scholarly journals The Use of a Knowledge Translation Program to Increase Use of Standardized Outcome Measures in an Outpatient Pediatric Physical Therapy Clinic: Administrative Case Report

2015 ◽  
Vol 95 (4) ◽  
pp. 613-629 ◽  
Author(s):  
Joseph Schreiber ◽  
Gregory F. Marchetti ◽  
Brook Racicot ◽  
Ellen Kaminski
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Knowledge Translation ◽  
Outcome Measures ◽  
Physical Therapists ◽  
Practice Change ◽  
Knowledge Broker ◽  
Self Report ◽  
Knowledge Assessment ◽  
Frequency Of Use

Background and Purpose Pediatric physical therapists face many challenges related to the application of research evidence to clinical practice. A multicomponent knowledge translation (KT) program may be an effective strategy to support practice change. The purpose of this case report is to describe the use of a KT program to improve the knowledge and frequency of use of standardized outcome measures by pediatric physical therapists practicing in an outpatient clinic. Case Description This program occurred at a pediatric outpatient facility with 1 primary clinic and 3 additional satellite clinics, and a total of 17 physical therapists. The initial underlying problem was inconsistency across staff recommendations for frequency and duration of physical therapist services. Formal and informal discussion with the department administrator and staff identified a need for increased use of standardized outcome measures to inform these decisions. The KT program to address this need spanned 6 months and included identification of barriers, the use of a knowledge broker, multiple workshop and practice sessions, online and hard-copy resources, and ongoing evaluation of the KT program with dissemination of results to staff. Outcome measures included pre- and post-knowledge assessment and self-report surveys and chart review data on use of outcome measures. Outcomes Participants (N=17) gained knowledge and increased the frequency of use of standardized outcome measures based on data from self-report surveys, a knowledge assessment, and chart reviews. Discussion Administrators and others interested in supporting practice change in physical therapy may consider implementing a systematic KT program that includes a knowledge broker, ongoing engagement with staff, and a variety of accessible resources.

Knowledge translation intervention increased the use of outcome measures by physical therapists in inpatient rehabilitation

2021 ◽  
pp. 1-10
Author(s):  
Wendy Romney ◽  
Michelle Wormley ◽  
Diana Veneri ◽  
Andrea Oberlander ◽  
Peter Grevelding ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Outcome Measures ◽  
Physical Therapists ◽  
Inpatient Rehabilitation

scholarly journals Using a Case Report of a Patient With Spinal Cord Injury to Illustrate the Application of the International Classification of Functioning, Disability and Health During Multidisciplinary Patient Management

2010 ◽  
Vol 90 (7) ◽  
pp. 1039-1052 ◽  
Author(s):  
Alexandra Rauch ◽  
Reuben Escorpizo ◽  
Daniel L. Riddle ◽  
Inge Eriks-Hoogland ◽  
Gerold Stucki ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Case Report ◽  
Physical Therapy ◽  
Patient Management ◽  
Physical Therapists ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Cord Injury

Background and PurposePhysical therapists require a comprehensive assessment of a patient's functioning status to address multiple problems in patients with severe conditions. The International Classification of Functioning, Disability and Health (ICF) is the universally accepted conceptual model for the description of functioning. Documentation tools have been developed based on ICF Core Sets to be used in multidisciplinary rehabilitation management and specifically by physical therapists. The purposes of this case report are: (1) to apply ICF-based documentation tools to the care of a patient with spinal cord injury and (2) to illustrate the use of ICF-based documentation tools during multidisciplinary patient management.Case DescriptionThe patient was a 22-year-old man with tetraplegia (C2 level) who was 5 months postinjury. The report describes the integration of the ICF-based documentation tools into the patient's examination, evaluation, prognosis, diagnosis, and intervention while he participated in a multidisciplinary rehabilitation program for 2 months.OutcomesThe patient's comprehensive functioning status at the beginning of the program, the rehabilitation goals, the intervention plan, and his improvements in functioning following rehabilitation and the according goal achievement were illustrated with physical therapy–specific and multidisciplinary ICF-based documentation tools.DiscussionThis case report illustrates how the ICF-based documentation template for physical therapists summarizes all relevant information to aid the physical therapist's patient management and how ICF-based documentation tools for multidisciplinary care complement one another and thus can be used to enhance multidisciplinary patient management. In addition, the ICF assists in clarifying clinician roles as part of a multidisciplinary team. The case report demonstrates that the ICF can be a viable framework both for physical therapy and multidisciplinary management and for clinical documentation.

scholarly journals Applying Knowledge Translation Theory to Physical Therapy Research and Practice in Balance and Gait Assessment: Case Report

2015 ◽  
Vol 95 (4) ◽  
pp. 579-587 ◽  
Author(s):  
Kathryn M. Sibley ◽  
Nancy M. Salbach
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Knowledge Translation ◽  
Best Practice ◽  
Physical Therapist ◽  
Intervention Development ◽  
Assessment Tools ◽  
Ongoing Research ◽  
Knowledge To Action ◽  
Gait Assessment

Background and PurposeKnowledge translation (KT) is an emerging discipline with a focus on implementing health evidence in decision making and clinical practice. Knowledge translation theories provide conceptual frameworks that can direct research focused on optimizing best practice. The objective of this case report is to describe one prominent KT theory—the knowledge-to-action (KTA) framework—and how it was applied to research on balance and gait assessment in physical therapist practice.Case DescriptionValid and reliable assessment tools are recommended to evaluate balance and gait function, but gaps in physical therapy practices are known. The KTA framework's 2-pronged approach (knowledge creation phase and action cycle) guided research questions exploring current practices in balance and gait assessment and factors influencing practice in Ontario, Canada, with the goal of developing and evaluating targeted KT interventions.OutcomesResults showed the rate at which therapists use standardized balance and gait tools was less than optimal and identified both knowledge-to-practice gaps and individual and organizational barriers to implementing best assessment practices. These findings highlighted the need for synthesis of evidence to address those gaps prior to the development of potential intervention strategies.DiscussionThe comprehensive KTA framework was useful in guiding the direction of these ongoing research programs. In both cases, the sequence of the individual KTA steps was modified to improve the efficiency of intervention development, there was a need to go back and forth between the 2 phases of the KTA framework, and additional behavior change and barrier assessment theories were consulted. Continued research is needed to explicitly evaluate the efficacy of applying KT theory to best practice in health care.

scholarly journals Physical Therapy Management of an Individual With Post-COVID Syndrome: A Case Report

2021 ◽  
Author(s):  
Kirby P Mayer ◽  
Angela K Steele ◽  
Melissa K Soper ◽  
Jill D Branton ◽  
Megan L Lusby ◽  
...  
Keyword(s):  
Case Report ◽  
Cognitive Function ◽  
Physical Therapy ◽  
Muscle Strength ◽  
Exercise Capacity ◽  
Cognitive Dysfunction ◽  
Clinical Presentation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Emotional Health

Abstract Objective The purpose of this case report is to present the clinical presentation and physical therapist management for a patient with post–COVID syndrome. Secondarily, the report highlights the importance of assessing cognitive and emotional health in patients with post–COVID syndrome. Methods (Case Description) A 37-year-old woman tested positive for SARS-CoV-2 and developed mild COVID-19 disease but did not require supplemental oxygen or hospitalization. The patient experienced persistent symptoms including dyspnea, headaches, and cognitive fog. On day 62, she participated in an outpatient physical therapist evaluation that revealed deficits in exercise capacity, obtaining 50% of her age-predicted 6-minute walk distance (6MWD). She had minor reductions in muscle strength and cognitive function. Self-reported quality of life (QoL) was 50, and she scored above established cut-off scores for provisional diagnosis of posttraumatic stress disorder (PTSD). Results The patient participated in biweekly physical therapist sessions for 8 weeks, which included aerobic training, strengthening exercises, diaphragmatic breathing techniques, and mindfulness training. Metabolic equivalent for task (METS) levels increased with variability over the course of the program. The patient’s muscle strength, physical function, and exercise capacity improved. 6MWD increased by 199 m, equating to 80% of her age-predicted distance. QoL and PTSD scores did not improve. At evaluation after physical therapy, the patient was still experiencing migraines, dyspnea, fatigue, and cognitive dysfunction. Conclusion This case report described the clinical presentation and physical therapist management of a person with post–COVID syndrome, a novel health condition for which little evidence exists to guide rehabilitation examination and interventions. Physical therapists should consider cognitive function and emotional health in their plan of care for patients with post–COVID syndromes. Impact This case alerts physical therapists to post–COVID syndrome—which can include debilitating symptoms of decreased aerobic tolerance, anxiety, PTSD, and cognitive dysfunction—and to the role that therapists can play in assessing these symptoms and managing these patients.

scholarly journals The Contribution of Conceptual Frameworks to Knowledge Translation Interventions in Physical Therapy

2015 ◽  
Vol 95 (4) ◽  
pp. 630-639 ◽  
Author(s):  
Anne Hudon ◽  
Mathieu-Joël Gervais ◽  
Matthew Hunt
Keyword(s):  
Physical Therapy ◽  
Knowledge Translation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Positive Impact ◽  
Conceptual Frameworks ◽  
Research Findings ◽  
Potential Benefits ◽  
Practice Gap ◽  
Knowledge Translation Interventions

There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions are identified, and limits related to their use are considered. A sample of 5 conceptual frameworks is evaluated, and how they address common barriers to knowledge translation in physical therapy is assessed. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Finally, the use of a conceptual framework is illustrated through a case example. Increased use of conceptual frameworks can have a positive impact on the field of knowledge translation in physical therapy and support the development and implementation of robust and effective knowledge translation interventions that help span the research-practice gap.

scholarly journals Misdiagnosis of Serotonin Syndrome as Fibromyalgia and the Role of Physical Therapists

2008 ◽  
Vol 88 (6) ◽  
pp. 757-765 ◽  
Author(s):  
Gregory M Alnwick
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Serotonin Syndrome ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Diagnostic Testing ◽  
Signs And Symptoms ◽  
Activity Level ◽  
Medical Evaluation ◽  
Successful Recovery

Background and Purpose With increased use of serotonergic medications, a condition triggered by serotonin excess within the brain and spinal cord has emerged and may be gaining prevalence. The purposes of this case report are to describe how to identify serotonin syndrome in a patient who is taking citalopram (a selective serotonin reuptake inhibitor) on the basis of signs and symptoms and to promote the ability of physical therapists to recognize such signs and symptoms. Case Description The patient was a 42-year-old woman referred for physical therapy with a diagnosis of fibromyalgia. The physical therapist recognized that the patient's symptoms did not resemble those of fibromyalgia and recommended referral to a neurologist for further diagnostic testing. Outcomes The patient was referred to a neurologist, who diagnosed serotonin syndrome related to the use of citalopram. The patient was weaned off citalopram and made a successful recovery, with scores on the Oswestry Disability Index decreasing from 70% to 28% at discharge from the physical therapy treatment and to 0% at the 6-month follow-up. The patient has since returned to her prior activity level, which includes skiing, motorcycle riding, and working at her consulting firm. Discussion This case report demonstrates how careful evaluation by the physical therapist indicated that signs and symptoms were not consistent with fibromyalgia, and further medical evaluation revealed the actual diagnosis of serotonin syndrome.

Improving Tinnitus with Mechanical Treatment of the Cervical Spine and Jaw

2013 ◽  
Vol 24 (07) ◽  
pp. 544-555 ◽  
Author(s):  
Kay Cherian ◽  
Neil Cherian ◽  
Chad Cook ◽  
James A. Kaltenbach
Keyword(s):  
Cervical Spine ◽  
Physical Therapy ◽  
Physical Therapists ◽  
Self Report ◽  
Blurred Vision ◽  
Flexion Extension ◽  
Spine Mobility ◽  
Emotional Deficits ◽  
Therapy Interventions ◽  
Cervical Motion

Background: Tinnitus affects approximately 30–50 million Americans. In approximately 0.5–1.0% of the population, tinnitus has a moderate to severe impact on their quality of life. Musculature and joint pathologies of the head and neck are frequently associated with tinnitus and have been hypothesized to play a contributing role in its etiology. However, specific physical therapy interventions to assist in improving tinnitus have not yet been reported. Purpose: To describe the examination and treatment intervention of a patient with subjective tinnitus. Patient Description: The patient was a 42-yr-old male experiencing intermittent bilateral tinnitus, headaches, blurred vision, and neck tightness. His occupation required long-term positioning into neck protraction. Examination found limitations in cervical extension, bilateral rotation, and side bending. Asymmetry was also noted with temporomandibular joint (TMJ) movements. Upon initial evaluation the patient demonstrated functional, physical, and emotional deficits per neck, headache, and dizziness self-report scales and a score on the Tinnitus Handicap Inventory (THI) of 62. Resisted muscle contractions of the cervical spine in flexion, extension, and rotation increased his tinnitus. Intervention: Treatment focused on normalizing cervical spine mobility through repetitive movements, joint mobilization, and soft tissue massage. Results: At 2.5 mo, the patient demonstrated a complete reversal of his tinnitus after 10 physical therapy sessions as noted by his score of 0 on the THI upon discharge. He also demonstrated objective improvements in his cervical motion. This case reflected treatment targeted at cervical and TMJ impairments and notable improvements to tinnitus. Future studies should further explore the direct and indirect treatment of tinnitus by physical therapists through clinical trials.

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