Up and Go (TUG), were collected pre- and posttherapy. Self-reported outcome measures, the Activities-Specific Balance Confidence Scale (ABC) and Numerical Pain Rating Scale (NPRS), were collected pre- and posttherapy and 3- and 6-month postdischarge. A 2-way (group by time) mixed-model analysis of covariance with initial outcome scores as a covariate revealed no difference between groups in any of the outcome measures (BBS, P = .53; TUG, P = .39; ABC, P = .63; NPRS, P = .27). Repeated-measures analysis and dependent t tests showed significant improvements in the BBS (P = .00) and TUG (P = .03) after APT. The ABC and NPRS did not improve significantly (ABC, P = .27; NPRS, P = .77). There were no significant differences found in balance measures, balance confidence, or pain levels for community-dwelling older adults between the Ai Chi and IBAT programs. Physical outcome measures improved with APT but patient-reported measures did not. Further study is indicated to determine the most effective treatment frequency and duration for this population.

Strategies to overcome size and mechanical disadvantages in manual therapy

PubMed Central

Hazle, Charles R.; Lee, Matthew

2016-01-01

The practice of manual therapy (MT) is often difficult when providing care for large patients and for practitioners small in stature or with other physical limitations. Many MT techniques can be modified using simple principles to require less exertion, permitting consistency with standards of practice even in the presence of physical challenges. Commonly used MT techniques are herein described and demonstrated with alternative preparatory and movement methods, which can also be adopted for use in other techniques. These alternative techniques and the procedures used to adapt them warrant discussion among practitioners and educators in order to implement care, consistent with the best treatment evidence for many common musculoskeletal (MSK) conditions. The inclusion in educational curricula and MT training programs is recommended to enrich skill development in physical therapists (PTs), spanning entry-level practitioners to those pursuing advanced manual skills. PMID:27559282

[Progress assessment of rehabilitation in patients after hip replacement. Preliminary report].

PubMed

Labecka, Monika; Pingot, Mariusz; Pingot, Julia; Woldańiska-Okońska, Marta

2014-01-01

Coxarthrosis is one of the most common diseases of the motor system. We distinguish primary and secondary coxarthrosis. The premises for total hip replacement include pain, damage to the surface of the acetabulum and the head of the hip, relative shortening of the limb, gluteal, femur and crus muscle atrophy and gait dysfunctions. The aim of this paper is to present the influence of rehabilitation on the improvement of physical ability, especially in respect to quality of gait and antianalgesic efficacy of the physical therapy in patients after total hip replacement. The study was carried out in 37 patients aged 35-72 (mean of age--53.78 +/- 9.92). The group consisted'of 21 women and 16 men. After the total hip replacement, all the patients underwent physical therapy which involved application of laser radiation on the postoperative scar, whirpool and classic massage of the operated limb, exercises in non-weight bearing and weight-bearing exercises and gait reeducation. Modified Laitinen Pain Indicator Questionnaire, Visual Analogue Scale-VAS and the standardized mobility test--Timed-Up-And-Go test were used in the study. The statistical analysis was carried out with the use of the STATYSTIKA 5 PL computer program. The results reached point to the analgesic efficacy of the physical therapy and a better gait quality. Multifactor physical therapy after total hip replacement shows analgesic action. Appropriate selection of exercises and physical treatment have positive influence on gait reeducation in patients after total hip replacement. The Timed Up and Go test may be used in functional assessment of gait in patients with musculoskeletal disorders.

[The effectiveness of physical therapy methods (Bobath and motor relearning program) in rehabilitation of stroke patients].

PubMed

Krutulyte, Grazina; Kimtys, Algimantas; Krisciūnas, Aleksandras

2003-01-01

The purpose of this study was to examine whether two different physiotherapy regimes caused any differences in outcome in the rehabilitation after stroke. We examined 240 patients with stroke. Examination was carried out at the Rehabilitation Center of Kaunas Second Clinical Hospital. Patients were divided into 2 groups: Bobath method was applied to the first (I) group (n=147), motor relearning program (MRP) method was applied to the second (II) group (n=93). In every group of patients we established samples according to sex, age, hospitalization to rehab unit as occurrence of CVA degree of disorder (hemiplegia, hemiparesis). The mobility of patients was evaluated according to European Federation for Research in Rehabilitation (EFRR) scale. Activities of daily living were evaluated by Barthel index. Analyzed groups were evaluated before physical therapy. When preliminary analysis was carried out it proved no statically reliable differences between analyzed groups (reliability 95%). The same statistical analysis was carried out after physical therapy. The results of differences between patient groups were compared using chi(2) method. Bobath method was applied working with the first group of patients. The aim of the method is to improve quality of the affected body side's movements in order to keep both sides working as harmoniously as possible. While applying this method at work, physical therapist guides patient's body on key-points, stimulating normal postural reactions, and training normal movement pattern. MRP method was used while working with the second group patients. This method is based on movement science, biomechanics and training of functional movement. Program is based on idea that movement pattern shouldn't be trained; it must be relearned. CONCLUSION. This study indicates that physiotherapy with task-oriented strategies represented by MRP, is preferable to physiotherapy with facilitation/inhibition strategies, such the Bobath programme, in the rehabilitation of stroke patients (p< 0.05).

Factors associated with physical activity in Australians with hip or knee osteoarthritis.

PubMed

Heesch, Kristiann Corbusier; Ng, Norman; Brown, Wendy

2011-03-01

Physical activity (PA) is recommended for managing osteoarthritis (OA). However, few people with OA are physically active. Understanding the factors associated with PA is necessary to increase PA in this population. This cross-sectional study examined factors associated with leisure-time PA, stretching exercises, and strengthening exercises in people with OA. For a mail survey, 485 individuals, aged 68.0 years (SD = 10.6) with hip or knee OA, were asked about factors that may influence PA participation, including use ofnon-PAOA management strategies and both psychological and physical health-related factors. Associations between factors and each PA outcome were examined in multivariable logistic regression models. Non-PA management strategies were the main factors associated with the outcomes. Information/education courses, heat/cold treatments, and paracetamol were associated with stretching and strengthening exercises (P < .05). Hydrotherapy and magnet therapy were associated with leisure-time PA; using orthotics and massage therapy, with stretching exercises; and occupational therapy, with strengthening exercises (P < .05). Few psychological or health-related factors were associated with the outcomes. Some management strategies may make it easier for people with OA to be physically active, and could be promoted to encourage PA. Providers of strategies are potential avenues for recruiting people with OA into PA programs.

A program of 3 physical therapy modalities improves peripheral arterial disease in diabetes type 2 patients: a randomized controlled trial.

PubMed

Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo A; Feriche-Fernández-Castanys, Belen; Fernández-Sola, Cayetano; Sánchez-Labraca, Nuria; Moreno-Lorenzo, Carmen

2013-01-01

Type 2 diabetes is one of the main causes of peripheral vascular disease. The beneficial effects of exercise on glucose homeostasis include a marked stimulation of blood glucose utilization during and after its performance. The objective of this study was to determine the effects of a program of 3 physical therapy modalities on blood circulation in patients with type 2 diabetes with peripheral arterial disease. A randomized controlled trial was undertaken. Sixty-eight patients with type 2 diabetes with Leriche-Fontaine stage I or IIa peripheral arterial disease were randomly assigned to an exercise or placebo group. For 20 weeks, the exercise group underwent treatment comprising 3 exercises at proximal, medium, and distal segments of the lower limbs, and the placebo group received sham treatment with disconnected ultrasound equipment. Peripheral arterial disease was determined by evaluating the ankle/brachial index (ABI), Doppler flow velocity, blood parameters, cardiovascular risk score, and heart rate during exercise test. After 20 weeks of treatment, significant differences between groups were found in the following: right (P < .039) and left (P < .023) ABI; Doppler flow velocity (cm/s) in the right (P < .010) and left (P < .026) posterior tibial artery and in the right (P < .012) and left (P < .022) dorsalis pedis artery; and fibrinogen (P < .045), hemoglobin (P < .021), cholesterol (P < .012), high-density lipoprotein cholesterol (P < .031), and HbA1c (P < .034) values. There was no significant difference in low-density lipoprotein cholesterol values (P < .110) between the groups. A program of these physical therapy modalities improves ABI, Doppler flow velocity, and blood parameters in patients with type 2 diabetes.

The efficacy of a multidisciplinary group program for patients with refractory chronic pain

PubMed Central

Inoue, Masayuki; Inoue, Shinsuke; Ikemoto, Tatsunori; Arai, Young-Chang P; Nakata, Masatoshi; Miyazaki, Atsuko; Nishihara, Makoto; Kawai, Takashi; Hatakeyama, Noboru; Yamaguchi, Setsuko; Shimo, Kazuhiro; Miyagawa, Hirofumi; Hasegawa, Tomomi; Sakurai, Hiroki; Hasegawa, Yoshinobu; Ohmichi, Yusuke; Ushida, Takahiro

2014-01-01

BACKGROUND: Chronic pain is a major problem because it can result in not only a reduction in activities of daily living and quality of life but also requires initiation of social assistance. Seeking only to eliminate pain itself would appear to be too narrow an objective, in addition to often being unachievable; therefore, a multifaceted, comprehensive approach with multiple objectives is needed. OBJECTIVE: To describe the effects of a program (the ‘Chronic Pain Class’) offering cognitive behavioural therapy to small groups of individuals with refractory chronic pain in Japan. Exercise was an important feature of the program. METHODS: A total of 46 patients who were experiencing treatment difficulties and decreased activity participated in the program. The programs were conducted in groups of five to seven patients who met weekly for nine weeks. Weekly sessions, which were approximately 2 h in duration, combined lectures with exercise. Several measures related to pain and physical function were administered at the beginning and the conclusion of the program. RESULTS: Nine patients dropped out during the program. A number of measures (eg, pain intensity, disability, catastrophizing thoughts) showed significant improvements after intervention (P<0.002 after Bonferroni correction). Furthermore, most measures of physical function showed substantial improvement, especially seated forward bends, zig-zag walking, self-care and 6 min walk test (P<0.001). CONCLUSION: The results of the present study provide evidence that a combination of cognitive behavioural therapy and exercise should be recommended to patients with refractory chronic pain. PMID:24992454

Perceived benefits and barriers to exercise for recently treated patients with multiple myeloma: a qualitative study.

PubMed

Craike, Melinda J; Hose, Kaye; Courneya, Kerry S; Harrison, Simon J; Livingston, Patricia M

2013-07-01

Understanding the physical activity experiences of patients with multiple myeloma (MM) is essential to inform the development of evidence-based interventions and to quantify the benefits of physical activity. The aim of this study was to gain an in-depth understanding of the physical activity experiences and perceived benefits and barriers to physical activity for patients with MM. This was a qualitative study that used a grounded theory approach. Semi-structured interviews were conducted in Victoria, Australia by telephone from December 2011-February 2012 with patients who had been treated for MM within the preceding 2-12 months. Interviews were transcribed and analysed using the constant comparison coding method to reduce the data to themes. Gender differences and differences between treatment groups were explored. Twenty-four interviews were completed. The sample comprised 13 females (54%), with a mean age of 62 years (SD = 8.8). Sixteen (67%) participants had received an autologous stem cell transplant (ASCT). All participants currently engaged in a range of light to moderate intensity physical activity; walking and gardening were the most common activities. Recovery from the symptoms of MM and side effects of therapy, psychological benefits, social factors and enjoyment were important benefits of physical activity. Barriers to physical activity predominately related to the symptoms of MM and side effects of therapy, including pain, fatigue, and fear of infection. Low self- motivation was also a barrier. Women participated in a more diverse range of physical activities than men and there were gender differences in preferred type of physical activity. Women were more likely to report psychological and social benefits; whereas men reported physical activity as a way to keep busy and self-motivation was a barrier. Patients treated with an ASCT more often reported affective benefits of participation in physical activity and fatigue as a barrier. Patients treated with other therapies (e.g., chemotherapy, radiotherapy) were more likely to report pain as a barrier. Patients with MM experience debilitating effects of their condition and therapy, which influences their level and intensity of physical activity participation. Physical activity programs should be individualised; take into consideration gender differences and the impact of different types of therapy on physical activity; and focus on meeting the psychological, coping and recovery needs of patients.

Construct validity of the Health Science Reasoning Test.

PubMed

Huhn, Karen; Black, Lisa; Jensen, Gail M; Deutsch, Judith E

2011-01-01

The aim of this study was to evaluate the construct validity of the Health Science Reasoning Test (HSRT) by determining if the test could discriminate between expert and novice physical therapists' critical-thinking skills. Experts identified from a random list of certified clinical specialists and students in the first year of their physical therapy education from two physical therapy programs completed the HSRT. Experts (n = 73) had a higher total HSRT score (mean 24.06, SD 3.92) than the novices (n = 79) (mean 22.49, SD 3.2), with the difference being statistically significant t (148) = 2.67, p = 0.008. The HSRT total score discriminated between expert and novice critical-thinking skills, therefore establishing construct validity. To our knowledge, this is the first study to compare expert and novice performance on a standardized test. The opportunity to have a tool that provides evidence of students' critical thinking skills could be helpful for educators and students. The test results could aid in identifying areas of students' strengths and weaknesses, thereby enabling targeted remediation to improve critical thinking skills, which are key factors in clinical reasoning, a necessary skill for effective physical therapy practice.

Changes in physical activity, physical fitness, self-perception and quality of life following a 6-month physical activity counseling and cognitive behavioral therapy program in outpatients with binge eating disorder.

PubMed

Vancampfort, Davy; Probst, Michel; Adriaens, An; Pieters, Guido; De Hert, Marc; Stubbs, Brendon; Soundy, Andy; Vanderlinden, Johan

2014-10-30

The aim of the current study was to explore the associations between changes in the number of binges, physical activity participation, physical fitness, physical self-perception and quality of life following a 6-month physical activity counseling and cognitive behavioral program in patients with binge eating disorder (BED). In total 34 (31 women) outpatients with BED (38.5±10.7 years) completed a 6-month 1-day per week group-based program. Participants completed the 36-item Short Form Health Survey, the Baecke Physical Activity questionnaire, the Physical Self Perception Profile and performed a 6-min walk test (6MWT) at baseline, after 3 and 6 months. Except for physical activity at work, physical strength and self-worth perception, all parameters significantly improved after 6 months. The effect sizes ranged from -0.33 for the number of binges to 1.67 for participation in sports activities. Significant increases in leisure time physical activity were associated with significant improvements in physical health related quality of life, perceived sports competence and physical fitness and in perceived body attractiveness. The significant reduction in the number of binges was associated with significant improvements in physical health related quality of life. Future research should focus on detailing which techniques can stimulate physical activity participation in patients with BED. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Aquatic physical therapy for children with developmental coordination disorder: a pilot randomized controlled trial.

PubMed

Hillier, Susan; McIntyre, Auburn; Plummer, Leanne

2010-05-01

Aquatic therapy is an intervention for children with Developmental Coordination Disorder (DCD) that has not been investigated formally. This was a pilot randomized controlled trial to investigate the feasibility and preliminary effectiveness of an aquatic therapy program to improve motor skills of children with DCD. Thirteen children (mean age 7 years 1 month; 10 males) with DCD were randomly allocated to receive either six sessions of aquatic therapy (once weekly session of 30 min for 6-8 weeks) or to a wait-list (control group). The intervention and measures were demonstrated to be feasible, but barriers, such as limited appointment times and accessibility, were encountered. Analysis of covariance indicated that at posttest, mean scores on the Movement Assessment Battery were higher for children who received aquatic therapy compared to those on the wait-list (p = .057). Similar trends were noted on the physical competence portion of the Pictorial Scale of Perceived Competence and Social Acceptance (p = .058). Participation levels, as measured by a parent questionnaire, showed improvement for both groups. Potential facilitators and barriers to implementation of an aquatic therapy for children with DCD are discussed.

Physical therapist assistant in a California home health agency.

PubMed

Roach, J P; Cook, L M

1981-09-01

A perpetual shortage of physical therapists qualified to provide home health care exists in Southern California. This paper presents one solution to the problem: the employment of a physical therapist assistant. The preparation, implementation, and evaluation of a program for employing a physical therapist assistant in a home health agency is presented and discussed. The use of the assistant increased the availability of physical therapy, and quality was not adversely affected. The assistant was accepted by staff and derived job satisfaction. We concluded that this assistant was a valuable adjunct to the home health team. Subsequently, The Visiting Nurse Association of Los Angeles employed two additional assistants in 1980.

A description of physical therapists' knowledge in managing musculoskeletal conditions.

PubMed

Childs, John D; Whitman, Julie M; Sizer, Phillip S; Pugia, Maria L; Flynn, Timothy W; Delitto, Anthony

2005-06-17

Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. However, further evidence is needed to determine if physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions. Therefore, the purpose of this study was to describe physical therapists' knowledge in managing musculoskeletal conditions. This study utilized a cross-sectional design in which 174 physical therapist students from randomly selected educational programs and 182 experienced physical therapists completed a standardized examination assessing knowledge in managing musculoskeletal conditions. This same examination has been previously been used to assess knowledge in musculoskeletal medicine among medical students, physician interns and residents, and across a variety of physician specialties. Experienced physical therapists had higher levels of knowledge in managing musculoskeletal conditions than medical students, physician interns and residents, and all physician specialists except for orthopaedists. Physical therapist students enrolled in doctoral degree educational programs achieved significantly higher scores than their peers enrolled in master's degree programs. Furthermore, experienced physical therapists who were board-certified in orthopaedic or sports physical therapy achieved significantly higher scores and passing rates than their non board-certified colleagues. The results of this study may have implications for health and public policy decisions regarding the suitability of utilizing physical therapists to provide direct access care for patients with musculoskeletal conditions.

Study protocol: Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer (RESPECT).

PubMed

Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis; Andersen, Lars Bo; Andersen, Karen Vitting; Christensen, Karl Bang; Hasle, Henrik; Heilmann, Carsten; Hejgaard, Nete; Johansen, Christoffer; Madsen, Marianne; Madsen, Svend Aage; Simovska, Venka; Strange, Birgit; Thing, Lone Friis; Wehner, Peder Skov; Schmiegelow, Kjeld; Larsen, Hanne Baekgaard

2013-11-14

During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers. The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n=120) and a matched control group in western Denmark (n=120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child's schoolteachers and classmates, and the child's parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs. RESPECT is the first population-based study to examine the effect of early rehabilitation for children with cancer, and to use healthy classmates as ambassadors to facilitate the normalization of social life in the hospital. For children with cancer, RESPECT contributes to expanding knowledge on rehabilitation that can also facilitate rehabilitation of other children undergoing hospitalization for long-term illness. Clinical Trials.gov: file. NCT01772849 and NCT01772862.

Effective physical treatment for chronic low back pain.

PubMed

Maher, C G

2004-01-01

It is now feasible to adopt an evidence-based approach when providing physical treatment for patients with chronic LBP. A summary of the efficacy of a range of physical treatments is provided in Table 1. The evidence-based primary care options are exercise, laser, massage, and spinal manipulation; however, the latter three have small or transient effects that limit their value as therapies for chronic LBP. In contrast, exercise produces large reductions in pain and disability, a feature that suggests that exercise should play a major role in the management of chronic LBP. Physical treatments, such as acupuncture, backschool, hydrotherapy, lumbar supports, magnets, TENS, traction, ultrasound, Pilates therapy, Feldenkrais therapy, Alexander technique, and craniosacral therapy are either of unknown value or ineffective and so should not be considered. Outside of primary care, multidisciplinary treatment or functional restoration is effective; however, the high cost probably means that these programs should be reserved for patients who do not respond to cheaper treatment options for chronic LBP. Although there are now effective treatment options for chronic LBP, it needs to be acknowledged that the problem of chronic LBP is far from solved. Though treatments can provide marked improvements in the patient's condition, the available evidence suggests that the typical chronic LBP patient is left with some residual pain and disability. Developing new, more powerful treatments and refining the current group of known effective treatments is the challenge for the future.

The UIC Therapeutic Partnership Project. Final Report.

ERIC Educational Resources Information Center

Lawlor, Mary C.; Cada, Elizabeth A.

This interdisciplinary inservice training project at the University of Illinois at Chicago was designed to improve early childhood occupational and physical therapy services by developing, implementing, evaluating, and disseminating a comprehensive training model. The competency-based program was designed to address the developmental needs of…

Effects of Pedalo® training on balance and fall risk in stroke patients.

PubMed

Kim, Do-Yeon; Lim, Chae-Gil

2017-07-01

[Purpose] This study sought to examine the effects of Pedalo ® training on balance and fall risk in stroke patients. [Subjects and Methods] Thirty-one subjects with stroke were recruited and randomly allocated into two groups: the Pedalo ® group (n=15) and the Treadmill group (n=16). The Pedalo ® group performed conventional physical therapy program with Pedalo ® training for 30 minutes, five times a week, for 8 weeks, while the Treadmill group conducted conventional physical therapy programs and treadmill gait training for 30 minutes, five times a week, for 8 weeks. [Results] After intervention, both groups showed a significant improvement in balance. A significant greater balance improvement was found in the Pedalo ® group compared to the Treadmill group. Also, a significant reduction in risk of fall was seen in both group but this reduction was not significantly different between the two groups. [Conclusion] Pedalo ® training may be used to improve balance and reduce fall risk in stroke patients.

Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: a randomized controlled trial.

PubMed

Kalron, Alon; Rosenblum, Uri; Frid, Lior; Achiron, Anat

2017-03-01

Evaluate the effects of a Pilates exercise programme on walking and balance in people with multiple sclerosis and compare this exercise approach to conventional physical therapy sessions. Randomized controlled trial. Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. Forty-five people with multiple sclerosis, 29 females, mean age (SD) was 43.2 (11.6) years; mean Expanded Disability Status Scale (S.D) was 4.3 (1.3). Participants received 12 weekly training sessions of either Pilates ( n=22) or standardized physical therapy ( n=23) in an outpatient basis. Spatio-temporal parameters of walking and posturography parameters during static stance. Functional tests included the Time Up and Go Test, 2 and 6-minute walk test, Functional Reach Test, Berg Balance Scale and the Four Square Step Test. In addition, the following self-report forms included the Multiple Sclerosis Walking Scale and Modified Fatigue Impact Scale. At the termination, both groups had significantly increased their walking speed ( P=0.021) and mean step length ( P=0.023). According to the 2-minute and 6-minute walking tests, both groups at the end of the intervention program had increased their walking speed. Mean (SD) increase in the Pilates and physical therapy groups were 39.1 (78.3) and 25.3 (67.2) meters, respectively. There was no effect of group X time in all instrumented and clinical balance and gait measures. Pilates is a possible treatment option for people with multiple sclerosis in order to improve their walking and balance capabilities. However, this approach does not have any significant advantage over standardized physical therapy.

Effects of a sitting boxing program on upper limb function, balance, gait, and quality of life in stroke patients.

PubMed

Park, Junhyuck; Gong, Jihwan; Yim, Jongeun

2017-01-01

Boxing training including traditional stretching, muscular strength training, and duration training would be considered to be effective for improved functional stretching, dynamic balance, walking speed, and quality of life. We aimed to investigate upper limb function, balance, gait, and quality of life in stroke patients before and after a sitting boxing program. Twenty-six participants were randomly allocated to a boxing group (n = 13) and control group (n = 13) after the upper limb function, balance, gait, and quality of Life were recorded. The boxing group underwent a sitting boxing program (3 times/week) as well as conventional physical therapy (3 times/week) for 6 weeks. The control group only underwent conventional physical therapy (3 times/week) for 6 weeks. The Manual Functional Test (MFT), non-affected hand grip, Berg Balance Scale (BBS), velocity moment with eye opened, 10-m Walk Test (10 MWT), and Stroke-Specific Quality of Life questionnaire (SS-QOL) were significantly improved in the boxing group (p < 0.05) and showed significantly greater improvements in the boxing group compared to the control group (p < 0.05) after 6 weeks. The sitting boxing program group had positive effects on upper extremity function, balance, gait, and quality of life in stroke patients.

Computer Model Of Fragmentation Of Atomic Nuclei

NASA Technical Reports Server (NTRS)

Wilson, John W.; Townsend, Lawrence W.; Tripathi, Ram K.; Norbury, John W.; KHAN FERDOUS; Badavi, Francis F.

1995-01-01

High Charge and Energy Semiempirical Nuclear Fragmentation Model (HZEFRG1) computer program developed to be computationally efficient, user-friendly, physics-based program for generating data bases on fragmentation of atomic nuclei. Data bases generated used in calculations pertaining to such radiation-transport applications as shielding against radiation in outer space, radiation dosimetry in outer space, cancer therapy in laboratories with beams of heavy ions, and simulation studies for designing detectors for experiments in nuclear physics. Provides cross sections for production of individual elements and isotopes in breakups of high-energy heavy ions by combined nuclear and Coulomb fields of interacting nuclei. Written in ANSI FORTRAN 77.

The long-term impacts of group treatment for partner abuse.

PubMed

Mcgregor, Marla; Tutty, Leslie M; Babins-Wagner, Robbie; Gill, Marlyn

2002-01-01

This paper evaluates Responsible Choices for Men, a 14-week therapy group for abusive men based on feminist perspectives using narrative methods. Pre-test and post-test information was available for 76 program completers measuring physical and non-physical abuse, self-esteem, perceived stress, family relations, depression, assertiveness, and sex-role beliefs. The men significantly improved on all variables. A further focus was following up with 22 group members, contacted 5 to 28 months post treatment and asked to complete the same measures. The results indicated not only maintenance of the post-group changes, but continued improvement. Clinical implications and recommendations for group programming with abusive men are presented.

myMoves Program: Feasibility and Acceptability Study of a Remotely Delivered Self-Management Program for Increasing Physical Activity Among Adults With Acquired Brain Injury Living in the Community.

PubMed

Jones, Taryn M; Dear, Blake F; Hush, Julia M; Titov, Nickolai; Dean, Catherine M

2016-12-01

People living with acquired brain injury (ABI) are more likely to be physically inactive and highly sedentary and, therefore, to have increased risks of morbidity and mortality. However, many adults with ABI experience barriers to participation in effective physical activity interventions. Remotely delivered self-management programs focused on teaching patients how to improve and maintain their physical activity levels have the potential to improve the overall health of adults with ABI. The study objective was to evaluate the acceptability and feasibility of a remotely delivered self-management program aimed at increasing physical activity among adults who dwell in the community and have ABI. A single-group design involving comparison of baseline measures with those taken immediately after intervention and at a 3-month follow-up was used in this study. The myMoves Program comprises 6 modules delivered over 8 weeks via email. Participants were provided with regular weekly contact with an experienced physical therapist via email and telephone. The primary outcomes were the feasibility (participation, attrition, clinician time, accessibility, and adverse events) and acceptability (satisfaction, worthiness of time, and recommendation) of the myMoves Program. The secondary outcomes were objective physical activity data collected from accelerometers, physical activity self-efficacy, psychological distress, and participation. Twenty-four participants commenced the program (20 with stroke, 4 with traumatic injury), and outcomes were collected for 23 and 22 participants immediately after the program and at a 3-month follow-up, respectively. The program required very little clinician contact time, with an average of 32.8 minutes (SD=22.8) per participant during the 8-week program. Acceptability was very high, with more than 95% of participants being either very satisfied or satisfied with the myMoves Program and stating that it was worth their time. All participants stated that they would recommend the program to others with ABI. The results were obtained from a small sample; hence, the results may not be generalizable to a larger ABI population. A remotely delivered self-management program aimed at increasing physical activity is feasible and acceptable for adults with ABI. Further large-scale efficacy trials are warranted. © 2016 American Physical Therapy Association.

The effects of short-term preoperative physical therapy and education on early functional recovery of patients younger than 70 undergoing total hip arthroplasty.

PubMed

Vukomanović, Aleksandra; Popović, Zoran; Durović, Aleksandar; Krstić, Ljiljana

2008-04-01

Hip arthroplasty is a routine operation which relieves pain in patients with osteoarthritis. The role of physical therapy after hip arthroplasty was recognized, but the importance of preoperative physical therapy and education is still to be judged. The aim of this paper was to investigate the effect of short-term preoperative program of education and physical therapy on patients' early functional recovery immediately after total hip arthroplasty (THA). This prospective study included 45 patients with hip osteoarthritis scheduled to undergo primary THA and admitted to the Department of Orthopedics of Military Medical Academy. They were randomized into 2 groups: study and control one (with and without preoperative education and physical therapy). Preoperative education was conducted through conversation (1 appointment with physiatrist) and brochure. The study group was instructed to perform exercises and basic activities from the postoperative rehabilitation program (2 practical classes with physiotherapist). Effects were measured with questionnaires (Harris, Oxford and Japanese Orthopaedic Association (JOA) hip scores), range of motion and visual analog scale of pain. Marks showing ability to perform basic activities and endurance were from 0 (did not perform activity) to 5 (independent and secure). Analyses examined differences between the groups over the preoperative and immediate postoperative periods and 15 months after the operation. There were no differences between the groups at discharge according to pain, range of motion, Harris hip score and JOA hip score. Oxford hip score did not differ between the groups 15 months after the operation. The groups started to walk at the same time, but the study group walked up and down stairs (3.7+/-1.66 vs 5.37+/-1.46, p< or =0.002), used toilet (2.3+/-0.92 vs 3.2+/-1.24, p< or =0.02) and chair (2.2+/-1.01 vs 3.25+/-1.21, p< or =0.006) significantly earlier than the control group. On the third day after the operation the study group was significantly more independent than the control one while performing any basic activities (changing position in bed from supine to side lying, from supine to sitting on the edge of the bed, from sitting to standing, from standing to lying in the bad, standing, walking, using toilet and chair). At discharge the patients from the control group still needed the therapist help for walking up and down stairs (3+/-1.26), while the patients from the study group performed there activities independently (4.85+/-0.37) (p< or =0.000). Endurance while walking was significantly better in the study group than in the control one. The length of hospital stay after the operation was similar for both groups, but the patients from the study group needed significantly less classes with the therapist (5.2+/-2.35 vs 6.85+/-1.14, p< or =0.02) during hospital stay. The short-term preoperative program of education with the elements of physical therapy accelerated early functional recovery of patients (younger than 70) immediately after THA and we recommend it for routine use.

Working the Continuum between Therapy and Exercise.

ERIC Educational Resources Information Center

Sova, Ruth

Because of the relative weightlessness factor, water exercise is an excellent low-impact aerobic activity for people with physical difficulties. Participants should inform their physicians of intentions to begin aquatic exercise, and physicians should advise participants that water exercise is exertive. Program instructors must be prepared to…

34 CFR 369.4 - What definitions apply to these programs?

Code of Federal Regulations, 2010 CFR

2010-07-01

... training in the use of prosthetic and orthotic devices; (3) Recreational therapy; (4) Physical and..., communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) in terms of an... to obtaining or retaining employment; (9) Eyeglasses and visual services, including visual training...

42 CFR 405.902 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... physical therapy or speech pathology services, or a community mental health center that has in effect a... 42 Public Health 2 2010-10-01 2010-10-01 false Definitions. 405.902 Section 405.902 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL...

[Social participation and activities of daily living of patients with inflammatory rheumatic diseases : support by self-help, exercise therapy and new media].

PubMed

Mattukat, K; Thyrolf, A

2014-02-01

Rheumatic patients are at risk of social isolation and physical inactivity which can have a significant impact on physical and mental health. Only every seventh patient is organized in a self-help group (SHG), most of them in the German League Against Rheumatism (GLAR). Members of a SHG are socially and physically more active and take part in exercise therapy (ET) more often. Depending on the study, the utilization of ET ranges from 25 % to 71 %. The functional training as the most attended offer of the GLAR showed positive effects at the physical and psychological levels. To motivate difficult to reach patients to engage in self-help and regular exercise, further development of exercise programs with individually tailored intensive strength and endurance elements as well as the increased use of new media seems promising. The Internet provides various opportunities for networking and social participation especially for severely impaired and temporally less flexible patients.

Temporomandibular disorders. Part 2: conservative management

PubMed Central

Shaffer, Stephen M; Brismée, Jean-Michel; Sizer, Phillip S; Courtney, Carol A

2014-01-01

Appropriate management of temporomandibular disorders (TMD) requires an understanding of the underlying dysfunction associated with the temporomandibular joint (TMJ) and surrounding structures. A comprehensive examination process, as described in part 1 of this series, can reveal underlying clinical findings that assist in the delivery of comprehensive physical therapy services for patients with TMD. Part 2 of this series focuses on management strategies for TMD. Physical therapy is the preferred conservative management approach for TMD. Physical therapists are professionally well-positioned to step into the void and provide clinical services for patients with TMD. Clinicians should utilize examination findings to design rehabilitation programs that focus on addressing patient-specific impairments. Potentially appropriate plan of care components include joint and soft tissue mobilization, trigger point dry needling, friction massage, therapeutic exercise, patient education, modalities, and outside referral. Management options should address both symptom reduction and oral function. Satisfactory results can often be achieved when management focuses on patient-specific clinical variables. PMID:24976744

Analysis of rehabilitation activities within skilled nursing and inpatient rehabilitation facilities after hip replacement for acute hip fracture.

PubMed

Munin, Michael C; Putman, Koen; Hsieh, Ching-Hui; Smout, Randall J; Tian, Wenqiang; DeJong, Gerben; Horn, Susan D

2010-07-01

To characterize rehabilitation services in two types of postacute facilities in patients who underwent hip replacement following a hip fracture. Multisite prospective observational cohort from 6 freestanding skilled nursing facilities and 11 inpatient rehabilitation facilities. Patients (n = 218) with hip fracture who had either hemiarthroplasty or total hip arthroplasty followed by rehabilitation at skilled nursing facilities or inpatient rehabilitation facilities were enrolled. Using a point-of-care methodology, we recorded data from actual physical therapy and occupational therapy sessions completed including functional outcomes during the postacute admission. Onset time from surgical repair to rehabilitation admission was not significantly different between sites. Average skilled nursing facilities length of stay was 24.7 +/- 13.6 days, whereas inpatient rehabilitation facilities was 13.0 +/- 5.7 days (P < 0.01). Total hours of physical therapy and occupational therapy services per patient day were 1.2 in skilled nursing facilities and 2.0 in inpatient rehabilitation facilities. For weekdays only, these data changed to 1.6 in skilled nursing facilities and 2.6 hrs per patient in inpatient rehabilitation facilities (P < 0.01). Patients in inpatient rehabilitation facilities accrued more time for gait training and exercise in physical therapy, which was found to be 48% and 40% greater, respectively, through day 8. In occupational therapy, patients of inpatient rehabilitation facilities had more time allocated to lower body dressing and transfers. Significant differences in rehabilitation activities were observed, and intensity was notably different within the first 8 therapy days even though baseline demographics and medical complexity were comparable across facility types. Our data suggest that after more complex hip replacement surgery, hip fracture patients can tolerate more intensive therapy earlier within the rehabilitation program.

Extracorporeal shockwave therapy versus exercise program in patients with low back pain: short-term results of a randomised controlled trial.

PubMed

Notarnicola, A; Maccagnano, G; Gallone, M F; Mastromauro, L; Rifino, F; Pesce, V; Covelli, I; Moretti, B

2018-01-01

The physiotherapy treatment of low back pain (LBP) with physical stimulation offers different possibilities of application. Until now, the physical therapies used in LBP are laser therapy, ultrasonotherapy and currents. We conducted a clinical trial in order to verify whether shockwave therapy, which is very effective in treating tendinopathies and fracture consolidation delays, leads to clinical and electromyographic improvement in patients affected by LBP. We randomized thirty patients affected by LBP treated with shock waves (shockwave group) or a standard protocol characterized by rehabilitative exercises (control group). At one and three months, the patients treated with shockwave therapy showed clinical improvement measured by VAS scales (p=0.002; p= 0.02), and disability evaluated with Roland scales (p=0.002; p=0.002) and Oswestry (p=0.002; p=0.002). At three months, the patients treated with shock waves, showed a significant improvement in terms of values of amplitude of the sensory nerve conduction velocity (SNCV) of the plantar medialis nerve (left: p=0.007; right: p=0.04), the motor nerve muscular conduction (MNCV) of the deep peroneal nerve (left: p=0.28; right: p=0.01) and recruitment of motor units of finger brevis extensor (left: p = 0.02; right: p=0.006). In the control group, there was a trend to increase the clinical and electromyographic results without statistical significance. The preliminary results suggest a good applicability of shockwave therapy in the treatment of LBP, in accordance with the antiinflammatory, antalgic, decontracting effects and remodeling of the nerve fiber damage verified in previous studies conducted on other pathological models. Future research will allow us to verify the integration of this therapy into a rehabilitation protocol combined with other physical therapies.

[Multifamily therapy in children with learning disabilities].

PubMed

Retzlaff, Rüdiger; Brazil, Susanne; Goll-Kopka, Andrea

2008-01-01

Multifamily therapy is an evidence-based method used in the treatment and prevention of severe psychiatric disorders, behavioral problems and physical illnesses in children, adolescents and adults. For preventive family-oriented work with children with learning disorders there is a lack of therapeutic models. This article presents results from an innovative pilot project--multiple family groups for families with a learning disabled child of primary school age (six to eleven years old). Based on a systemic approach, this resource-oriented program integrates creative, activity-based interventions and group therapy techniques and conveys a comprehensive understanding of the challenges associated with learning disorders. Because of the pilot character of the study and the small sample size, the results have to be interpreted with care. The results do however clearly support the wider implementation and evaluation of the program in child guidance clinics, social-pediatric centers, as well as child and adolescent clinics and schools.

Power and promise of narrative for advancing physical therapist education and practice.

PubMed

Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann

2015-06-01

This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge-the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice. © 2015 American Physical Therapy Association.

Effects of different frequencies (2-3 days/week) of aquatic therapy program in adults with chronic low back pain. A non-randomized comparison trial.

PubMed

Baena-Beato, Pedro Angel; Arroyo-Morales, Manuel; Delgado-Fernández, Manuel; Gatto-Cardia, Maria Claudia; Artero, Enrique G

2013-01-01

To study the effects of an aquatic therapy program with different frequencies (2 vs 3 days per week) in chronic low back pain. [corrected] Non-randomized comparison trial. Sport and spa community health club. Fifty-four adults with chronic low back pain (48.9 ± 10.0 years). Eight-week aquatic therapy program. Pain (visual analog scale [VAS]), disability (Oswestry Disability Index), and quality of life (Short-Form Health Survey 36), body composition (weight, body mass index, body fat mass, body fat percentage, and skeletal muscle mass), and health-related fitness (sit and reach, handgrip strength, curl-up, Rockport 1-mile test). Both experimental groups presented significant improvements in low back pain and disability (P < 0.001) compared with control group. The 3 days/week group showed significantly greater benefits at VAS flexion and disability (P < 0.001) than the 2 days/week group. Regarding quality of life, both intervention groups presented significant differences for Physical Role (P < 0.05), Bodily Pain (P < 0.001), General Health (P = 0.012), and Standardized Physical Component (P < 0.001) compared with control group. Both experimental groups significantly improved all health-related fitness parameters (P < 0.01). The 3 days/week group showed significantly greater benefits at curl-up and heart rate (P < 0.001) than the 2 days/week group. No significant changes between treatment groups and control were found in body composition. Eight weeks of aquatic therapy program decrease levels of back pain and disability, increase quality of life, and improve health-related fitness in adults with chronic low back pain without effects in body composition. A dose-response effect was observed in some parameters, with greater benefits when exercising 3 days per week compared with 2 days. Wiley Periodicals, Inc.

Patient education and rehabilitation after hip arthroplasty in an Italian spa center: a pilot study on its feasibility

NASA Astrophysics Data System (ADS)

Musumeci, Alfredo; Pranovi, Giulia; Masiero, Stefano

2018-05-01

Nowadays, some spa centers are suitable for providing rehabilitative and preventive treatment in association with traditional spa therapy. This study aims to evaluate the feasibility and the effectiveness of an intensive rehabilitation program after hip arthroplasty in an Italian spa center. Early after total hip arthroplasty for severe osteoarthritis (≤ 10 days after the intervention), 12 consecutive patients (5 males and 7 females) aged between 50 and 85 years were enrolled for this study. All the patients performed a 2-week thermal multimodal rehabilitation program, which consisted of education and physical rehabilitative measures. Patients had 2-h and half/day session of land-based and hydrokinesitherapy (aquatic therapy) consisted in active and passive joint mobilization, respiratory and functional re-education exercises, gait and balance training, resistance exercise, and power training mainly for the upper limb associated to physical therapy modalities (electrotherapy and low-level laser therapy). An educational program was performed to both patients and families. Both before and after the rehabilitation treatment, patients underwent clinical evaluation, hip flexion/abduction range of motion, and Numeric Pain Rating Scale. Harris Hip Score (HHS) and SF-12 questionnaires (physical—PCS-12—and mental health component—MCS-12) were also administered. After the 2-week thermal spa treatment, hip flexion/abduction improved significantly (p < 0.05), but there was no statistically significant reduction in pain (p = 0.350). The HHS score improved significantly from 62.6 ± 12.8 to 82.15 ± 12.7 (p < 0.05), and the PCS-12 score from 36.37 ± 8.4 to 43.61 ± 8.95 (p < 0.05). There was no adverse event during spa treatment. After total hip arthroplasty, patients who underwent an intensive post-acute multimodal rehabilitation program showed an improvement in motor and functional recovery and a positive impact on quality of life. Therefore, we believe that the thermal setting is a suitable place for providing intensive rehabilitative treatment in orthopedic musculoskeletal disability.

A physical exercise program using music-supported video-based training in older adults in nursing homes suffering from dementia: a feasibility study.

PubMed

Spildooren, Joke; Speetjens, Ite; Abrahams, Johan; Feys, Peter; Timmermans, Annick

2018-04-28

Motivation towards an exercise program is higher in a small group setting in comparison to individual therapy. Due to attentional problems, group exercises are difficult for people with Alzheimer disease (AD). This study evaluates the feasibility of a music-supported video-based group exercise program in older adults suffering from AD. Five participants with moderate AD were recruited from a nursing home. A progressive physical exercise program using a video-based training with musical accompaniment was performed and digitally recorded to investigate the adherence and performed accuracy of the exercises. The overall participation during the exercises was 84.1%. The quality of the performance was for all exercises above the cut-off scores. A music-supported video-based group exercise program is feasible in persons with AD. The participants were motivated and the expectations towards the program increased over time. Music seemed an important factor for attention in participants with AD.

An intergenerational program for persons with dementia using Montessori methods.

PubMed

Camp, C J; Judge, K S; Bye, C A; Fox, K M; Bowden, J; Bell, M; Valencic, K; Mattern, J M

1997-10-01

An intergenerational program bringing together older adults with dementia and preschool children in one-on-one interactions is described. Montessori activities, which have strong ties to physical and occupational therapy, as well as to theories of developmental and cognitive psychology, are used as the context for these interactions. Our experience indicates that older adults with dementia can still serve as effective mentors and teachers to children in an appropriately structured setting.

[Implementation and evaluation of an ambulatory exercise therapy based rehabilitation program for breast cancer patients].

PubMed

Schulz, K H; Szlovák, C; Schulz, H; Gold, S; Brechtel, L; Braumann, M; Koch, U

1998-01-01

Physical exercise does not only have positive effects on physical fitness but also on mental health. However, there has been little empirical study on effects of rehabilitation programmes based on physical exercise in cancer patients. We conducted a study to examine the interrelation between the participation of breast cancer patients in an exercise rehabilitation training and aspects of quality of life and physical fitness. 28 patients with not metastasized mamma carcinoma participated in a structured exercise rehabilitation program twice a week for ten weeks. Before and after the intervention the patients were asked to fill in questionnaires to assess their quality of life. At the same instants they underwent physical examination and a bicycle ergometry as well as a blood drawing. The training was aimed at changes at the social, emotional, as well as the motor physical level. Pre-post comparisons demonstrated an improvement in quality of life, such as decreased levels of depression and anxiety. Furthermore the women proved to show an obvious increase in physical fitness. Present results support an implementation of an exercise rehabilitation training for breast cancer outpatients.

Behavioral Bibliotherapy: A Review of Self-Help Behavior Therapy Manuals

ERIC Educational Resources Information Center

Glasgow, Russell E.; Rosen, Gerald M.

1978-01-01

Describes the organizing concepts and strategies for the development and evaluation of self-help behavioral treatment manuals. Reviews programs that have been published or empirically tested for the treatment of phobias, smoking, obesity, sexual dysfunction, assertiveness, child behavior problems, study skills, and physical fitness, as well as…

Nancy's Story.

ERIC Educational Resources Information Center

Sallans, Dennis

1999-01-01

Nancy's recent psychotic episode left her an anxious, fearful person. Participating in an adventure therapy program enabled her to connect with peers, regain social skills and physical stamina, adjust to a full-day activity, regain her confidence, reconstruct purpose and meaning in life, and follow through on plans to complete university and get a…

Outward Bound--An Adjunctive Psychiatric Therapy: Preliminary Research Findings.

ERIC Educational Resources Information Center

Stich, Thomas F.; Sussman, Lewis R.

According to a small study, Outward Bound can enhance the treatment of hospitalized psychiatric patients. Researchers measured the effect of a therapeutic Outward Bound program of prescribed physical and social tasks on the contentment and self-esteem of seven patients undergoing short-term treatment at the Veterans Administration Hospital in…

42 CFR Appendix E to Part 75 - Standards for Accreditation of Educational Programs for Radiation Therapy Technologists

Code of Federal Regulations, 2013 CFR

2013-10-01

... universities; (b) Hospitals, clinics, or autonomous radiation oncology centers meeting the criteria for major... structure and function; (f) Oncologic pathology; (g) Radiation oncology; (h) Radiobiology; (i) Mathematics; (j) Radiation physics; (k) Radiation protection; (l) Radiation oncology technique; (m) Radiographic...

42 CFR Appendix E to Part 75 - Standards for Accreditation of Educational Programs for Radiation Therapy Technologists

Code of Federal Regulations, 2014 CFR

2014-10-01

... universities; (b) Hospitals, clinics, or autonomous radiation oncology centers meeting the criteria for major... structure and function; (f) Oncologic pathology; (g) Radiation oncology; (h) Radiobiology; (i) Mathematics; (j) Radiation physics; (k) Radiation protection; (l) Radiation oncology technique; (m) Radiographic...

42 CFR Appendix E to Part 75 - Standards for Accreditation of Educational Programs for Radiation Therapy Technologists

Code of Federal Regulations, 2012 CFR

2012-10-01

... universities; (b) Hospitals, clinics, or autonomous radiation oncology centers meeting the criteria for major... structure and function; (f) Oncologic pathology; (g) Radiation oncology; (h) Radiobiology; (i) Mathematics; (j) Radiation physics; (k) Radiation protection; (l) Radiation oncology technique; (m) Radiographic...

42 CFR Appendix E to Part 75 - Standards for Accreditation of Educational Programs for Radiation Therapy Technologists

Code of Federal Regulations, 2011 CFR

2011-10-01

... universities; (b) Hospitals, clinics, or autonomous radiation oncology centers meeting the criteria for major... structure and function; (f) Oncologic pathology; (g) Radiation oncology; (h) Radiobiology; (i) Mathematics; (j) Radiation physics; (k) Radiation protection; (l) Radiation oncology technique; (m) Radiographic...

Oral Anatomy Laboratory Examinations in a Physical Therapy Program

ERIC Educational Resources Information Center

Fabrizio, Philip A.

2013-01-01

The process of creating and administering traditional tagged anatomy laboratory examinations is time consuming for instructors and limits laboratory access for students. Depending on class size and the number of class, sections, creating, administering, and breaking down a tagged laboratory examination may involve one to two eight-hour days.…

42 CFR 485.717 - Condition of participation: Rehabilitation program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.717 Condition of... (NFs) to which the agency furnishes services. The hospital, SNF, or NF is responsible for ensuring that qualified staff furnish services for which they arrange or contract for their patients. The rehabilitation...

Development of a residency program in radiation oncology physics: an inverse planning approach.

PubMed

Khan, Rao F H; Dunscombe, Peter B

2016-03-08

Over the last two decades, there has been a concerted effort in North America to organize medical physicists' clinical training programs along more structured and formal lines. This effort has been prompted by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP) which has now accredited about 90 residency programs. Initially the accreditation focused on standardized and higher quality clinical physics training; the development of rounded professionals who can function at a high level in a multidisciplinary environment was recognized as a priority of a radiation oncology physics residency only lately. In this report, we identify and discuss the implementation of, and the essential components of, a radiation oncology physics residency designed to produce knowledgeable and effective clinical physicists for today's safety-conscious and collaborative work environment. Our approach is that of inverse planning, by now familiar to all radiation oncology physicists, in which objectives and constraints are identified prior to the design of the program. Our inverse planning objectives not only include those associated with traditional residencies (i.e., clinical physics knowledge and critical clinical skills), but also encompass those other attributes essential for success in a modern radiation therapy clinic. These attributes include formal training in management skills and leadership, teaching and communication skills, and knowledge of error management techniques and patient safety. The constraints in our optimization exercise are associated with the limited duration of a residency and the training resources available. Without compromising the knowledge and skills needed for clinical tasks, we have successfully applied the model to the University of Calgary's two-year residency program. The program requires 3840 hours of overall commitment from the trainee, of which 7%-10% is spent in obtaining formal training in nontechnical "soft skills".

Application of Intervention Mapping to the Development of a Complex Physical Therapist Intervention.

PubMed

Jones, Taryn M; Dear, Blake F; Hush, Julia M; Titov, Nickolai; Dean, Catherine M

2016-12-01

Physical therapist interventions, such as those designed to change physical activity behavior, are often complex and multifaceted. In order to facilitate rigorous evaluation and implementation of these complex interventions into clinical practice, the development process must be comprehensive, systematic, and transparent, with a sound theoretical basis. Intervention Mapping is designed to guide an iterative and problem-focused approach to the development of complex interventions. The purpose of this case report is to demonstrate the application of an Intervention Mapping approach to the development of a complex physical therapist intervention, a remote self-management program aimed at increasing physical activity after acquired brain injury. Intervention Mapping consists of 6 steps to guide the development of complex interventions: (1) needs assessment; (2) identification of outcomes, performance objectives, and change objectives; (3) selection of theory-based intervention methods and practical applications; (4) organization of methods and applications into an intervention program; (5) creation of an implementation plan; and (6) generation of an evaluation plan. The rationale and detailed description of this process are presented using an example of the development of a novel and complex physical therapist intervention, myMoves-a program designed to help individuals with an acquired brain injury to change their physical activity behavior. The Intervention Mapping framework may be useful in the development of complex physical therapist interventions, ensuring the development is comprehensive, systematic, and thorough, with a sound theoretical basis. This process facilitates translation into clinical practice and allows for greater confidence and transparency when the program efficacy is investigated. © 2016 American Physical Therapy Association.

Using the Health Physics Student Volunteer Program for a Research Project Sponsored by the Medical Section of the Health Physics Society.

PubMed

Steiner, Joseph; Leinwander, Penny

2017-04-01

The Health Physics Society (HPS) Medical Health Physics Section (MHPS) received a request to research data on radiation safety guidance related to the death of patients who have recently received therapeutic doses of sealed or unsealed therapy sources. The MHPS elected to use student volunteers to perform this research. The purpose of this manuscript is to describe and provide a template for the process used by the MHPS to develop a student volunteer program. To implement the student volunteer program, the MHPS collaborated with the HPS Student Support Committee to develop a research proposal and a student volunteer selection process. The research proposal was sent to HPS student members in a call for volunteers. Two student volunteers were chosen based on predetermined qualifications to complete the work effort outlined in the research proposal. This project progressed with the use of milestones and culminated with the students presenting their findings at the annual HPS meeting. The students received HPS student travel awards to present at the conference. This work effort proved to be extremely beneficial to all parties involved.

Advancing our profession: are higher educational standards the answer?

PubMed

Boyleston, Erin S; Collins, Marie A

2012-01-01

Educational models in health care professions have changed drastically since on-the-job training models. The purpose of this manuscript was to investigate how the professions of physical therapy, occupational therapy, physician assistant, nursing and respiratory therapy have advanced their educational models for entry into practice and to recommend how dental hygiene can integrate similar models to advance the profession. The recommendations are to create an accreditation council for dental hygiene education and to mandate articulation agreements for baccalaureate degree completion in developing and existing programs. Dental hygiene must continue on the path to advance our profession and glean lessons from other health professions.

42 CFR 485.713 - Condition of participation: Physical therapy services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Physical therapy... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.713 Condition of participation: Physical therapy services. If the organization offers physical therapy services...

42 CFR 485.713 - Condition of participation: Physical therapy services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Physical therapy... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.713 Condition of participation: Physical therapy services. If the organization offers physical therapy services...

[Physiotherapy, exercise and strength training and physical therapies in the treatment of fibromyalgia syndrome].

PubMed

Schiltenwolf, M; Häuser, W; Felde, E; Flügge, C; Häfner, R; Settan, M; Offenbächer, M

2008-06-01

A guideline for the treatment and diagnostic procedures for fibromyalgia syndrome (FMS) was developed in cooperation with 10 German medical and psychological associations and 2 patient self-help groups. A systematic literature search including all controlled studies evaluating physiotherapy, exercise and strength training as well as physical therapies was performed in the Cochrane Collaboration Reviews (1993-12/2006), Medline (1980-12/2006), PsychInfo (1966-12/2006) and Scopus (1980-12/ 2006). Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine. Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized procedures to reach a consensus on recommendations were used. Aerobic exercise training is strongly recommended (grade A) and the temporary use of whole body hyperthermia, balneotherapy and spa therapy is recommended (grade B). The significance which can be assigned to most of the studies on the various procedures for therapy is restricted due to short study duration (mean 6-12 weeks) and small sample sizes.

Physical therapy in the treatment of fibromyalgia.

PubMed

Offenbächer, M; Stucki, G

2000-01-01

Fibromyalgia (FM) is a syndrome of unknown etiology characterized by chronic wide spread pain, increased tenderness to palpation and additional symptoms such as disturbed sleep, stiffness, fatigue and psychological distress. While medication mainly focus on pain reduction, physical therapy is aimed at disease consequences such as pain, fatigue, deconditioning, muscle weakness and sleep disturbances and other disease consequences. We systematically reviewed current treatment options in the treatment of fibromyalgia. Based on evidence from randomized controlled trials cardiovascular fitness training importantly improves cardiovascular fitness, both subjective and objective measures of pain as well as subjective energy and work capacity and physical and social activities. Based on anecdotal evidence or small observational studies physiotherapy may reduce overloading of the muscle system, improve postural fatigue and positioning, and condition weak muscles. Modalities and whole body cryotherapy may reduce localized as well as generalized pain in short term. Trigger point injection may reduce pain originating from concomitant trigger points in selected FM patient. Massage may reduce muscle tension and may be prescribed as a adjunct with other therapeutic interventions. Acupuncture may reduce pain and increase pain threshold. Biofeedback may positively influence subjective and objective disease measures. TENS may reduce localized musculoskeletal pain in fibromyalgia. While there seems to be no single best treatment option, physical therapy seem to reduce disease consequences. Accordingly a multidisciplinary approach combining these therapies in a well balanced program may be the most promising strategy and is currently recommended in the treatment of fibromyalgia.

School-based practice patterns: a survey of occupational therapists in Colorado.

PubMed

Spencer, Karen C; Turkett, Amanda; Vaughan, Roberta; Koenig, Sandra

2006-01-01

This purpose of this study was to describe school-based occupational therapy practice for kindergarten through twelfth-grade students in Colorado and to examine occupational therapy practice in light of current education policy and published views of best practice. Study data were provided by 105 occupational therapists and occupational therapy assistants who completed a 24-item questionnaire. Occupational therapists carried an average caseload of 43.68 students; most frequently served kindergarten through third-grade students with perceptual or communicative disabilities; and delivered services most often in pullout treatment areas. Practitioners spent most of their work week providing direct services. Remedial or developmental approaches were used 62% of the time and compensatory and educational approaches 37% of the time. Individualized education program goals addressed by occupational therapists were most frequently developed by the occupational therapist and targeted students' sensory or motor impairments. Workshops on autism and sensorimotor intervention techniques were reported as the primary and preferred forms of professional development. The strong majority of reported occupational therapy services contrasted with emerging views of best practice. They were, however, consistent with the Colorado Department of Education's guidelines for "motor specialists" that address occupational therapy, physical therapy, and adaptive physical educators working in schools. Study findings are discussed.

Early ICU Standardized Rehabilitation Therapy for the Critically Injured Burn Patient

DTIC Science & Technology

2016-10-01

physical therapy , respiratory therapy and related disciplines. Accordingly, the investigators feel that the proposed continuation plan will both fall... physical therapy , and progressive resistance exercise. The usual care group received weekday physical therapy when ordered by the clinical team. For the... physical therapy , and 3.0 (1.0-5.0) for progressive resistance exercise. Themedian days of delivery of physical therapy for the usual care group was 1.0

[Effectiveness of dog-assisted therapy in the elderly. A preliminary study].

PubMed

Folch, Anabel; Torrente, Margarita; Heredia, Luis; Vicens, Paloma

2016-01-01

Animal-assisted therapy is increasingly present in several educational and health areas. The aim of this study is to assess the effectiveness of such interventions in the elderly population living in residential settings. A 12-week dog-assisted intervention program was designed, with 16 participants from a nursing home divided into an experimental group and a control group. Several physical and psychological variables were assessed before and after the intervention. While there were no significant differences in the control group, the experimental group improved significantly after participating in the program. The results support the hypothesis that animal-assisted interventions may be beneficial for residents in elderly care homes. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Biomedical research, development, and engineering at the Johns Hopkins University Applied Physics Laboratory. Annual report 1 October 1978-30 September 1979

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The Medical Institutions of The Johns Hopkins University and The Johns Hopkins University Applied Physics Laboratory have developed a vigorous collaborative program of biomedical research, development, and systems engineering. An important objective of the program is to apply the expertise in engineering, the physical sciences, and systems analysis acquired by APL in defense and space research and development to problems of medical research and health care delivery. This program has grown to include collaboration with many of the clinical and basic science departments of the medical divisions. Active collaborative projects exist in ophthalmology, neurosensory research and instrumentation development, cardiovascular systems,more » patient monitoring, therapeutic and rehabilitation systems, clinical information systems, and clinical engineering. This application of state-of-the-art technology has contributed to advances in many areas of basic medical research and in clinical diagnosis and therapy through improvement of instrumentation, techniques, and basic understanding.« less

Education and training of medical physics in Iran: The past, the present and the future.

PubMed

Mahdavi, Seyed Rabi; Rasuli, Behrouz; Niroomand-Rad, Azam

2017-04-01

The aim of this study was to investigate the current status of education and training programs in medical physics in Iran. A questionnaire was designed and sent to 274 IAMP (Iranian Association of Medical Physicists) members focusing on these two topics: the educational situation (course syllabus, number of faculty members, number of PhD and MSc students and sub-fields offered in the department) and the professional situation (work experience, workplaces of medical physicists, postgraduate degrees that were granted and the amount of therapy and imaging equipment). Medical physics education in Iran is provided at 14 universities at master and doctorate levels. All medical physics departments offer an MSc program and 6 of them offer a PhD program. Most medical physics faculty (24%) work in the radiotherapy physics sub-specialty. Also, about 95 medical physics students graduate every year. There are six major peer-reviewed Iranian journals that publish medical physics papers in English. In addition, there are 74 radiotherapy machines including Co-60 and LINACs (LINear ACcelerators) across Iran as of 2013. The curriculum of medical physics programs (MSc and PhD) in Iran must be improved to include long-term clinical courses in the four major sub-specialties of radiotherapy, medical imaging, nuclear medicine and radiation protection. It is hoped that clinical medical physicists will go through nationally-accredited exams before assuming independent clinical responsibilities. Moreover, the work situation of the medical physics profession in Iran should be clear and the government authorities must recognize importance of this interdisciplinary field in medicine. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Nonoperative treatment of symptomatic spondylolysis.

PubMed

Kurd, Mark F; Patel, Deepan; Norton, Robert; Picetti, George; Friel, Brian; Vaccaro, Alexander R

2007-12-01

Symptomatic spondylolysis resulting from a stress fracture of the pars interarticularis is a cause of low back pain in the juvenile and adolescent patient. Treatment is conservative in the majority of cases. To analyze the outcome of patients with symptomatic isthmic spondylolysis treated nonoperatively with a custom fit thoracolumbar orthosis and activity cessation for 3 months followed by an organized physical therapy program. Retrospective case series. Four hundred thirty-six juvenile and adolescent patients with spondylolysis. Pain improvement, hamstring flexibility, range of motion, resolution of back spasms, and return to previous activities. Retrospective review of 436 juvenile and adolescent patients with symptomatic spondylolysis confirmed by single-photon emission computed tomography or computed tomography. Clinical outcomes were assessed through patient history and physical examination. Ninety-five percent of patients achieved excellent results according to a modified Odom's Criteria. The remaining 5% of patients achieved good results as they required occasional nonsteroidal anti-inflammatory drugs to relieve pain. Back spasms were resolved and hamstring tightness and range of motion returned to normal in all patients. All patients returned to their preinjury activity level. No patients went on to surgery. Symptomatic juvenile and adolescent patients with an isthmus spondylolysis may be effectively managed with a custom fit thoracolumbar orthosis brace and activity cessation for approximately 3 months followed by an organized physical therapy program.

Can physical therapists deliver a pain coping skills program? An examination of training processes and outcomes.

PubMed

Bryant, Christina; Lewis, Prudence; Bennell, Kim L; Ahamed, Yasmin; Crough, Denae; Jull, Gwendolen A; Kenardy, Justin; Nicholas, Michael K; Keefe, Francis J

2014-10-01

Physical therapists are well established as providers of treatments for common, painful, and disabling conditions, such as knee osteoarthritis (OA). Thus, they are well placed to deliver treatments that integrate physical and psychosocial elements. Attention is usually given to outcomes of such programs, but few studies have examined the processes and outcomes of training physical therapists to deliver such treatments. The aim of this study was to describe the processes in training physical therapists: (1) to deliver a standardized pain coping skills treatment and (2) to evaluate the effectiveness of that training. This study was an analysis of data relating to therapist performance in a randomized clinical trial. Eleven physical therapists were trained to deliver a 10-session pain coping skills training program for people with knee OA as part of a randomized controlled trial (N=222). The initial training was provided in a workshop format and included extensive, ongoing supervision by a psychologist and rigorous use of well-defined performance criteria to assess competence. Adherence to the program, ratings of performance, and use of advanced skills were all measured against these criteria in a sample (n=74, 10%) of the audio recordings of the intervention sessions. Overall, the physical therapists achieved a very high standard of treatment delivery, with 96.6% adherence to the program and mean performance ratings all in the satisfactory range. These results were maintained throughout the intervention and across all sessions. Only 10% of the delivered sessions were analyzed, and the physical therapists who took part in the study were a self-selected group. This study demonstrated that a systematic approach to training and accrediting physical therapists to deliver a standardized pain coping skills program can result in high and sustained levels of adherence to the program. Training fidelity was achieved in this group of motivated clinicians, but the supervision provided was time intensive. The data provide a promising indicator of greater potential for psychologically informed practice to be a feature of effective health care. © 2014 American Physical Therapy Association.

Physical Therapy Protocols for Arthroscopic Bankart Repair.

PubMed

DeFroda, Steven F; Mehta, Nabil; Owens, Brett D

Outcomes after arthroscopic Bankart repair can be highly dependent on compliance and participation in physical therapy. Additionally, there are many variations in physician-recommended physical therapy protocols. The rehabilitation protocols of academic orthopaedic surgery departments vary widely despite the presence of consensus protocols. Descriptive epidemiology study. Level 3. Web-based arthroscopic Bankart rehabilitation protocols available online from Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic surgery programs were included for review. Individual protocols were reviewed to evaluate for the presence or absence of recommended therapies, goals for completion of ranges of motion, functional milestones, exercise start times, and recommended time to return to sport. Thirty protocols from 27 (16.4%) total institutions were identified out of 164 eligible for review. Overall, 9 (30%) protocols recommended an initial period of strict immobilization. Variability existed between the recommended time periods for sling immobilization (mean, 4.8 ± 1.8 weeks). The types of exercises and their start dates were also inconsistent. Goals to full passive range of motion (mean, 9.2 ± 2.8 weeks) and full active range of motion (mean, 12.2 ± 2.8 weeks) were consistent with other published protocols; however, wide ranges existed within the reviewed protocols as a whole. Only 10 protocols (33.3%) included a timeline for return to sport, and only 3 (10%) gave an estimate for return to game competition. Variation also existed when compared with the American Society of Shoulder and Elbow Therapists' (ASSET) consensus protocol. Rehabilitation protocols after arthroscopic Bankart repair were found to be highly variable. They also varied with regard to published consensus protocols. This discrepancy may lead to confusion among therapists and patients. This study highlights the importance of attending surgeons being very clear and specific with regard to their physical therapy instructions to patients and therapists.

Finding the "Right-Size" Physical Therapy Workforce: International Perspective Across 4 Countries.

PubMed

Jesus, Tiago S; Koh, Gerald; Landry, Michel; Ong, Peck-Hoon; Lopes, António M F; Green, Peter L; Hoenig, Helen

2016-10-01

Finding the "right-size" physical therapy workforce is an increasingly important issue, but it has had limited study, particularly across nations. This perspective article provides a comprehensive examination of physical therapy workforce issues across 4 countries (United States, Singapore, Portugal, and Bangladesh), which were deliberately selected to allow consideration of key contextual factors. This investigation provides a theoretical model uniquely adapted to focus on variables most likely to affect physical therapy workforce needs. This theoretical model was used to guide acquisition of public domain data across the respective countries. The data then were used to provide a contextualized interpretation about the physical therapy workforce supply (ie, physical therapists per capita) across the 4 countries in light of the following factors: indicators of physical therapy need, financial and administrative barriers affecting physical therapy access and demand, the proportion of physical therapy graduates (with varying trends over time across the countries), and the role of emigration/immigration in supply inequalities among countries of lower and higher income. In addition, both the physical therapy workforce supply and scope of practice were analyzed in the context of other related professions across the 4 countries. This international comparison indicated that there may not be a "one-size-fits-all" recommendation for physical therapy workforce supply across countries or an ideal formula for its determination. The optimal, country-specific physical therapy workforce supply appears to be affected by discipline-specific health care and contextual factors that may vary across countries, and even within the same country. This article provides a conceptual framework and basis for such contextualized evaluations of the physical therapy workforce. © 2016 American Physical Therapy Association.

A community-based, interdisciplinary rehabilitation engineering course.

PubMed

Lundy, Mary; Aceros, Juan

2016-08-01

A novel, community-based course was created through collaboration between the School of Engineering and the Physical Therapy program at the University of North Florida. This course offers a hands-on, interdisciplinary training experience for undergraduate engineering students through team-based design projects where engineering students are partnered with physical therapy students. Students learn the process of design, fabrication and testing of low-tech and high-tech rehabilitation technology for children with disabilities, and are exposed to a clinical experience under the guidance of licensed therapists. This course was taught in two consecutive years and pre-test/post-test data evaluating the impact of this interprofessional education experience on the students is presented using the Public Service Motivation Scale, Civic Actions Scale, Civic Attitudes Scale, and the Interprofessional Socialization and Valuing Scale.

Acceptability of Virtual Reality Interoceptive Exposure for the Treatment of Panic Disorder with Agoraphobia

ERIC Educational Resources Information Center

Quero, Soledad; Pérez-Ara, M. Ángeles; Bretón-López, Juana; García-Palacios, Azucena; Baños, Rosa M.; Botella, Cristina

2014-01-01

Interoceptive exposure (IE) is a standard component of cognitive-behavioural therapy (CBT) for panic disorder and agoraphobia. The virtual reality (VR) program "Panic-Agoraphobia" has several virtual scenarios designed for applying exposure to agoraphobic situations; it can also simulate physical sensations. This work examines patients'…

Physical Therapy Principles in Rehabilitation

PubMed Central

Sparto, Patrick J.

2016-01-01

The use of vestibular rehabilitation for persons with balance and vestibular disorders is used to improve function and decrease dizziness symptoms. Principles of a vestibular rehabilitation program are described including common exercises and outcome measures used to report change. A review of negative and positive predictive factors related to recovery is also provided. PMID:22027077

One-Minute Paper: Student Perception of Learning Gains

ERIC Educational Resources Information Center

Anderson, Deborah; Burns, Shari

2013-01-01

The purpose of this study was to determine students' perceptions of learning gains when using the one-minute paper. Thirty-one students from the Physical Therapy (PT) and Nurse Anesthesia (NA) programs participated in this study. Students completed the one-minute paper in three classes. An email to students clarified the "muddy" points…

Using Live Tissue Laboratories to Promote Clinical Reasoning in Doctor of Physical Therapy Students

ERIC Educational Resources Information Center

Moore, W. Allen; Noonan, Ann Cassidy

2010-01-01

Recently, the use of animal laboratories has decreased in medical and basic science programs due to lack of trained faculty members, student concerns about animal welfare, and the increased availability of inexpensive alternatives such as computer simulations and videos. Animal laboratories, however, have several advantages over alternative forms…

75 FR 27801 - Announcement of Funding Awards for the Indian Community Development Block Grant Program for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-18

... System Diabetes Education and Physical Therapy Building. Pascua Yaqui Tribe, Peter Yucupicio, 2,200,000... Amount funded Activity funded Project description Alabama--Quassarte Tribal Town, Tarpie $797,305 Public...--Community Activity center with a Wallace, Chief, P.O. Box 350, Seneca, Center. gymnasium and classroom MO...

78 FR 40271 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... care hospital length of stay. ADL Activities of daily living. AHRQ Agency for Healthcare Research and.... DHHS Department of Health and Human Services. DM Diabetes mellitus. DME Durable medical equipment. DRA... payment [Adjustment]. POC Plan of care. PRRB Provider Reimbursement Review Board. PT Physical therapy. QAP...

Health Care Professionals' Attitudes toward Licensure, National Certification, and Continuing Education Requirements: Results of a Texas Survey.

ERIC Educational Resources Information Center

Hagus, Cheryll K.

2000-01-01

Survey responses (n=1,620) from health processionals in communications disorders, clinical laboratory science, health information management, physical therapy, and respiratory care indicated the majority support licensure and certification; 45.3% had difficulty finding accessible, relevant continuing education programs; cost and distance were…

[Physical therapy].

PubMed

Chohnabayashi, Naohiko

2008-01-01

Recently, pulmonary rehabilitation program is widely considered one of the most effective and evidence-based treatment for not only chronic obstructive pulmonary disease (COPD) but many clinical situations including neuro-muscular disease, post-operative status and weaning period from the ventilator, etc. The essential components of a pulmonary rehabilitation program are team assessment, patient training, psycho-social intervention, exercise, and follow-up. In 2003, Japanese medical societies (J. Thoracic Society, J. Pul. Rehabilitation Society and J. Physiotherapist Society) made a new guideline for pulmonary rehabilitation, especially how to aproach the execise training. As for the duration after surgical operation, airway cleaning is the important technique to prevent post-operative complications including pneumonia. Postural dranage technique is well known for such condition, at the same time, several instruments (flutter vulve, positive expiratory mask, high frequecy oscillation, etc) were also used for the patient to expectrate airway mucus easier. Lung transplantation is a new method of treatment for the critically-ill patients with chronic respiratoy failure. Several techniques of physical therapy are must be needed before and after lung transplantation to prevent both pulmonary infection and osteoporosis.

Muscle stretching exercises and resistance training in fibromyalgia: which is better? A three-arm randomized controlled trial.

PubMed

Assumpção, Ana; Matsutani, Luciana A; Yuan, Susan L; Santo, Adriana S; Sauer, Juliana; Mango, Pamela; Marques, Amelia P

2017-11-29

Exercise therapy is an effective component of fibromyalgia (FM) treatment. However, it is important to know the effects and specificities of the different types of exercise: muscle stretching and resistance training. To verify and compare the effectiveness of muscle stretching exercise and resistance training for symptoms and quality of life in FM patients. Randomized controlled trial. Physical therapy service, FM outpatient clinic. Forty-four women with FM (79 screened). Patients were randomly allocated into a stretching group (n=14), resistance group (n=16), and control group (n=14). Pain was assessed using the visual analog scale, pain threshold using a Fischer dolorimeter, FM symptoms using the Fibromyalgia Impact Questionnaire (FIQ), and quality of life using the Medical Outcomes Study 36-item Short- Form Health Survey (SF-36). The three intervention groups continued with usual medical treatment. In addition, the stretching and resistance groups performed two different exercise programs twice a week for 12 weeks. After treatment, the stretching group showed the highest SF-36 physical functioning score (p=0.01) and the lowest bodily pain score (p=0.01). The resistance group had the lowest FIQ depression score (p=0.02). The control group had the highest score for FIQ morning tiredness and stiffness, and the lowest score for SF-36 vitality. In clinical analyses, the stretching group had significant improvement in quality of life for all SF-36 domains, and the resistance group had significant improvement in FM symptoms and in quality of life for SF-36 domains of physical functioning, vitality, social function, emotional role, and mental health. Muscle stretching exercise was the most effective modality in improving quality of life, especially with regard to physical functioning and pain, and resistance training was the most effective modality in reducing depression. The trial included a control group and two intervention groups, both of which received exercise programs created specifically for patients with FM. In clinical practice, we suggest including both of these modalities in an exercise therapy program for FM.

Factors affecting recruitment of physical therapy personnel in Utah.

PubMed

Okerlund, V W; Jackson, P B; Parsons, R J

1994-02-01

This study assessed the current and future needs of physical therapy personnel in Utah, including both physical therapists and physical therapist assistants. Three hundred twenty-two health care facilities selected from four major employer groups in Utah and a total of 590 physical therapy personnel were surveyed. Two hundred forty-four health care facilities (76%) and 198 physical therapy personnel (33.6%) responded. Two survey instruments were developed: one to assess the current and future supply and demand of physical therapy personnel in Utah, and the other to determine recruitment and retention factors. Utah health care facilities projected a need for 46 additional physical therapists and 28 additional physical therapist assistants in 1992. Surveyed physical therapy personnel reported feeling satisfied with the profession and had chosen the profession through a person of influence. Freedom on the job and development of skills were the most often mentioned determinants of job satisfaction, and pay and benefits were the major determinants of retention. Physical therapy personnel should have a role in recruitment efforts. Physical therapy personnel have many options for employment and often choose to seek a diversity of opportunities for better compensation.

Update on rehabilitation in multiple sclerosis.

PubMed

Donzé, Cécile

2015-04-01

Given that mobility impairment is a hallmark of multiple sclerosis, people with this disease are likely to benefit from rehabilitation therapy throughout the course of their illness. The review provides an update on rehabilitation focused on balance and walking impairment. Classical rehabilitation focusing on muscle rehabilitation, neurotherapeutic facilitation is effective and recommended. Other techniques did not prove their superiority: transcutaneal neurostimulation, repetitive magnetic stimulation, electromagnetic therapy, whole body vibration and robot-assisted gait rehabilitation and need more studies to conclude. Cooling therapy, hydrotherapy, orthoses and textured insoles could represent a complementary service to other techniques in specific conditions. Multidisciplinary rehabilitation program provides positive effects and high satisfaction for patients with multiple sclerosis but needs more evaluation. New technologies using serious game and telerehabilitation seem to be an interesting technique to promote physical activity, self-management and quality of life. Rehabilitation like other therapy needs regular clinical evaluation to adapt the program and propose appropriate techniques. Moreover, the objective of rehabilitation needs to be decided with the patient with realistic expectation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Results of a physical therapy program in nursing home residents: A randomized clinical trial].

PubMed

Casilda-López, Jesús; Torres-Sánchez, Irene; Garzón-Moreno, Victor Manuel; Cabrera-Martos, Irene; Valenza, Marie Carmen

2015-01-01

The maintenance of the physical functionality is a key factor in the care of the elderly. Inactive people have a higher risk of death due to diseases associated with inactivity. In addition, the maintenance of optimal levels of physical and mental activity has been suggested as a protective factor against the development and progression of chronic illnesses and disability. The objective of this study is to assess the effectiveness of an 8-week exercise program with elastic bands, on exercise capacity, walking and balance in nursing home residents. A nursing home sample was divided into two groups, intervention group (n=26) and control group (n=25). The intervention group was included in an 8-week physical activity program using elastic bands, twice a week, while the control group was took part in a walking programme. Outcome measurements were descriptive variables (anthropometric characteristics, quality of life, fatigue, fear of movement) and fundamental variables (exercise capacity, walking and balance). A significant improvement in balance and walking speed was observed after the programme. Additionally, exercise capacity improved significantly (P≤.001), and the patients showed an improvement in perceived dyspnea after the physical activity programme in the intervention group. The exercise program was safe and effective in improving dyspnea, exercise capacity, walking, and balance in elderly. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

[Efficacy of nebulizer therapy with acetylcystein in outpatients with chronic obstructive lung disease].

PubMed

Stepanishcheva, L A; Ignatova, G L; Blinova, E V

2005-01-01

Chronic obstructive lung disease (COLD) is a widespread illness with constantly growing mortality. Mucolytic therapy plays a significant role in treatment of patients with COLD. The paper contains the results of nebulization with acetyl-cystein as part of rehabilitation program in outpatients with stable clinical course of I-II stage of COLD. The results demonstrated significant clinical improvement, as well as positive changes in external respiration parameters (1 sforced expiratory volume), increase of physical activity tolerance, and disappearance of acute inflammation phase reactants in saliva.

Telerehabilitation booster sessions and remote patient monitoring in the management of chronic low back pain: A case series.

PubMed

Peterson, Seth

2018-05-01

Improvements in chronic low back pain (CLBP) seen in physical therapy do not appear to be retained over the long term. Booster sessions have been proposed, but barriers exist to their implementation. Telerehabilitation (TR) and remote patient monitoring (RPM) may be ways to circumvent these barriers. The purpose of this case series was to describe the implementation of TR booster sessions and RPM in three patients with CLBP. Three females with CLBP tracked their daily pain level and home exercise program adherence using a mobile phone application for 12 months following discharge from traditional face-to-face physical therapy. Synchronous audio and video TR booster sessions were conducted at months 1, 3, 6, and 12. All patients met their individual goals. They demonstrated excellent home exercise program adherence and self-efficacy. A temporary increase in pain was seen in all patients, but they managed solely with the TR booster sessions and without other healthcare resources. Satisfaction with the program was very high. This case series describes the use of TR booster sessions and RPM in three patients with CLBP. The positive results suggest this approach may be helpful in improving long-term management of patients with CLBP but demand further investigation.

Formal Physical Therapy May Not Be Necessary After Unicompartmental Knee Arthroplasty: A Randomized Clinical Trial.

PubMed

Fillingham, Yale A; Darrith, Brian; Lonner, Jess H; Culvern, Chris; Crizer, Meredith; Della Valle, Craig J

2018-02-21

The purpose of this randomized clinical trial was to compare formal outpatient physical therapy (PT) and unsupervised home exercises after unicompartmental knee arthroplasty (UKA). Fifty-two patients were randomized to 6 weeks of outpatient PT or an unsupervised home exercise program after UKA. The primary outcome was change in range of motion at 6 weeks with secondary outcomes including total arc of motion, Knee Society Score, Knee Injury and Osteoarthritis Outcome Score Jr, Lower Extremity Functional Scale, and Veterans Rands-12 score. Twenty-five patients received outpatient PT, 22 patients the self-directed exercise program, while 3 patients deviated from the protocol, 1 patient withdrew, and 1 patient was lost to follow-up. There was no difference in the change of range of motion (P = .43) or total arc of motion at 6 weeks (P = .17) between the groups and likewise no significant differences were found in any of the secondary outcomes. Two patients who crossed over from the unsupervised home exercise program to formal outpatient PT within the first 2 weeks postoperatively required a manipulation under anesthesia. Our results suggest self-directed exercises may be appropriate for most patients following UKA. However, there is a subset of patients who may benefit from formal PT. Copyright © 2018 Elsevier Inc. All rights reserved.

42 CFR 418.74 - Waiver of requirement-Physical therapy, occupational therapy, speech-language pathology, and...

Code of Federal Regulations, 2010 CFR

2010-10-01

..., occupational therapy, speech-language pathology, and dietary counseling. 418.74 Section 418.74 Public Health... requirement—Physical therapy, occupational therapy, speech-language pathology, and dietary counseling. (a) A... providing physical therapy, occupational therapy, speech-language pathology, and dietary counseling services...

42 CFR 418.74 - Waiver of requirement-Physical therapy, occupational therapy, speech-language pathology, and...

Code of Federal Regulations, 2011 CFR

2011-10-01

..., occupational therapy, speech-language pathology, and dietary counseling. 418.74 Section 418.74 Public Health... requirement—Physical therapy, occupational therapy, speech-language pathology, and dietary counseling. (a) A... providing physical therapy, occupational therapy, speech-language pathology, and dietary counseling services...

Direct access compared with referred physical therapy episodes of care: a systematic review.

PubMed

Ojha, Heidi A; Snyder, Rachel S; Davenport, Todd E

2014-01-01

Evidence suggests that physical therapy through direct access may help decrease costs and improve patient outcomes compared with physical therapy by physician referral. The purpose of this study was to conduct a systematic review of the literature on patients with musculoskeletal injuries and compare health care costs and patient outcomes in episodes of physical therapy by direct access compared with referred physical therapy. Ovid MEDLINE, CINAHL (EBSCO), Web of Science, and PEDro were searched using terms related to physical therapy and direct access. Included articles were hand searched for additional references. Included studies compared data from physical therapy by direct access with physical therapy by physician referral, studying cost, outcomes, or harm. The studies were appraised using the Centre for Evidence-Based Medicine (CEBM) levels of evidence criteria and assigned a methodological score. Of the 1,501 articles that were screened, 8 articles at levels 3 to 4 on the CEBM scale were included. There were statistically significant and clinically meaningful findings across studies that satisfaction and outcomes were superior, and numbers of physical therapy visits, imaging ordered, medications prescribed, and additional non-physical therapy appointments were less in cohorts receiving physical therapy by direct access compared with referred episodes of care. There was no evidence for harm. There is evidence across level 3 and 4 studies (grade B to C CEBM level of recommendation) that physical therapy by direct access compared with referred episodes of care is associated with improved patient outcomes and decreased costs. Primary limitations were lack of group randomization, potential for selection bias, and limited generalizability. Physical therapy by way of direct access may contain health care costs and promote high-quality health care. Third-party payers should consider paying for physical therapy by direct access to decrease health care costs and incentivize optimal patient outcomes.

42 CFR 484.32 - Condition of participation: Therapy services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... and occupational therapy assistant. Services furnished by a qualified physical therapy assistant or qualified occupational therapy assistant may be furnished under the supervision of a qualified physical or occupational therapist. A physical therapy assistant or occupational therapy assistant performs services...

The effects of therapeutic climbing in patients with chronic low back pain: a randomized controlled study.

PubMed

Engbert, Kai; Weber, Michaela

2011-05-15

A randomized controlled study investigated the effects of therapeutic climbing in patients with chronic low back pain. Before and after 4 weeks of training, physical and mental well-being were measured by two questionnaires (36-Item Short Form Health Survey [SF-36]; Hannover Functional Ability Questionnaire for measuring back pain-related disability [FFbH-R]). Therapeutic climbing has been suggested to increase muscular strength and perceived physical and mental well-being. This study focused on the psychological effects of therapeutic climbing and compared it with standard exercise therapy. Therapeutic climbing has become increasingly popular in rehabilitation and its effects on muscular strengthening have been shown. Therapeutic climbing has also been suggested to yield psychological effects such as changes in attentional focus from pain to physical capabilities. To date, no controlled clinical trial has investigated these psychological effects and it is unclear whether therapeutic climbing is comparable or superior to other forms of exercise. Twenty-eight patients with chronic low back pain conducted either a therapeutic climbing or a standard exercise regime. Each program took 4 weeks, including four guided training sessions per week. Before and after the program, patients answered two questionnaires assessing their physical and mental well-being. For the Hannover Functional Ability Questionnaire for measuring back pain-related disability, there was no difference before versus after or between the treatments. For the SF-36, both treatments showed significant improvements in 3/8 subscales of the SF-36. In 2/8 subscales, only the participants of the therapeutic climbing improved and in 1/8 subscales the converse was true. Comparing both groups, significantly larger improvements were found after therapeutic climbing in two subscales of the SF-36: physical functioning and general health perception. The benefits of therapeutic climbing were comparable with those of a standard exercise regime. In two subscales of the SF-36, the benefits of therapeutic climbing exceeded those of standard exercise therapy, primarily in perceived health and physical functioning of the patients. This finding demonstrates that therapeutic climbing is equivalent and partly superior to standard exercise therapy for patients with chronic low back pain.

Early Experience with a Brief, Multimodal, Multidisciplinary Treatment Program for Fibromyalgia

PubMed Central

Vincent, Ann; Whipple, Mary O.; Oh, Terry H.; Guderian, Janet A.; Barton, Debra L.; Luedtke, Connie A.

2014-01-01

Fibromyalgia is a complex, heterogeneous disorder for which a multidisciplinary individualized approach is currently advocated. We executed a 1 week multidisciplinary fibromyalgia clinical program with 7 patients, based on our previous experience with our existing 1.5 day multidisciplinary fibromyalgia program that has demonstrated both short- and long-term benefits. The current expanded program was not designed as a clinical study, but rather as a clinical feasibility assessment and was multidisciplinary in nature, with cognitive behavioral therapy, activity pacing and graded exercise therapy as major components. We assessed changes in individual patients at 1 week and 3 months following the program utilizing validated self-report measures of pain, fatigue, and self-efficacy. All patients indicated at least small improvements in pain and physical symptoms both at 1 week and 3 months and all but one patient showed improvement in self-efficacy at 1 week and 3 months. Similar trends were observed for fatigue. Based on our early clinical experience, we conclude that the 1 week multidisciplinary fibromyalgia program is logistically feasible and has potential for clinical efficacy. Further research is needed and is planned to test the clinical efficacy of this program and compare it with other interventions. PMID:24315246

42 CFR 440.110 - Physical therapy, occupational therapy, and services for individuals with speech, hearing, and...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Physical therapy, occupational therapy, and..., occupational therapy, and services for individuals with speech, hearing, and language disorders. (a) Physical...) Where applicable, licensed by the State. (b) Occupational therapy. (1) Occupational therapy means...

42 CFR 418.72 - Condition of participation: Physical therapy, occupational therapy, and speech-language pathology.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., occupational therapy, and speech-language pathology. 418.72 Section 418.72 Public Health CENTERS FOR MEDICARE...: Physical therapy, occupational therapy, and speech-language pathology. Physical therapy services, occupational therapy services, and speech-language pathology services must be available, and when provided...

42 CFR 418.72 - Condition of participation: Physical therapy, occupational therapy, and speech-language pathology.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., occupational therapy, and speech-language pathology. 418.72 Section 418.72 Public Health CENTERS FOR MEDICARE...: Physical therapy, occupational therapy, and speech-language pathology. Physical therapy services, occupational therapy services, and speech-language pathology services must be available, and when provided...

42 CFR 418.72 - Condition of participation: Physical therapy, occupational therapy, and speech-language pathology.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., occupational therapy, and speech-language pathology. 418.72 Section 418.72 Public Health CENTERS FOR MEDICARE...: Physical therapy, occupational therapy, and speech-language pathology. Physical therapy services, occupational therapy services, and speech-language pathology services must be available, and when provided...

Self care programs and multiple sclerosis: physical therapeutics treatment - literature review.

PubMed

Demaille-Wlodyka, S; Donze, C; Givron, P; Gallien, P

2011-03-01

To clarify the therapeutic education program impact with multiple sclerosis patients, literature review. Highlight contents and efficacy. A non-systematic review on Medline, PubMed and Cochrane library databases from 1966 to 2010 using the following keywords: "multiple sclerosis", "self-care", "self-management" and specific symptoms keywords. Clinical trials and randomized clinical trials, as well as literature reviews published in English, French and German will be analyzed. Counseling is a part of the non-pharmacological management of chronic illnesses such as multiple sclerosis. Symptoms' diversity and the different clinical forms limit standardized programs of self-care management, applicable to patients. In the literature review, counseling programs have often low metrology. A behavior change with patients and medical staff could exist. To empower the patient, to reduce symptoms' impact and to improve treatment access are the aims of educational therapy. Therapeutic education program for multiple sclerosis patients could progress with their standardization and assessment, for each sign. To promote the educational therapy of multiple sclerosis patients, a specific training for medical staff, as specific financing are necessary. 2011 Elsevier Masson SAS. All rights reserved.

INEEL BNCT research program. Annual report, January 1, 1996--December 31, 1996

DOE Office of Scientific and Technical Information (OSTI.GOV)

Venhuizen, J.R.

1997-04-01

This report is a summary of the progress and research produced for the Idaho National Engineering and Environmental Laboratory (INEEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1996. Contributions from the individual investigators about their projects are included, specifically, physics: treatment planning software, real-time neutron beam measurement dosimetry, measurement of the Finnish research reactor epithermal neutron spectrum, BNCT accelerator technology; and chemistry: analysis of biological samples and preparation of {sup 10}B enriched decaborane.

An interprofessional palliative care oncology rehabilitation program: effects on function and predictors of program completion.

PubMed

Chasen, M R; Feldstain, A; Gravelle, D; Macdonald, N; Pereira, J

2013-12-01

After treatment, patients with active cancer face a considerable burden from the effects of both the disease and its treatment. The Palliative Rehabilitation Program (prp) is designed to ameliorate disease effects and to improve the patient's functioning. The present study evaluated predictors of program completion and changes in functioning, symptoms, and well-being after the program. The program received referrals for 173 patients who had finished anticancer therapy. Of those 173 patients, 116 with advanced cancer were eligible and enrolled in the 8-week interprofessional prp; 67 completed it. Measures of physical, nutritional, social, and psychological functioning were evaluated at entry to the program and at completion. Participants experienced significant improvements in physical performance (p < 0.000), nutrition (p = 0.001), symptom severity (p = 0.005 to 0.001), symptom interference with functioning (p = 0.003 to 0.001), fatigue (p = 0.001), and physical endurance, mobility, and balance or function (p = 0.001 to 0.001). Reasons that participants did not complete the prp were disease progression, geographic inaccessibility, being too well (program not challenging enough), death, and personal or unknown reasons. A normal level of C-reactive protein (<10 mg/L, p = 0.029) was a predictor of program completion. Patients living with advanced cancers who underwent the interprofessional prp experienced significant improvement in functioning across several domains. Program completion can be predicted by a normal level of C-reactive protein.

42 CFR 482.56 - Condition of participation: Rehabilitation services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... provides rehabilitation, physical therapy, occupational therapy, audiology, or speech pathology services... to properly supervise and administer the services. (2) Physical therapy, occupational therapy, speech..., physical therapist assistants, occupational therapists, occupational therapy assistants, speech-language...

Effects of an endurance and resistance exercise program on persistent cancer-related fatigue after treatment.

PubMed

Dimeo, F; Schwartz, S; Wesel, N; Voigt, A; Thiel, E

2008-08-01

Fatigue is a relevant problem of cancer patients during and after treatment. Several studies have shown that exercise can improve quality of life and functional status of cancer patients undergoing chemo- or radiotherapy. However, there is a lack of information about the effects of this intervention on persistent cancer-related fatigue. Therefore, we assessed the effects of an exercise program on cancer-related fatigue after treatment. A consecutive series of 32 cancer patients with mild to severe persistent fatigue [scores on the Brief Fatigue Inventory (BFI) > 25] participated in a 3-week exercise program consisting of endurance (30 min walking on a treadmill) and resistance/coordination exercises for the major muscle groups. Fatigue, mood, and anxiety were assessed with questionnaires and physical performance with a stress test before and after the program. At the end of the program, we observed a significant increase of physical performance (workload at the anaerobic threshold pre 61 +/- 26 W, post 78 +/- 31 W, P < 0.0001) and reduction of global fatigue (Functional Assessment of Cancer Therapy: pre 45.7 +/- 13.4, post 52.6 +/- 12.4, P < 0.0001; BFI: pre 37.9 +/- 18.3, post 31.2 +/-17.1, P < 0.001). However, no significant improvement of cognitive fatigue or reduction of anxiety was observed. A 3-week exercise program leads to a substantial improvement of physical performance and reduction of mental and physical fatigue in cancer patients after treatment. However, this intervention does not affect depression, anxiety, or cognitive fatigue.

Can therapy dogs improve pain and satisfaction after total joint arthroplasty? A randomized controlled trial.

PubMed

Harper, Carl M; Dong, Yan; Thornhill, Thomas S; Wright, John; Ready, John; Brick, Gregory W; Dyer, George

2015-01-01

The use of animals to augment traditional medical therapies was reported as early as the 9th century but to our knowledge has not been studied in an orthopaedic patient population. The purpose of this study was to evaluate the role of animal-assisted therapy using therapy dogs in the postoperative recovery of patients after THA and TKA. We asked: (1) Do therapy dogs have an effect on patients' perception of pain after total joint arthroplasty as measured by the VAS? (3) Do therapy dogs have an effect on patients' satisfaction with their hospital stay after total joint arthroplasty as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)? A randomized controlled trial of 72 patients undergoing primary unilateral THA or TKA was conducted. Patients were randomized to a 15-minute visitation with a therapy dog before physical therapy or standard postoperative physical therapy regimens. Both groups had similar demographic characteristics. Reduction in pain was assessed using the VAS after each physical therapy session, beginning on postoperative Day 1 and continuing for three consecutive sessions. To ascertain patient satisfaction, the proportion of patients selecting top-category ratings in each subsection of the HCAHPS was compared. Patients in the treatment group had lower VAS scores after each physical therapy session with a final VAS score difference of 2.4 units (animal-assisted therapy VAS, 1.7; SD, 0.97 [95% CI, 1.4-2.0] versus control VAS, 4.1; SD, 0.97 [95% CI, 3.8-4.4], p<0.001) after the third physical therapy session. Patients in the treatment group had a higher proportion of top-box HCAHPS scores in the following fields: nursing communication (33 of 36, 92% [95% CI, 78%-98%] versus 69%, 25 of 36 [95% CI, 52%-84%], p=0.035; risk ratio, 1.3 [95% CI of risk ratio, 1.0-1.7]; risk difference, 23% [95% CI of risk difference, 5%-40%]), pain management (34 of 36, 94% [95% CI, 81%-99%], versus 26 of 36, 72% [95% CI, 55%-86%], p=0.024; risk ratio, 1.3 [95% CI of risk ratio, 1.1-1.6]; risk difference, 18% [95% CI of risk difference, 5%-39%]). The overall hospital rating also was greater in the treatment group (0-10 scale) (9.6; SD, 0.7 [95% CI, 9.3-9.8] versus 8.6, SD, 0.9 [95% CI, 8.3-8.9], p<0.001). The use of therapy dogs has a positive effect on patients' pain level and satisfaction with hospital stay after total joint replacement. Surgeons are encouraged to inquire about the status of volunteer-based animal-assisted therapy programs in their hospital as this may provide a means to improve the immediate postoperative recovery for a select group of patients having total joint arthroplasty. Level II, randomized controlled study. See Instructions for Authors for a complete description of levels of evidence.

An acceptance-oriented cognitive-behavioral therapy in multimodal rehabilitation: a pre-post test evaluation in highly distressed patients with rheumatic diseases.

PubMed

Vriezekolk, Johanna E; Eijsbouts, Agnes M M; van Lankveld, Wim G J M; Beenackers, Hanneke; Geenen, Rinie; van den Ende, Cornelia H M

2013-06-01

To examine the potential effectiveness of a multimodal rehabilitation program including an acceptance-oriented cognitive-behavioral therapy for highly distressed patients with rheumatic diseases. An observational study employing a one-group pre-post test design (N=25). The primary outcome was psychological distress. Secondary outcomes were quality of life, illness acceptance, and coping flexibility. Group pre-to-post and pre-to-12 months follow-up treatment changes were evaluated by paired-samples t-tests and Cohen's effect sizes (d). Individual changes were evaluated by the reliable change index (RCI) and clinically significant change (CSC) parameters. Significant effects were found post-treatment and maintained at 12 months in psychological distress (d>0.80), illness acceptance (d=1.48) and the SF-36 subscales role physical, vitality, and mental health (d ≥ 0.65). No significant effects were found for coping flexibility and the SF-36 subscales physical functioning, bodily pain, social functioning, and role emotional. Both a reliable (RCI) and clinically significant (CSC) improvement was observed for almost half of the highly distressed patients. The patients enrolled in the multimodal rehabilitation program showed improved psychological health status from pre to post-treatment. A randomized clinical trial is needed to confirm or refute the added value of an acceptance-oriented cognitive-behavioral therapy for highly distressed patients in rehabilitation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

42 CFR 409.23 - Physical therapy, occupational therapy, and speech-language pathology services.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-language pathology services. 409.23 Section 409.23 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... § 409.23 Physical therapy, occupational therapy, and speech-language pathology services. Medicare pays for physical therapy, occupational therapy, or speech-language pathology services as posthospital SNF...

42 CFR 409.23 - Physical therapy, occupational therapy, and speech-language pathology services.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-language pathology services. 409.23 Section 409.23 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... § 409.23 Physical therapy, occupational therapy, and speech-language pathology services. Medicare pays for physical therapy, occupational therapy, or speech-language pathology services as posthospital SNF...

42 CFR 409.23 - Physical therapy, occupational therapy, and speech-language pathology services.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-language pathology services. 409.23 Section 409.23 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... § 409.23 Physical therapy, occupational therapy, and speech-language pathology services. Medicare pays for physical therapy, occupational therapy, or speech-language pathology services as posthospital SNF...

42 CFR 409.23 - Physical therapy, occupational therapy, and speech-language pathology services.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-language pathology services. 409.23 Section 409.23 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... § 409.23 Physical therapy, occupational therapy, and speech-language pathology services. Medicare pays for physical therapy, occupational therapy, or speech-language pathology services as posthospital SNF...

Mobility, strength, and fitness after a graded activity program for patients with subacute low back pain. A randomized prospective clinical study with a behavioral therapy approach.

PubMed

Lindström, I; Ohlund, C; Eek, C; Wallin, L; Peterson, L E; Nachemson, A

1992-06-01

Patients with nonspecific mechanical low back pain (n = 103), examined by an orthopaedic surgeon and a social worker, were randomized to an activity group (n = 51) and a control group (n = 52). Patients with defined orthopaedic, medical, or psychiatric diagnoses were excluded before randomization. No patients were excluded due to place of birth or difficulties in speaking or understanding the Swedish language. The purpose of the study was to compare mobility, strength and fitness after traditional care and after traditional care plus a graded activity program with a behavioral therapy approach. A graded activity program, with a behavioral therapy approach was given under the guidance of a physical therapist. The endpoint of the graded activity program was return to work. This program significantly increased mobility, strength, and fitness more than could be explained by only a time recovery effect, especially in males. The patients in the activity group returned to work earlier than did the patients in the control group. Spinal rotation, abdominal muscle endurance time and lifting capacity were significantly correlated to rate of return to work. Traditional care plus a graded activity program were superior to only traditional care, evaluated in terms of mobility, strength and fitness. The graded activity program proved to be a successful method of restoring occupational function and facilitating return to work in subacute low back pain patients. The patients in the graded activity program learned that it is safe to move, while regaining function.

Effects of horticultural therapy on elderly' health: protocol of a randomized controlled trial.

PubMed

Chan, Hui Yu; Ho, Roger Chun-Man; Mahendran, Rathi; Ng, Kheng Siang; Tam, Wilson Wai-San; Rawtaer, Iris; Tan, Chay Hoon; Larbi, Anis; Feng, Lei; Sia, Angelia; Ng, Maxel Kian-Wee; Gan, Goh Lee; Kua, Ee Heok

2017-08-29

Due to a rapidly ageing population in the world, it is increasingly pertinent to promote successful ageing strategies which are cost-effective, easily accessible, and more likely to be acceptable to the elderly. Past research associates exposure to natural environments and horticultural therapy (HT) with positive psychological, social and physical health benefits. This Randomized Controlled Trial (RCT) is designed to evaluate the efficacy of HT in promoting Asian elderly' mental health, cognitive functioning and physical health. 70 elderly participants aged 60 to 85 years old will be randomized to participate in either the active horticultural therapy group or be in the waitlist control. Sessions will be weekly for 12 weeks, and monthly for 3 months. Mental health will be assessed through self-reports of depressive and anxiety symptomatology, life satisfaction, social connectedness and psychological well-being, collaborated with immunological markers. Outcome measures of cognitive functioning and physical health include neuropsychological tests of cognitive function and basic health screening. Outcomes will be assessed at baseline, 3 months and 6 months post-intervention. This RCT comprehensively investigates the efficacy of a non-invasive intervention, HT, in enhancing mental health, cognitive functioning and physical health. The results have tremendous potential for supporting future successful ageing programs and applicability to larger populations. ClinicalTrials.gov NCT02495194 . Trial registration date: July 13, 2015. Retrospectively registered.

Patterns of Clinical Reasoning in Physical Therapist Students.

PubMed

Gilliland, Sarah; Wainwright, Susan Flannery

2017-05-01

Clinical reasoning is a complex, nonlinear problem-solving process that is influenced by models of practice. The development of physical therapists' clinical reasoning abilities is a crucial yet underresearched aspect of entry-level (professional) physical therapist education. The purpose of this qualitative study was to examine the types of clinical reasoning strategies physical therapist students engage in during a patient encounter. A qualitative descriptive case study design involving within and across case analysis was used. Eight second-year, professional physical therapist students from 2 different programs completed an evaluation and initial intervention for a standardized patient followed by a retrospective think-aloud interview to explicate their reasoning processes. Participants' clinical reasoning strategies were examined using a 2-stage qualitative method of thematic analysis. Participants demonstrated consistent signs of development of physical therapy-specific reasoning processes, yet varied in their approach to the case and use of reflection. Participants who gave greater attention to patient education and empowerment also demonstrated greater use of reflection-in-action during the patient encounter. One negative case illustrates the variability in the rate at which students may develop these abilities. Participants demonstrated development toward physical therapist--specific clinical reasoning, yet demonstrated qualitatively different approaches to the patient encounter. Multiple factors, including the use of reflection-in-action, may enable students to develop greater flexibility in their reasoning processes. © 2017 American Physical Therapy Association

Strength training alone, exercise therapy alone, and exercise therapy with passive manual mobilisation each reduce pain and disability in people with knee osteoarthritis: a systematic review.

PubMed

Jansen, Mariette J; Viechtbauer, Wolfgang; Lenssen, Antoine F; Hendriks, Erik J M; de Bie, Rob A

2011-01-01

What are the effects of strength training alone, exercise therapy alone, and exercise with additional passive manual mobilisation on pain and function in people with knee osteoarthritis compared to control? What are the effects of these interventions relative to each other? A meta-analysis of randomised controlled trials. Adults with osteoarthritis of the knee. INTERVENTION TYPES: Strength training alone, exercise therapy alone (combination of strength training with active range of motion exercises and aerobic activity), or exercise with additional passive manual mobilisation, versus any non-exercise control. Comparisons between the three interventions were also sought. The primary outcome measures were pain and physical function. 12 trials compared one of the interventions against control. The effect size on pain was 0.38 (95% CI 0.23 to 0.54) for strength training, 0.34 (95% CI 0.19 to 0.49) for exercise, and 0.69 (95% CI 0.42 to 0.96) for exercise plus manual mobilisation. Each intervention also improved physical function significantly. No randomised comparisons of the three interventions were identified. However, meta-regression indicated that exercise plus manual mobilisations improved pain significantly more than exercise alone (p = 0.03). The remaining comparisons between the three interventions for pain and physical function were not significant. Exercise therapy plus manual mobilisation showed a moderate effect size on pain compared to the small effect sizes for strength training or exercise therapy alone. To achieve better pain relief in patients with knee osteoarthritis physiotherapists or manual therapists might consider adding manual mobilisation to optimise supervised active exercise programs. Copyright © 2011 Australian Physiotherapy Association. Published by .. All rights reserved.

Safe patient handling perceptions and practices: a survey of acute care physical therapists.

PubMed

Olkowski, Brian F; Stolfi, Angela M

2014-05-01

Acute care physical therapists are at risk for developing work-related musculoskeletal disorders (WMSDs) due to manual patient handling. Safe patient handling (SPH) reduces WMSDs caused by manual handling. The purpose of this study was to describe the patient handling practices of acute care physical therapists and their perceptions regarding SPH. Additionally, this study determined whether an SPH program influences the patient handling practices and perceptions regarding SPH of acute care physical therapists. Subscribers to the electronic discussion board of American Physical Therapy Association's Acute Care Section were invited to complete a survey questionnaire. The majority of respondents used SPH equipment and practices (91.1%), were confident using SPH equipment and practices (93.8%), agreed that evidence supports the use of SPH equipment and practices (87.0%), and reported the use of SPH equipment and practices is feasible (92.2%). Respondents at a facility with an SPH program were more likely to use SPH equipment and practices, have received training in the use of SPH equipment and practices, agree that the use of SPH equipment and practices is feasible, and feel confident using SPH equipment and practices. The study might not reflect the perceptions and practices of the population of acute care physical therapists. Acute care physical therapists are trained to use SPH equipment and practices, use SPH equipment and practices, and have positive perceptions regarding SPH. Acute care physical therapists in a facility with an SPH program are more likely to use SPH equipment and practices, receive training in SPH equipment and practices, and have positive perceptions regarding SPH. Quasi-regulatory organizations should incorporate SPH programs into their evaluative standards.

Development of a Multi-Disciplinary Intervention for the Treatment of Childhood Obesity Based on Cognitive Behavioral Therapy

ERIC Educational Resources Information Center

Bathrellou, Eirini; Yannakoulia, Mary; Papanikolaou, Katerina; Pehlivanidis, Artemios; Pervanidou, Panagiota; Kanaka-Gantenbein, Christina; Tsiantis, John; Chrousos, George P.; Sidossis, Labros S.

2010-01-01

Along the lines of the evidence-based recommendations, we developed a multi-disciplinary intervention for overweight children 7- to 12-years-old, primarily aiming at helping children to adopt healthier eating habits and a physically active lifestyle. The program combined nutrition intervention, based on a non-dieting approach, with physical…

Occupational Therapy and Physical Therapy Guidelines for the Public Schools.

ERIC Educational Resources Information Center

Texas Education Agency, Austin. Div. of Special Education Programs.

This document provides general guidelines to promote consistency of occupational therapy and physical therapy service delivery in the Texas educational system. These guidelines are intended to clarify the roles of occupational therapy and physical therapy as related special education services. The guidelines cover: (1) differences between the…

Dementia wander garden aids post cerebrovascular stroke restorative therapy: a case study.

PubMed

Detweiler, Mark B; Warf, Carlena

2005-01-01

An increasing amount of literature suggests the positive effects of nature in healthcare. The extended life expectancy in the US and the consequent need for long-term care indicates a future need for restorative therapy innovations to reduce the expense associated with long-term care. Moving carefully selected stroke patients' sessions to the peaceful setting of a dementia wander garden, with its designed paths and natural stimuli, may be beneficial. Natural settings have been shown to improve attention and reduce stress--both important therapy objectives in many post-stroke rehabilitation programs. In this case study, using the dementia wander garden for restorative therapy of a non-dementia patient was a novel idea for the restorative therapy group, which does not have a horticultural therapy program. The dementia wander garden stage of the post-stroke rehabilitation helped the patient through a period of treatment resistance. The garden provided both an introduction to the patient's goal of outdoor rehabilitation and a less threatening environment than the long-term care facility hallways. In part because the patient was less self-conscious about manifesting his post-stroke neurological deficits, falling, and being viewed as handicapped when in the dementia wander garden setting, he was able to resume his treatment plan and finish his restorative therapy. In many physical and mental rehabilitation plans, finding a treatment modality that will motivate an individual to participate is a principal goal. Use of a dementia wander garden may help some patients achieve this goal in post-stroke restorative therapy.

Usability and Effects of an Exergame-Based Balance Training Program.

PubMed

Wüest, Seline; Borghese, Nunzio Alberto; Pirovano, Michele; Mainetti, Renato; van de Langenberg, Rolf; de Bruin, Eling D

2014-04-01

Background: Post-stroke recovery benefits from structured, intense, challenging, and repetitive therapy. Exergames have emerged as promising to achieve sustained therapy practice and patient motivation. This study assessed the usability and effects of exergames on balance and gait. Subjects and Methods: Sixteen elderly participants were provided with the study intervention based on five newly developed exergames. The participants were required to attend 36 training sessions; lasting for 20 minutes each. Adherence, attrition and acceptance were assessed together with (1) Berg Balance Scale, (2) 7-m Timed Up and Go, (3) Short Physical Performance Battery, (4) force platform stance tests, and (5) gait analysis. Results: Thirteen participants completed the study (18.8 percent attrition), without missing a single training session (100 percent adherence). Participants showed high acceptance of the intervention. Only minor adaptations in the program were needed based on the users' feedback. No changes in center of pressure area during quiet stance on both stable and unstable surfaces and no changes of walking parameters were detected. Scores for the Berg Balance Scale ( P =0.007; r =0.51), the 7-m Timed Up and Go ( P =0.002; r =0.56), and the Short Physical Performance Battery ( P =0.013; r =0.48) increased significantly with moderate to large effect sizes. Conclusion: Participants evaluated the usability of the virtual reality training intervention positively. Results indicate that the intervention improves gait- and balance-related physical performance measures in untrained elderly. The present results warrant a clinical explorative study investigating the usability and effectiveness of the exergame-based program in stroke patients.

Personal resurrection: female childhood sexual abuse survivors' experience of the Wellness-Program.

PubMed

Sigurdardottir, Sigrun; Halldorsdottir, Sigridur; Bender, Soley S; Agnarsdottir, Guðrun

2016-03-01

Childhood sexual abuse (CSA) survivors deal with complex mental, physical and relationship problems in adulthood which negatively affects their well-being and health. The aim of the present paper was to present a description of the Wellness-Program for female CSA survivors, the participating women's evaluation of the different therapies in the program as well as a qualitative study on their experience of the program's effects on their life, health and well-being. The Wellness-Program lasted for 10 weeks with organised schedule 20 hours per week. A team of health professionals used a holistic approach and provided traditional and complementary individual and group therapy focusing on both mind and body. In-depth phenomenological interviews with ten women, 22-53 years old, were conducted 1 week before and 1 week after the program as well as 15 months later. Data collection and data analysis were guided by the Vancouver School of doing phenomenology. Prior to participating in the program, the women were unable to work or attend school, were on disability allowance, were socially isolated and had complex health problems. After the Wellness-Program, all the women, except one, were back to work, school or in further rehabilitation. Furthermore, the in-depth interviews showed that their health and well-being, personal life and relationship with partners, family and friends improved. They felt empowered, more in control and had developed increased trust towards others. Six themes were constructed from the in-depth interviews. They were: feeling totally lost, releasing experiences, developing trusting relationships, gaining control, experiencing positive changes in physical and mental health and, finally, feeling of empowerment. The overriding theme of the study was personal resurrection. The Wellness-Program contributed considerably to improved health and well-being of the women. However, further assessment of the program is recommended before making it available within the healthcare system. © 2015 Nordic College of Caring Science.

Design of an instrument to measure the quality of care in Physical Therapy.

PubMed

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; Prado, Cristiane do; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care.

The effectiveness of transcutaneous electrical nerve stimulation in the management of patients with complex regional pain syndrome: A randomized, double-blinded, placebo-controlled prospective study.

PubMed

Bilgili, Adem; Çakır, Tuncay; Doğan, Şebnem Koldaş; Erçalık, Tülay; Filiz, Meral Bilgilisoy; Toraman, Füsun

2016-11-21

To investigate the effect of transcutaneous electrical nerve stimulation (TENS) on clinical recovery in the management of patients with complex regional pain syndrome Type I (CRPS Type I). The study included 30 patients with stage 1 and 2 CRPS Type I in the upper extremities. The patients were randomly assigned into 2 groups, group 1 (n= 15) received conventional TENS therapy for 20 minutes, and group 2 (n= 15) received sham TENS therapy. The standard physical therapy program, which included contrast bath for 20 minutes; whirlpool bath for 15 minutes; assisted active and passive range of motion, and static stretching exercises up to the pain threshold, was also conducted in both groups. Therapy was scheduled for 15 sessions. A visual analogue scale (VAS) was used to assess spontaneous pain. The Leeds Assessment of Neuropathic Signs and Symptoms (LANSS) scale and the Douleur Neuropathique en 4 Questions (DN-4) were used to assess neuropathic pain. In addition, range of motion (ROM) was measured using a goniometer and volumetric measurements were taken to assess edema. Functional capacity was assessed using a hand dynamometer and the Duruöz Hand Index (DHI). All measurements were performed at baseline and after therapy. Significant improvements were achieved in spontaneous and neuropathic pain scores, edema, ROM, and functional capacity in both groups (p< 0.05). However, improvement was found to be significantly greater in group 1 regarding pain intensity, neuropathic pain assessed using LANNS, edema, and in the 2nd-3rd finger ROM measurements (p< 0.05). No significant difference was detected between groups regarding improvements in 4th-5th finger and wrist ROM measurements, grip strength, and DN4 and DHI scores (p> 0.05). The addition of TENS to the physical therapy program was seen to make a significant contribution to clinical recovery in CRPS Type 1.

FAST INdiCATE Trial protocol. Clinical efficacy of functional strength training for upper limb motor recovery early after stroke: neural correlates and prognostic indicators.

PubMed

Pomeroy, Valerie M; Ward, Nick S; Johansen-Berg, Heidi; van Vliet, Paulette; Burridge, Jane; Hunter, Susan M; Lemon, Roger N; Rothwell, John; Weir, Christopher J; Wing, Alan; Walker, Andrew A; Kennedy, Niamh; Barton, Garry; Greenwood, Richard J; McConnachie, Alex

2014-02-01

Functional strength training in addition to conventional physical therapy could enhance upper limb recovery early after stroke more than movement performance therapy plus conventional physical therapy. To determine (a) the relative clinical efficacy of conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy for upper limb recovery; (b) the neural correlates of response to conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy; (c) whether any one or combination of baseline measures predict motor improvement in response to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Randomized, controlled, observer-blind trial. The sample will consist of 288 participants with upper limb paresis resulting from a stroke that occurred within the previous 60 days. All will be allocated to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Functional strength training and movement performance therapy will be undertaken for up to 1·5 h/day, five-days/week for six-weeks. Measurements will be undertaken before randomization, six-weeks thereafter, and six-months after stroke. Primary efficacy outcome will be the Action Research Arm Test. Explanatory measurements will include voxel-wise estimates of brain activity during hand movement, brain white matter integrity (fractional anisotropy), and brain-muscle connectivity (e.g. latency of motor evoked potentials). The primary clinical efficacy analysis will compare treatment groups using a multilevel normal linear model adjusting for stratification variables and for which therapist administered the treatment. Effect of conventional physical therapy combined with functional strength training versus conventional physical therapy combined with movement performance therapy will be summarized using the adjusted mean difference and 95% confidence interval. To identify the neural correlates of improvement in both groups, we will investigate associations between change from baseline in clinical outcomes and each explanatory measure. To identify baseline measurements that independently predict motor improvement, we will develop a multiple regression model. © 2013 The Authors. International Journal of Stroke published by John Wiley & Sons Ltd on behalf of World Stroke Organization.

Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Anterior Cruciate Ligament Reconstruction.

PubMed

Makhni, Eric C; Crump, Erica K; Steinhaus, Michael E; Verma, Nikhil N; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

2016-08-01

To assess the quality and variability found across anterior cruciate ligament (ACL) rehabilitation protocols published online by academic orthopaedic programs. Web-based ACL physical therapy protocols from United States academic orthopaedic programs available online were included for review. Main exclusion criteria included concomitant meniscus repair, protocols aimed at pediatric patients, and failure to provide time points for the commencement or recommended completion of any protocol components. A comprehensive, custom scoring rubric was created that was used to assess each protocol for the presence or absence of various rehabilitation components, as well as when those activities were allowed to be initiated in each protocol. Forty-two protocols were included for review from 155 U.S. academic orthopaedic programs. Only 13 protocols (31%) recommended a prehabilitation program. Five protocols (12%) recommended continuous passive motion postoperatively. Eleven protocols (26%) recommended routine partial or non-weight bearing immediately postoperatively. Ten protocols (24%) mentioned utilization of a secondary/functional brace. There was considerable variation in range of desired full-weight-bearing initiation (9 weeks), as well as in the types of strength and proprioception exercises specifically recommended. Only 8 different protocols (19%) recommended return to sport after achieving certain strength and activity criteria. Many ACL rehabilitation protocols recommend treatment modalities not supported by current reports. Moreover, high variability in the composition and time ranges of rehabilitation components may lead to confusion among patients and therapists. Level II. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Physical Therapy and Occupational Therapy: Suggested Readings [and] Physical Therapy: Supply/Demand--Some Facts [and] Occupational Therapy: Supply and Demand--Some Facts. Information on Personnel Supply and Demand.

ERIC Educational Resources Information Center

National Clearinghouse for Professions in Special Education, Reston, VA.

Brought together are two fact sheets on the supply of and demand for physical therapists and occupational therapists. The fact sheets cite statistical data from the National Easter Seal Society, the American Physical Therapy Association, and the American Occupational Therapy Association. The cited facts focus on the need to recruit and retain…

Motor Retraining (MoRe) for Functional Movement Disorders: Outcomes From a 1-Week Multidisciplinary Rehabilitation Program.

PubMed

Jacob, Alexandra; Kaelin, Darryl; Roach, Abbey; Ziegler, Craig; LaFaver, Kathrin

2018-05-18

Functional movement disorders (FMDs) are conditions of abnormal motor control thought to be caused by psychological factors. These disorders are commonly seen in neurologic practice, and prognosis is often poor. No consensus treatment guidelines have been established; however, the role of physical therapy in addition to psychotherapy has increasingly been recognized. This study reports patient outcomes from a multidisciplinary FMD treatment program using motor retraining (MoRe) strategies. To assess outcomes of FMD patients undergoing a multidisciplinary treatment program and determine factors predictive of treatment success. Retrospective chart review. University-affiliated rehabilitation institute. Thirty-two consecutive FMD patients admitted to the MoRe program from July 2014-July 2016. Patients participated in a 1-week, multidisciplinary inpatient treatment program with daily physical, occupational, speech therapy, and psychotherapy interventions. Primary outcome measures were changes in the patient-rated Clinical Global Impression Scale (CGI) and the physician-rated Psychogenic Movement Disorder Rating Scale (PMDRS) based on review of standardized patient videos. Measurements were taken as part of the clinical evaluation of the program. Twenty-four of the 32 patients were female with a mean age of 49.1 (±14.2) years and mean symptom duration of 7.4 (±10.8) years. Most common movement phenomenologies were abnormal gait (31.2%), hyperkinetic movements (31.2%), and dystonia (31.2%). At discharge, 86.7% of patients reported symptom improvement on the CGI, and self-reported improvement was maintained in 69.2% at the 6-month follow-up. PMDRS scores improved by 59.1% from baseline to discharge. Longer duration of symptoms, history of abuse, and comorbid psychiatric disorders were not significant predictors of treatment outcomes. The majority of FMD patients experienced improvement from a 1-week multidisciplinary inpatient rehabilitation program. Treatment outcomes were not negatively correlated with longer disease duration or psychiatric comorbidities. The results from our study are encouraging, although further long-term prospective randomized studies are needed. Level III. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Development of a residency program in radiation oncology physics: an inverse planning approach

PubMed Central

Dunscombe, Peter B.

2016-01-01

Over the last two decades, there has been a concerted effort in North America to organize medical physicists’ clinical training programs along more structured and formal lines. This effort has been prompted by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP) which has now accredited about 90 residency programs. Initially the accreditation focused on standardized and higher quality clinical physics training; the development of rounded professionals who can function at a high level in a multidisciplinary environment was recognized as a priority of a radiation oncology physics residency only lately. In this report, we identify and discuss the implementation of, and the essential components of, a radiation oncology physics residency designed to produce knowledgeable and effective clinical physicists for today's safety‐conscious and collaborative work environment. Our approach is that of inverse planning, by now familiar to all radiation oncology physicists, in which objectives and constraints are identified prior to the design of the program. Our inverse planning objectives not only include those associated with traditional residencies (i.e., clinical physics knowledge and critical clinical skills), but also encompass those other attributes essential for success in a modern radiation therapy clinic. These attributes include formal training in management skills and leadership, teaching and communication skills, and knowledge of error management techniques and patient safety. The constraints in our optimization exercise are associated with the limited duration of a residency and the training resources available. Without compromising the knowledge and skills needed for clinical tasks, we have successfully applied the model to the University of Calgary's two‐year residency program. The program requires 3840 hours of overall commitment from the trainee, of which 7%–10% is spent in obtaining formal training in nontechnical “soft skills”. PACS number(s): 01.40 Di, 01.40.gb, 87.10‐e PMID:27074469

Benefits of Comprehensive Rehabilitation Therapy in Thymectomy for Myasthenia Gravis: A Propensity Score Matching Analysis.

PubMed

Ambrogi, Vincenzo; Mineo, Tommaso Claudio

2017-02-01

To demonstrate the effectiveness of a comprehensive program of rehabilitation therapy in patients undergoing thymectomy for myasthenia gravis (MG). From 2005 to 2010, 46 consecutive patients affected by MG underwent a rehabilitation program both before and after thymectomy. We matched each patient with a "control patient" who underwent thymectomy within the period 1999 to 2004 with no preoperative rehabilitation, who had the closest propensity score matching. All patients but 2 were able to complete the intended program. Eighteen patients (41%) experienced mild fatigue (>25 at MG quantitative score). Propensity score selected a group of 17 patients for the matching process. The group of patients who underwent the rehabilitation program showed significant preoperative improvement associated with a reduced operative risk, a decreased early postoperative morbidity, a lower rate of postoperative intensive care unit needed (12% vs 35%; P = 0.01) and a shorter hospital stay (3 vs 5 days; P = 0.04). After the expected perioperative decline, all major myasthenic outcomes demonstrated a significant faster recovery at 3 months. Complete stable remission did not reveal significant differences. Exercise is not necessarily a contraindication in MG, and rehabilitation can be safely performed before and after thymectomy, reducing operative risks and decreasing recovery time. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCMECME OBJECTIVES: Upon completion of this article, the reader should be able to do the following: (1) appreciate the benefits of physical therapy in individuals with myasthenia gravis; (2) describe the benefits of physical therapy on postoperative morbidity in myasthenia gravis patients who undergo thymectomy; and (3) incorporate appropriate rehabilitation into the treatment plan of patient with myasthenia gravis. AdvancedACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Two Different Types of High-Frequency Physical Therapy Promote Improvements in the Balance and Mobility of Persons With Multiple Sclerosis.

PubMed

Davies, Brenda L; Arpin, David J; Liu, Min; Reelfs, Heidi; Volkman, Kathleen G; Healey, Kathleen; Zabad, Rana; Kurz, Max J

2016-12-01

To evaluate the mobility and postural balance improvements that could be achieved in a cohort of persons with multiple sclerosis (MS) who participated in a motor adaptation protocol and a cohort of persons with MS who participated in a therapeutic exercise protocol. A cohort design, where subjects were evaluated before and after a 6-week intervention period. Clinical laboratory setting. Individuals (N=42) with relapsing-remitting or secondary progressive MS (Expanded Disability Status Scale [EDSS] scores, 3.0-6.5) were initially screened for eligibility for participation in the study, from which those who fit the inclusion criteria (n=32) were enrolled in the study. Subjects were pseudorandomly assigned to a treatment group and matched based on EDSS scores. Fourteen individuals in the motor adaptation cohort (MAC) (mean age ± SD, 52.6±9y; mean EDSS score ± SD, 5.5±0.9) and 13 individuals in the therapeutic exercise cohort (TEC) (mean age ± SD, 54.0±9y; mean EDSS score ± SD, 5.3±0.9) completed the entire duration of their respective programs. Both cohorts completed their therapy twice a day, 5 days each week, for 6 weeks. Each session of the MAC program consisted of balance and gait training that encouraged new ways to adapt to challenging task demands. The TEC program was similar to a traditional exercise program. The Sensory Organization Test, 6-minute walk test, and gait spatiotemporal kinematics. Collectively, both treatment groups had improvements in postural balance (P=.001), walking endurance (P=.002), walking speed (P=.004), and step length (P<.001) after therapy. However, there were no statistical differences between the 2 treatment groups for any of the outcome variables (P values >.01). Our exploratory results suggest that a high frequency of physical therapy rather than a specific activity focus might be an important parameter for persons with MS. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Influence of learning style on instructional multimedia effects on graduate student cognitive and psychomotor performance.

PubMed

Smith, A Russell; Cavanaugh, Catherine; Jones, Joyce; Venn, John; Wilson, William

2006-01-01

Learning outcomes may improve in graduate healthcare students when attention is given to individual learning styles. Interactive multimedia is one tool shown to increase success in meeting the needs of diverse learners. The purpose of this study was to examine the effect of learning style and type of instruction on physical therapy students' cognitive and psychomotor performance. Participants were obtained by a sample of convenience with students recruited from two physical therapy programs. Twenty-seven students volunteered to participate from Program 1. Twenty-three students volunteered to participate from Program 2. Gregorc learning styles were identified through completion of the Gregorc Style Delineator. Students were randomly assigned to one of two instructional strategies: 1) instructional CD or 2) live demonstration. Differences in cognitive or psychomotor performance following instructional multimedia based on learning style were not demonstrated in this study. Written examination scores improved with both instructional strategies demonstrating no differences between the strategies. Practical examination ankle scores were significantly higher in participants receiving CD instruction than in participants receiving live presentation. Learning style did not significantly affect this improvement. Program 2 performed significantly better on written knee and practical knee and ankle examinations. Learning style had no significant effect on student performance following instruction in clinical skills via interactive multimedia. Future research may include additional measurement instruments assessing other models of learning styles and possible interaction of learning style and instructional strategy on students over longer periods of time, such as a semester or an entire curriculum.

A journey into medical physics as viewed by a physicist

NASA Astrophysics Data System (ADS)

Gueye, Paul

2007-03-01

The world of physics is usually linked to a large variety of subjects spanning from astrophysics, nuclear/high energy physics, materials and optical sciences, plasma physics etc. Lesser is known about the exciting world of medical physics that includes radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. These physicists are typically based in hospital departments of radiation oncology or radiology, and provide technical support for patient diagnosis and treatment in a clinical environment. This talk will focus on providing a bridge between selected areas of physics and their medical applications. The journey will first start from our understanding of high energy beam production and transport beamlines for external beam treatment of diseases (e.g., electron, gamma, X-ray and proton machines) as they relate to accelerator physics. We will then embrace the world of nuclear/high energy physics where detectors development provide a unique tool for understanding low energy beam distribution emitted from radioactive sources used in Brachytherapy treatment modality. Because the ultimate goal of radiation based therapy is its killing power on tumor cells, the next topic will be microdosimetry where responses of biological systems can be studied via electromagnetic systems. Finally, the impact on the imaging world will be embraced using tools heavily used in plasma physics, fluid mechanics and Monte Carlo simulations. These various scientific areas provide unique opportunities for faculty and students at universities, as well as for staff from research centers and laboratories to contribute in this field. We will conclude with the educational training related to medical physics programs.

Comparison of physical therapy anatomy performance and anxiety scores in timed and untimed practical tests.

PubMed

Schwartz, Sarah M; Evans, Cathy; Agur, Anne M R

2015-01-01

Students in health care professional programs face many stressful tests that determine successful completion of their program. Test anxiety during these high stakes examinations can affect working memory and lead to poor outcomes. Methods of decreasing test anxiety include lengthening the time available to complete examinations or evaluating students using untimed examinations. There is currently no consensus in the literature regarding whether untimed examinations provide a benefit to test performance in clinical anatomy. This study aimed to determine the impact of timed versus untimed practical tests on Master of Physical Therapy student anatomy performance and test anxiety. Test anxiety was measured using the State-Trait Anxiety Inventory (STAI). Differences in performance, anxiety scores, and time taken were compared using paired sample Student's t-tests. Eighty-one of the 84 students completed the study and provided feedback. Students performed significantly higher on the untimed test (P = 0.005), with a significant reduction in test anxiety (P < 0.001). Students who were unsuccessful on the timed test showed the greatest improvement on the untimed test ( x¯ = 20.4 ±10%). Eighty-three percent (n = 69) of students preferred the untimed test, 8.4% (n = 7) the timed test, and 8.4% (n = 7) had no preference. Students took on average eight minutes longer on the untimed test. This study found that physical therapy students perform better on untimed tests, which may be related to a reduction in test anxiety. If the intended goal of evaluating health care professional students is to determine fundamental competencies, these factors should be considered when designing future curricula. © 2014 American Association of Anatomists.

Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial

PubMed Central

2010-01-01

Background This randomised, single-blind controlled pilot trial aimed to determine the effectiveness of a physiotherapy program, including exercise and manual therapy, in reducing impairments and improving physical function and health-related quality of life in people with a history of painful osteoporotic vertebral fracture. Methods 20 participants were randomly allocated to an intervention (n = 11) or control (n = 9) group. The intervention group attended individual sessions with an experienced clinician once a week for 10 weeks and performed daily home exercises with adherence monitored by a self-report diary. The control group received no treatment. Blinded assessment was conducted at baseline and 11 weeks. Questionnaires assessed self-reported changes in back pain, physical function, and health-related quality of life. Objective measures of thoracic kyphosis, back and shoulder muscle endurance (Timed Loaded Standing Test), and function (Timed Up and Go test) were also taken. Results Compared with the control group, the intervention group showed significant reductions in pain during movement (mean difference (95% CI) -1.8 (-3.5 to -0.1)) and at rest (-2.0 (-3.8 to -0.2)) and significantly greater improvements in Qualeffo physical function (-4.8 (-9.2 to -0.5)) and the Timed Loaded Standing test (46.7 (16.1 to 77.3) secs). For the perceived change in back pain over the 10 weeks, 9/11 (82%) participants in the intervention group rated their pain as 'much better' compared with only 1/9 (11%) participants in the control group. Conclusion Despite the modest sample size, these results support the benefits of exercise and manual therapy in the clinical management of patients with osteoporotic vertebral fractures, but need to be confirmed in a larger sample. Trail registration NCT00638768 PMID:20163739

Clinical experience using a 5-week treadmill training program with virtual reality to enhance gait in an ambulatory physical therapy service.

PubMed

Shema, Shirley Roth; Brozgol, Marina; Dorfman, Moran; Maidan, Inbal; Sharaby-Yeshayahu, Lior; Malik-Kozuch, Hila; Wachsler Yannai, Orly; Giladi, Nir; Hausdorff, Jeffrey M; Mirelman, Anat

2014-09-01

Current literature views safe gait as a complex task, relying on motor and cognitive resources. The use of virtual reality (VR) in gait training offers a multifactorial approach, showing positive effects on mobility, balance, and fall risk in elderly people and individuals with neurological disorders. This form of training has been described as a viable research tool; however, it has not been applied routinely in clinical practice. Recently, VR was used to develop an adjunct training method for use by physical therapists in an ambulatory clinical setting. The aim of this article is to describe the initial clinical experience of applying a 5-week VR clinical service to improve gait and mobility in people with a history of falls, poor mobility, or postural instability. A retrospective data analysis was conducted. The clinical records of the first 60 patients who completed the VR gait training program were examined. Training was provided 3 times per week for 5 weeks, with each session lasting approximately 1 hour and consisting of walking on a treadmill while negotiating virtual obstacles. Main outcome measures were compared across time and included the Timed "Up & Go" Test (TUG), the Two-Minute Walk Test (2MWT), and the Four Square Step Test (FSST). After 5 weeks of training, time to complete the TUG decreased by 10.3%, the distance walked during the 2MWT increased by 9.5%, and performance on the FSST improved by 13%. Limitations of the study include the use of a retrospective analysis with no control group and the lack of objective cognitive assessment. Treadmill training with VR appears to be an effective and practical tool that can be applied in an outpatient physical therapy clinic. This training apparently leads to improvements in gait, mobility, and postural control. It, perhaps, also may augment cognitive and functional aspects. © 2014 American Physical Therapy Association.

Blended care; development of a day treatment program for medically unexplained physical symptoms (MUPS) in the Dutch Armed Forces.

PubMed

Zeylemaker, M M P; Linn, F H H; Vermetten, E

2015-01-01

A subgroup of servicemen can be identified that seek a disproportionally amount of health care in comparison to diagnostic and therapeutic perspectives. This group can be identified on the basis of an absence of a structural medical explanation for their symptoms. The symptoms manifest predominantly as fatigue and pain, and are often chronic. Patients with medical unexplained medical symptoms (MUPS) often have multiple and complex problems that would be best treated by a multidisciplinary team of medical specialists and paramedics. The military is characterized by high loyalty towards peers and leadership, leading to neglect for personal care. While consensus on the biological basis for these complaints is lacking, awareness on the need for effective treatments for this patient group is high. Based on reviews, expert recommendations and clinical demand, a specialized treatment program for soldiers with MUPS has recently been developed and implemented in the system of health care in the Netherlands Armed Forces. We developed a functional rehabilitation program with blended care elements of cognitive behavioral therapy (CBT), physical therapy, case management, and psychoeducation, embedded in a day treatment setting. The program received high scores on participant as well as team satisfaction. The program is illustrated by two clinical vignettes. The blended care program for MUPS that focused on allostatic load awareness offered a more holistic and preventive approach that contributed to a reduction of unnecessary medical consumption, and increased job participation. We recommend that the development of guidelines for diagnoses and treatment of these complaints in military settings will improve the quality of patient care, reduce disability, facilitate reintegration, and encourage scientific research.

42 CFR 410.60 - Outpatient physical therapy services: Conditions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...

42 CFR 410.60 - Outpatient physical therapy services: Conditions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...

42 CFR 410.60 - Outpatient physical therapy services: Conditions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...

42 CFR 410.60 - Outpatient physical therapy services: Conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...

42 CFR 410.60 - Outpatient physical therapy services: Conditions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only if...

Educating Physical Therapist Students in Tobacco Cessation Counseling: Feasibility and Preliminary Outcomes.

PubMed

Pignataro, Rose M; Gurka, Matthew; Jones, Dina L; Kershner, Ruth E; Ohtake, Patricia J; Stauber, William; Swisher, Anne K

2015-09-01

Smoking is the leading preventable cause of chronic disease and premature morbidity. People with physical disabilities experience elevated smoking prevalence when compared with their non-disabled peers. The physical therapy profession is dedicated to meeting needs of people with physical disabilities, yet most physical therapists (PT) do not typically provide tobacco cessation interventions. Similar deficits exist among other health professions, creating a demand for improved services to address smoking-related health burdens. Within other health professions, insufficient tobacco cessation counseling (TCC) education has been linked to a lack of interventions and may account for similar deficits in physical therapy practice. Goals were to assess feasibility, implementation, and results of a tailored TCC educational program for entry-level physical therapist (PT) students. Two cohorts of entry-level physical therapist (PT) students (n = 12 and n = 17). Educational objectives were established based on prior review of the literature, a survey of national PT education programs, and clinical guidelines for TCC established by the United States Public Health Service (USPHS). Based on these objectives, the team designed a 3-hour workshop involving didactic content and problem-based skills practice. A pre- and post-test survey was used to measure 6 dimensions: knowledge, perceived barriers, perceived facilitators, self-efficacy, outcome expectations, and self-rated skill in TCC. Within each cohort, changes in score were compared using a paired t test. The ability to apply clinical guidelines for TCC was assessed using case scenarios and structured observation. These outcomes were selected based on the Theory of Reasoned Action, which states that future behavior is determined by intention to act. Intention to act is a product of knowledge, a positive balance between perceived barriers and facilitators, strong self-efficacy, favorable outcome expectations, and necessary skills. Student satisfaction with training was assessed through anonymous written feedback. Feasibility was based on cost analysis, including material resources, as well as faculty time and effort. Following participation, both cohorts improved in knowledge, perceived facilitators, outcome expectations, and self-rated skill. Cohort 2 also showed an increase in self-efficacy ( P < .01). Structured observation revealed competencies in application of clinical guidelines for case-based scenarios. Mean student satisfaction ratings for the educational experience were 5/5, and cost-estimate for delivery of the 3-hour educational intervention was approximately $32 per student. This research study demonstrated feasibility and impact of an evidence-based curricular model designed to increase likelihood of TCC by future PTs by enhancing factors known to promote TCC behaviors. The program was well-received by students, and objectives were achieved through efficient use of faculty time and resources. Subsequent research should examine the effects of training on the provision of TCC within clinical settings, as well as the impact of TCC on smoking quit rates for patients who have received this intervention as a component of their physical therapy plan of care.

Patient-Reported Outcomes Associated With Use of Physical Therapist Services by Older Adults With a New Visit for Back Pain

PubMed Central

Sherman, Karen J.; Heagerty, Patrick J.; Mock, Charles; Jarvik, Jeffrey G.

2015-01-01

Background Among older adults, it is not clear how different types or amounts of physical therapy may be associated with improvements in back pain and function. Objective The study objective was to investigate the association between types or amounts of physical therapist services and 1-year outcomes among older adults with back pain. Design This was a prospective cohort study. Methods A total of 3,771 older adults who were enrolled in a cohort study and who had a new primary care visit for back pain participated. Physical therapy use was ascertained from electronic health records. The following patient-reported outcomes were collected over 12 months: back-related disability (Roland-Morris Disability Questionnaire) and back and leg pain intensity (11-point numerical rating scale). Marginal structural models were used to estimate average effects of different amounts of physical therapy use on disability and pain for all types of physical therapy and for active, passive, and manual physical therapy. Results A total of 1,285 participants (34.1%) received some physical therapy. There was no statistically significant gradient in relationships between physical therapy use and back-related disability score. The use of passive or manual therapy was not consistently associated with pain outcomes. Higher amounts of active physical therapy were associated with decreased back and leg pain and increased odds of clinically meaningful improvements in back and leg pain relative to results obtained with no active physical therapy. Limitations The fact that few participants had high amounts of physical therapy use limited precision and the ability to test for nonlinear relationships for the amount of use. Conclusions Higher amounts of active physical therapy were most consistently related to the greatest improvements in pain intensity; however, as with all observational studies, the results must be interpreted with caution. PMID:25278334

Effectiveness of a Blended Physical Therapist Intervention in People With Hip Osteoarthritis, Knee Osteoarthritis, or Both: A Cluster-Randomized Controlled Trial.

PubMed

Kloek, Corelien J J; Bossen, Daniël; Spreeuwenberg, Peter M; Dekker, Joost; de Bakker, Dinny H; Veenhof, Cindy

2018-05-17

Integrating physical therapy sessions and an online application (e-Exercise) might support people with hip osteoarthritis (OA), knee OA, or both (hip/knee OA) in taking an active role in the management of their chronic condition and may reduce the number of physical therapy sessions. The objective of this study was to investigate the short- and long-term effectiveness of e-Exercise compared to usual physical therapy in people with hip/knee OA. The design was a prospective, single-blind, multicenter, superiority, cluster- randomized controlled trial. The setting included 143 primary care physical therapist practices. The participants were 208 people with hip/knee OA and were 40 to 80 years of age. e-Exercise is a 3-month intervention in which about 5 face-to-face physical therapy sessions were integrated with an online application consisting of graded activity, exercise, and information modules. Usual physical therapy was conducted according to the Dutch physical therapy guidelines on hip and knee osteoarthritis. Primary outcomes, measured at baseline after 3 and 12 months, were physical functioning and free-living physical activity. Secondary outcome measures were pain, tiredness, quality of life, self-efficacy, and the number of physical therapy sessions. The e-Exercise group (N = 109) received, on average, 5 face-to-face sessions; the usual physical therapy group (N = 99) received 12. No significant differences in primary outcomes between the e-Exercise group and the usual physical therapy group were found. Within-group analyses for both groups showed a significant improvement in physical functioning. After 3 months, participants in the e-Exercise group reported an increase in physical activity; however, no objectively measured differences in physical activity were found. With respect to secondary outcomes, after 12 months, sedentary behavior significantly increased in the e-Exercise group compared with the usual physical therapy group. In both groups, there were significant improvements for pain, tiredness, quality of life, and self-efficacy. The response rate at 12 months was 65%. The blended intervention e-Exercise was not more effective than usual physical therapy in people with hip/knee osteoarthritis.

Financing physical therapy doctoral education: methods used by entry-level students and the financial impact after graduation.

PubMed

Thompson, Kris; Coon, Jill; Handford, Leandrea

2011-01-01

With the move to the doctor of physical therapy (DPT) degree and increasing tuition costs, there is concern about financing entry-level education. The purposes of this study were to identify how students finance their DPT education and to describe the financial impact after graduation. A written survey was used to collect data on financing DPT education, student debt, and the financial impact on graduates. There were 92 subjects who had graduated from one program. Frequencies as well as nonparametric statistics using cross-tabulations and chi-squared statistics were calculated. The response rate was 55%. Of the respondents, 86% had student loans, 66% worked during school, 57% received some family assistance, and 21% had some scholarship support. The amount of monthly loan repayment was not statistically related to the ability to save for a house, the ability to obtain a loan for a house or car, or the decision to have children. Saving for the future (p = 0.016) and lifestyle choices (p = 0.035) were related to the amount of monthly loan repayment. Major sources of funding were student loans, employment income, and/or family assistance. Respondent's ability to save for the future and lifestyle choices were negatively impacted when loan debt increased. Physical therapist education programs should consider offering debt planning and counseling.

POSTACTIVATION POTENTIATION: AN INTRODUCTION

PubMed Central

2011-01-01

Improving strength and power in the athlete who is being rehabilitated is a central focus of the sports physical therapist, particularly in the terminal phases of rehabilitation where the emphasis shifts to readiness to return to sport and sports performance enhancement. High load strength training and power training through plyometric exercises are two key components of performance enhancement programs. A current concept in the strength and conditioning literature that is relatively unknown in sports physical therapy is postactivation potentiation (PAP). Even though we have limited data and there may be limited application of the concept of PAP for the sports physical therapist, awareness of this phenomenon is important nonetheless. The purpose of this clinical commentary is to introduce the sports physical therapist to the concept of PAP. PMID:21904700

Medical Physics Education at the University of Novi Sad - Serbia

NASA Astrophysics Data System (ADS)

Stanković, Slobodanka; Vesković, Miroslav; Klisurić, Olivera; Spasić, Vesna

2007-04-01

Overview of new educational program and training in Medical Physics at the University of Novi Sad is presented, where the medical physics education from undergraduate to doctoral study is established in the last decade. Necessity for basic and additional education and hospital training for medical physicists becomes the evident subject in clinical practice in which physicists and physicians are in close collaboration to ensure high quality of patient care. Learning objectives: to incorporate the latest scientific and professional findings in the field of medical physics, medical diagnostics, therapy and instruments; to accomodate students' pursuits of individual fields by offering elective courses from different areas of current medical practice; to reflect the multidisciplinary spirit of the studies, since teaching is performed by experts from diverse fields.

Predictors of the use of physical therapy services among patients with rheumatoid arthritis.

PubMed

Iversen, Maura D; Chhabriya, Ritu K; Shadick, Nancy

2011-01-01

Although physical therapy is a proven and recommended intervention for managing rheumatoid arthritis (RA), few studies have explored correlates of physical therapy service use among people with RA. The purposes of this study were: (1) to describe physical therapy use among people with RA and (2) to identify biopsychosocial factors associated with physical therapy use. It was expected that use of physical therapy services would be lower than previously reported, considering recent medical advancements, and that including contextual factors may lead to identification of new factors associated with physical therapy use. This was a cohort study. Of 1,032 patients prospectively recruited from a large hospital registry, 772 completed baseline and laboratory assessments, received a physical examination, and completed a 1-year follow-up survey regarding physical therapy service use. Measures included: demographics (ie, age, sex, marital status, race, employment, disability status, insurance, income, comorbidities, and education), disease duration, RA medications, self-efficacy (assessed with the Arthritis Self-Efficacy Scale), social support (assessed with the Berkman-Syme Social Network Index), function (assessed with the Multi-Dimensional Health Assessment Questionnaire), and disease activity (assessed with the Rheumatoid Arthritis Disease Activity Index). Self-reported use of physical therapy (yes/no) was assessed at the 1-year follow-up. A staged regression approach, based on a theoretical model, was used to select and enter variables into the regression to develop a parsimonious set of predictors. The patients were well educated and had modestly high incomes, and most had health insurance. Approximately 15.3% of the patients used physical therapy services during the designated follow-up period. Using multivariable modeling, the most significant predictors of physical therapy service use were moderate to high disease activity (odds ratio [OR]=1.4, 95% confidence interval [CI]=1.1-1.8), less than a college education (OR=0.5, 95% CI=0.2-0.8), greater social networks (OR=2.1, 95% CI=1.3-3.5), and being on disability (OR=2.4, 95% CI=1.3-4.6). The limitations of this study were use of a convenience sample and the potential for misclassification of physical therapy service use. Patients with less than college education were less likely to receive physical therapy services, and those with more active disease, those who were on disability, and those who had greater social networks were more likely to receive physical therapy services.

42 CFR 409.23 - Physical therapy, occupational therapy and speech-language pathology.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-language pathology. 409.23 Section 409.23 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... § 409.23 Physical therapy, occupational therapy and speech-language pathology. Medicare pays for... therapy or speech-language pathology services must be furnished— (1) By qualified physical therapists...

Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three month physical exercise therapy

PubMed Central

Flodin, P.; Martinsen, S.; Mannerkorpi, K.; Löfgren, M.; Bileviciute-Ljungar, I.; Kosek, E.; Fransson, P.

2015-01-01

Physical exercise is one of the most efficient interventions to mitigate chronic pain symptoms in fibromyalgia (FM). However, little is known about the neurophysiological mechanisms mediating these effects. In this study we investigated resting-state connectivity using functional magnetic resonance imaging (fMRI) before and after a 15 week standardized exercise program supervised by physical therapists. Our aim was to gain an understanding of how physical exercise influences previously shown aberrant patterns of intrinsic brain activity in FM. Fourteen FM patients and eleven healthy controls successfully completed the physical exercise treatment. We investigated post- versus pre-treatment changes of brain connectivity, as well as changes in clinical symptoms in the patient group. FM patients reported improvements in symptom severity. Although several brain regions showed a treatment-related change in connectivity, only the connectivity between the right anterior insula and the left primary sensorimotor area was significantly more affected by the physical exercise among the fibromyalgia patients compared to healthy controls. Our results suggest that previously observed aberrant intrinsic brain connectivity patterns in FM are partly normalized by the physical exercise therapy. However, none of the observed normalizations in intrinsic brain connectivity were significantly correlated with symptom changes. Further studies conducted in larger cohorts are warranted to investigate the precise relationship between improvements in fibromyalgia symptoms and changes in intrinsic brain activity. PMID:26413476

Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three month physical exercise therapy.

PubMed

Flodin, P; Martinsen, S; Mannerkorpi, K; Löfgren, M; Bileviciute-Ljungar, I; Kosek, E; Fransson, P

2015-01-01

Physical exercise is one of the most efficient interventions to mitigate chronic pain symptoms in fibromyalgia (FM). However, little is known about the neurophysiological mechanisms mediating these effects. In this study we investigated resting-state connectivity using functional magnetic resonance imaging (fMRI) before and after a 15 week standardized exercise program supervised by physical therapists. Our aim was to gain an understanding of how physical exercise influences previously shown aberrant patterns of intrinsic brain activity in FM. Fourteen FM patients and eleven healthy controls successfully completed the physical exercise treatment. We investigated post- versus pre-treatment changes of brain connectivity, as well as changes in clinical symptoms in the patient group. FM patients reported improvements in symptom severity. Although several brain regions showed a treatment-related change in connectivity, only the connectivity between the right anterior insula and the left primary sensorimotor area was significantly more affected by the physical exercise among the fibromyalgia patients compared to healthy controls. Our results suggest that previously observed aberrant intrinsic brain connectivity patterns in FM are partly normalized by the physical exercise therapy. However, none of the observed normalizations in intrinsic brain connectivity were significantly correlated with symptom changes. Further studies conducted in larger cohorts are warranted to investigate the precise relationship between improvements in fibromyalgia symptoms and changes in intrinsic brain activity.

A Stage I Pilot Study of Acceptance and Commitment Therapy for Methadone Detoxification

PubMed Central

Stotts, Angela L.; Green, Charles; Masuda, Akihiko; Grabowski, John; Wilson, Kelly; Northrup, Thomas; Moeller, F. Gerard; Schmitz, Joy

2012-01-01

BACKGROUND While agonist replacement therapies are effective for managing opioid dependence, community treatment programs are increasingly choosing detoxification. Unfortunately, success rates for opioid detoxification are very low, in part, due to physical and psychological symptoms associated with opioid withdrawal. Few behavior therapies specifically address the distressing experiences specific to opioid withdrawal. A novel behavioral treatment, Acceptance and Commitment Therapy (ACT), works from the premise that the avoidance of unpleasant private experiences (thoughts, feelings, bodily sensations) is ubiquitous yet may be pathogenic, resulting in treatment drop-out and further drug use. METHODS This Stage I pilot study developed and tested an ACT-based opioid detoxification behavioral therapy. Opioid dependent patients (N = 56) who were attending a licensed methadone clinic were randomized to receive either 24 individual therapy sessions of ACT or Drug Counseling (DC) in the context of a 6-month methadone dose reduction program. RESULTS While no difference was found on opioid use during treatment, 37% of participants in the ACT condition were successfully detoxified at the end of treatment compared to 19% of those who received DC. Fear of detoxification was also reduced across time in the ACT condition relative to DC. CONCLUSION This first study of ACT to assist opioid detoxification indicates promise. Research is needed to refine specific treatment strategies for this population to further strengthen effects. PMID:22425411

Ovarian Failure and the Menopause

PubMed Central

McEwen, Donald C.

1965-01-01

Long-term replacement therapy for ovarian deficiency or failure, including the menopause, has been widely debated. In the past, treatment, if indicated, was reassurance, sedation, and occasionally short-term estrogen therapy. Today, because of recent advances in steroid synthesis, the consequences of ovarian deficiency may be preventable. Ovarian function and failure are discussed, the apparent physiological renaissance of nine patients documented, and the methods of treatment detailed. Thirty-three patients, who took part in this program during the past two years, have continued treatment with enthusiasm, without major problems in management, and have shown evidence of improved physical and emotional well-being. Further unbiased long-term research, possibly using modern computer technique, is needed to decide between traditional and replacement therapy for the menopause. ImagesFig. 1 PMID:14289145

[How useful is physical therapy in old age?].

PubMed

Brenke, Rainer

2016-03-01

Physical therapy is the most important element of naturopathy. In old age conditions accumulate that can be readily treated with physical therapy. It is possible to save on simultaneous drug treatment, and the risk of side effects can be reduced. The prescription of physical therapy in old age should not be regarded as restrictive.

Development of Physical Therapy Practical Assessment System by Using Multisource Feedback

ERIC Educational Resources Information Center

Hengsomboon, Ninwisan; Pasiphol, Shotiga; Sujiva, Siridej

2017-01-01

The purposes of the research were (1) to develop the physical therapy practical assessment system by using the multisource feedback (MSF) approach and (2) to investigate the effectiveness of the implementation of the developed physical therapy practical assessment system. The development of physical therapy practical assessment system by using MSF…

42 CFR 485.719 - Condition of participation: Arrangements for physical therapy and speech pathology services to be...

Code of Federal Regulations, 2011 CFR

2011-10-01

... physical therapy and speech pathology services to be performed by other than salaried organization... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.719 Condition of participation: Arrangements for physical therapy and speech pathology services to be performed...

42 CFR 485.719 - Condition of participation: Arrangements for physical therapy and speech pathology services to be...

Code of Federal Regulations, 2010 CFR

2010-10-01

... physical therapy and speech pathology services to be performed by other than salaried organization... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.719 Condition of participation: Arrangements for physical therapy and speech pathology services to be performed...

42 CFR 485.719 - Condition of participation: Arrangements for physical therapy and speech pathology services to be...

Code of Federal Regulations, 2013 CFR

2013-10-01

... physical therapy and speech pathology services to be performed by other than salaried organization... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.719 Condition of participation: Arrangements for physical therapy and speech pathology services to be performed...

42 CFR 485.719 - Condition of participation: Arrangements for physical therapy and speech pathology services to be...

Code of Federal Regulations, 2014 CFR

2014-10-01

... physical therapy and speech pathology services to be performed by other than salaried organization... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.719 Condition of participation: Arrangements for physical therapy and speech pathology services to be performed...

42 CFR 485.719 - Condition of participation: Arrangements for physical therapy and speech pathology services to be...

Code of Federal Regulations, 2012 CFR

2012-10-01

... physical therapy and speech pathology services to be performed by other than salaried organization... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.719 Condition of participation: Arrangements for physical therapy and speech pathology services to be performed...

[Using complementary therapy with a hemodialysis patient with colon cancer and a sense of hopelessness].

PubMed

Yeh, Shih-Chun; Yeh, Hui-Fang

2007-10-01

Hemodialysis patients usually have a sense of hopelessness. This can affect their physical, mental and spiritual health, and can even be life- threatening. This article discusses a nursing experience involving a dialysis patient who also suffered from cancer had and a sense of hopelessness due to the distress caused by the two severe illnesses. The author assessed the patient by means of Roy's theory during the nursing period (5/7/2005-6/18/2005). Data were collected through physical assessments, interviews, observation of interaction with family members and a medical history review. The patient had characteristics of hopelessness, such as pessimism, moodiness, frequent sighing, frowning, eye-closing and negative thinking. The author applied a safe, easy, and non-invasive complementary therapy program including music therapy, aromatherapy and massage with essential oil to improve the patient's physical and mental states. Through these approaches, the patient learned to release stress, and to express his feelings, so that he could adapt to his current life, changed as it was by the illnesses, and face the impact of those illnesses with a positive attitude. The author would like to share this case report to provide nursing professionals with a source of reference for healthcare quality improvement.

Controversial Issues in Healthcare Policy: A Survey of Doctor of Physical Therapy Students in a Public University.

PubMed

Snyder, Drew D; Bennett, Teale K; Oller, Jeremy C; Ge, Weiqing

2017-01-01

The recently passed legislation and proposed policy changes governing the healthcare system have been met with extensive debate and controversy. The primary objective of the study was to determine the attitudes of Doctor of Physical Therapy (DPT) students towards some of these controversial issues. The secondary objective was to determine the demographic factors, including number of years in a physical therapy program, that contribute to their attitude formation. The research design was a cross-sectional non-experimental survey. Purposive sampling was used to recruit subjects in a public university. Subjects took the survey including nine Likert scale questions/statements on controversial issues inspired from legislative efforts and news media sources and one open-ended question. Of the 111 recruited, 106 students agreed to participate as subjects and completed the survey. Only 18.9% agreed or strongly agreed that the Patient Protection and Affordable Care Act is a positive solution for the healthcare system in America. Political affiliation, class level, and developmental environment were associated with a few questions/statements. DPT students in the sample had very diverse attitudes towards controversial issues in healthcare policy. Some of these attitudes revealed very different paradigms from the results found among medical students and the general public.

The effects of a Pilates-based exercise rehabilitation program on functional outcome and fall risk reduction in an aging adult status-post traumatic hip fracture due to a fall.

PubMed

Stivala, Adam; Hartley, Greg

2014-01-01

Currently, little information describing the relationship of Pilates-based strength and stability exercises with fall risk in the geriatric population exists. The purpose of this report was to examine the impact of a Pilates-based rehabilitation (PBR) program on reducing fall risk in an aging adult status postfall with resulting hip fracture and open reduction and internal fixation. The patient was an 84-year-old woman admitted to a skilled nursing facility (SNF) after a right hip fracture resulting from a fall at home. The patient's relevant medical history included frequent falls due to loss of balance, a previous left hip fracture with resultant arthroplasty, and a stroke roughly 20 years prior. The patient received physical therapy and occupational therapy 6 days per week for 26 days in an SNF. The physical therapy intervention consisted of gait and transfer training, neuromuscular reeducation, and an adjunct of specialized PBR exercises for the following impairments: decreased core strength and awareness and poor dynamic stabilization during functional activities. The patient demonstrated increases in lower extremity strength and active range of motion, ambulation distance and speed, and transfer ability. The patient was able to return home and live with her husband while requiring only incidental assistance with activities of daily living. She was able to independently ambulate around her home with her rolling walker. Her fall risk was also reduced from initial evaluation based on several fall risk assessments, including the Four Square Step Test, the Berg Balance Scale, and the Timed Up and Go. This case illustrates the benefit of integrating PBR exercises into a standard SNF rehabilitation program, which may contribute to decreased fall risk.

Design of an instrument to measure the quality of care in Physical Therapy

PubMed Central

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; do Prado, Cristiane; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

ABSTRACT Objective: To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. Methods: The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Results: Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. Conclusion: The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care. PMID:26154548

Clinical trial registration in physical therapy journals: a cross-sectional study.

PubMed

Babu, Abraham Samuel; Veluswamy, Sundar Kumar; Rao, Pratiksha Tilak; Maiya, Arun G

2014-01-01

Clinical trial registration has become an important part of editorial policies of various biomedical journals, including a few physical therapy journals. However, the extent to which editorial boards enforce the need for trial registration varies across journals. The purpose of this study was to identify editorial policies and reporting of trial registration details in MEDLINE-indexed English-language physical therapy journals. This study was carried out using a cross-sectional design. Editorial policies on trial registration of MEDLINE-indexed member journals of the International Society of Physiotherapy Journal Editors (ISPJE) (Journal of Geriatric Physical Therapy, Journal of Hand Therapy, Journal of Neurologic Physical Therapy, Journal of Orthopaedic and Sports Physical Therapy, Journal of Physiotherapy [formerly Australian Journal of Physiotherapy], Journal of Science and Medicine in Sport, Manual Therapy, Physical Therapy, Physical Therapy in Sport, Physiotherapy, Physiotherapy Research International, Physiotherapy Theory and Practice, and Revista Brasileira de Fisioterapia) were reviewed in April 2013. Full texts of reports of clinical trials published in these journals between January 1, 2008, and December 31, 2012, were independently assessed for information on trial registration. Among the 13 journals, 8 recommended trial registration, and 6 emphasized prospective trial registration. As of April 2013, 4,618 articles were published between January 2008 and December 2012, of which 9% (417) were clinical trials and 29% (121/417) of these reported trial registration details. A positive trend in reporting of trial registration was observed from 2008 to 2012. The study was limited to MEDLINE-indexed ISPJE member journals. Editorial policies on trial registration of physical therapy journals and a rising trend toward reporting of trial registration details indicate a positive momentum toward trial registration. Physical therapy journal editors need to show greater commitment to prospective trial registration to make it a rule rather than an option.

Use of physical therapy services among middle-aged and older adults with multiple sclerosis.

PubMed

Finlayson, Marcia; Plow, Matthew; Cho, Chi

2010-11-01

There is limited understanding of the utilization of and perceived need for physical therapy services among middle-aged and older adults with multiple sclerosis (MS). The resulting knowledge gap compromises efforts for physical therapy service planning for this population. The purpose of this study was to examine the use of and need for physical therapy services in a sample of adults with MS living in the Midwestern United States. This was a cross-sectional, descriptive study. Data from telephone interviews with 1,065 people with MS, aged 45 to 90 years, were used for the study. A multinomial regression model was used to determine factors associated with use of physical therapy services (never, within the past year, more than a year ago). Logistic regression analysis examined factors associated with unmet needs for these services. Thirty-six percent of the sample reported never using physical therapy services, 33% reported using physical therapy services within the past year, and 31% reported using physical therapy services more than a year prior to the interview. Factors associated with recent use of physical therapy services included living in an urban or suburban community, deteriorating MS status, experiencing problems with spasticity (ie, hypertonicity), having difficulty moving inside the house, being hospitalized in the past 6 months, and seeing a family physician. These same factors were associated with unmet needs. Limitations Physical therapy service use was self-reported. Data were collected in 5 Midwestern states from people 45 years of age or older, which may limit generalizability. Factors associated with use of and need for physical therapy services reflect issues of access (geographical, referrals), MS status, and mobility difficulties.

Serious Games for Parkinson's Disease Fine Motor Skills Rehabilitation Using Natural Interfaces.

PubMed

Foletto, Antônio Augusto; Cordeiro d'Ornellas, Marcos; Cervi Prado, Ana Lucia

2017-01-01

Parkinson's Disease rehabilitation can be long and boring being difficult to maintain patient engagement on therapy programs. Novel technologies are allowing computer games to be played throught natural interfaces. This paper presents the development and assessment of a system of serious games for fine motor skills rehabilitation using natural interfaces. The games were assessed throught a questionnaire that evaluated the game experience through seven components: immersion, flow, competence, tension, challenge and positive and negative affect. In addition, a conceptual framework for development of serious games for fine motor skills rehabilitation was proposed. The results from the quantitative questionnaire suggested that the player experience was positive on all components assessed. Also, player experience between the three games was statistically the same, implying that the games can be used with consistency in a physical therapy rehabilitation program.

Addressing agricultural issues in health care education: an occupational therapy curriculum program description.

PubMed

Smallfield, Stacy; Anderson, Angela J

2008-01-01

Medical and allied health professionals who work in agricultural states frequently address the needs of clients who live and work in rural and frontier environments. The primary occupations of those living in rural areas include farming, ranching, or other agriculture-related work. Farming is consistently ranked as one of the most high-risk occupations for work-related injuries and accidents; therefore, it is critical that health education programs include content to prepare future medical and health professionals to work with this population. This paper describes the rural issues component of the occupational therapy curriculum at The University of South Dakota. This rural issues module is designed to provide occupational therapists with training about the physical, temporal, and sociocultural aspects of production agriculture and the impact these have on the health and well-being of the agricultural population. It also addresses the occupational therapy implications for farmers and ranchers who have disabilities. Student assessments of the course content have been above average. Training in agricultural health enables our occupational therapy students to be well prepared for work in the rural and frontier areas of South Dakota and other rural locations.

Physical therapy activities in stroke, knee arthroplasty, and traumatic brain injury rehabilitation: their variation, similarities, and association with functional outcomes.

PubMed

DeJong, Gerben; Hsieh, Ching-Hui; Putman, Koen; Smout, Randall J; Horn, Susan D; Tian, Wenqiang

2011-12-01

The mix of physical therapy services is thought to be different with different impairment groups. However, it is not clear how much variation there is across impairment groups. Furthermore, the extent to which the same physical therapy activities are associated with functional outcomes across different types of patients is unknown. The purposes of this study were: (1) to examine similarities and differences in the mix of physical therapy activities used in rehabilitation among patients from different impairment groups and (2) to examine whether the same physical therapy activities are associated with functional improvement across impairment groups. This was a prospective observational cohort study. The study was conducted in inpatient rehabilitation facilities. The participants were 433 patients with stroke, 429 patients with total knee arthroplasty (TKA), and 207 patients with traumatic brain injury (TBI). Measures used in this study included: (1) the Comprehensive Severity Index to measure the severity of each patient's medical condition, (2) the Functional Independence Measure (FIM) to measure function, and (3) point-of-care instruments to measure time spent in specific physical therapy activities. All 3 groups had similar admission motor FIM scores but varying cognitive FIM scores. Patients with TKA spent more time on exercise than the other 2 groups (average=31.7 versus 6.2 minutes per day). Patients with TKA received the most physical therapy (average=65.3 minutes per day), whereas the TBI group received the least physical therapy (average=38.3 minutes per day). Multivariate analysis showed that only 2 physical therapy activities (gait training and community mobility) were both positively associated with discharge motor FIM outcomes across all 3 groups. Three physical therapy activities (assessment time, bed mobility, and transfers) were negatively associated with discharge motor FIM outcome. The study focused primarily on physical therapy without concurrently considering other therapies such as occupational therapy, speech-language pathology, nursing care, and case management or the potential interaction of these inputs. This analysis did not consider the interventions that physical therapists used when patients participated in discrete physical therapy activities. All 3 patient groups spent a considerable portion of their physical therapy time in gait training relative to other activities. Both gait training and community mobility are higher-level activities that were positively associated with outcomes, although all 3 groups spent little time in community mobility activities. Further research studies, such as randomized clinical trials and predictive validity studies, are needed to investigate whether higher-level or more-integrated therapy activities are associated with better patient outcomes.

Pilot evaluation of a group therapy program for children bereaved by suicide.

PubMed

Daigle, Marc S; Labelle, Réal J

2012-01-01

Thousands of children are bereaved each year by suicide, yet there exists very little literature specifically on the psychological care, programs, and interventions available to help them. (1) To build and validate theoretical models for the Group Therapy Program for Children Bereaved by Suicide (PCBS); (2) to test these models in a preliminary evaluation. In the first part, we built theoretical models, which were then validated by scientists and clinicians. In the second part, the sessions of the PCBS were observed and rated. The participating children were tested pre- and postprogram. Positive changes were observed in the participating children in terms of basic safety, realistic understanding and useful knowledge, inappropriate behaviors, physical and psychological symptoms, child-parent and child-child communication, capacity for social and affective reinvestment, actualization of new models of self and the world, self-esteem, awareness and use of tools, cognitive, verbal, written and drawing abilities, cognitive dissonance, ambivalence, antagonism, and isolation. The changes reported in the bereaved children show that the PCBS has some efficacy.

Iraq and Afghanistan Veterans: National Findings from VA Residential Treatment Programs

PubMed Central

Cook, Joan M.; Dinnen, Stephanie; O’Donnell, Casey; Bernardy, Nancy; Rosenheck, Robert; Desai, Rani

2013-01-01

A quality improvement effort was undertaken in Department of Veterans Affairs’ (VA) residential treatment programs for Posttraumatic Stress Disorder (PTSD) across the United States. Qualitative interviews were conducted with over 250 directors, providers, and staff during site visits of 38 programs. The aims of this report are to describe clinical issues and distinctive challenges in working with veterans from Iraq and Afghanistan and approaches to addressing their needs. Providers indicated that the most commonly reported problems were: acute PTSD symptomotology; other complex mental health symptom presentations; broad readjustment problems; and difficulty with time demands of and readiness for intensive treatment. Additional concerns included working with active duty personnel and mixing different eras in therapy. Programmatic solutions address structure (e.g., blended versus era-specific therapy), content (e.g., physical activity), and adaptations (e.g., inclusion of family; shortened length of stay). Clinical implications for VA managers and policy makers as well as non-VA health care systems and individual health care providers are noted. PMID:23458113

Educating Educators: Perceptions of Preceptors and Clinical Education Coordinators Regarding Training at a Division II Athletic Training Program

ERIC Educational Resources Information Center

Bomar, Renae Ellen; Mulvihill, Thalia

2016-01-01

Context: Clinical experiences give the student athletic trainer the opportunity to relate and apply didactic information to a real-world setting. During these experiences student athletic trainers are supervised by certified, licensed health care providers working in a variety of settings (e.g., hospital, physical therapy clinic, doctor's office).…

Implementation of structured physical activity in the pediatric stem cell transplantation.

PubMed

Rosenhagen, A; Bernhörster, M; Vogt, L; Weiss, B; Senn, A; Arndt, S; Siegler, K; Jung, M; Bader, P; Banzer, W

2011-05-01

The peripheral blood stem cell transplantation (PBSCT) represents a specific, but stressful therapy for hemato-oncological diseases. While for adults, data suggest positive eff ects for a supportive sport therapy, this question is not evaluated sufficiently for children. The objective of this study was to examine the integration of sports activity into pediatric PBSCT and to indicate attainable results. This 2-step case-control-study included 23 children and adolescents from the PBSCT: During the isolation phase 13 patients trained 3 times per week on a cycle ergometer and passed a course with different sports equipment. Apart from recording physiologic adaptations, quality of live was inquired in a pre-post design using questionnaires. Guided interviews according to necessity and requirements for sports activity at the PBSCT unit completed the evaluation and were used for the intervention as well as for the control group (n = 10) without sports therapy. On the ergometer, patients trained average 25 min with 0.6 watt / kg. In the majority, a loss of muscular power could be avoided. Quality of life and fatigue symptoms improved by trend. Interview analysis showed general acceptance of physical activity during PBSCT. After initial skepticism due to the additional burden, our implementation study showed the feasibility of supportive sports therapy in PBSCT. Quality and flexibility of the equipment should be higher than normal and different physical and psychological conditions of the patients should be anticipated and integrated into the training program.

Short-term effect of back school based on cognitive behavioral therapy involving multidisciplinary collaboration.

PubMed

Motoya, Ryo; Otani, Koji; Nikaido, Takuya; Ono, Yoko; Matsumoto, Takatomo; Yamagishi, Ryohei; Yabuki, Shoji; Konno, Shin-Ichi; Niwa, Shin-Ichi; Yabe, Hirooki

2017-08-09

ObjectivesThe purpose of this study was to develop a comprehensive back school program that included elements of CBT (Cognitive Behavioral Therapy), implement this through multidisciplinary collaboration, and ascertain its effectiveness as a pilot study. DesignThis school was implemented in the form of five 90-minute group sessions held every other week.MethodsParticipants comprised 7 chronic low back pain patients with poor improvement in the usual treatment. Practitioners were orthopaedic surgeon, physical therapist, and a clinical psychologist. This school contents were patient education, self-monitoring, back exercise, relaxation, stress management, cognitive restructuring, activity pacing, and exposure. ResultsFrom the Wilcoxon signed-rank test, each score of four scales or items (sense of control, PCS (pain catastrophizing), PASS-20 (escape/avoidance), FFD (finger-floor distance)) after this program significantly improved. Results of calculating the effect size, sense of control (d=0.55) is 'moderate', the PCS (d=1.12) and the PASS-20 (d=1.64) were 'large'.ConclusionsThis back school may be useful for physical function and psychological variables which much related to pain management and daily disabilities in patients with poor respond to standard orthopaedic treatment.

Rehabilitation of low back pain patients. A review.

PubMed

Revel, M

1995-01-01

Numerous methods have been developed for the rehabilitation of low back pain patients, including spinal flexion and extension exercises, lumbar spine locking in an intermediate position, enhancement of spinal and pelvic proprioceptive sensibility, swimming pool therapy, back schools, and functional restoration. Each seeks to achieve a goal assumed to be central to the prevention of a first or recurrent episode of low back pain. Goals include short-term pain relief, an improved ability to achieve self-sedation, abdominal and lumbar muscle strengthening, increased hip and lumbar spine mobility, improved lumbar and pelvic proprioceptive sensibility, intervertebral joint stabilization, lumbar posture modification and improved general fitness. Less than 30 studies meeting widely accepted validity and applicability criteria for therapeutic trials have addressed the clinical efficacy of rehabilitation in low back pain patients. Most studies of the back school approach have found no benefit. Spinal flexion and extension exercise programs have yielded short-lived improvements, with no differences across methods. There is evidence that functional restoration programs based on graded activity may provide long-term benefits including better social and occupational outcomes. We have evaluated the physical therapy methods most commonly taught to and used by physical therapists in France.

Promoting reintegration of National Guard veterans and their partners using a self-directed program of integrative therapies: a pilot study.

PubMed

Collinge, William; Kahn, Janet; Soltysik, Robert

2012-12-01

This article reports pilot data from phase I of a project to develop and evaluate a self-directed program of integrative therapies for National Guard personnel and significant relationship partners to support reintegration and resilience after return from Iraq or Afghanistan. Data are reported on 43 dyads. Intervention was an integrated multimedia package of guided meditative, contemplative, and relaxation exercises (CD) and instruction in simple massage techniques (DVD) to promote stress reduction and interpersonal connectedness. A repeated measures design with standardized instruments was used to establish stability of baseline levels of relevant mental health domains (day 1, day 30), followed by the intervention and assessments 4 and 8 weeks later. Significant improvements in standardized measures for post-traumatic stress disorder, depression, and self-compassion were seen in both veterans and partners; and in stress for partners. Weekly online reporting tracked utilization of guided exercises and massage. Veterans reported significant reductions in ratings of physical pain, physical tension, irritability, anxiety/worry, and depression after massage, and longitudinal analysis suggested declining baseline levels of tension and irritability. Qualitative data from focus groups and implications for continued development and a phase II trial are discussed.

Enhanced knee joint function due to accelerated rehabilitation exercise after anterior cruciate ligament reconstruction surgery in Korean male high school soccer players.

PubMed

Lee, Myungchun; Sung, Dong Jun; Lee, Joohyung; Oh, Inyoung; Kim, Sojung; Kim, Seungho; Kim, Jooyoung

2016-02-01

This study was conducted on Korean male high school soccer players who underwent anterior cruciate ligament reconstruction (ACLR) to identify the effects of an accelerated rehabilitation exercise (ARE) program on knee joint isometric strength, thigh circumference, Lysholm score, and active balance agility. We assigned eight test participants each to a physical therapy group (PTG) and an accelerated rehabilitation exercise group (AREG), and compared differences between the groups. Both the PTG and AREG showed significant increases in 30° away and 60° toward isometric strength after treatment. In addition, significant differences were observed in these strength tests between the two groups. Both groups also showed significant increases in thigh circumference, Lysholm score, and active balance agility after treatment, but no significant differences were observed between the two groups. We conclude that the ARE treatment was more effective for improving isometric strength of the knee joint than that of physical therapy, and that an active rehabilitation exercise program after ACLR had positive effects on recovery performance of patients with an ACL injury and their return to the playing field.

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and Functional Symptoms.

PubMed

Epperly, Ted; Dunay, Megan A; Boice, Jack L

2017-06-15

Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant but clinically small delays in various domains of cognitive and functional decline in select patients with Alzheimer disease. Vitamin E has been shown to delay functional decline in patients with mild to moderate Alzheimer disease, especially when taken in combination with a cholinesterase inhibitor. Structured programs of physical exercise improve physical function and reduce rates of neuropsychiatric symptoms in patients with mild to severe Alzheimer disease. Cognitive stimulation programs show benefit in maintenance of cognitive function and improved self-reported quality of life in patients with mild to moderate Alzheimer disease.

The medium-term effects of diadynamic currents in chronic low back pain; TENS versus diadynamic currents: A randomised, follow-up study.

PubMed

Sayilir, Selcuk; Yildizgoren, Mustafa Turgut

2017-11-01

The aims of the study were to evaluate the medium-term effects of diadynamic (DD) currents on relieving symptoms/improving physical functionality in patients with chronic low back pain (LBP) and to compare the efficacy of DD versus TENS. The patients were divided into two groups as the TENS group (n = 26) and the DD group (n = 29). Additional treatment of hot pack + therapeutic ultrasound was applied to all patients. The therapy programs were administered as a total of 10 sessions over a period of 2 weeks. Roland Morris Disability Questionnaire (RDQ), Oswestry Disability Index and Visual Analog Scale (VAS) values were recorded. Both groups showed significant improvements in VAS and RDQ scores after one month of the therapies (all p < 0.05). Using TENS and DD currents in chronic LBP can lead to reduced pain, and improved physical functions. Hence, DD currents can be used as an adjuvant therapy for rehabilitation of chronic LBP. Copyright © 2017 Elsevier Ltd. All rights reserved.

42 CFR 484.38 - Condition of participation: Qualifying to furnish outpatient physical therapy or speech pathology...

Code of Federal Regulations, 2013 CFR

2013-10-01

... outpatient physical therapy or speech pathology services. 484.38 Section 484.38 Public Health CENTERS FOR... furnish outpatient physical therapy or speech pathology services. An HHA that wishes to furnish outpatient physical therapy or speech pathology services must meet all the pertinent conditions of this part and also...

42 CFR 484.38 - Condition of participation: Qualifying to furnish outpatient physical therapy or speech pathology...

Code of Federal Regulations, 2014 CFR

2014-10-01

... outpatient physical therapy or speech pathology services. 484.38 Section 484.38 Public Health CENTERS FOR... furnish outpatient physical therapy or speech pathology services. An HHA that wishes to furnish outpatient physical therapy or speech pathology services must meet all the pertinent conditions of this part and also...

42 CFR 484.38 - Condition of participation: Qualifying to furnish outpatient physical therapy or speech pathology...

Code of Federal Regulations, 2011 CFR

2011-10-01

... outpatient physical therapy or speech pathology services. 484.38 Section 484.38 Public Health CENTERS FOR... furnish outpatient physical therapy or speech pathology services. An HHA that wishes to furnish outpatient physical therapy or speech pathology services must meet all the pertinent conditions of this part and also...

42 CFR 484.38 - Condition of participation: Qualifying to furnish outpatient physical therapy or speech pathology...

Code of Federal Regulations, 2012 CFR

2012-10-01

... outpatient physical therapy or speech pathology services. 484.38 Section 484.38 Public Health CENTERS FOR... furnish outpatient physical therapy or speech pathology services. An HHA that wishes to furnish outpatient physical therapy or speech pathology services must meet all the pertinent conditions of this part and also...

42 CFR 484.38 - Condition of participation: Qualifying to furnish outpatient physical therapy or speech pathology...

Code of Federal Regulations, 2010 CFR

2010-10-01

... outpatient physical therapy or speech pathology services. 484.38 Section 484.38 Public Health CENTERS FOR... furnish outpatient physical therapy or speech pathology services. An HHA that wishes to furnish outpatient physical therapy or speech pathology services must meet all the pertinent conditions of this part and also...

Technical aspects of home hemodialysis.

PubMed

Alhomayeed, B; Lindsay, R M

2009-03-01

Home hemodialysis (HHD) has proved to be a useful form of renal replacement therapy. The economic advantage of HHD is well established and interest in it is renewed. Once it has been decided to establish a HHD program, a well developed strategic plan is required. This should address financial and logistical issues and establish policies that will address responsi-bilities of both patients and HD centers. The recruitment of patients is facilitated by ensuring that all incident patients have early access to an education program describing all forms of renal replacement therapy that the regional renal program provides. Patients and members of the pre-dialysis education program should understand the selection process criteria in advance. Once the assessment is completed and the patient agrees to the proceedings, a plan of action should be esta-blished for enrolling the patient into the program and initiating training. Patients' education pro-gram should take into consideration principles of adult learning. When choosing dialysis equip-ment for home use, the needs and preferences of the patients should be respected. As a rule of thumb, the equipment should be simple to use, yet still provide adequate and reliable therapy. De-ciding where to set up and position the HHD equipment is important. Installation of HHD ma-chine at home requires a continuous supply of accessories. Before establishing a HHD program, commitment of the dialysis center to provide and maintain the infrastructure of the program is mandatory. The estimated patients suitable for HHD are less than 15% of all prospective dialysis patients. Generally, those who are have greatly improved quality of life and by using modalities such as nocturnal and daily dialysis can have improved physical well-being with considerable potential cost savings.

Spasticity

MedlinePlus

Exercise, including muscle stretching, can help make symptoms less severe. Physical therapy is also helpful. ... therapist. Physical therapy involves different exercises, including muscle stretching and strengthening exercises. Physical therapy exercises can be ...

Community-based and college-based needs assessment of physically disabled persons.

PubMed

Burnett, S E; Yerxa, E J

1980-03-01

A descriptive survey was conducted to determine the self-perceived needs of physically disabled persons as a preliminary step toward establishing or designing a knowledge base for occupational therapy intervention at a community college. Demographic and needs data were statistically compared with those from a sample of nondisabled college students. Significant differences in the confidence to perform congnitive/problem-solving, social/recreational, school/vocational, home and community mobility skills were found, with the disabled reporting lowered or less confidence. Confidence in performing basic activities of daily living was the only area in which the difference was not significant. No significant differences were obtained in general interests except that a higher frequency of disabled reported not wanting to participate in sports. The greatest amounts of interest were in crafts/fine arts and in social/recreational activities. Implications were drawn for occupational therapy programming to improve confidence in independent living skills by using the subjects' predominant interests.

Effectiveness of computer-assisted interactive videodisc instruction in teaching rheumatology to physical and occupational therapy students.

PubMed

Sanford, M K; Hazelwood, S E; Bridges, A J; Cutts, J H; Mitchell, J A; Reid, J C; Sharp, G

1996-01-01

A computer-assisted interactive videodisc instructional program, HP-RHEUM was designed to teach clinical findings in arthritis to occupational and physical therapy students. Using the Rheumatology Image Library videodisc produced by the National Library of Medicine, HP-RHEUM consists of instructional modules which employ advance organizers, examples/nonexamples, summaries, and immediate feedback. To see if HP-RHEUM would be as effective as traditional classroom instruction, control data were collected in 1991 from 52 OT and PT students. Treatment data were collected from 61 students in 1992 when HP-RHEUM entirely replaced lectures. Identical pre- and post-tests consisted of 70 multiple choice questions, with 24 matched to slides. On the slide questions the HP-RHEUM group had significantly higher scores. Otherwise, there was no significant difference in performance between groups. HP-RHEUM provided an independent learning method and enhanced visual comprehension of rheumatologic disease concepts.

Determining Need for School-Based Physical Therapy Under IDEA: Commonalities Across Practice Guidelines.

PubMed

Vialu, Carlo; Doyle, Maura

2017-10-01

The Individuals with Disabilities Education Act (IDEA) includes physical therapy (PT) as a related service that may be provided to help students with disabilities benefit from their education. However, the IDEA does not provide specific guidance for the provision of school-based PT, resulting in variations in practice across the United States. The authors examined 22 state and local education agency guidelines available online to find commonalities related to the determination of a student's need for PT. Seven commonalities found: educational benefit, team decision, need for PT expertise, establishment of Individualized Education Program (IEP) goal before determining need for PT, distinction between medical and educational PT, the student's disability adversely affects education, and the student's potential for improvement. These commonalities are discussed in relation to current PT and special education literature. This article suggests applying these commonalities as procedural requirements and questions for discussion during an IEP team meeting.

Structure of the physical therapy benefit in a typical Blue Cross Blue Shield preferred provider organization plan available in the individual insurance market in 2011.

PubMed

Sandstrom, Robert W; Lehman, Jedd; Hahn, Lee; Ballard, Andrew

2013-10-01

The Affordable Care Act of 2010 establishes American Health Benefit Exchanges. The benefit design of insurance plans in state health insurance exchanges will be based on the structure of existing small-employer-sponsored plans. The purpose of this study was to describe the structure of the physical therapy benefit in a typical Blue Cross Blue Shield (BCBS) preferred provider organization (PPO) health insurance plan available in the individual insurance market in 2011. A cross-sectional survey design was used. The physical therapy benefit within 39 BCBS PPO plans in 2011 was studied for a standard consumer with a standard budget. First, whether physical therapy was a benefit in the plan was determined. If so, then the structure of the benefit was described in terms of whether the physical therapy benefit was a stand-alone benefit or part of a combined-discipline benefit and whether a visit or financial limit was placed on the physical therapy benefit. Physical therapy was included in all BCBS plans that were studied. Ninety-three percent of plans combined physical therapy with other disciplines. Two thirds of plans placed a limit on the number of visits covered. The results of the study are limited to 1 standard consumer, 1 association of insurance companies, 1 form of insurance (a PPO), and 1 PPO plan in each of the 39 states that were studied. Physical therapy is a covered benefit in a typical BCBS PPO health insurance plan. Physical therapy most often is combined with other therapy disciplines, and the number of covered visits is limited in two thirds of plans.

Quality in physical therapist clinical education: a systematic review.

PubMed

McCallum, Christine A; Mosher, Peter D; Jacobson, Peri J; Gallivan, Sean P; Giuffre, Suzanne M

2013-10-01

Many factors affect student learning throughout the clinical education (CE) component of professional (entry-level) physical therapist education curricula. Physical therapist education programs (PTEPs) manage CE, yet the material and human resources required to provide CE are generally overseen by community-based physical therapist practices. The purposes of this systematic review were: (1) to examine how the construct of quality is defined in CE literature and (2) to determine the methodological rigor of the available evidence on quality in physical therapist CE. This study was a systematic review of English-language journals using the American Physical Therapy Association's Open Door Portal to Evidence-Based Practice as the computer search engine. The search was categorized using terms for physical therapy and quality and for CE pedagogy and models or roles. Summary findings were characterized by 5 primary themes and 14 subthemes using a qualitative-directed content analysis. Fifty-four articles were included in the study. The primary quality themes were: CE framework, CE sites, structure of CE, assessment in CE, and CE faculty. The methodological rigor of the studies was critically appraised using a binary system based on the McMaster appraisal tools. Scores ranged from 3 to 14. Publication bias and outcome reporting bias may be inherent limitations to the results. The review found inconclusive evidence about what constitutes quality or best practice for physical therapist CE. Five key constructs of CE were identified that, when aggregated, could construe quality.

Capturing readiness to learn and collaboration as explored with an interprofessional simulation scenario: A mixed-methods research study.

PubMed

Rossler, Kelly L; Kimble, Laura P

2016-01-01

Didactic lecture does not lend itself to teaching interprofessional collaboration. High-fidelity human patient simulation with a focus on clinical situations/scenarios is highly conducive to interprofessional education. Consequently, a need for research supporting the incorporation of interprofessional education with high-fidelity patient simulation based technology exists. The purpose of this study was to explore readiness for interprofessional learning and collaboration among pre-licensure health professions students participating in an interprofessional education human patient simulation experience. Using a mixed methods convergent parallel design, a sample of 53 pre-licensure health professions students enrolled in nursing, respiratory therapy, health administration, and physical therapy programs within a college of health professions participated in high-fidelity human patient simulation experiences. Perceptions of interprofessional learning and collaboration were measured with the revised Readiness for Interprofessional Learning Scale (RIPLS) and the Health Professional Collaboration Scale (HPCS). Focus groups were conducted during the simulation post-briefing to obtain qualitative data. Statistical analysis included non-parametric, inferential statistics. Qualitative data were analyzed using a phenomenological approach. Pre- and post-RIPLS demonstrated pre-licensure health professions students reported significantly more positive attitudes about readiness for interprofessional learning post-simulation in the areas of team work and collaboration, negative professional identity, and positive professional identity. Post-simulation HPCS revealed pre-licensure nursing and health administration groups reported greater health collaboration during simulation than physical therapy students. Qualitative analysis yielded three themes: "exposure to experiential learning," "acquisition of interactional relationships," and "presence of chronology in role preparation." Quantitative and qualitative data converged around the finding that physical therapy students had less positive perceptions of the experience because they viewed physical therapy practice as occurring one-on-one rather than in groups. Findings support that pre-licensure students are ready to engage in interprofessional education through exposure to an experiential format such as high-fidelity human patient simulation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Physician ownership of physical therapy services. Effects on charges, utilization, profits, and service characteristics.

PubMed

Mitchell, J M; Scott, E

1992-10-21

To evaluate the effects of physician ownership of freestanding physical therapy and rehabilitation facilities on utilization, charges, profits, and three measures of service characteristics for physical therapy treatments. Statistical comparison by physician joint venture ownership status of freestanding physical therapy and comprehensive rehabilitation facilities providing physical therapy treatments in Florida. A total of 118 outpatient physical therapy facilities and 63 outpatient comprehensive rehabilitation facilities providing services in Florida during 1989. The data from the facilities were collected under a legislative mandate. Visits per patient, average revenue per patient, percent operating income, percent markup, profits per patient, licensed therapist time per visit, and licensed and nonlicensed medical worker time per visit. Visits per patient were 39% to 45% higher in joint venture facilities. Both gross and net revenue per patient were 30% to 40% higher in facilities owned by referring physicians. Percent operating income and percent markup were significantly higher in joint venture physical therapy and rehabilitation facilities. Licensed physical therapists and licensed therapist assistants employed in non-joint venture facilities spend about 60% more time per visit treating physical therapy patients than licensed therapists and licensed therapist assistants working in joint venture facilities. Joint ventures also generate more of their revenues from patients with well-paying insurance. Our results indicate that utilization, charges per patient, and profits are higher when physical therapy and rehabilitation facilities are owned by referring physicians. With respect to service characteristics, joint venture firms employ proportionately fewer licensed therapists and licensed therapist assistants to perform physical therapy, so that licensed professionals employed in joint venture businesses spend significantly less time per visit treating patients. These results should be of interest to the medical profession, third-party payers, and policymakers, all of whom are concerned about the consequences of physician self-referral arrangements.

Adapted Physical Education, Occupational Therapy, and Physical Therapy in the Public School. Procedures and Recommended Guidelines (Revised 1997).

ERIC Educational Resources Information Center

Colorado State Dept. of Education, Denver.

This manual is designed to assist Colorado personnel in developing and providing adapted physical education, occupational therapy, and physical therapy to Colorado public school students who have needs in the motor area. Guidelines are presented that have been developed to focus on the problems encountered by students with needs in the physical…

Exploration of Critical Self-Reflection in the Teaching of Ethics: The Case of Physical Therapy.

ERIC Educational Resources Information Center

Jensen, Gail M.

The effect of clinical simulations on student learning in the teaching of ethics in a physical therapy curriculum was examined in a study of the experiences of 54 physical therapy students enrolled in a course in ethics in physical therapy practice. During the three-semester-hour course, the students participated in two clinical simulations that…

Physical Therapy for Chronic Low Back Pain in North Carolina: Overuse, Underuse, or Misuse?

PubMed Central

Carey, Timothy S.; Holmes, George M.

2011-01-01

Background There are limited population-based studies of determinants of physical therapy use for chronic low back pain (LBP) and of the types of treatments received by individuals who see a physical therapist. Objective The purposes of this study were: (1) to identify determinants of physical therapy use for chronic LBP, (2) to describe physical therapy treatments for chronic LBP, and (3) to compare use of treatments with current best evidence on care for this condition. Design This study was a cross-sectional, population-based telephone survey of North Carolinians. Methods Five hundred eighty-eight individuals with chronic LBP who had sought care in the previous year were surveyed on their health and health care use. Bivariate and multivariable analyses were conducted to identify predisposing, enabling, and need characteristics associated with physical therapy use. Descriptive analyses were conducted to determine the use of physical treatments for individuals who saw a physical therapist. Use of treatments was compared with evidence from systematic reviews. Results Of our sample, 29.7% had seen a physical therapist in the previous year, with a mean of 15.6 visits. In multivariable analyses, receiving workers' compensation, seeing physician specialists, and higher Medical Outcomes Study 12-Item Short-Form Health Survey questionnaire (SF-12) physical component scores were positively associated with physical therapy use. Having no health insurance was negatively associated with physical therapy use. Exercise was the most frequent treatment received (75% of sample), and traction was the least frequent treatment received (7%). Some effective treatments were underutilized, whereas some ineffective treatments were overutilized. Limitations Only one state was examined, and findings were based on patient report. Conclusions Fewer than one third of individuals with chronic LBP saw a physical therapist. Health-related and non–health-related factors were associated with physical therapy use. Individuals who saw a physical therapist did not always receive evidence-based treatments. There are potential opportunities for improving access to and quality of physical therapy for chronic LBP. PMID:21330449

Beyond supervised learning: A multi-perspective approach to outpatient physical therapy mentoring.

PubMed

Buning, Megan M; Buning, Shaun W

2018-02-23

Novice physical therapists face multiple challenges as they transition to autonomous, efficient, and seasoned therapists. Mentoring is known to facilitate growth among novice therapists; however, formalized mentoring programs within the outpatient setting are scarce or management-centered. This study sought to explore the most desired components of a formal mentoring program from multiple perspectives. An inductive qualitative inquiry explored perceptions of participants (n = 35) from four populations. Interviews were conducted with students (n = 5) and novice therapists (n = 5), and survey data was collected from faculty (n = 7) and expert therapists (n = 18). Thematic content analysis was used for data analysis. Three primary themes emerged as program emphasis: 1) Program function; 2) novice therapists' needs; and 3) the making of a mentorship (including mentor/mentee characteristics and matching strategy). This study captured multiple perspectives as to the components of interest in development of a formalized mentoring program for novice therapists in the outpatient setting. As the profession continues to emphasize standards for guided learning, steps must be taken by individual employers to promote and facilitate the most effective practices. Findings provide depth and suggestions for developing an outpatient-mentoring program.

42 CFR 410.105 - Requirements for coverage of CORF services.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... (3) Exceptions. (i) Physical therapy, occupational therapy, and speech-language pathology services... 60 days for respiratory therapy services and every 90 days for physical therapy, occupational therapy...

[Modification of expiratory peak flow (EPF) in 14 asthmatic subjects from Benin by short duration exercise training].

PubMed

Lawani, M M; Hounkpatin, S; Akplogan, B

2006-01-01

Asthma is a world wide public health problem. It is the most commom chronic disease of school age children. Its severity is in constant increase. The frequency of the hospitalizations for asthma increased in practically all countries. Physical exercises and sport are used more and more as therapeutic means, in northern deveopped countries of where it was very early understood that it is necessary to integrate the asthmatic subjects into a program of specific physical training. This study undertaken in south saharian african country considers also assiduity in a physical training program as the factor of increase in the expiratory peak flow, of reinforcement of some principal muscles necessary to the improvement, and of the respiratory function of the asthmatic subject. Physical exercise is used as a non pharmacological therapy of asthma. This transversal study was carried out on fourteen asthmatic subjects of colleges in Porto-Novo's town, aged 15 years old to 25 years, of the two sexes. The results showed that: the Expiratory Peak Flow of Point (EPF) of the subjects at the beginning of the program is lower than the minimal average value of the group whatever the sex; the subjects average EPF increased from approximately 35% compared to the average at the beginning of the program; the subjects from family with asthmatic line, are much more inclined with respiratory embarrassments post-exercises than those who did not come from it; the respiratory embarrassments post-exercises noticed in the first weeks, grew blurred before the end of the program. This study suggests physical exercise adapted to the asthmatic subjects for the improvement of their health.