Journal of Acute Care Physical Therapy最新文献

{"title":"Rehabilitation Outcomes for Patients With Severe Presentation of COVID-19: A Case Series.","authors":"Kathryn Solon, Allison Larson, Julie Ronnebaum, Catherine Stevermer","doi":"10.1097/JAT.0000000000000153","DOIUrl":"10.1097/JAT.0000000000000153","url":null,"abstract":"<p><p>To provide an outline of the timeline from acute care admission to inpatient rehabilitation facility discharge and describe the functional progress and tolerance of 2 individuals who were hospitalized but not intubated because of COVID-19.</p><p><strong>Method: </strong>Retrospective data were collected from the electronic medical record to describe the rehabilitation course of the first 2 consecutive patients admitted to the rehabilitation facility who were recovering from COVID-19. Both patients were octogenarian men who experienced functional decline while hospitalized for symptoms of COVID-19 and were recommended for further inpatient rehabilitation services. Progress during inpatient rehabilitation was tracked using the following outcome measures: Centers for Medicare & Medicaid Services Quality Indicators (QI), 6-Minute Walk Test, 10-Meter Walk Test, Timed Up and Go, and Berg Balance Scale.</p><p><strong>Results: </strong>Patient 1 had an 18-day acute care stay, a 13-day inpatient rehabilitation facility stay, and was discharged to home. Patient 2 had an interrupted 19-day acute care stay, a 15-day inpatient rehabilitation facility stay, and was discharged to a skilled nursing facility. Patient 1 improved 160.98 m in the 6-Minute Walk Test, 0.08 m/s in self-selected walking speed, and 85 points in the total Quality Indicators score. Patient 2 improved 115.22 m in the 6-Minute Walk Test, 0.14 m/s in self-selected walking speed, and 39 points in the total Quality Indicators score.</p><p><strong>Conclusion: </strong>The patients made clinically meaningful improvements in each outcome measure during their length of stay for inpatient rehabilitation. This reveals the positive rehabilitation potential of 2 older adult patients with COVID-19 and demonstrates the patients' ability to maintain inpatient rehabilitation facility level of activity. With individualized care and discharge planning, similar patients may make significant gains in function despite advanced age and comorbid conditions.</p>","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"12 3","pages":"115-121"},"PeriodicalIF":0.5,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224693/pdf/jat-12-115.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39056146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amended List of Reviewers for 2020","authors":"","doi":"10.1097/jat.0000000000000170","DOIUrl":"https://doi.org/10.1097/jat.0000000000000170","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47177742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FSS-ICU Scores at ICU Discharge Differ Across Postacute Care Dispositions","authors":"J. Skrzat, Michael Pechulis, Marcel DiFiore, Amanda Fink, George Fischer, Marian Jordan, Erika M Lebron, Alyssa Rieger","doi":"10.1097/JAT.0000000000000177","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000177","url":null,"abstract":"Purpose: To determine whether Functional Status Score for the Intensive Care Unit (FSS-ICU) scores acquired within 24 hours of medical-surgical intensive care unit (MSICU) discharge differ among postacute care discharge dispositions in a nonsurgical patient population. Methods: A retrospective medical record review for data collection was conducted over 12 months for patients in an MSICU. FSS-ICU scores were collected within 24 hours of MSICU discharge. Subjects were categorized into 4 postacute care discharge dispositions: home, subacute rehabilitation (SAR), inpatient rehabilitation (IP), or other. A 1-way analysis of variance and post hoc analyses were performed. Results: One hundred fifteen subjects were included. FSS-ICU scores acquired within 24 hours of MSICU discharge were significantly different (P < .001) between postacute care discharge dispositions. Post hoc analysis showed a statistically significant difference between home and SAR (P < .001), home and IP (P < .001), and home and other (P = .005). Conclusions: A difference was found in FSS-ICU scores acquired within 24 hours of MSICU discharge between home and all other postacute care discharge dispositions in a nonsurgical patient population. An FSS-ICU score less than 27 at MSICU discharge indicates that discharge planning to a postacute care discharge disposition other than home may be warranted.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"77 - 82"},"PeriodicalIF":0.5,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41784420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2021 Academy of Acute Care Physical Therapy Annual Lecture Award","authors":"P. Ohtake","doi":"10.1097/jat.0000000000000175","DOIUrl":"https://doi.org/10.1097/jat.0000000000000175","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41642848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the April 29, 2021, Letter to the Editor","authors":"K. E. Brueilly","doi":"10.1097/jat.0000000000000174","DOIUrl":"https://doi.org/10.1097/jat.0000000000000174","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47201105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximizing Effectiveness of Examination of Patients With Acute Dizziness in the Emergency Department","authors":"John Corsino","doi":"10.1097/JAT.0000000000000169","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000169","url":null,"abstract":"Physical therapists practicing on hospital units or in emergency departments must be prepared to do more than simply treat vestibular disorders diagnosed by other providers; we need to help care teams identify the source of a dizzy patient's complaints. Because the consequences of delayed or erroneous diagnosis may be catastrophic for the dizzy patient, the evaluating therapist's responsibility is to minimize the likelihood of inaccuracy in the diagnostic process. Practice standards, which involve both examination techniques and reasoning frameworks, are not widely used. Therapists who apply these standards can reduce diagnostic error. Understanding the strategies described within is essential for therapists who evaluate acutely dizzy patients and contribute diagnostic information to care teams.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"45 - 53"},"PeriodicalIF":0.5,"publicationDate":"2021-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47504480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the Acute Care Curriculum","authors":"Megan J. Sabatke, Ashley M. Young, A. Johnson, J. Darbee, K. Mayer","doi":"10.1097/JAT.0000000000000166","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000166","url":null,"abstract":"Objective: The purpose of this study was to describe the effect of acute care curriculum changes on a university's doctor of physical therapy (DPT) graduates by aggregating quantitative data from 2 academic surveys. Methods: This was a retrospective study describing physical therapist students' perspective, confidence, and employment in acute care physical therapy using data from 2 academic surveys administered to graduates from a DPT program. Results: From 2010 to 2018, 569 students graduated from the DPT program with a median of 100% (interquartile range 97%-100.5%) response rate for the self-assessment survey and a median of 38% (interquartile range 33%-48%) completion of the graduate outcome survey. The majority of DPT graduates self-reported being at or above expected level of competence with cardiopulmonary and complex patients, which appeared to increase from 77.4% and 88.7% in 2012 to 97% and 100% in 2018, respectively. Similar increasing trends were noted with the number of first jobs in the acute care setting (+5.4%) and interest (+9.1%) in the acute care setting, but not as consistently. DPT graduates' level of comfort in the acute care setting did not change over time. Conclusions: Curricular changes devised to enhance acute care physical therapy training in a program's DPT curriculum may have led to graduates reporting increased competency in the unique skill set needed to work in this setting. DPT programs require the continued assessment of educational requirements and competencies to fulfill the growing need for physical therapists in the acute care setting.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"16 - 23"},"PeriodicalIF":0.5,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42809184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making a Connection","authors":"Traci L. Norris","doi":"10.1097/JAT.0000000000000168","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000168","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41738024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Therapy and Discharge Disposition Following Acute Hospitalization for UTI in Community-Dwelling Older Adults","authors":"T. Simmons, Stephanie A Miller, E. Moore, S. J. Stikeleather","doi":"10.1097/JAT.0000000000000162","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000162","url":null,"abstract":"Background: Bed rest during acute hospitalization is associated with new-onset mobility impairments in community-dwelling older adults, resulting in discharge to skilled nursing facilities rather than home. Purpose: The purpose of this retrospective study is to determine whether the number of physical therapy (PT) visits is related to discharge disposition following an acute hospitalization for urinary tract infection (UTI) in the older adult population. Methods: Medical records over a 3-year period of 523 community-dwelling older adults (65 years and older) admitted from home functionally independent were reviewed. Demographic and patient characteristics, including age, gender, living status, length of stay (LOS), discharge disposition, and the number of PT visits, were collected. Multinomial regression was conducted to determine predictors of disposition. Results: The multinomial logistic regression model was statistically significant, χ2(2) = 6.90, P = .032. Older age, longer LOS with fewer PT visits during acute hospitalization, and a higher comorbidity score were significant predictors of hospital discharge to subacute rehabilitation facilities than those who were able to return home with home health PT. These variables were not predictors of the disposition for younger patients with fewer comorbidities. Limitations: Due to the retrospective nature of this study, assessment of potential preexisting levels of frailty, standardized delivery of PT, and level of activity outside of PT could not be performed. Conclusions: Reduced frequency of physical therapist intervention for older adults hospitalized with UTI was associated with discharge to rehabilitation in a skilled nursing facility compared with those of similar age with increased PT intervention frequency.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"54 - 60"},"PeriodicalIF":0.5,"publicationDate":"2021-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44897715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Care Physical Therapy Practice Analysis Identifies the Need for a Core Outcome Measurement Set","authors":"K. Mayer, Traci Norris, Sowmya Kumble, N. Morelli, S. Gorman, P. Ohtake","doi":"10.1097/JAT.0000000000000161","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000161","url":null,"abstract":"Purpose: This study's primary objective is to determine the current use of outcome measures (OMs) by physical therapists practicing in acute care settings. Secondarily, this study aims to establish whether physical therapists support the development of a core OM set for use in acute care settings. Methods: An investigator-developed online survey (Qualtrics) was distributed to acute care physical therapy stakeholders, including practicing clinicians, educators, and administrators. The survey contained 4 sections with 28 questions: (1) acute care physical therapy practice patterns; (2) use of OMs in practice; (3) the development of a core OM set; and (4) demographic, education, and experience in the physical therapy profession. Descriptive statistics were used to assess response frequency and rationale for the use of specific OMs. Results: A convenience sample of 170 acute physical therapy stakeholders completed the survey. Respondents represented 38 states, with most respondents (n = 153; 90%) practicing in one or more acute care specialty areas. The majority of respondents (n = 145; 83%) reported using an OM more than 50% of the time in their practice. Physical function was the main construct (n = 163; 96%) respondents assessed with an OM. Acute care physical therapists primarily used OMs to track response to interventions (n = 134; 79%) and develop a care plan (n = 91; 54%). Length of time required to complete an OM and its clinical utility were the most common rationales for selecting an OM (n = 150, 88%; n = 147, 86%, respectively). Strong support was found for developing a core OM set for acute physical therapist practice (n = 147; 86%). The preferred methods for the organization of a core OM set, in rank order, were by diagnosis, International Classification of Functioning, Disability, and Health (ICF) framework, domains of health, and settings/location. Conclusion: Most physical therapists participating in this study of practice in acute care reported using OMs in their daily practice. This survey confirms the desire to develop a core OM set with high clinical utility for use in acute care settings.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"12 1","pages":"150 - 157"},"PeriodicalIF":0.5,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41684622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}