scholarly journals Managing a Patient's Constipation With Physical Therapy

2006 ◽  
Vol 86 (11) ◽  
pp. 1511-1519 ◽  
Author(s):  
Kendra L Harrington ◽  
Esther M Haskvitz
Keyword(s):  
Physical Therapy ◽  
Physical Therapist ◽  
The United States ◽  
Program Outcomes ◽  
Diet Modification ◽  
Unsuccessful Treatment ◽  
Patient Reported ◽  
Abdominal Massage ◽  
Typical Treatment ◽  
And Function

Abstract Background and Purpose. 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. Case Description. 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. Outcomes. Upon re-examination, the patient reported a return of normal bowel frequency and function without the need to strain or use digital evacuation. Discussion. 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. [Harrington KL, Haskvitz EM. Managing a patient's constipation with physical therapy. Phys Ther. 2006;86:1511–1519.]

Feasibility of Goal Attainment Scaling in Chronic Low Back Pain: Protocol for Training & Implementation in an Outpatient Physical Therapy Setting (Preprint)

2021 ◽  
Author(s):  
Douglas Haladay ◽  
Rebecca Edgeworth Ditwiler ◽  
Aimee Klein ◽  
Rebecca Miro ◽  
Matthew Lazinski ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Clinical Setting ◽  
Goal Attainment ◽  
Physical Therapists ◽  
The United States ◽  
Goal Attainment Scaling ◽  
Low Back ◽  
Patient Centered ◽  
Patient Reported ◽  
Qualitative Phase

BACKGROUND Patient engagement in decisions regarding their healthcare may lead to improved outcomes and improved adherence to treatment plans. While there are several options for involving patients in their healthcare, goal setting is a readily accessible method for physical therapists to increase the involvement of patients in healthcare decisions. Physical therapy goals are often provider-generated and based on subjective information or standardized fixed-item patient-reported outcome measures. However, these outcome measures may provide a limited scope of activity and participation limitations which may not capture the needs of individual patients. Goal Attainment Scaling (GAS) is a patient-centered approach to involving patients in setting meaningful goals. While GAS has been shown to be reliable, valid, and sensitive to change in various population, there is limited evidence in the United States about utilizing GAS in the physical therapist management of patients with low back pain (LBP). OBJECTIVE The purpose of this report is to describe the protocol for a study to a) develop an application of GAS procedures to be used by physical therapists treating patients with chronic LBP in the United States and b) to test the feasibility of applying GAS procedures in chronic LBP in an outpatient physical therapy setting. METHODS This study will use a mixed-methods design with two (2) phases (Phase 1: Qualitative, Phase 2: Quantitative). The qualitative phase of the study will employ focus groups of patients with chronic LBP to identify an inventory of goals that are important and measurable. This inventory will be used to develop a series of leading questions that will allow physical therapists to assist patients in establishing goals in the clinical setting. The quantitative phase of the study will pilot-test the inventory developed in the qualitative arm in patients with chronic LBP to determine feasibility, reliability, validity, and responsiveness. We will also compare how well GAS captures change over time as compared to traditional fixed-item patient-reported measures. RESULTS We anticipate that this study will demonstrate that GAS can be implemented successfully by outpatient physical therapists, and it will demonstrate clinically important changes that are important to patients with chronic LBP. CONCLUSIONS GAS represents an opportunity for patient-centered care in the physical therapy management of chronic LBP. While GAS is not new, it has never been studied in a real-world clinical setting for the physical therapy management of chronic LBP which have unique time and productivity constraints. For GAS to be successfully implemented in this environment, we must demonstrate that clinicians can be trained efficiently and reliably, that GAS can be implemented in the clinical setting in under 15 minutes, and that GAS is able to detect clinically meaningful change in patient outcomes. CLINICALTRIAL N/A

scholarly journals 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

2016 ◽  
Vol 13 ◽  
pp. 35 ◽  
Author(s):  
Jennifer C. Reneker ◽  
Kyra Weems ◽  
Vincent Scaia
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Student Perceptions ◽  
Geriatric Patients ◽  
Physical Therapist ◽  
The United States ◽  
Community Dwelling ◽  
Effect Sizes ◽  
Entry Level ◽  
Geriatric Education

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<0.05) 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.

scholarly journals One Grip a Little Stronger

2003 ◽  
Vol 83 (11) ◽  
pp. 1014-1021 ◽  
Author(s):  
Pamela W Duncan
Keyword(s):  
United States ◽  
Health Care ◽  
Physical Therapy ◽  
Stroke Rehabilitation ◽  
American Heart Association ◽  
American Heart ◽  
Physical Therapist ◽  
Heart Association ◽  
The United States ◽  
Rehabilitation Research

Abstract Pamela W Duncan, PT, PhD, FAPTA Dr Duncan has actively participated in and contributed to physical therapist practice, physical therapist professional education, professional preparation of other health care providers, national policy development related to rehabilitation after stroke and aging, and scientific investigation. She has served several government appointments and provides leadership within several organizations. She served as co-chair of the Consensus Panel on Establishing Guidelines for Stroke Rehabilitation for the Agency for Health Care Policy, Research, and Education. She was a panel member on the National Institutes of Health's Total Hip Replacement Consensus Conference and served on the Strategic Planning Group for Stroke Research for the National Institute of Neurological Disorders and Stroke. She recently was appointed to serve on the Steering Committee of the Department of Education's National Institute on Disability and Rehabilitation Research and is currently on the Executive Leadership Council of the American Stroke Foundation and the Advisory Committee of the Canadian Stroke Network. She has served on committees and panels for the American Heart Association and was president of APTA's Neurology section. Dr Duncan's research activities focus on geriatric rehabilitation, stroke rehabilitation, and health outcomes measurement. She developed the Functional Reach Test, used to assess balance in older adults. In the past 20 years, she has received $13 million in research awards as principal investigator or co-investigator from agencies such as the National Institutes of Health, National Institute on Aging, American Heart Association, Department of Veteran's Affairs, and National Center for Medical Rehabilitation Research and from multiple private funding sources. Dr Duncan has disseminated her research findings in more than 80 peer-reviewed articles in 20 different journals, and she has written a book and 12 book chapters. Dr Duncan's work has influenced the care and rehabilitation of patients in the United States and worldwide. Physical therapy education programs across the country incorporate her findings and professional vision into the preparation of the next generation of physical therapists. APTA has awarded Dr Duncan the Marian Williams Award for Research in Physical Therapy, the Catherine Worthingham Fellowship Award, and the Mary McMillan Scholarship Award. She has also received research awards from the APTA Neurology Section, Sports Physical Therapy Section, and Section on Geriatrics, as well as a service award from the Neurology Section. She is an elected fellow of the Stroke Council of the American Heart Association and has given 8 invited lectureships at universities across the United States.

A Conversation with IAYT President Matthew Taylor

2008 ◽  
Vol 18 (1) ◽  
pp. 105-108
Author(s):  
Kelly McGonigal
Keyword(s):  
Physical Therapy ◽  
United States Army ◽  
Physical Therapist ◽  
The United States ◽  
Alternative Health ◽  
Yoga Therapy ◽  
Baylor University ◽  
Transformation Learning ◽  
The Board Of Directors ◽  
Learning And Change

Matthew J. Taylor, PT, PhD, RYT was elected president of the board of directors for IAYT in February 2008. He has 27 years of clinical experience in physical therapy and is a leader in integrating Yoga with Western approaches to rehabilitation and therapy. He received his Masters of Physical Therapy degree from Baylor University in 1981, and served as a physical therapist and active duty Army Medical Specialist officer in the United States Army from 1980 through 1988. In 1988, he left the military and opened a private physical therapy practice in Galena, Illinois. In 1995, he expanded his physical therapy practice into an integrated clinic and health club. He became a certified, advanced-level Integrative Yoga Therapy therapist in 1998, and in 2006, he completed his PhD in transformational learning and change thorough the California Institute of Integral Studies. In 2003, he founded the Dynamic Systems Rehabilitation (DSR) clinics in Scottsdale, AZ. The clinic offers therapy and wellness services that integrate classical Yoga, physical therapy, and modern transformation learning theory. He has been an IAYT board member since February 2007 and is IAYT's representative for the Academic Consortium for Complementary and Alternative Health Care. Matt sat down with us to discuss his perspective on Yoga therapy, IAYT, and some possibilities for the future of both.

scholarly journals Use of Physical Therapy for Low Back Pain by Medicaid Enrollees

2015 ◽  
Vol 95 (12) ◽  
pp. 1668-1679 ◽  
Author(s):  
Julie M. Fritz ◽  
Jaewhan Kim ◽  
Anne Thackeray ◽  
Josette Dorius
Keyword(s):  
Emergency Department ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
The United States ◽  
Health Care Use ◽  
Low Back ◽  
Future Health ◽  
Patient Reported ◽  
Future Health Care

Background Medicaid insures an increasing proportion of adults in the United States. Physical therapy use for low back pain (LBP) in this population has not been described. Objective The study objectives were: (1) to examine physical therapy use by Medicaid enrollees with new LBP consultations and (2) to evaluate associations with future health care use and LBP-related costs. Design The study was designed as a retrospective evaluation of claims data. Methods A total of 2,289 patients with new LBP consultations were identified during 2012 (mean age=39.3 years [SD=11.9]; 68.2% women). The settings in which the patients entered care and comorbid conditions were identified. Data obtained at 1 year after entry were examined, and physical therapy use was categorized with regard to entry setting, early use (within 14 days of entry), or delayed use (&gt;14 days after entry). The 1-year follow-up period was evaluated for use outcomes (imaging, injection, surgery, and emergency department visit) and LBP-related costs. Variables associated with physical therapy use and cost outcomes were evaluated with multivariate models. Results Physical therapy was used by 457 patients (20.0%); 75 (3.3%) entered care in physical therapy, 89 (3.9%) received early physical therapy, and 298 (13.0%) received delayed physical therapy. Physical therapy was more common with chronic pain or obesity comorbidities and less likely with substance use disorders. Entering care in the emergency department decreased the likelihood of physical therapy. Entering care in physical medicine increased the likelihood. Relative to primary care entry, physical therapy entry was associated with lower 1-year costs. Limitations A single state was studied. No patient-reported outcomes were included. Conclusions Physical therapy was used often by Medicaid enrollees with LBP. High rates of comorbidities were evident and associated with physical therapy use. Although few patients entered care in physical therapy, this pattern may be useful for managing costs.

scholarly journals Mismatch between the proposed ability concepts of the Graduate Record Examination and the critical thinking skills of physical therapy applicants suggested by an expert panel in the United States

2019 ◽  
Vol 16 ◽  
pp. 24 ◽  
Author(s):  
Emily Shannon Hughes
Keyword(s):  
Critical Thinking ◽  
Physical Therapy ◽  
Assessment Tool ◽  
Expert Panel ◽  
Physical Therapist ◽  
Graduate Programs ◽  
The United States ◽  
Thinking Skills ◽  
Graduate Record Examination ◽  
Delphi Approach

Purpose: The Graduate Record Examination (GRE) is a general examination predictive of success in US-based graduate programs. Used to assess students’ written, mathematical, and critical thinking (CT) skills, the GRE is utilized for admission to approximately 85% of US physical therapist education (PTE) programs. The purpose of this study was to assess whether the CT skills measured by the GRE match those deemed by an expert panel as the most important to assess for PTE program acceptance.Methods: Using a modified E-Delphi approach, a 3-phase survey was distributed over 8 weeks to a panel consisting of licensed US physical therapists with expertise on CT and PTE program directors. The CT skills isolated by the expert panel, based on Facione’s Delphi report, were compared to the CT skills assessed by the GRE.Results: The CT skills supported by the Delphi report and chosen by the expert panel for assessment prior to acceptance into US PTE programs included clarifying meaning, categorization, and analyzing arguments. Only clarifying meaning matched the CT skills from the GRE.Conclusion: The GRE is a test for general admission to graduate programs, lacking context related to healthcare or physical therapy. The current study fails to support the GRE as an assessment tool of CT for admission to PTE programs. A context-based admission test evaluating the CT skills identified in this study should be developed for use in the admission process to predict which students will complete US PTE programs and pass the licensure exam.

Referral for Imaging in Physical Therapist Practice: Key Recommendations for Successful Implementation

2021 ◽  
Author(s):  
Aaron Paul Keil ◽  
Charles Hazle ◽  
Amma Maurer ◽  
Connie Kittleson ◽  
Daniel Watson ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Diagnostic Imaging ◽  
Physical Therapists ◽  
Physical Therapist ◽  
The United States ◽  
Successful Implementation ◽  
Program Accreditation ◽  
Therapy Program ◽  
Normative Practice ◽  
American Physical

Abstract In recent years, the use of diagnostic imaging in physical therapist practice in the United States (US) has gained considerable interest. In several countries around the world and in the US military, patient direct referral for diagnostic imaging has been considered normative practice for decades. US physical therapy program accreditation standards now stipulate that diagnostic imaging content must be included in physical therapist educational curricula. The American Physical Therapy Association (APTA) has made efforts to pursue practice authority for imaging referral. A recent review of state practice acts and other statutory language concluded that many states have no prohibitions against physical therapists referring for imaging studies. Additionally, physical therapists can now pursue certification as musculoskeletal sonographers. In light of these advances, and with a growing number of PTs serving patients who have not yet seen another healthcare provider, it may be helpful for those who have been actively involved in the use of imaging in PT practice to provide their collective recommendations to serve as a guideline to those interested in incorporating this practice privilege. The purpose of this perspective article is to provide an overview of the key elements necessary for effective implementation of referral for imaging in physical therapist practice while emphasizing the cornerstone of effective communication.

We Don’t Know our Own Strength: A Survey of Strength Training Attitudes, Behaviors and Knowledge in Physical Therapists and Physical Therapist Students

2021 ◽  
Author(s):  
Reed Handlery ◽  
Emma Shover ◽  
Thavi Chhoun ◽  
Lauren Durant ◽  
Kaci Handlery ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Strength Training ◽  
Professional Education ◽  
Physical Therapists ◽  
Physical Therapist ◽  
The United States ◽  
Physical Therapy Students ◽  
Physical Therapy Education ◽  
Education Participation ◽  
Therapy Education

Abstract Objective Strength training is frequently utilized by physical therapists; however, there has been discussion about whether physical therapists utilize strength training adequately. The purpose of this study was to describe and compare the strength training attitudes, behaviors, and knowledge of physical therapists and physical therapy students and to determine how participant characteristics influenced knowledge scores. Methods An anonymous survey was created in 3 rounds. For round 1, researchers used textbooks to create items assessing demographics, attitudes, behaviors, and knowledge regarding strength training. Rounds 2 and 3 consisted of feedback from 7 content experts until 80% consensus was reached; items were added, removed, or edited based on feedback. The final survey was distributed through social media, list servs, and email, targeting physical therapists and students based in the United States. Response frequencies for all items were reported. Overall knowledge scores were calculated by summing correct responses for each item, with a maximum score of 13; scores &lt;70% were considered low. Binomial logistic regression determined which characteristics (demographics, attitudes, or behaviors) influenced whether participants adequately utilized strength training principles (scored ≥70% on knowledge items). Results There were 777 physical therapist and 648 student participants. Nearly 90% of therapists and students reported frequently prescribing strength training. Over 48% of therapists felt their professional education did not prepare them to apply strength training (compared with 24% of students), and 68% believed that strength training is inadequately applied in physical therapy (compared with 40% of students). Sixty-two percent of therapists and 55% of students scored ≥70% for knowledge items. Additional strength training education and regular participation in strength training increased the odds of scoring ≥70% on knowledge items. Conclusions Physical therapists and physical therapy students frequently prescribe strength training, despite similarly low knowledge scores. To increase knowledge, greater emphasis on strength training in professional education, continuing education, participation in strength training, or all 3 is warranted. Impact Strength training is an important intervention used in physical therapy and must be used appropriately to improve the health of patients. According to these findings, strength training education may not currently be optimal, as demonstrated by low knowledge scores by both therapists and students. Further work is needed to determine how knowledge of strength training relates to patient outcomes and also how best to implement strength training in physical therapy education and practice.

scholarly journals Toward Sensitive Practice: Issues for Physical Therapists Working With Survivors of Childhood Sexual Abuse

1999 ◽  
Vol 79 (3) ◽  
pp. 248-261 ◽  
Author(s):  
Candice L Schachter ◽  
Carol A Stalker ◽  
Eli Teram
Keyword(s):  
Sexual Abuse ◽  
Physical Therapy ◽  
Childhood Sexual Abuse ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Adult Survivors ◽  
The United States ◽  
Female Survivors ◽  
Semistructured Interviews

Abstract Background and Purpose. The high rates of prevalence of childhood sexual abuse in the United States and Canada suggest that physical therapists work, often unknowingly, with adult survivors of childhood sexual abuse. The purposes of this qualitative study were to explore the reactions of adult female survivors of childhood sexual abuse to physical therapy and to listen to their ideas about how practitioners could be more sensitive to their needs. The dynamics and long-term sequelae of childhood sexual abuse, as currently understood by mental health researchers and as described by the participants, are summarized to provide a context for the findings of this study. Subjects and Methods. Twenty-seven female survivors (aged 19–62 years) participated in semistructured interviews in which they described their reactions to physical therapy. Results. Survivors' reactions to physical therapy, termed “long-term sequelae of abuse that detract from feeling safe in physical therapy,” are reported. Participant-identified suggestions that could contribute to the sense of safety are shared. Conclusions and Discussion. Although the physical therapist cannot change the survivor's history, an appreciation of issues associated with child sexual abuse theoretically can increase clinicians' understanding of survivors' reactions during treatment. We believe that attention by the physical therapist to the client's sense of safety throughout treatment can maximize the benefits of the physical therapy experience for the client who is a survivor. [Schachter CL, Stalker CA, Teram E. Toward sensitive practice: issues for physical therapists working with survivors of childhood sexual abuse.

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