Physical Therapy最新文献

{"title":"Feasibility of a Multidomain Resiliency Assessment in Patients with Advanced Heart Failure Requiring Surgery: A Pilot Study","authors":"Karlyn J Green, Rebecca North, Adam D DeVore, Samantha Green, Ashley K Poole","doi":"10.1093/ptj/pzae135","DOIUrl":"https://doi.org/10.1093/ptj/pzae135","url":null,"abstract":"Objective The resiliency of patients who have advanced heart failure (HF) and undergo a physical stressor such as heart transplantation or left ventricular assist device implantation has yet to be studied in the physical, cognitive, and psychosocial domains. The primary aim of this pilot study was to assess the feasibility of a multidomain resiliency assessment in patients who have advanced HF and require surgery. Methods A battery of assessments in each of the domains was completed at baseline before surgical intervention, after intensive care discharge, and 3 and 6 months after surgery. Feasibility was assessed through completion rates, time required to complete the assessments, and qualitative feedback from assessors. Results Although various completion rates were noted at different time points, high completion rates were seen for grip strength, the modified Fried frailty phenotype, and the Montreal Cognitive Assessment. Additionally, when controlled for patients who were medically restricted from physical function, the Short Physical Performance Battery, gait speed, and the 30-second chair stand test also had high completion rates. A trend toward return to baseline status or an improvement in baseline status was observed in all physical and cognitive assessments and most psychosocial assessments at 3 and 6 months. Minimal change was noted in the Brief Resilience Scale questionnaire. Conclusion This pilot study demonstrates that a multidomain assessment of resiliency is feasible in patients with advanced HF. Future studies are needed to help determine specific assessments or patient factors that would help predict positive postsurgical outcomes in this population. Impact This study has implications for clinical practice on the most feasible assessments in multiple domains for patients who have advanced HF and are being evaluated for heart transplantation or left ventricular assist device.","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Written Mobility Communication in Acute Care Medical Wards: An Observational Study of Physical Therapists’ and Nurses’ Documentation Practice","authors":"Emily Harvey, Julie Adsett, Alison Mudge, Michael Steele, Prue McRae","doi":"10.1093/ptj/pzae122","DOIUrl":"https://doi.org/10.1093/ptj/pzae122","url":null,"abstract":"Objective Low inpatient mobility is associated with poor hospital outcomes. Poor communication between clinicians has been identified as a barrier to improving mobility. Understanding how mobility is communicated within the multi-disciplinary team may help inform strategies to improve inpatient mobility. The aim of this study was to describe written mobility communication by physical therapists and nurses in acute care medical wards. Methods This cross-sectional observational study was conducted across 4 hospitals in an Australian health service. A survey of physical therapists and nurses identified preferred sources and content of written mobility communication. An audit described and compared written mobility communication in the most strongly preferred documentation sources. Findings were described and compared graphically between discipline and site. Results Questionnaires were completed by 85 physical therapists and 150 nurses. Twenty-two sources of documentation about mobility were identified. Preferences for sources and content varied between disciplines. Physical therapists nominated several preferred information sources and sought and documented broader mobility content. Nurses often sought nursing documents which focused on current mobility assistance and aids, with limited communication of mobility level or mobility goals. Audits of 104 patient records found that content varied between sources and sites, and content was variably missing or inconsistent between sources. Conclusion Written mobility communication focused on mobility assistance and aids, rather than mobility levels or mobility goals, with poor completion and inconsistency within documentation. More complete and consistent documentation might improve progressive mobilization of hospital inpatients. Impact statement Physical therapists and nurses seek and document different content in a wide range of locations, leading to incomplete and inconsistent written documentation. Understanding and resolving these practice differences offers potential to improve mobility communication and practice.","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neck or Shoulder? Establishing Consensus for Spine Screening in Patients with Shoulder Pain: an International Modified Delphi Study.","authors":"Néstor Requejo-Salinas, Rubén Fernández-Matías, Angela Cadogan, Rachel Chester, Jean-Sébastien Roy, Filip Struyf, Marcus Bateman, Simon Balster, Melina Nevoeiro Haik, Amee L Seitz, Leanne Bisset, Paula Rezende Camargo, Jean-Michel Brismée, Stephen May, Tom Walker, Craig Wassinger, Ross Lenssen, Jared K Powell, Karen McCreesh, Jo Gibson, Paula M Ludewig, Roy La Touche, Enrique Lluch-Girbés","doi":"10.1093/ptj/pzae133","DOIUrl":"https://doi.org/10.1093/ptj/pzae133","url":null,"abstract":"<p><strong>Objective: </strong>There is no established consensus for screening the spine in patients with shoulder pain. The aim of this study was to explore the role of the spine in shoulder pain and generate a set of recommendations for assessing the potential involvement of the spine in patients with shoulder pain.</p><p><strong>Methods: </strong>A modified Delphi study was conducted through use of an international shoulder physical therapist's expert panel. Three domains (clinical reasoning, history, physical examination) were evaluated using a Likert scale, with consensus defined as Aiken Validity Index ≥0.7.</p><p><strong>Results: </strong>Twenty-two physical therapists participated. Consensus was reached on a total of 30 items: clinical reasoning (n = 9), history (n = 13), and physical examination (n = 8). The statement that spinal and shoulder disorders can coexist, sometimes influencing each other and at other times remaining independent issues, along with the concept of radiating pain as an explanatory phenomenon for the spine contribution to shoulder pain, achieved the highest degree of consensus.</p><p><strong>Conclusion: </strong>International physical therapists shoulder experts reached consensus on key aspects when screening the spine in people with shoulder pain, including consideration of the distal location of symptoms relative to the shoulder, the presence or previous history of neck pain, the changes in symptoms related to neck movements, and the presence of neuropathic-like symptoms. They also acknowledged the importance of assessing active cervical or cervicothoracic movements and the usefulness of the Spurling test and symptom modification techniques applied to the spine.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Have Faith in God That I Will Get Better\"-The Multidimensional Perceptions and Expectations of Patients with Chronic Shoulder Pain: A Qualitative Analysis of Common Sense.","authors":"Letícia Jonas Freitas, Gisele Harumi Hotta, Rafael Krasic Alaiti, Leandro Fukusawa, Domingo Palacios-Ceña, Anamaria Siriani Oliveira","doi":"10.1093/ptj/pzae132","DOIUrl":"https://doi.org/10.1093/ptj/pzae132","url":null,"abstract":"<p><strong>Objective: </strong>This descriptive qualitative study aimed to gain insights into the expectations of individuals with chronic shoulder pain and to investigate how different levels of disability may influence their beliefs and expectations regarding improvement.</p><p><strong>Methods: </strong>This qualitative study utilized the Common Sense Model (CSM) as its theoretical framework. Conducted within a public physical therapist clinic, individuals with chronic shoulder pain who were awaiting the initiation of the treatment were included. Participants, female and male [aged 30 to 69 years], were purposefully sampled. Thirty participants, categorized into 2 groups based on the Shoulder Pain and Disability Index (SPADI) scores, underwent semi-structured interviews. Group 1, lower SPADI scores (0 to 60), had 10 participants, and Group 2, higher SPADI scores (61 to 100), had 20 participants. Thematic analysis and inductive coding were employed to analyze the interviews.</p><p><strong>Results: </strong>Common themes emerged in both groups: the use of medical terms for understanding the diagnosis and the multidimensional impact of pain. The last 2 themes differed between groups. Notable differences included Group 1's focus on resources for pain relief and positive expectations with physical therapy, while Group 2 emphasized rest, religion as a resource for pain relief, and God's role in improvement.</p><p><strong>Conclusion: </strong>These findings highlight the complexity of beliefs and expectations among patients with chronic shoulder pain. Individuals with greater disability often incorporated religious beliefs into their coping strategies, but they held lower recovery expectations and reported negative treatment experiences. These insights have implications for tailoring patient-centered care approaches.</p><p><strong>Impact: </strong>This study underscores the need for health care providers to consider the multidimensionality of recovery expectations, which can significantly influence patient outcomes. Clinicians can reflect on this knowledge to optimize treatment strategies and improve patient prognosis.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Knowledge to Action: Fostering Advocacy Skills for Planetary Health in Physical Therapy.","authors":"Emma Swärdh, Filip Maric","doi":"10.1093/ptj/pzae130","DOIUrl":"https://doi.org/10.1093/ptj/pzae130","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Functional Therapy for Chronic Low Back Pain: A Systematic Review and Meta-Analysis.","authors":"Lena Thiveos, Peter Kent, Natasha C Pocovi, Peter O'Sullivan, Mark J Hancock","doi":"10.1093/ptj/pzae128","DOIUrl":"https://doi.org/10.1093/ptj/pzae128","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to investigate the effectiveness of cognitive functional therapy (CFT) in the management of people with chronic nonspecific low back pain (LBP) and explore the variability in available trials to understand the factors which may affect the effectiveness of the intervention.</p><p><strong>Methods: </strong>A systematic review with meta-analyses was conducted. Four databases were searched from inception to October 12th 2023. Randomized controlled trials investigating CFT compared to any control group in patients with nonspecific LBP were included. Mean difference and 95% CIs were calculated for pain, disability, and pain self-efficacy. Certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Seven trials were included. Low to moderate certainty of evidence was found that CFT was effective for disability at short, medium, and long term time points compared to alternate treatments, including usual care. Low to moderate certainty of evidence was found that CFT is effective for pain in the short and medium terms and probably in the long term. There was high certainty evidence CFT was effective in increasing pain self-efficacy in the medium and long terms. A single study found CFT was cost-effective compared to usual care. Variability was found in the training and implementation of CFT across the included trials, which may contribute to some heterogeneity in the results.</p><p><strong>Conclusion: </strong>The results show promise in the use of CFT as an intervention likely to effectively manage disability, pain, and self-efficacy in people with chronic nonspecific LBP. The number of clinicians trained, their experience, and quality of training (including competency assessment) may be important in achieving optimal effectiveness.</p><p><strong>Impact statement: </strong>This is the most comprehensive review of CFT to date and included investigation of between-trial differences. CFT is a promising intervention for chronic LBP and high-quality synthesis of evidence of its effectiveness is important for its clinical application.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training an Anti-Ableist Physical Therapist Workforce: Critical Perspectives of Health Care Education That Contribute to Health Inequities for People With Disabilities.","authors":"Cara N Whalen Smith, Susan M Havercamp, Leyla Tosun, Samantha Shetterly, Armin Munir, Winston Kennedy, Heather A Feldner, Deana Herrman, Bethany M Sloane, Faye H Weinstein","doi":"10.1093/ptj/pzae092","DOIUrl":"10.1093/ptj/pzae092","url":null,"abstract":"<p><p>Americans with disabilities represent the largest historically underserved and marginalized health disparity population in the United States. This perspective piece will raise the awareness of physical therapist faculty and clinicians on gaps in health care provider knowledge about disability and provide actionable strategies, frameworks, and resources available to improve disability competence to make changes in clinical education and practice. In this perspective piece, 3 contributions are made. First, health disparities experienced by Americans with disabilities as a result of health care providers' biased assumptions about disability and lack of disability competence are described through an in-depth illustration of lived experiences of people with disabilities. Second, a discussion of disability competence in physical therapist education is provided. Finally, critical and evidence-based insights and actionable frameworks and resources to address disability competence training gaps and to promote anti-ableist practice are provided.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Disparities in Rehabilitation-Education Focus.","authors":"Dawn Magnusson","doi":"10.1093/ptj/pzae111","DOIUrl":"https://doi.org/10.1093/ptj/pzae111","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Benchmarks to Understand How Doctor of Physical Therapy Learners From Minoritized Race and Ethnicity Groups Perceive Their Physical Therapist Education Program.","authors":"Richard K Shields, Julia Chevan, Kai Kennedy, Charlotte Bailey, Shauna Dudley-Javoroski","doi":"10.1093/ptj/pzae047","DOIUrl":"10.1093/ptj/pzae047","url":null,"abstract":"<p><strong>Objective: </strong>The demographic homogeneity of the physical therapist workforce and its educational pathway may undermine the profession's potential to improve the health of society. Building academic environments that support the development of all learners is fundamental to building a workforce to meet societal health care needs. The Benchmarking in Physical Therapy Education study uses the Physical Therapy Graduation Questionnaire to comprehensively assess learner perceptions of the physical therapist academic environment. The present report examined whether racial and ethnic minoritized (REM) physical therapist learners perceive their doctor of physical therapy education differently from their non-REM peers.</p><p><strong>Methods: </strong>Five thousand and eighty graduating doctor of physical therapy learners in 89 institutions provided demographic data and perceptions of a range of learning environment domains. Analyses included REM versus non-REM comparisons as well as comparisons among individual race and ethnicity groups.</p><p><strong>Results: </strong>Compared with their non-minoritized peers, REM respondents expressed less satisfaction with their education and lower confidence in their preparedness for entry-level practice. REM respondents observed more faculty professionalism disconnects and demonstrated less agreement that their program had fostered their overall psychological well-being. REM respondents experienced higher rates of mistreatment than their peers and reported higher rates of exhaustion and disengagement, the 2 axes of academic burnout. Black/African American and Hispanic/Latino/a/x (Hispanic, Latino, Latina, and/or Latinx) respondents incurred significantly more educational debt than Asian and White respondents. REM respondents reported greater empathy and greater interest in working in underserved communities.</p><p><strong>Conclusion: </strong>REM respondents perceived the physical therapist learning environment more negatively than their non-minoritized peers but expressed strong interest in serving people from underserved communities. These national benchmarks offer academic institutions the opportunity to self-assess their own environment and to work to improve the quality of the educational experience for all learners.</p><p><strong>Impact: </strong>In a nationwide benchmarking study, learners from minoritized race and ethnicity backgrounds reported more negative experiences and outcomes during physical therapist education than their non-minoritized peers. These same learners demonstrated high empathy and interest in serving people from underserved (under-resourced) communities. Learning environments that permit all individuals to thrive may be an essential avenue to improve the health of a rapidly diversifying society.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140189929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equitable Grading Practices in Physical Therapist Education: A Case Report.","authors":"Shannon Richardson, Monica Dial, Janet Kneiss, Nipaporn Somyoo, Kimberly Varnado","doi":"10.1093/ptj/pzae084","DOIUrl":"10.1093/ptj/pzae084","url":null,"abstract":"<p><strong>Objective: </strong>To optimize learning in physical therapist education, learners need opportunities to grow from their unique starting points. Traditional grading practices like A to F grades, zero grades, and grading on timeliness and professionalism hinder content mastery and accurate competency assessment. Grading should focus on mastery of skill and content, using summative assessments for final grades, a no-zero policy, and actionable feedback. Equitable grading supports learners from all backgrounds and identities and promotes academic success. This case study provides guidance and recommendations for implementing equitable grading practices in academic physical therapist programs.</p><p><strong>Methods: </strong>Over a 2-year period, a doctor of physical therapy program began implementing 5 strategies to create more equitable grading practices: (1) eliminating zero grades, (2) allowing late assignment submissions without penalty, (3) using low-stakes formative assessments throughout the semester, (4) weighing end-of-course assessments more heavily than initial ones, and (5) offering a no-stakes anatomy prep course before matriculation.</p><p><strong>Results: </strong>Outcomes from implementing equitable grading practices varied. Some learners felt increased stress from fewer points opportunities, while others appreciated the reduced anxiety from low-stakes assessments. Some saw multiple attempts for peers as unfair. Faculty faced higher workloads due to detailed feedback and remediation but believed it benefited learners. Median final grades improved in some courses, remained stable in others, and slightly decreased in one. Overall, the changes had minimal impact on most learners' grades but significantly improved outcomes and retention for struggling learners.</p><p><strong>Conclusion: </strong>This case report documents the implementation of equitable grading practices in a Doctor of Physical Therapy program, offering valuable insights and recommendations for other institutions aiming to adopt similar practices.</p><p><strong>Impact: </strong>Inequity in assessment widens the gap between learners entering professional programs. Equitable assessment practices level the playing field, enabling learners from diverse backgrounds and identities to succeed. Increased diversity benefits everyone, especially patients, by reducing health disparities for historically marginalized groups.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}