scholarly journals Impact of Continuing Education Interventions on Clinical Outcomes of Patients With Neck Pain Who Received Physical Therapy

2006 ◽  
Vol 86 (9) ◽  
pp. 1251-1262 ◽  
Author(s):  
Gerard P Brennan ◽  
Julie M Fritz ◽  
Stephen J Hunter
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Continuing Education ◽  
Clinical Outcomes ◽  
Clinical Improvement ◽  
Physical Therapists ◽  
Improvement Project ◽  
Clinical Databases ◽  
Education Interventions ◽  
Ongoing Project

Abstract Background and Purpose. Physical therapists frequently attend continuing education courses with the goal of providing better care, yet the effectiveness of continuing education for improving outcomes has not been examined. Subjects. Data were obtained for all eligible patients (n=1,365; mean age=42.1 years, SD=14.0 years; 69.9% female) with a chief complaint of neck pain who were treated in 13 physical therapy clinics over a 24-month period. Disability data (Neck Disability Index scores) from the initial and final therapy sessions were recorded from clinical databases. Methods. Thirty-four of 57 physical therapists employed within the 13 clinics attended a 2-day continuing education course. Eleven of the 34 attendees also participated in an ongoing clinical improvement project for patients with neck pain. Clinical outcomes were compared in the pre- and post-course periods for therapists attending or not attending the course, and for therapists participating or not participating in the ongoing project. Results. There were no differences in clinical outcomes based on attendance at the continuing education course. There was an interaction between time and participation in the ongoing project, such that participants achieved greater change in disability after the course. The percentage of patients achieving at least the minimum detectable amount of change in disability with treatment increased significantly for participants after the course. Discussion and Conclusion. Attendance at a 2-day continuing education course was not associated with improvement in clinical outcomes, but participation in an ongoing improvement project did result in greater clinical improvement for patients with neck pain. Further investigation of educational methods to improve clinical outcomes is needed. These results suggest that traditional continuing education formats may not be effective for improving patient care. [Brennan GP, Fritz JM, Hunter SJ. Impact of continuing education interventions on clinical outcomes of patients with neck pain who received physical therapy. Phys Ther. 2006;86:1251–1262.]

scholarly journals Does Continuing Education Improve Physical Therapists’ Effectiveness in Treating Neck Pain? A Randomized Clinical Trial

2009 ◽  
Vol 89 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Joshua A Cleland ◽  
Julie M Fritz ◽  
Gerard P Brennan ◽  
Jake Magel
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Continuing Education ◽  
Rating Scale ◽  
Physical Therapists ◽  
Neck Disability Index ◽  
Mean Difference ◽  
Educational Outreach ◽  
Final Visit ◽  
Pain Rating

Background and PurposePhysical therapists often attend continuing education (CE) courses to improve their overall clinical performance and patient outcomes. However, evidence suggests that CE courses may not improve the outcomes for patients receiving physical therapy for the management of neck pain. The purpose of this study was to investigate the effectiveness of an ongoing educational intervention for improving the outcomes for patients with neck pain.ParticipantsThe study participants were 19 physical therapists who attended a 2-day CE course focusing on the management of neck pain. All patients treated by the therapists in this study completed the Neck Disability Index (NDI) and a pain rating scale at the initial examination and at their final visit.MethodsTherapists from 11 clinics were invited to attend a 2-day CE course on the management of neck pain. After the CE course, the therapists were randomly assigned to receive either ongoing education consisting of small group sessions and an educational outreach session or no further education. Clinical outcomes achieved by therapists who received ongoing education and therapists who did not were compared for both pretraining and posttraining periods. The effects of receiving ongoing education were examined by use of linear mixed-model analyses with time period and group as fixed factors; improvements in disability and pain as dependent variables; and age, sex, and the patient's initial NDI and pain rating scores as covariates.ResultsPatients treated by therapists who received ongoing education experienced significantly greater reductions in disability during the study period (pretraining to posttraining) than those treated by therapists who did not receive ongoing training (mean difference=4.2 points; 95% confidence interval [CI]=0.69, 7.7). Changes in pain did not differ for patients treated by the 2 groups of therapists during the study period (mean difference=0.47 point; 95% CI=−0.11, 1.0). Therapists in the ongoing education group also used fewer visits during the posttraining period (mean difference=1.5 visits; 95% CI=0.81, 2.3).Discussion and ConclusionThe results of this study demonstrated that ongoing education for the management of neck pain was beneficial in reducing disability for patients with neck pain while reducing the number of physical therapy visits. However, changes in pain did not differ for patients treated by the 2 groups of therapists. Although it appears that a typical CE course does not improve the overall outcomes for patients treated by therapists attending that course, more research is needed to evaluate other educational strategies to determine the most clinically effective and cost-effective interventions.

scholarly journals Description of Common Clinical Presentations and Associated Short-Term Physical Therapy Clinical Outcomes in Patients With Neck Pain

2015 ◽  
Vol 96 (10) ◽  
pp. 1756-1762 ◽  
Author(s):  
Maggie E. Horn ◽  
Gerard P. Brennan ◽  
Steven Z. George ◽  
Jeffrey S. Harman ◽  
Mark D. Bishop
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Clinical Outcomes ◽  
Short Term ◽  
Clinical Presentations

scholarly journals Management of Back and Neck Pain: Who Seeks Care From Physical Therapists?

2005 ◽  
Vol 85 (9) ◽  
pp. 872-886 ◽  
Author(s):  
Janet K Freburger ◽  
Timothy S Carey ◽  
George M Holmes
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Illness Severity ◽  
Initial Evaluation ◽  
Factors Associated ◽  
Health And Illness ◽  
Spine Care ◽  
Therapy Services

Abstract Background and Purpose Little information is available on factors associated with physical therapist use by people with back or neck pain. Identifying the characteristics of people who seek care from physical therapists is a useful first step in determining whether there is appropriate use of physical therapy services. The purpose of this study was to identify factors associated with physical therapist use by people with back or neck pain. Subjects The subjects were 29,049 people who had back pain or neck pain, or both, and who were seen for an initial evaluation at 1 of 21 US spine care centers. Each subject and evaluating physician completed a written survey at the time of the initial evaluation. Methods Multiple logistic regression analyses were conducted to identify factors associated with physical therapist use. Results Several measures of health and illness severity were associated with physical therapist use. Age and being male were negatively associated with physical therapist use. Education level, having workers' compensation coverage, and being in litigation were positively associated with physical therapist use. Physical therapist use also varied by previous physician use and census region. Discussion and Conclusion The results suggest that variations in physical therapist use are associated with factors other than health and illness severity. The results also suggest that people who would benefit from physical therapy may not be receiving it or that people who would not benefit from physical therapy are receiving it, or both.

scholarly journals Clinical Outcomes, Utilization, and Charges in Persons With Neck Pain Receiving Guideline Adherent Physical Therapy

2016 ◽  
Vol 39 (4) ◽  
pp. 421-434 ◽  
Author(s):  
Maggie E. Horn ◽  
Gerard P. Brennan ◽  
Steven Z. George ◽  
Jeffrey S. Harman ◽  
Mark D. Bishop
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Clinical Outcomes

scholarly journals An Overview of 5 Years of Patient Self-Referral for Physical Therapy in the Netherlands

2014 ◽  
Vol 94 (12) ◽  
pp. 1785-1795 ◽  
Author(s):  
Ilse C.S. Swinkels ◽  
Margit K. Kooijman ◽  
Peter M. Spreeuwenberg ◽  
Daniël Bossen ◽  
Chantal J. Leemrijse ◽  
...  
Keyword(s):  
General Practice ◽  
Physical Therapy ◽  
The Netherlands ◽  
Neck Pain ◽  
Physical Therapists ◽  
Incidence Rates ◽  
Data Sources ◽  
Low Back ◽  
Gp Care ◽  
Existing Data

BackgroundSelf-referral for physical therapy was introduced in 2006 in the Netherlands. Internationally, debate on self-referral is still ongoing.ObjectiveThe aim of this study was to evaluate the effects of self-referral for physical therapy in the Netherlands, focusing on volume of general practice and physical therapy care (incidence rates and utilization of services).DesignThe study was based on monitoring data from existing data sources.MethodsLongitudinal electronic medical record data from general practitioners (GPs) and physical therapists participating in the NIVEL Primary Care Database were used, as well as public data from Statistics Netherlands. Descriptive statistics and Poisson multilevel regression analyses were used for analyzing the data.ResultsIncidence rates of back (including low back), shoulder, and neck pain in general practice declined slightly from 2004 to 2009. No linear trends were found for number of contacts in GP care for back (including low back) and neck pain. The number of patients visiting physical therapists and the proportion of self-referrers are growing. Self-referrers receive treatment less often after initial intake than referred patients, and the mean number of visits is lower.LimitationsThis study was based on data of various patient populations from existing data sources.ConclusionsThe current study indicates that self-referral in the Netherlands has fulfilled most expectations held prior to its introduction, although no changes to the workload of GP care have been found. Use of physical therapy grew, but due to population aging and increasing prevalence of chronic diseases, it remains unclear whether self-referral affects health care utilization. Therefore, cost-benefit analyses are recommended.

scholarly journals Variables Influencing Physical Therapists’ Perceptions of Continuing Education

2007 ◽  
Vol 87 (8) ◽  
pp. 1023-1036 ◽  
Author(s):  
Tricia M Austin ◽  
Kim C Graber
Keyword(s):  
Physical Therapy ◽  
Continuing Education ◽  
Qualitative Methodology ◽  
Physical Therapists ◽  
Physical Therapist ◽  
The Core ◽  
Core Set ◽  
Analyze Data

Background and Purpose: As of October 1, 2002, physical therapy continuing education (CE) in Illinois was mandated. Research examining the recent mandate for physical therapists to engage in CE is limited. The purposes of this study were to examine the perceptions of physical therapist clinicians and managers concerning the barriers to and facilitators of CE and to identify how physical therapists perceive the role of their department in the CE process.Subjects: Participants were 23 physical therapists at 6 hospitals.Methods: Qualitative methodology was used to analyze data.Results: Four themes were identified: negotiating and managing the variables associated with CE, providing and promoting opportunities that meet physical therapists’ CE needs, identifying the elements of employment environments that foster CE, and perceived implications of mandating CE.Discussion and Conclusion: This investigation highlights the need to identify the core set of variables associated with engaging in CE and to promote the elements of employment environments that foster CE.

scholarly journals Preliminary Examination of a Proposed Treatment-Based Classification System for Patients Receiving Physical Therapy Interventions for Neck Pain

2007 ◽  
Vol 87 (5) ◽  
pp. 513-524 ◽  
Author(s):  
Julie M Fritz ◽  
Gerard P Brennan
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Classification System ◽  
Interrater Reliability ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Neck Disability Index ◽  
Mean Difference ◽  
Classification Methods ◽  
Therapy Interventions

Background and PurposeNeck pain frequently is managed by physical therapists. The development of classification methods for matching interventions to subgroups of patients may improve clinical outcomes. The purpose of this study was to describe a proposed classification system for patients with neck pain by examining data for consecutive patients receiving physical therapy interventions.Subjects and MethodsStandardized methods for collecting baseline and intervention data were used for all patients receiving physical therapy interventions for neck pain over 1 year. Outcome variables were the Neck Disability Index (NDI), numeric pain rating, and number of visits. Treatment was provided at the discretion of the physical therapist. After the completion of treatment, each patient was classified by use of baseline variables. The interventions received by the patient were categorized as being matched or not matched to the classification. Outcomes for patients who received matched interventions were compared with those for patients who received nonmatched interventions. The interrater reliability of the classification algorithm was examined with a subset of 50 patients.ResultsA total of 274 patients were included in this study (74% women; age [X̄±SD]=44.4±16.0 years). The most common classification was centralization (34.7%); next were exercise and conditioning (32.8%) and mobility (17.5%). The interrater reliability for classification decisions was high (kappa=.95, 95% confidence interval [CI]=0.87–1.0). A total of 113 patients (41.2%) received interventions matched to the classification. Receiving matched interventions was associated with greater improvements in the NDI (mean difference=5.6 points, 95% CI=2.6–8.6) and in pain ratings (mean difference=0.74 point, 95% CI=0.21–1.3) than receiving nonmatched interventions.Discussion and ConclusionThe development of classification methods for patients with neck pain may improve the outcomes of physical therapy intervention. This study was done to examine a previously proposed classification system for patients receiving physical therapy interventions for neck pain. Receiving interventions matched to the classification system was associated with better outcomes than receiving nonmatched interventions. Although the design of this study prohibited drawing conclusions about the effectiveness of the system, the results suggest that further research on the system may be warranted.

scholarly journals Mandatory Continuing Education in Physical Therapy: Survey of Physical Therapists in States With and States Without a Mandate

2005 ◽  
Vol 85 (9) ◽  
pp. 861-871 ◽  
Author(s):  
Merrill R Landers ◽  
James W McWhorter ◽  
Laura L Krum ◽  
David Glovinsky
Keyword(s):  
Physical Therapy ◽  
Continuing Education ◽  
Physical Therapists ◽  
Years Of Experience ◽  
State Mandate ◽  
Mandatory Continuing Education ◽  
Significant Relationships ◽  
Or Practice ◽  
American Physical ◽  
Survey Questionnaires

Abstract Background and Purpose Although formal continuing education (CE) in physical therapy is one part of professional development, its value for renewing licensure is not shared by all states. The purpose of this study was to explore the differences in how physical therapists pursue formal continuing education on the basis of state mandate, sex, years of experience, practice specialty, American Physical Therapy Association membership, motivation, and perception of the benefits of CE. Subjects and Methods A survey questionnaire was sent to 3,000 physical therapists in 7 states—1,500 to physical therapists in states with mandatory CE and 1,500 to physical therapists in states without a requirement. A total of 1,145 usable survey questionnaires were returned, for a response rate of 38.2%. Results Physical therapists in states with mandatory CE averaged 33.8 hours of CE per year, whereas physical therapists in states without a mandate averaged 28.3 hours per year; 5.9% of therapists in states without a mandate reported taking no CE at all, and 10.8% reported taking 2 or fewer hours of CE within the preceding 5 years. No statistically significant relationships were observed between the amount of CE taken and years of experience, sex, or practice specialty. Therapists who reported membership in the American Physical Therapy Association participated in 7.2 more hours of CE per year than therapists who did not report membership. Significant motivational variables that respondents noted for taking CE were state mandate, increased clinical competence, and certification. Therapists overwhelmingly (96.2%) believed that CE had a beneficial effect on their clinical practice. Discussion and Conclusion Results from this study suggest that mandatory CE does have a significant association with the number of formal CE hours taken by physical therapists.

Sign in / Sign up

Export Citation Format

Share Document