Pub Date : 2024-01-01DOI: 10.1097/jat.0000000000000231
K. E. Brueilly
{"title":"Where Do We Go From Here? An Editor's Update on the Journal","authors":"K. E. Brueilly","doi":"10.1097/jat.0000000000000231","DOIUrl":"https://doi.org/10.1097/jat.0000000000000231","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1097/jat.0000000000000233
Sujoy Bose
{"title":"Overcoming Barriers to Unique Valuation of Acute Care Physical Therapy","authors":"Sujoy Bose","doi":"10.1097/jat.0000000000000233","DOIUrl":"https://doi.org/10.1097/jat.0000000000000233","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139126083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1097/jat.0000000000000232
Vinh Q. Tran, Brian L. Hull, Kyle J. Ridgeway
{"title":"Creating Value Together: A Triad of Clinicians, Administrators, and Researchers","authors":"Vinh Q. Tran, Brian L. Hull, Kyle J. Ridgeway","doi":"10.1097/jat.0000000000000232","DOIUrl":"https://doi.org/10.1097/jat.0000000000000232","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Purpose: In today's fast-paced health care environment, simulation-based learning experiences (SBLEs) are viewed as an optimal approach to provide health professions students an opportunity for safe and deliberate practice in clinical scenarios with an element of risk. Evidence supporting the benefits of SBLEs in preparation for doctor of physical therapy (DPT) students' initial inpatient clinical experience (CE) has recently become available; however, no literature exists describing the use and effect of simulation in training preprofessional physical therapist assistants (PTAs) for higher acuity clinical environments. The authors aimed to describe the perceived value of SBLEs in preparing PTA students for the first inpatient CE, through multiple perspectives: student perception of readiness for the environment, clinical instructor (CI) perception of student preparation, and student performance ratings within the clinical practicum. Case Description: Effect of a newly implemented series of SBLEs was explored with a single cohort of PTA students (n = 14) and their associated CIs (n = 8) at one institution. Quantitative and qualitative data were captured through student and CI surveys, focus groups, and the Physical Therapist Assistant Manual for Assessment of Clinical Skills (PTAMACS). Outcomes: Student mean scores on a modified Acute Care Confidence Survey were 88.2%, indicating high levels of perceived preparation. This was further supported by themes in the focus group discussions. CIs reported student readiness for the setting, rating students somewhat prepared (occasional cues/<50% assist) or better, on the CI Questionnaire in 85.6% of survey items. CI focus group themes also generally supported student preparation. All students met the PTAMACS required threshold to pass the CE. Discussion and Conclusion: Implementation of the SBLE was practicable and well received by a single cohort of PTA students and their CIs; and, students were successful in their inpatient CE following the experiences. PTA student and CI perceptions were consistent with literature on the benefits of SBLE for DPT students. Further research on SBLE and PTA education in larger cohort studies is warranted.
背景和目的：在当今快节奏的医疗保健环境中，模拟学习体验（SBLEs）被视为一种最佳方法，可为医疗专业学生提供在具有风险因素的临床场景中进行安全、谨慎练习的机会。最近有证据表明，SBLE 对准备物理治疗博士（DPT）学生的初始住院临床经验（CE）大有裨益；然而，目前还没有文献描述模拟在培训预科物理治疗师助理（PTA）以适应更高危临床环境方面的应用和效果。作者旨在从多个角度描述 SBLE 在帮助 PTA 学生为首次住院 CE 做好准备方面的感知价值：学生对环境准备情况的感知、临床教师 (CI) 对学生准备情况的感知以及学生在临床实习中的表现评分。案例介绍：在一所院校中，对新实施的一系列 SBLEs 的效果进行了探讨，研究对象是一批 PTA 学生（14 人）及其相关的 CI（8 人）。通过学生和 CI 调查、焦点小组以及《物理治疗师助理临床技能评估手册》（PTAMACS）获取了定量和定性数据。结果：学生在修改后的急症护理信心调查中的平均得分率为 88.2%，这表明学生已做好充分准备。焦点小组讨论的主题进一步证实了这一点。在 85.6% 的调查项目中，CI 报告了学生对环境的准备情况，在 CI 问卷中将学生评为有点准备（偶尔提示/<50% 协助）或更好。CI 焦点小组的主题也普遍支持学生做好准备。所有学生都达到了 PTAMACS 要求的通过 CE 的门槛。讨论和结论：SBLE 的实施是切实可行的，受到了一批 PTA 学生和他们的 CI 的欢迎；学生们在体验后成功通过了住院 CE。PTA 学生和 CI 的看法与有关 SBLE 对 DPT 学生益处的文献一致。有必要对 SBLE 和 PTA 教育进行更大规模的队列研究。
{"title":"Exploring the Addition of Simulation-Based Learning Experiences to Prepare Student Physical Therapist Assistants for Inpatient Clinical Experience","authors":"Sharon Dunnivan-Mitchell, Joyce Maring, Kristin Curry-Greenwood","doi":"10.1097/JAT.0000000000000229","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000229","url":null,"abstract":"Background and Purpose: In today's fast-paced health care environment, simulation-based learning experiences (SBLEs) are viewed as an optimal approach to provide health professions students an opportunity for safe and deliberate practice in clinical scenarios with an element of risk. Evidence supporting the benefits of SBLEs in preparation for doctor of physical therapy (DPT) students' initial inpatient clinical experience (CE) has recently become available; however, no literature exists describing the use and effect of simulation in training preprofessional physical therapist assistants (PTAs) for higher acuity clinical environments. The authors aimed to describe the perceived value of SBLEs in preparing PTA students for the first inpatient CE, through multiple perspectives: student perception of readiness for the environment, clinical instructor (CI) perception of student preparation, and student performance ratings within the clinical practicum. Case Description: Effect of a newly implemented series of SBLEs was explored with a single cohort of PTA students (n = 14) and their associated CIs (n = 8) at one institution. Quantitative and qualitative data were captured through student and CI surveys, focus groups, and the Physical Therapist Assistant Manual for Assessment of Clinical Skills (PTAMACS). Outcomes: Student mean scores on a modified Acute Care Confidence Survey were 88.2%, indicating high levels of perceived preparation. This was further supported by themes in the focus group discussions. CIs reported student readiness for the setting, rating students somewhat prepared (occasional cues/<50% assist) or better, on the CI Questionnaire in 85.6% of survey items. CI focus group themes also generally supported student preparation. All students met the PTAMACS required threshold to pass the CE. Discussion and Conclusion: Implementation of the SBLE was practicable and well received by a single cohort of PTA students and their CIs; and, students were successful in their inpatient CE following the experiences. PTA student and CI perceptions were consistent with literature on the benefits of SBLE for DPT students. Further research on SBLE and PTA education in larger cohort studies is warranted.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139012048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-04DOI: 10.1097/jat.0000000000000230
J. Skrzat, Gayathri Iyer Santhanam, Molly S. Olejer, Trisha A. Sando
Literature about early mobilization of patients with femoral intra-aortic balloon pumps (IABPs) is emerging. The purpose of our study is to describe the development and implementation of a mobility checklist for patients with advanced heart failure (HF) who had a femoral IABP and assess its safety and feasibility. A description of the development and implementation of our institution's IABP Mobility Checklist is provided. A retrospective review was conducted for patients with advanced HF who had a femoral IABP to assess safety and feasibility of mobilization. Subjects' demographic, medical, and physical therapy data, as well as safety data, were analyzed. The IABP Mobility Checklist was designed to mirror our institution's practice patterns. It is unique in 2 ways. First, it uses a body systems review screening approach to assess a patient's readiness and tolerance to mobilization. Second, the checklist breaks the screening process into 4 broad but distinct mobility phases to encompass a spectrum of movement. Twenty subjects with advanced HF who had a femoral IABP received 49 physical therapy sessions. The highest level of mobility with a femoral IABP was ambulation (50%). There were no major safety events and 2 minor safety events. Subjects stabilized with termination of mobilization. No additional medical interventions were required. The IABP Mobility Checklist was developed and successfully implemented in patients with advanced HF who had a femoral IABP. Through knowledge acquisition, education, and interprofessional collaboration, mobilization in this patient population was safe and feasible.
{"title":"Mobility Checklist for Patients With Advanced Heart Failure and a Femoral Intra-aortic Balloon Pump","authors":"J. Skrzat, Gayathri Iyer Santhanam, Molly S. Olejer, Trisha A. Sando","doi":"10.1097/jat.0000000000000230","DOIUrl":"https://doi.org/10.1097/jat.0000000000000230","url":null,"abstract":"\u0000 \u0000 Literature about early mobilization of patients with femoral intra-aortic balloon pumps (IABPs) is emerging. The purpose of our study is to describe the development and implementation of a mobility checklist for patients with advanced heart failure (HF) who had a femoral IABP and assess its safety and feasibility.\u0000 \u0000 \u0000 \u0000 A description of the development and implementation of our institution's IABP Mobility Checklist is provided. A retrospective review was conducted for patients with advanced HF who had a femoral IABP to assess safety and feasibility of mobilization. Subjects' demographic, medical, and physical therapy data, as well as safety data, were analyzed.\u0000 \u0000 \u0000 \u0000 The IABP Mobility Checklist was designed to mirror our institution's practice patterns. It is unique in 2 ways. First, it uses a body systems review screening approach to assess a patient's readiness and tolerance to mobilization. Second, the checklist breaks the screening process into 4 broad but distinct mobility phases to encompass a spectrum of movement. Twenty subjects with advanced HF who had a femoral IABP received 49 physical therapy sessions. The highest level of mobility with a femoral IABP was ambulation (50%). There were no major safety events and 2 minor safety events. Subjects stabilized with termination of mobilization. No additional medical interventions were required.\u0000 \u0000 \u0000 \u0000 The IABP Mobility Checklist was developed and successfully implemented in patients with advanced HF who had a femoral IABP. Through knowledge acquisition, education, and interprofessional collaboration, mobilization in this patient population was safe and feasible.\u0000","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139012165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-04DOI: 10.1097/JAT.0000000000000228
James M. Smith, Riley Arsenault, Sam Berry-Sullivan, Shana Lavier, Kayla Longo, Benjamin Petersen, Taylor Tansley
Introduction: Coronavirus disease 2019 (COVID-19) is a respiratory and multisystem infection accompanied by risk for multisystemic problems. Recent research proposed a risk for skeletal muscle weakness among those who experienced COVID-19 infection. The purpose of this systematic review is to identify if muscle strength impairment follows COVID-19 infection. Methods: This systematic review of the literature complied with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the design of the review was registered prospectively with International Prospective Register of Systematic Reviews (PROSPERO). To reveal appropriate studies, PubMed, CINAHL, and Cochrane Database of Systematic Reviews were searched. Risk of bias was measured through the Scottish Intercollegiate Guidelines Network, Methodology Checklist 3: Cohort studies. Results: Included were 6 studies with a total of 659 participants with COVID-19 infection (mean age: 59.8 years), all of whom were hospitalized or in a nursing facility. Risk of bias assessment revealed that 5 of the studies were of acceptable methodological quality and 1 was of high quality. Four of the studies measured strength using hand-grip dynamometry, 3 studies measured strength using handheld dynamometry, and 1 study measured performance on the 1-minute sit-to-stand test. Across all studies the results showed some degree of a decrease in skeletal muscle strength. Discussion: Those with more severe COVID-19 infections were at greater risk for weakness within skeletal muscles. Two studies measured performance by larger muscles (ie, those with greater cross-sectional size) and identified that larger muscles were at greater risk for weakness. Conclusion: People recovering from a COVID-19 infection are at risk for experiencing muscle weakness. Clinicians should measure strength among patients who have had COVID-19 infection, including the performance of larger muscles.
{"title":"COVID-19 Infection Is Associated With Loss of Muscle Strength","authors":"James M. Smith, Riley Arsenault, Sam Berry-Sullivan, Shana Lavier, Kayla Longo, Benjamin Petersen, Taylor Tansley","doi":"10.1097/JAT.0000000000000228","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000228","url":null,"abstract":"Introduction: Coronavirus disease 2019 (COVID-19) is a respiratory and multisystem infection accompanied by risk for multisystemic problems. Recent research proposed a risk for skeletal muscle weakness among those who experienced COVID-19 infection. The purpose of this systematic review is to identify if muscle strength impairment follows COVID-19 infection. Methods: This systematic review of the literature complied with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the design of the review was registered prospectively with International Prospective Register of Systematic Reviews (PROSPERO). To reveal appropriate studies, PubMed, CINAHL, and Cochrane Database of Systematic Reviews were searched. Risk of bias was measured through the Scottish Intercollegiate Guidelines Network, Methodology Checklist 3: Cohort studies. Results: Included were 6 studies with a total of 659 participants with COVID-19 infection (mean age: 59.8 years), all of whom were hospitalized or in a nursing facility. Risk of bias assessment revealed that 5 of the studies were of acceptable methodological quality and 1 was of high quality. Four of the studies measured strength using hand-grip dynamometry, 3 studies measured strength using handheld dynamometry, and 1 study measured performance on the 1-minute sit-to-stand test. Across all studies the results showed some degree of a decrease in skeletal muscle strength. Discussion: Those with more severe COVID-19 infections were at greater risk for weakness within skeletal muscles. Two studies measured performance by larger muscles (ie, those with greater cross-sectional size) and identified that larger muscles were at greater risk for weakness. Conclusion: People recovering from a COVID-19 infection are at risk for experiencing muscle weakness. Clinicians should measure strength among patients who have had COVID-19 infection, including the performance of larger muscles.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139012204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1097/jat.0000000000000218
Alan Chong W. Lee
The author has no conflict of interest and no source of funding to declare. Submitted for publication: May 13, 2023; accepted for publication May 14, 2023; published online September 21, 2023.
{"title":"Ongoing Lessons From the Global Pandemic: Telehealth, DEI, and Pursuit of Excellence","authors":"Alan Chong W. Lee","doi":"10.1097/jat.0000000000000218","DOIUrl":"https://doi.org/10.1097/jat.0000000000000218","url":null,"abstract":"The author has no conflict of interest and no source of funding to declare. Submitted for publication: May 13, 2023; accepted for publication May 14, 2023; published online September 21, 2023.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135324727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1097/jat.0000000000000227
Traci Norris, Jim Smith
This quarter we would like to spotlight the advocacy efforts being undertaken by members of this Academy within APTA House of Delegates. Many of our members advocate daily for the needs of the patients; however, we must continue to champion for changes in the profession nationally, locally, institutionally, and within APTA in order to ensure that we anticipate and meet the needs of current and future Academy of Acute Care Physical Therapy members. Do you follow the annual cycle of APTA's House of Delegates? Did you attend Academy townhalls to understand proposed motions? APTA's House of Delegates (House) is a policymaking body that is comprised of voting delegates from APTA's chapters, academies (sections), and PTA Caucus. The House also includes delegates that have a voice, however not a vote (eg, the Board of Directors, APTA Student Assembly, and consultants). The House meets annually and at the July 22-23, 2023, meeting, APTA Acute Care was represented by Dr. Jim Smith (Chief Delegate), Kate Brito (Delegate), and Traci Norris (President and Alternate Delegate). The business of the House typically involves establishing positions and priorities for the profession, making amendments to APTA's bylaws, and electing APTA's leaders on the Board of Directors and Nominating Committee. The 2023 House did exciting work on all of those things! The minutes for the 2023 House will be published at the end of September; therefore, we do not yet have the final language from the report. However, we want to share with you some of the exciting highlights from the House that promises to advance the profession and elevate the work being performed by acute care physical therapists (PTs) and physical therapist assistants (PTAs). APTA supports initiatives to improve rural health, such as increasing content about rural health in our education programs, promoting PTs as essential providers in rural health settings, while promoting PT and PTA inclusion in student scholarships, loan modification, and repayment programs that focus on rural areas. APTA is opposed to policies or rules of third-party payers being used or substituted for regulatory purposes. This position affirms that PTs and PTAs shall follow their jurisdictional practice acts that contain the statutes and regulations, along with APTA's ethical documents for the profession, and not rules imposed by third-party payers. APTA recommends education for PTs, PTAs, and students about human trafficking, including learning about screening tools for signs of human trafficking and methods of intervention to ensure optimal safety of the individual. APTA supports pay equity on the basis of sex assigned at birth/gender/gender identity in the physical therapy profession and society. A related motion directs APTA to work to promote pay equity on the basis of sex assigned at birth/gender/gender identity among PTs and PTAs. Additionally, APTA supports pay transparency by employers of PTs and PTAs. APTA will develop clinical an
{"title":"APTA's 2023 House of Delegates Advances the Profession","authors":"Traci Norris, Jim Smith","doi":"10.1097/jat.0000000000000227","DOIUrl":"https://doi.org/10.1097/jat.0000000000000227","url":null,"abstract":"This quarter we would like to spotlight the advocacy efforts being undertaken by members of this Academy within APTA House of Delegates. Many of our members advocate daily for the needs of the patients; however, we must continue to champion for changes in the profession nationally, locally, institutionally, and within APTA in order to ensure that we anticipate and meet the needs of current and future Academy of Acute Care Physical Therapy members. Do you follow the annual cycle of APTA's House of Delegates? Did you attend Academy townhalls to understand proposed motions? APTA's House of Delegates (House) is a policymaking body that is comprised of voting delegates from APTA's chapters, academies (sections), and PTA Caucus. The House also includes delegates that have a voice, however not a vote (eg, the Board of Directors, APTA Student Assembly, and consultants). The House meets annually and at the July 22-23, 2023, meeting, APTA Acute Care was represented by Dr. Jim Smith (Chief Delegate), Kate Brito (Delegate), and Traci Norris (President and Alternate Delegate). The business of the House typically involves establishing positions and priorities for the profession, making amendments to APTA's bylaws, and electing APTA's leaders on the Board of Directors and Nominating Committee. The 2023 House did exciting work on all of those things! The minutes for the 2023 House will be published at the end of September; therefore, we do not yet have the final language from the report. However, we want to share with you some of the exciting highlights from the House that promises to advance the profession and elevate the work being performed by acute care physical therapists (PTs) and physical therapist assistants (PTAs). APTA supports initiatives to improve rural health, such as increasing content about rural health in our education programs, promoting PTs as essential providers in rural health settings, while promoting PT and PTA inclusion in student scholarships, loan modification, and repayment programs that focus on rural areas. APTA is opposed to policies or rules of third-party payers being used or substituted for regulatory purposes. This position affirms that PTs and PTAs shall follow their jurisdictional practice acts that contain the statutes and regulations, along with APTA's ethical documents for the profession, and not rules imposed by third-party payers. APTA recommends education for PTs, PTAs, and students about human trafficking, including learning about screening tools for signs of human trafficking and methods of intervention to ensure optimal safety of the individual. APTA supports pay equity on the basis of sex assigned at birth/gender/gender identity in the physical therapy profession and society. A related motion directs APTA to work to promote pay equity on the basis of sex assigned at birth/gender/gender identity among PTs and PTAs. Additionally, APTA supports pay transparency by employers of PTs and PTAs. APTA will develop clinical an","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135274444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-25DOI: 10.1097/jat.0000000000000226
K. E. Brueilly, Amanda M. Feller, Jonathan M. Ahearn, Jonathan S. Goodwin
Modified weight-bearing recommendations are commonly prescribed after surgical intervention for injuries to the lower extremity to reduce the risk of nonunion and delayed healing associated with load bearing through the injured limb and to combat the deleterious effects of immobility. The physical therapist (PT) in the acute care setting is likely to instruct patients after lower extremity injury in weight-bearing-restricted ambulation. A new device is now available for use in the training of weight-bearing status. The study examines whether the ComeBack Mobility crutch tip reporting weight-bearing on the lower extremity is a reliable and valid tool in determining force when compared with the gold standard force plate measurement of lower extremity weight-bearing. Previous studies have shown that patients are often not able to adequately learn or adhere to restrictive weight-bearing modifications. This may be due to an inability to provide immediate and ongoing feedback on weight-bearing. The new ComeBack Mobility crutch tip system is now available for the acute care PT to use in instruction and for patients to receive real-time feedback throughout their rehabilitation process. A sample of convenience of 6 able-bodied PTs was used. Each subject performed 30 trials of axillary crutch-assisted weight-bearing ambulation using the new device. The weight-bearing reported by the device was compared with the weight-bearing measured through force plates via correlations, t tests, and Bland-Altman plot. The new device demonstrated moderate-good reliability in the measurement of non-weight-bearing and 50% partial weight-bearing in trials completed. The ComeBack Mobility crutch tip system could be useful and should be considered for clinical use as a reliable and valid tool in providing auditory feedback for compliance to a prescribed weight-bearing protocol. The system could be useful in the training of patients in the first use of crutches such as prior to discharge from an acute care hospital. Further research is needed with clinical populations as well as with varied weight-bearing protocols.
{"title":"Validation Testing of a New Crutch Tip Biofeedback Device for Prescribed Lower Extremity Weight-Bearing","authors":"K. E. Brueilly, Amanda M. Feller, Jonathan M. Ahearn, Jonathan S. Goodwin","doi":"10.1097/jat.0000000000000226","DOIUrl":"https://doi.org/10.1097/jat.0000000000000226","url":null,"abstract":"\u0000 \u0000 Modified weight-bearing recommendations are commonly prescribed after surgical intervention for injuries to the lower extremity to reduce the risk of nonunion and delayed healing associated with load bearing through the injured limb and to combat the deleterious effects of immobility. The physical therapist (PT) in the acute care setting is likely to instruct patients after lower extremity injury in weight-bearing-restricted ambulation. A new device is now available for use in the training of weight-bearing status. The study examines whether the ComeBack Mobility crutch tip reporting weight-bearing on the lower extremity is a reliable and valid tool in determining force when compared with the gold standard force plate measurement of lower extremity weight-bearing.\u0000 \u0000 \u0000 \u0000 Previous studies have shown that patients are often not able to adequately learn or adhere to restrictive weight-bearing modifications. This may be due to an inability to provide immediate and ongoing feedback on weight-bearing. The new ComeBack Mobility crutch tip system is now available for the acute care PT to use in instruction and for patients to receive real-time feedback throughout their rehabilitation process.\u0000 \u0000 \u0000 \u0000 A sample of convenience of 6 able-bodied PTs was used.\u0000 \u0000 \u0000 \u0000 Each subject performed 30 trials of axillary crutch-assisted weight-bearing ambulation using the new device. The weight-bearing reported by the device was compared with the weight-bearing measured through force plates via correlations, t tests, and Bland-Altman plot.\u0000 \u0000 \u0000 \u0000 The new device demonstrated moderate-good reliability in the measurement of non-weight-bearing and 50% partial weight-bearing in trials completed.\u0000 \u0000 \u0000 \u0000 The ComeBack Mobility crutch tip system could be useful and should be considered for clinical use as a reliable and valid tool in providing auditory feedback for compliance to a prescribed weight-bearing protocol. The system could be useful in the training of patients in the first use of crutches such as prior to discharge from an acute care hospital. Further research is needed with clinical populations as well as with varied weight-bearing protocols.\u0000","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46491518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-14DOI: 10.1097/JAT.0000000000000222
Dana Tischler, Janine Wood, M. Shotwell, W. Pitney, Cade Mooney
Purpose: To describe the current use of and perceived benefits and barriers to using patient-reported outcome measures (PROMs) by pediatric physical therapists (PTs) in the acute care setting and to explore demographic factors that may explain the use of PROMs. Methods: An electronic survey was distributed to PTs who work in a pediatric acute care setting. Descriptive statistics were used to assess the frequency of PROM use, identify differences in PROM use based on demographic factors, and evaluate the likelihood of various benefits and barriers. Open-ended survey responses were analyzed inductively to identify common themes. Results: The survey was completed by a convenience sample of 92 pediatric acute care PTs (30% response rate). Half of the respondents (n = 46; 50%) reported “rarely” or “never” using PROMs, while only 4.3% (n = 4) reported “always” using PROMs. No significant differences were found in the frequency of PROM between years of experience, entry-level degree, clinical specialization, or other demographic factors. Participants were “somewhat” or “extremely likely” to use the rate of perceived exertion (71%), the Ages and Stages Questionnaire (24%), and the Pediatric Quality of Life Inventory (17%). The primary facilitator was improving communication with patients (68%), while the main barrier was lack of availability (57%). Thematic analysis of open-ended responses indicated that the benefits of using PROMs include improving communication, providing objective data, and measuring progress. Barriers identified include inadequate resources, lack of time, and irrelevance to clinical practice. Conclusion: Many pediatric acute care PTs underutilize PROMs, with reported barriers of limited access and lack of time hindering implementation within the pediatric acute care setting. Survey respondents reported the desire to measure health-related quality of life and participation, which may be feasible through future quality improvement or knowledge translation initiatives.
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