Physical Therapy

OBJECTIVE: The purpose of this study was to describe the referrals and use of a hybrid care model for low back pain that includes on-site care by physical therapists, physical activity training, and psychologically informed practice (PiP) delivered by telehealth in the Improving Veteran Access to Integrated Management of Low Back Pain (AIM-Back) trial. METHODS: Data were collected from November 2020 through February 2023 from 5 Veteran Health Administration clinics participating in AIM-Back, a multisite, cluster-randomized embedded pragmatic trial...

OBJECTIVE: The purpose of this study was to develop and externally validate multivariable prediction models for future pain intensity outcomes to inform targeted interventions for patients with neck or low back pain in primary care settings. METHODS: Model development data was obtained from a group of 679 adults with neck or low back pain who consulted a participating United Kingdom general practice. Predictors included self-report items regarding pain severity and impact from the STarT MSK Tool...

Research agendas play an important role in directing scholarly inquiry in a field. The Research Agenda for Physical Therapy From the American Physical Therapy Association (APTA) outlines research priorities that are vital to advancing physical therapist practice and the profession. The development of the research agenda included multiple iterative steps and feedback from stakeholders. A research agenda subgroup (n = 6) of the APTA Scientific Practice and Advisory Committee (SPAC), with APTA staff support, gathered information on existing research agendas, developed draft priority descriptions, and gathered feedback via surveys...

The health care industry has sought to reduce errors and patient harm by drawing upon human factors research developed largely in the aviation industry. However, literature that explicitly applies human factors concepts to physical therapist practice is scarce. Therefore, this clinical perspective highlights key concepts in aviation safety and training that should be considered for application to physical therapist education and practice in the acute care setting, including the law of primacy, pilot in command, crew resource management, situational awareness, the instrument scan, currency versus proficiency, the advanced qualification program, and the use of checklists...

OBJECTIVES: This study examined the association between hospital participation in Bundled Payments for Care Improvement (BPCI) or Comprehensive Care for Joint Replacement (CJR) and the timely initiation of home health rehabilitation services for lower extremity joint replacements. Furthermore, this study examined the association between the timely initiation of home health rehabilitation services with improvement in self-care, mobility, and 90-day hospital readmission. METHOD: This retrospective cohort study used Medicare inpatient claims and home health assessment data from 2016-2017 for older adults discharged to home with home health following hospitalization after joint replacement...

OBJECTIVES: Studies have examined floor-to-stand performance in varied adult populations both quantitatively and qualitatively. Despite an elevated risk of falls and inability to independently return to stand after a fall, few have examined the ability to stand from the floor in patients recovering from stroke. There were 2 objectives of the study: to identify the relationships between floor-to-stand performance using a timed supine-to-stand test (TSS) and physical performance measures of gait, balance, and balance confidence among persons in the subacute phase after stroke; and to analyze descriptive strategies used in the completion of the TSS...

OBJECTIVE: The Avoidance of Daily Activities Photo Scale for Patients With Shoulder Pain (ADAP Shoulder Scale) was developed to assess pain-related avoidance behavior during daily activities in people with shoulder pain. However, its measurement properties must be verified according to international guidelines. As such, this study investigated the following 4 measurement properties of the ADAP Shoulder Scale: reliability, measurement errors, convergent validity, and floor and ceiling effects...

OBJECTIVE: The main aims of this study were: (1) to create a patient-reported outcome measure (PROM) item bank for measuring the impact of lower quadrant edema (LQE) on physical function using item response theory and (2) to assess reliability, validity, and administration efficiency of LQE PROM scores based on computerized adaptive test (CAT) and the reliability of a 10-item short form (SF). METHODS: This retrospective study included data from patients treated in outpatient rehabilitation clinics for lower quadrant edema who responded to all 30 candidate items at intake...

OBJECTIVE: Video-based pose estimation is an emerging technology that shows significant promise for improving clinical gait analysis by enabling quantitative movement analysis with little costs of money, time, or effort. The objective of this study is to determine the accuracy of pose estimation-based gait analysis when video recordings are constrained to 3 common clinical or in-home settings (ie, frontal and sagittal views of overground walking, sagittal views of treadmill walking). METHODS: Simultaneous video and motion capture recordings were collected from 30 persons after stroke during overground and treadmill walking...

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OBJECTIVE: Mixed methods research (MMR) integrates quantitative and qualitative methods throughout the research process to answer complex research questions. Mixed methods research designs align with the guiding frameworks of patient-centered care and social determinants of health by effectively examining the role of contextual factors and human experiences in influencing health and rehabilitation outcomes. Reporting standards and critical appraisal tools ensure quality and transparency of the research process...

OBJECTIVE: This study aimed to examine the presence of distinct trajectories of adherence to home-based exercise recommendations among people with low back pain. This study also aimed to identify differences in baseline characteristics among groups. METHODS: This study was a secondary analysis of a prospective, multicenter cluster randomized controlled trial investigating the cost-effectiveness of a stratified blended physical therapist intervention compared to usual care physical therapy in patients with low back pain...

OBJECTIVE: The purpose of this trial is to evaluate the effect of twice-weekly, moderate-to-high intensity progressive resistance training for 1 year on lumbar spine bone mineral density in individuals with low bone mineral density, compared to attention control. Secondary analyses will examine if resistance training improves other health outcomes; if high intensity is more effective than moderate intensity resistance training for all outcomes; the cost of intervention versus benefit; the willingness to pay; and harms...

OBJECTIVE: The purpose of this case report is to describe pairing vagus nerve stimulation (VNS) with mobility training in an individual after stroke. METHODS (CASE DESCRIPTION): A 53-year-old man with left hemiparesis 14.2 months after an ischemic stroke participated in a pilot study investigating the safety and feasibility of VNS paired with upper limb rehabilitation. In addition to upper limb impairment, the participant had impaired gait and wanted to improve his mobility...

PURPOSE: The purpose of this study was to systematically review and conduct a meta-analysis to examine the impact of comprehensive outpatient cardiac rehabilitation on exercise capacity, functional status, and quality of life in patients with heart failure. METHODS: PubMed, Embase, and CINAHL were searched using keywords and MeSH terms on heart failure and cardiac rehabilitation. Randomized clinical trials published in English using outpatient exercise-based cardiac rehabilitation in patients with heart failure were included...

OBJECTIVE: The aim of this study was to compare the short-term clinical effects of 2 telerehabilitation programs, functional versus aerobic exercises, both combined with breathing techniques, regarding the improvement of long COVID-19 symptoms. METHODS: A randomized controlled trial was conducted. The participants were assigned randomly to either the functional exercise (FE) group or aerobic exercise (AE) group, both including breathing techniques. The interventions lasted for 8 weeks with 3 sessions per week, and they were conducted through the Fisiotrack mobile phone application...

OBJECTIVE: The objective of this study was to evaluate the impact of intensive care unit (ICU)-acquired weakness (ICUAW) on the functional independence of patients hospitalized for COVID-19 over 6 months after ICU discharge. METHODS: This was a prospective cohort study that included patients who were admitted to the ICU because of COVID-19 and who were monitored for 6 months after discharge from the ICU via telephone. Patients were evaluated at 3 times (30 days, 3 months, and 6 months after discharge from the ICU) for functional independence for personal care and mobility activities (Barthel Scale), independence for self-care (Katz Index), impact of COVID-19 on functional status (Post-COVID-19 Functional Status Scale [PCFS]), and mobility level (ICU Mobility Scale)...

Each year, approximately 700,000 people, including 46,000 Americans, die by suicide; however, many more people experience suicidal thoughts and behaviors. Historically, the prevention of suicide has largely been the domain of mental health professionals working within specialist mental health care settings. An issue with this approach is that many individuals who experience suicidal ideation never disclose these thoughts to a mental health professional. The nonprofessional and paraprofessional mental health movement aims to bring suicide prevention to the people who need it, rather than wait for them to seek help...

OBJECTIVE: This randomized controlled superiority trial will determine if an 18-month telehealth walking exercise self-management program produces clinically meaningful changes in walking exercise sustainability compared to attention-control education for veterans living with lower-limb amputation. METHODS: Seventy-eight participants with lower-limb amputation (traumatic or non-traumatic) aged 50 to 89 years will be enrolled. Two groups will complete 6 one-on-one intervention sessions, and 6 group sessions over an 18-month intervention period...

OBJECTIVE: The objective of this study was to estimate the prevalence of cognitive impairment (including cognitive impairment no dementia [CIND] and dementia) among Medicare fee-for-service beneficiaries who used outpatient physical therapy and to estimate the prevalence of cognitive impairment by measures that are relevant to rehabilitation practice. METHODS: This cross-sectional analysis included 730 Medicare fee-for-service beneficiaries in the 2016 wave of the Health and Retirement Study (HRS) with claims for outpatient physical therapy...