scholarly journals Emergence of Delayed Posttraumatic Stress Disorder Symptoms Related to Sexual Trauma: Patient-Centered and Trauma-Cognizant Management by Physical Therapists

2012 ◽  
Vol 92 (2) ◽  
pp. 339-351 ◽  
Author(s):  
Kim Dunleavy ◽  
Amy Kubo Slowik
Keyword(s):  
Physical Therapy ◽  
Sexual Trauma ◽  
Stress Disorder ◽  
Physical Therapists ◽  
Ptsd Symptoms ◽  
Behavioral Strategies ◽  
Patient Centered ◽  
Physical Therapy Treatment ◽  
History Of ◽  
Therapy Treatment

Background and PurposeSexual violence has been identified as one of the most common predictors of posttraumatic stress disorder (PTSD). This case report describes the emergence of delayed PTSD symptoms, disclosure of history of sexual trauma, and the influence of re-experiencing, avoidance, and hyperarousal symptoms on physical therapy treatment.Case DescriptionA 60-year-old woman was seen for treatment of low back pain. Discussion of a discord between fear of falling and no balance impairments led to disclosure of sexual assault by a physician at 19 years of age. The patient's PTSD symptoms emerged after 10 weeks of physical therapy. The physical therapists monitored somatic responses and body language closely and modified and planned treatment techniques to avoid PTSD triggers and limit hyperarousal. Collaborative communication approaches included reinforcement of cognitive-behavioral strategies introduced by her psychotherapists.OutcomesTrauma-cognizant approaches supported the patient's efforts to manage PTSD symptoms sufficiently to tolerate physical therapy and participate in a back care class. Nonlinear psychological healing is illustrated.DiscussionSymptoms of PTSD may emerge during physical therapy treatment, and patient-sensitive responses to disclosure are important. The trauma-cognizant approach (2-way communication, patient-centered management, and integration of psychological elements into clinical decision making) helped identify and respond to triggers. The physical therapists reinforced cognitive-behavioral strategies introduced by psychotherapists to manage PTSD symptoms. Patient-centered care with further refinement to a trauma-cognizant approach may play an important role in assisting patients with PTSD or a history of sexual trauma to manage symptoms while addressing rehabilitation needs.

scholarly journals Internal and External Focus of Attention During Gait Re-Education: An Observational Study of Physical Therapist Practice in Stroke Rehabilitation

2013 ◽  
Vol 93 (7) ◽  
pp. 957-966 ◽  
Author(s):  
Louise Johnson ◽  
Jane H. Burridge ◽  
Sara H. Demain
Keyword(s):  
Physical Therapy ◽  
Stroke Rehabilitation ◽  
Physical Therapists ◽  
Focus Of Attention ◽  
Small Sample ◽  
Gait Rehabilitation ◽  
External Focus ◽  
Physical Therapy Treatment ◽  
The Impact ◽  
Therapy Treatment

BackgroundFocus of attention is known to play an important role in motor skill learning, yet little is known about how attention is directed within the context of stroke rehabilitation.ObjectiveThe aims of this study were: (1) to identify physical therapists' use of internal and external focus of attention during gait rehabilitation for individuals with hemiplegia following stroke and (2) to use the findings to design an experimental study examining the impact of focus of attention on learning poststroke.DesignThe study design involved direct nonparticipation observation of physical therapy treatment sessions.MethodsEight physical therapy treatment sessions, in which gait rehabilitation was taking place, were video recorded. Patients were aged between 36 and 85 years, and ranged from 7 to 216 days poststroke; physical therapists had between 3 and 12 years of experience in stroke rehabilitation. Data analysis took 2 forms: (1) clear definitions of internal and external focus of attention were agreed on via a consensus group and used to develop an analysis matrix through which incidences of instruction and feedback were identified, categorized, and counted; and (2) verbal dialogue was transcribed verbatim and transcripts were thematically analyzed to provide a detailed description of how instructions and feedback were used, illustrated by examples.ResultsThe use of instructions and feedback (internal and external focus) was high; an average of one verbal instruction or feedback statement was delivered every 14 seconds. Sixty-seven percent of the statements were internally focused, 22% were externally focused, and 11% were of mixed focus. Unfocused statements (eg, “good”) also were used regularly. Patients were frequently encouraged to “think about” their performance.LimitationsObservational data collection methods may result in changes in the behavior of those observed, which is a potential source of bias. The small sample size also was a limitation of the study.ConclusionPhysical therapists frequently encouraged patients to be aware of their movements and their performance (internal focus). This approach may reduce automaticity and hinder learning and retention.

Patient perspectives on using a smartphone application to support home-based exercise during physical therapy treatment: a qualitative study. (Preprint)

2021 ◽  
Author(s):  
Remco Arensman ◽  
Corelien Kloek ◽  
Martijn Pisters ◽  
Tjarco Koppenaal ◽  
Raymond Ostelo ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Smartphone Application ◽  
Patient Perspectives ◽  
Low Back ◽  
Home Based ◽  
Physical Therapy Treatment ◽  
And Performance ◽  
Therapy Treatment

BACKGROUND Home-based exercise is an important part of physical therapy treatment for patients with low back pain. However, treatment effectiveness depends heavily on patient adherence to home-based exercise recommendations. Smartphone applications designed to support home-based exercise have the potential to support adherence to exercise recommendations and potentially improve treatment effects. A better understanding of patient perspectives on the use of smartphone applications to support home-based exercise during physical therapy treatment can assist physical therapists with optimal use and implementation of these applications in clinical practice. OBJECTIVE The aim of this study is to investigate patient perspectives on the acceptability, satisfaction, and performance of a smartphone application to support home-based exercise following recommendations from a physical therapist. METHODS Using a interpretivist phenomenology approach, nine patients with non-specific low back pain recruited from two primary care physical therapy practices were interviewed within two weeks after treatment ended. The Physitrack® smartphone application was used to support home-based exercise as part of treatment for all patients. Data was analyzed using a framework approach to assist with interpretation of the data. RESULTS Data-analysis revealed eleven categories distributed among the three themes “acceptability”, “satisfaction”, and “performance”. Patients are willing to accept the application as part of treatment when it is easy to use, benefits the patient, and when the physical therapist instructs the patient in its use. Satisfaction with the app is determined by the perceived support from the application when exercising at home and the perceived increase in adherence. The video and text instructions, reminder functions, and self-monitor functions are considered most important for performance during treatment. The patients did not view the Physitrack® app as a replacement for the physical therapist and relied on their therapist for instruction and support when needed. CONCLUSIONS Patients who used an app to support home-based exercise as part of treatment are accepting of the app when it is easy to use, benefits the patient, and the therapist instructs the patient in its use. Physical therapists using an app to support home-based exercise can use the findings from this study to more effectively support their patients when exercising at home during treatment.

scholarly journals Primary Care Physical Therapy in People With Fibromyalgia: Opportunities and Boundaries Within a Monodisciplinary Setting

2010 ◽  
Vol 90 (12) ◽  
pp. 1815-1822 ◽  
Author(s):  
Jo Nijs ◽  
Kaisa Mannerkorpi ◽  
Filip Descheemaeker ◽  
Boudewijn Van Houdenhove
Keyword(s):  
Primary Care ◽  
Physical Therapy ◽  
Aerobic Exercise ◽  
Physical Therapists ◽  
Tertiary Care ◽  
Strengthening Exercise ◽  
Physical Therapy Treatment ◽  
Few Data ◽  
Evidence Based Guidelines ◽  
Therapy Treatment

Despite the fact that people with fibromyalgia syndrome (FMS) frequently are seen by primary care physical therapists, guidelines for the management of FMS are based primarily on outcomes from multidisciplinary and tertiary care treatment studies. Few data addressing the treatment of patients with FMS in primary care currently are available. The evidence-based guidelines on the management of FMS are based, in part, on evidence from studies examining physical therapy treatment components alone (eg, aerobic exercise, education). Thus, the recommendations can be applied to primary care physical therapy. Primary care physical therapy for patients with FMS should include education, aerobic exercise, and strengthening exercise. For other treatment components such as passive treatments, activity management, and relaxation, less evidence currently is available to advocate their use in primary care physical therapy. Superior results are to be expected when various treatment components are combined.

Physical Therapy Treatment of Nonoperative and Operative Articular Defects in the Knee

2008 ◽  
Vol 16 (4) ◽  
pp. 212-220 ◽  
Author(s):  
Troy J. Bourgeois ◽  
J. Randy Hernandez ◽  
Brett M. Cascio
Keyword(s):  
Physical Therapy ◽  
Physical Therapy Treatment ◽  
Therapy Treatment

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 Physical therapy treatment in incontinent women provided by a Public Health Service

2011 ◽  
Vol 24 (2) ◽  
pp. 327-335 ◽  
Author(s):  
Daniela D'Attilio Toledo ◽  
Anny Caroline Dedicação ◽  
Maria Elisabete Salina Saldanha ◽  
Miriam Haddad ◽  
Patricia Driusso
Keyword(s):  
Urinary Incontinence ◽  
Physical Therapy ◽  
Medical Treatment ◽  
Chi Square ◽  
Treatment Protocols ◽  
Significance Level ◽  
Chi Square Test ◽  
Physical Therapy Treatment ◽  
Therapy Treatment

INTRODUCTION: Urinary incontinence affects more than 50 million people worldwide, it has a great impact on quality of life by affecting social, domestic, occupational and sex life, regardless of age. Objective: The objective of this study was to analyze the effectiveness of physical therapy treatment in women attending the Urogynecology service of Hospital and Maternity Leonor Mendes de Barros. METHOD: We retrospectively assessed 65 records of patients with diagnosis of urinary incontinence treated between November 2005 and November 2006. In order to have their data analyzed, patients were divided into two groups; group MF, which underwent medical treatment and physiotherapy, and group M, which had only medical treatment. In order to compare both groups' quantitative data, the analysis was performed in Statistica® software using Mann Whitney's non-parametric test. The analysis of association between the quantitative variables was performed through the Chi-Square test at 5% (p > 0.05) significance level. RESULTS: We observed that 60.6% of patients who underwent physical therapy treatment and medical treatment had the urinary incontinence symptoms decreased or completely cured, while 80% of women belonging to the medical treatmen only-group underwent surgery. CONCLUSION: Thus, we conclude that physical therapy is essential in treatment protocols of urinary incontinence outpatient clinics and to prevent surgery.

Use of Support Personnel for Physical Therapy Treatment

1993 ◽  
Vol 73 (7) ◽  
pp. 421-429 ◽  
Author(s):  
Harriette Laden Bashi ◽  
Elizabeth Domholdt
Keyword(s):  
Physical Therapy ◽  
Support Personnel ◽  
Physical Therapy Treatment ◽  
Therapy Treatment

scholarly journals Percepção do portador de hérnia de disco acerca do tratamento fisioterapêutico

Bionorte ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 26-35
Author(s):  
Camila Almeida Guida ◽  
Valmir Juneo Ferreira ◽  
Francielle Vieira de Souza
Keyword(s):  
Physical Therapy ◽  
Treatment Method ◽  
Descriptive Study ◽  
Treatment Modalities ◽  
Lumbar Region ◽  
Main Risk Factor ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Physical Therapy Treatment ◽  
Therapy Treatment

Objective: to analyze the benefits of physicaltherapytreatmentinpatients withaclinicaldiagnosisofherniateddisc.Materials and Methods: this descriptive study is characterized as a qualitative, quantitative and cross-sectional research. An online questionnaire was collected to collect data about the benefits of physical therapytreatmentinpatientswithdischerniation.Results:itwasevidencedprevalenceofdisc hernias in individuals aged 38 to 42 years, male, with predominance in the lumbar region, having as main risk factor to take / carry weight. As a conservative treatment method, 68.3% underwent physical therapy and 61% of individuals reported having associated exercises with the treatment method. Of 41 respondents, 30 reported that physical therapy treatment helped reduce pain. Conclusion: it can be concluded that the physiotherapeutic treatment through its various treatment modalities provides benefitsto the disc herniated patient, reducing the pain and improving the whole kinesiofunctionalcomplex.

scholarly journals Knowledge of continent women on physiotherapy as a treatment of urinary incontinence

2018 ◽  
Vol 6 (8) ◽  
pp. 153-166
Author(s):  
ENILDA MARTA CARNEIRO DE LIMA MELLO ◽  
HANNA HELLEN FERNANDES MEDEIROS ◽  
NIKELLY YORANNE DE AQUINO DE MATOS
Keyword(s):  
Urinary Incontinence ◽  
Physical Therapy ◽  
Quantitative Study ◽  
Health Professionals ◽  
Age Groups ◽  
Cross Sectional ◽  
Physical Therapy Treatment ◽  
The Subject ◽  
Information Providers ◽  
Therapy Treatment

Objective: To identify the knowledge about physiotherapy as a treatment of urinary incontinence in continent women. Methods: The study was characterized by a cross-sectional and quantitative study. A ten items questionnaire, created by the researchers, was used with related questions about women's health. The sample consisted of 60 continents women, aged between 20-90 years, divided into age groups, accommodating ten participants in each age delimitation as follows: 20-29, 30-39, 40-49, 50-59, 60-69, 70-90. Results: The results showed that 65% of the women did not know about the physiotherapeutic treatment for UI, 28.33% had heard and 6.67% knew about it. The channels of knowledge selected by the volunteers who claimed to know or hear about physiotherapy in the UI were 18.18% media, 31.82% were people known, 45.45% were health professionals, and 4.55% were other unna/med forms. It was also found that women aged between 60 and 90 years have more knowledge on the subject (15%) than those aged 20 to 39 (5%) and 40 to 59 years (0%). Conclusion: It is concluded, therefore, that continents women need more information regarding physical therapy treatment for urinary incontinence. In addition, this awareness should occur in a multidisciplinary way to cover a greater number of women and information providers, in view of the search for treatment early avoid greater complications.

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