Physical Therapy最新文献

{"title":"Relationship between Fear of Movement and Physical Activity in Patients with Cardiac, Rheumatologic, Neurologic, Pulmonary, or Pain Conditions: A Systematic Review and Meta-Analysis.","authors":"Miriam Goubran, Ataallah Farajzadeh, Ian M Lahart, Martin Bilodeau, Matthieu P Boisgontier","doi":"10.1093/ptj/pzaf050","DOIUrl":"https://doi.org/10.1093/ptj/pzaf050","url":null,"abstract":"<p><strong>Objective: </strong>Physical activity contributes to the primary, secondary, and tertiary prevention of multiple diseases. However, in some patients, fear of movement may induce avoidance behaviors and reduce engagement in physical activity. This study aims to examine whether this fear of movement is negatively associated with physical activity across several health conditions, and what factors may influence this relationship.</p><p><strong>Methods: </strong>Five databases were searched for studies including both a measure of fear of movement and physical activity. Two reviewers screened articles for inclusion, assessed risk of bias, and extracted data from each study. Pearson product-moment correlations were pooled from eligible studies using the generic inverse pooling and random effects method to examine the relationship between fear of movement and physical activity.</p><p><strong>Results: </strong>Seventy-four studies were included in the systematic review and 63 studies (83 estimates, 12,278 participants) in the main meta-analysis. Results showed a negative correlation between fear of movement and physical activity (r = -0.19 [95% CI = -0.26 to -0.13]; I2 = 85.5%). Funnel plot analysis showed evidence of publication bias, but p-curve analysis suggested that our results could not be caused by selective reporting. A subgroup meta-analysis showed that the correlation was statistically significant in patients with cardiac, rheumatologic, neurologic, or pulmonary conditions, but not in patients with chronic or acute pain.</p><p><strong>Conclusions: </strong>Our results suggest that higher levels of fear of movement are associated with lower levels of physical activity in several health conditions that are not necessarily painful.</p><p><strong>Impact: </strong>Fear of movement should be dissociated from pain and considered in relation to specific health conditions when implementing exercise therapy. Fear of movement may have prognostic and therapeutic implications in patients for whom physical activity contributes to prevent recurrence or worsening of their condition.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796063","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":"Shared Decision Making in Physical Therapist Care for People with Shoulder Problems: An Observer-Based Analysis of Audio-Recorded Consultations.","authors":"Sijmen Hacquebord, Henri Kiers, Philip van der Wees, Thomas J Hoogeboom","doi":"10.1093/ptj/pzaf047","DOIUrl":"https://doi.org/10.1093/ptj/pzaf047","url":null,"abstract":"<p><strong>Objective: </strong>Despite the substantial diagnostic and therapeutic uncertainties in the decision-making process, it remains largely unclear to what extent shared decision making is applied in physical therapist care for people with shoulder problems. The purpose of our study was to determine to what extent shared decision making is part of the decision-making process in initial physical therapist consultations of people with shoulder problems, and to identify factors associated with the level of shared decision making.</p><p><strong>Methods: </strong>In this cross-sectional study, the level of shared decision making was measured by assessing audio-recorded initial physical therapist consultations of people with shoulder problems using the 5-item Observing Patient Involvement in Shared Decision Making tool (OPTION-5; 0-100, higher OPTION scores indicate higher level of shared decision making). Associations between the level of shared decision making and the characteristics of patients, physical therapists, and consultations were assessed using multilevel analysis.</p><p><strong>Results: </strong>A total of 100 initial physical therapist consultations of 41 participating physical therapists were included. The mean OPTION-5 score was 27 (range 5-70). On none of the individual items of the OPTION-5 the highest score \"exemplar effort\" was observed. The multilevel analysis showed that 3 determinants were associated with higher level of shared decision making: younger age of the patient (b = -1.8; 95% CI = -3.1 to -0.4), longer duration of the consultation (b = 5.5; 95% CI = 2.7 to 8.3), and higher level of education of the physical therapist (b = 9.1; 95% CI = 2.7 to 15.4).</p><p><strong>Conclusions: </strong>The level of shared decision making in daily physical therapist practice for people with shoulder problems leaves room for improvement. Future research should focus on strategies to improve the application of shared decision making in physical therapist care for people with shoulder problems. The determinants duration of the consultation, and the level of education of the physical therapist, might provide guidance in developing these strategies for improving the application of shared decision making.</p><p><strong>Impact: </strong>The findings of this study give insight in the limited application of shared decision making in physical therapy for people with shoulder problems. Duration of the consultations and level of education of the physical therapist impact the level of shared decision making.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788759","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":"Preventing Falls in Older Adults After Upper Limb Fractures: A Scoping Review.","authors":"Bárbara Santos Lobo, Maynara do Amaral Alfonsi, Camila Astolphi Lima, Sarah Giulia Bandeira Felipe, Morten Tange Kristensen, Lauren A Beaupre, Catherine Sherrington, Andrea M Bruder, Monica Rodrigues Perracini","doi":"10.1093/ptj/pzaf020","DOIUrl":"10.1093/ptj/pzaf020","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to identify and describe fall prevention strategies in upper limb fracture rehabilitation for older people using recent fall prevention guidelines as a standard.</p><p><strong>Methods: </strong>A systematic search was conducted in 9 electronic databases (PubMed/MEDLINE, EBSCOhost, Cochrane Library, Lilacs, SPORTDiscus, CINAHL, Web of Science, AgeLine, and SciELO), gray literature, and in bibliographic and citation searching of selected articles between May and December 2022 and updated between February and March 2024. Two independent reviewers screened citations for inclusion. Data extraction was performed by 1 reviewer and verified by a second reviewer. A frequency of strategies and content analysis syntheses were conducted.</p><p><strong>Results: </strong>A broad search strategy was used, initially identifying 25,945 articles and including 6 randomized clinical trials. The gray literature search identified 18 records. Five studies included forearm fractures, 1 upper limb fracture, and no study exclusively on rehabilitation after humerus fractures. None of the studies provided comprehensive multifactorial fall risk assessments to guide tailored interventions. Assessments mainly focused on gait and balance. Exercise was the most offered intervention alone or in combination with education. Exercise programs were aligned with recommendations to include progressive balance and functional exercises overall. However, the frequency of ≥3 times weekly was less frequently offered. The gray literature showed a lack of fall prevention-specific information after upper limb fractures and mostly called attention to fall prevention after hip fractures.</p><p><strong>Conclusion: </strong>Upper limb fracture rehabilitation in older adults, considered at high risk of falling, did not include comprehensive and tailored multifactorial fall assessment and intervention. Unequivocally, exercise programs were overall aligned with recent recommendations and were the most frequent intervention. There is a crucial gap for humerus fractures. This study can help align the treatment of upper limb fractures with updated fall prevention recommendations and impact future research, guiding and influencing implementation in clinical practice.</p><p><strong>Impact: </strong>There is an urgent need to implement comprehensive and tailored multifactorial fall assessments and interventions in rehabilitation programs for older adults recovering from upper limb fractures. Guidelines should direct this work to enhance clinical practice.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468817","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":"Frailty Is Strongest Need Factor Among Predictors of Prehabilitation Utilization for Total Hip or Knee Arthroplasty in Fee-for-Service Medicare Beneficiaries.","authors":"Brocha Z Stern, Graham C Sabo, Uma Balachandran, Raquelle Agranoff, Brett L Hayden, Calin S Moucha, Jashvant Poeran","doi":"10.1093/ptj/pzae183","DOIUrl":"10.1093/ptj/pzae183","url":null,"abstract":"<p><strong>Objective: </strong>Prehabilitation may have benefits for total hip arthroplasty (THA) and total knee arthroplasty (TKA), given an aging population with multimorbidity and the growth of value-based programs that focus on reducing postoperative costs. This study aimed to describe prehabilitation use and examine predictors of utilization in fee-for-service Medicare beneficiaries.</p><p><strong>Methods: </strong>This retrospective cohort study using the Medicare Limited Data Set included fee-for-service Medicare beneficiaries who were ≥66 years old and who underwent inpatient elective THA or TKA between January 1, 2016, and September 30, 2021. The study assessed predictors of receiving preoperative physical therapist services within 90 days of surgery (prehabilitation) using a mixed-effects generalized linear model with a binary distribution and logit link. Adjusted odds ratios (ORs) were reported.</p><p><strong>Results: </strong>Of 24,602 THA episodes, 18.5% of patients received prehabilitation; of 38,751 TKA episodes, 17.8% of patients received prehabilitation. For both THA and TKA, patients with medium or high (vs low) frailty were more likely to receive prehabilitation (OR = 1.72-2.64). Male (vs female) patients, Black (vs White) patients, those with worse county-level social deprivation, those with dual eligibility, and those living in rural areas were less likely to receive prehabilitation before THA or TKA (OR = 0.65-0.88). Patients who were ≥85 years old (vs 66-69 years old) and who underwent THA were also less likely to receive services (OR = 0.84). Additionally, there were geographic differences in prehabilitation utilization and increased utilization in more recent years.</p><p><strong>Conclusion: </strong>The need factor of frailty was most strongly associated with increased prehabilitation utilization. The variation in utilization by predisposing factors (eg, race) and enabling factors (eg, county-level social deprivation) suggests potential disparities.</p><p><strong>Impact: </strong>The findings describe prehabilitation use in a large cohort of fee-for-service Medicare beneficiaries. Although services seem to be targeted to those at greater risk for adverse outcomes and high spending, potential disparities related to access warrant further examination.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877661","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":"Correction to: Feasibility of a Multidomain Resiliency Assessment in Patients With Advanced Heart Failure Requiring Surgery: A Pilot Study.","authors":"","doi":"10.1093/ptj/pzaf041","DOIUrl":"https://doi.org/10.1093/ptj/pzaf041","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"105 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780861","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":"The Case for Aggregated Rehabilitation-Relevant Data Across Health Care Systems and Settings.","authors":"Margaret A French, Joshua K Johnson, Jacob Kean, Janet K Freburger, Daniel L Young","doi":"10.1093/ptj/pzaf022","DOIUrl":"10.1093/ptj/pzaf022","url":null,"abstract":"<p><p>Health care value, quantified as outcome per unit cost, requires knowing which outcomes are influenced by which intervention at what cost. The value of rehabilitation is still largely unknown. Much of the reason for this limited evidence is historically poor standardization and collection of rehabilitation interventions, and objectively measured outcomes across care settings, care providers, and health care systems. The purposeful standardization and aggregation of rehabilitation-relevant data about interventions, cost, and outcomes from routine clinical practices offers potential to understand and improve the value of rehabilitation. This perspective details the critical need for rehabilitation-relevant data that are aggregated across settings, providers, and systems and proposes 3 options to meet this need, including (1) integrating rehabilitation-relevant data into existing research registry databases that are condition specific, (2) adding rehabilitation-relevant data to federally funded research networks, and (3) creating a novel rehabilitation registry database. There must be continued pursuit of discovering which rehabilitation interventions achieve which specific outcomes, in which settings, for which patients, and at what costs. Successfully aggregating rehabilitation-relevant data is critical for generating evidence that answers these key questions about the value of rehabilitation.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics, Trends, and Implications of Hybrid Doctor of Physical Therapy Programs in the United States.","authors":"Kendra Gagnon, Teresa Bachman, Amy Garrigues","doi":"10.1093/ptj/pzaf043","DOIUrl":"https://doi.org/10.1093/ptj/pzaf043","url":null,"abstract":"<p><strong>Importance: </strong>Hybrid Doctor of Physical Therapy (hDPT) programs, which combine online and in-person instruction, are becoming an increasingly common model for delivering physical therapist education. Understanding their characteristics, trends, and implications is critical to guiding their development and ensuring equitable and effective educational outcomes.</p><p><strong>Objective: </strong>The objective of this study was to examine characteristics and trends in hybrid (hDPT) education programs through a secondary analysis of publicly available data.</p><p><strong>Design: </strong>This study involved a secondary analysis of publicly available data on hDPT programs in the United States.</p><p><strong>Setting/participants/intervention: </strong>The study included accredited, candidate, and developing hDPT programs in the US and involved descriptive analyses of program-level data.</p><p><strong>Main outcomes and measures: </strong>Key variables included institution type, institution and program characteristics, admissions and enrollment data, and program outcomes.</p><p><strong>Results: </strong>There are 33 hDPT programs at 25 unique institutions in the United States, located in 21 states. hDPT programs enroll a more racially and ethnically diverse body compared to national averages. Mean hDPT program cohort size was 32% larger than national average. Mean first-time pass rate for the National Physical Therapy Examination (NPTE) for hDPT graduates was reported at 71%, while ultimate pass rates, graduation rates, and employment rates ranged from 96% to 99%. Mean program duration and costs were consistent with national averages.</p><p><strong>Conclusion and relevance: </strong>hDPT programs demonstrate potential to broaden access and diversity in the physical therapy profession. Standardized data collection and further research are essential to exploring these challenges and supporting development of accessible, equitable, and high-quality hybrid education pathways in physical therapy.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754145","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":"Effectiveness of Home-Based Rehabilitation on Activities of Daily Living in Patients with Stroke: Systematic Review and Meta-Analysis.","authors":"Yerim Do, Youngeun Lim, Shiyu Jin, Haneul Lee","doi":"10.1093/ptj/pzaf044","DOIUrl":"https://doi.org/10.1093/ptj/pzaf044","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review compared the effectiveness of home-based rehabilitation with that of hospital-based rehabilitation and usual care on activities of daily living (ADL) independence in patients with stroke.</p><p><strong>Methods: </strong>Ovid MEDLINE, Ovid EMBASE, and the Cochrane Library databases were searched for studies published between January 2000 and January 2024. This review was registered in the International Prospective Register of Systematic Reviews. Randomized controlled trials on home-based rehabilitation of patients with stroke were included. The included studies investigated ADL independence, upper limb function, mobility, balance, aerobic endurance, and quality of life. Two independent researchers extracted data using an extraction form and assessed the risk of bias and quality of evidence.</p><p><strong>Results: </strong>Forty-six studies were included in the qualitative synthesis and 34 studies were included in the quantitative synthesis using Review Manager software 5.4. ADL independence was not significantly different between patients receiving home-based rehabilitation and hospital-based rehabilitation (standardized mean difference = 0.17 [95% CI = 0.00 to 0.34], I2 = 29%). However, a significant difference was observed between home-based rehabilitation and usual care (standardized mean difference = 1.24 [95% CI = 0.69 to 1.79], I2 = 91%).</p><p><strong>Conclusion: </strong>Home-based rehabilitation is comparable to hospital-based rehabilitation and more effective than usual care and should be considered for patients with stroke after discharge to facilitate effective recovery. However, the high overall risk of bias requires cautious interpretation.</p><p><strong>Impact: </strong>Home-based rehabilitation can be an effective alternative method for improving ADL independence in patients with stroke by providing a familiar and convenient environment.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754146","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":"Meeting Physical Activity Guidelines for Persons with Multiple Sclerosis Reduces Fatigue Severity and Impact: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Libak Abou, Tanner Murphy, Ethan Truong, Joseph Peters","doi":"10.1093/ptj/pzaf046","DOIUrl":"https://doi.org/10.1093/ptj/pzaf046","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Regular physical activity is a recommended behavioral goal for persons with multiple sclerosis. This review aimed to determine the effect of interventions that met physical activity guidelines for persons with multiple sclerosis on fatigue measures and to compare the magnitudes of the effect sizes for meeting these guidelines with the minimal clinically important differences for fatigue measures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The search was conducted in PubMed, EMBASE, Web of Science, SPORTDiscus, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and PsycINFO from inception to October 2024. Only randomized clinical trials that explicitly met physical activity guidelines and evaluated fatigue were included. Two independent reviewers screened articles for inclusion and evaluated the risk of bias of included trials using the Cochrane risk-of-bias tool for randomized trials. Findings were summarized, and a meta-analysis was conducted. Fatigue measures included the Fatigue Severity Scale, Fatigue Impact Scale, and modified Fatigue Impact Scale. The Grading of Recommendations, Assessment, Development and Evaluation was used to evaluate the quality of the evidence. The review protocol was preregistered in the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number: CRD42023387305).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-two randomized clinical trials with 920 participants were included in the review; 17 studies were included in the meta-analysis. Findings indicated that interventions meeting physical activity guidelines for at least 4 weeks significantly reduced fatigue severity (standardized mean difference = -1.46; 95% CI = -2.11 to -0.81) and fatigue impact measured with the modified Fatigue Impact Scale (mean difference = -11.88; 95% CI = -20.57 to -3.19) and Fatigue Impact Scale (mean difference = -21.08; 95% CI = -31.01 to -11.15). All findings were clinically relevant, with effect sizes exceeding the established minimal clinically important differences for the fatigue measures. Some methodological concerns were noted, and the evidence level ranged from very low to moderate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Evidence suggests that engaging in physical activity for at least 150 min/wk or 2 sessions of 10 to 30 minutes of moderate-intensity aerobic training plus 2 sessions of resistance training per week results in clinically significant reductions in fatigue severity and impact necessary to improve the quality of life of persons with multiple sclerosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact: &lt;/strong&gt;Fatigue is a highly prevalent symptom associated with poor outcomes including falls, activity restrictions, pain, cognitive problems, functional limitations, and mortality risk among persons with multiple sclerosis. Our study suggests that adhering to physical activity guidelines developed for persons with multiple sclerosis clinically reduces the severity and impact o","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754148","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":"An Improvement Science Framework to Advance Sense of Belonging for Physical Therapist Students from Minoritized Backgrounds.","authors":"Keshrie Naidoo, Camille Powell, Diane U Jette","doi":"10.1093/ptj/pzaf045","DOIUrl":"https://doi.org/10.1093/ptj/pzaf045","url":null,"abstract":"<p><p>To better serve an increasingly racially and ethnically diverse United States population, the physical therapy profession has been focused on increasing the diversity of the physical therapy workforce and increasing recruitment of racially and ethnically minoritized (REM) students in Doctor of Physical Therapy (DPT) programs. In contributing to the goal of a diverse, equitable, and inclusive profession, DPT programs must admit, support, retain, and graduate individuals who represent diversity in its many aspects. However, factors such as a lack of REM mentors and decreased sense of belonging, contribute to disparate academic outcomes for REM DPT students. Although educators must act to implement innovative strategies to support a sense of belonging among students who have been historically marginalized, a systematic approach to decision-making, action, and analysis is needed when dealing with a complex problem with multifaceted causes and multiple possible solutions. Improvement science is a continuous improvement approach that uses a series of data-informed processes and the expertise of multiple stakeholders to promote equity in education, offering a framework for seeing the problem from the perspective of REM DPT students. Plan-Do-Study-Act (PDSA) cycles offer the opportunity to introduce educational changes on a smaller scale to evaluate variation prior to applying it to a larger setting. This perspective highlights a series of PDSA cycles trialing interventions aimed at decreasing barriers to success and improving a sense of belonging for REM DPT students. Even in the face of structural and institutionalized barriers, leveraging an improvement science framework can help to ensure that change is meaningful and lasting.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743373","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}