Considerations for Planning and Conducting Clinic-Based Research in Physical Therapy

Abstract There is growing demand to increase the volume of clinic-based research in physical therapy. Special considerations, unique to the planning and conduct of clinic-based research, need to be addressed to increase the likelihood that these studies will be completed successfully. The purposes of this perspective are to discuss factors affecting clinic-based research and to offer suggestions for addressing these problems when designing and conducting research studies in a clinical setting. This perspective discusses issues such as patient management, determining the availability of target patient populations, acquiring support from physical therapists and physicians, reporting and managing research-related injury or illness, and modifying or terminating projects. Some of the points made in this perspective are illustrated using examples from the authors' experiences in conducting clinical research.

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Feasibility of Goal Attainment Scaling in Chronic Low Back Pain: Protocol for Training & Implementation in an Outpatient Physical Therapy Setting (Preprint)

10.2196/preprints.32457 ◽

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

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Are Physical Therapy Interns Competent in Patient Management Skills? Assessment of the Views of Clinical and Academic Physical Therapists

Journal of Physical Therapy Science ◽

10.1589/jpts.25.649 ◽

2013 ◽

Vol 25 (5) ◽

pp. 649-655 ◽

Cited By ~ 4

Author(s):

Saad M. Bindawas ◽

Vishal Vennu ◽

Samy A. Azer

Keyword(s):

Physical Therapy ◽

Patient Management ◽

Physical Therapists ◽

Skills Assessment ◽

Management Skills

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Awareness and Perception of Physical Therapy Education, Role in Patient Management and Health Promotion Held by Senior Medical Practitioners

Asian Journal of Allied Health Sciences (AJAHS) ◽

10.52229/ajahs.v2i3.299 ◽

2020 ◽

pp. 13-17

Author(s):

OJS Admin

Keyword(s):

Health Promotion ◽

Physical Therapy ◽

Patient Management ◽

Physical Therapists ◽

Physical Therapist ◽

Well Being ◽

Physical Therapy Education ◽

Health Providers ◽

Medical Practitioners ◽

Therapy Education

Physical therapists are integral part of health care system. In collaboration with other health providers, physical therapist can play an effective role in patient handling and well-being of individuals. The awareness and perception of senior medical practitioners is less known regarding physical therapy education, role in patient management and health promotion.

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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

Physical Therapy ◽

10.2522/ptj.20090327 ◽

2010 ◽

Vol 90 (7) ◽

pp. 1039-1052 ◽

Cited By ~ 41

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.

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Review of: Foundations of Clinical Research Applications to Practice (3rd edition)

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2010.1324 ◽

2010 ◽

Author(s):

Robin Washington

Keyword(s):

Health Care ◽

Critical Thinking ◽

Physical Therapy ◽

Clinical Research ◽

Physical Therapists ◽

Occupational Therapists ◽

Health Professions ◽

The Third ◽

User Friendly ◽

Intended Use

Foundations of Clinical Research: Applications to Practice is the third edition written by physical therapy professors at MGH Institute of Health Professions in Boston Massachusetts. The textbook is intended as the primary textbook for educational instruction related to research and critical thinking. The authors intended use of this text by physical therapists, occupational therapists, speech therapists, nursing, medicine, exercise physiologists and other health care related disciplines. This user-friendly textbook can be utilized by anyone interested in step-by-step illustrations for developing, implementing and disseminating research related activities.

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The Hypothesis-Oriented Algorithm for Clinicians II (HOAC II): A Guide for Patient Management

Physical Therapy ◽

10.1093/ptj/83.5.455 ◽

2003 ◽

Vol 83 (5) ◽

pp. 455-470 ◽

Cited By ~ 73

Author(s):

Jules M Rothstein ◽

John L Echternach ◽

Daniel L Riddle

Keyword(s):

Health Care ◽

Decision Making ◽

Clinical Practice ◽

Physical Therapy ◽

Patient Management ◽

Physical Therapists ◽

Physical Therapist ◽

Functional Deficits ◽

Original Algorithm ◽

Contemporary Practice

Abstract In this era of health care accountability, a need exists for a new decision-making and documentation guide in physical therapy. The original Hypothesis-Oriented Algorithm for Clinicians (HOAC) provided clinicians and students with a framework for science-based clinical practice and focused on the remediation of functional deficits and how changes in impairments related to these deficits. The HOAC II was designed to address shortcomings in the original HOAC and be more compatible with contemporary practice, including the Guide to Physical Therapist Practice. Disablement terminology is used in the HOAC II to guide clinicians and students when documenting patient care and incorporating evidence into practice. The HOAC II, like the HOAC, can be applied to a patient regardless of age or disorder and allows for identification of problems by physical therapists when patients are not able to communicate their problems. A feature of the HOAC II that was lacking in the original algorithm is the concept of prevention and how to justify and document interventions directed at prevention.

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Programming a Cochlear Implant for Tinnitus Suppression

Journal of the American Academy of Audiology ◽

10.3766/jaaa.18086 ◽

2020 ◽

Vol 31 (04) ◽

pp. 302-308 ◽

Cited By ~ 1

Author(s):

Ann Perreau ◽

Richard Tyler ◽

Patricia C. Mancini

Keyword(s):

Electrical Stimulation ◽

Cochlear Implant ◽

Clinical Research ◽

Clinical Setting ◽

Optimal Parameters ◽

Research Designs ◽

Optimal Programming ◽

Stimulation Of ◽

Research Studies

Abstract Background Electrical stimulation of the cochlea to treat tinnitus has been explored for decades. However, few studies have investigated the most salient programming parameters for tinnitus suppression in cochlear implant (CI) patients. Purpose The purpose of this study was to review the available CI programming parameters for tinnitus suppression and to consider possible clinical research designs for selecting the optimal programming parameters for CI patients. Results Across research studies, the optimal parameters vary significantly and are often based on data fromonly a fewparticipants. Electrical stimulation using lowand high rates, different electrode numbers, and low T-levels were helpful in suppressing tinnitus, although more research is needed from a greater number of CI patients. Possible designs for evaluating these parameters in a clinical setting are presented. Conclusions Programming a CI to reduce the prominence of tinnitus is complex, and audiologists should consider adjusting CI parameters systematically for CI patients with bothersome tinnitus.

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Clinical Research Agenda for Physical Therapy

Physical Therapy ◽

10.1093/ptj/80.5.499 ◽

2000 ◽

Vol 80 (5) ◽

pp. 499-513 ◽

Cited By ~ 53

Keyword(s):

Clinical Practice ◽

Physical Therapy ◽

Clinical Research ◽

Research Agenda ◽

Physical Therapists ◽

Physical Therapist ◽

Focal Point ◽

Scientific Basis ◽

Funding Agencies ◽

American Physical

Abstract The American Physical Therapy Association (APTA) has developed a clinical research agenda that is designed to support, explain, and enhance physical therapy clinical practice by facilitating research that is useful primarily to clinicians. The Clinical Research Agenda was developed through a series of conferences and extensive editorial and review processes and represents input from a large number of physical therapists. The Clinical Research Agenda represents questions that are believed to be important to clinical practice, the profession, and APTA. The themes of the Clinical Research Agenda were developed in an attempt to span the breadth of patient/client management beyond the particulars of any single question and to signal the full emergence of the physical therapist clinician as a scientific practitioner. Furthermore, the Clinical Research Agenda is intended to serve as a benchmark of the systematic progression of the scientific basis of the profession as a whole. As approved by APTA's Board of Directors, the Clinical Research Agenda will serve as the focal point for the research programs of the Foundation for Physical Therapy as directed by the Foundation's trustees, and will be shared with other funding agencies and researchers outside of physical therapy as well.

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