Navigating the Intersection Between Persistent Pain and the Opioid Crisis: Population Health Perspectives for Physical Therapy

Abstract The physical therapy profession has recently begun to address its role in preventing and managing opioid use disorder (OUD). This topic calls for discussion of the scope of physical therapist practice, and the profession’s role, in the prevention and treatment of complex chronic illnesses, such as OUD. OUD is not just an individual-level problem. Abundant scientific literature indicates OUD is a problem that warrants interventions at the societal level. This upstream orientation is supported in the American Physical Therapy Association’s vision statement compelling societal transformation and its mission of building communities. Applying a population health framework to these efforts could provide physical therapists with a useful viewpoint that can inform clinical practice and research, as well as develop new cross-disciplinary partnerships. This Perspective discusses the intersection of OUD and persistent pain using the disease prevention model. Primordial, primary, secondary, and tertiary preventive strategies are defined and discussed. This Perspective then explains the potential contributions of this model to current practices in physical therapy, as well as providing actionable suggestions for physical therapists to help develop and implement upstream interventions that could reduce the impact of OUD in their communities.

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Contributions of Non-professional Local Physical Therapist In the Promotion of Community Health Activities in the Arsi Zone, Southeast Ethiopia (Preprint)

10.2196/preprints.27789 ◽

2021 ◽

Author(s):

Leta Melaku

Keyword(s):

Health Promotion ◽

Physical Therapy ◽

Physical Therapists ◽

Physical Therapist ◽

Sampling Technique ◽

Cross Sectional Study ◽

Cross Sectional ◽

Arsi Zone ◽

Southeast Ethiopia ◽

The Impact

BACKGROUND Physical activity is a first-line therapy and secures against persistent illnesses. Essential medical care professionals are obviously situated to advance actual action. Active recuperation mediations focused on advancement and upkeep of wellbeing, personal satisfaction, and wellness. There is, notwithstanding, a deficiency of such examination proof in Ethiopia. OBJECTIVE We planned to assess the degree of KAP of nonprofessional local physical therapists' towards wellbeing advancement in Arsi zone of Oromia, Southeast Ethiopia. METHODS Community based cross sectional study was conducted in April 2018 among 45 physical therapists. Data were collected using pre-tested, structured and self-administrative questionnaires. Participants were selected by quota sampling technique. The questionnaire was drafted specifically to test the KAP. Data were double entered and analyzed by SPSS Version 20.0 program. Descriptive statistics were used. The KAP were estimated using proportion. RESULTS In present response rate is 90.0%. Ages of respondents ranged between 24 – 87 years. 57.8% of participants got initial physical therapy knowledge from either of their parents. 53.3% of the respondents hear about health promotion from families and friends. 57.8% of them provided health promotion at their workplace. The overall percentage of all the respondents’ KAP in health promotion was 60.1%. CONCLUSIONS The respondents’ have good KAP towards health promotion. However there is still room for improvement. Also there is a lack of proper guide lines in determining the impact physical therapy.

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Decision-Making Ability of Physical Therapists: Physical Therapy Intervention or Medical Referral

Physical Therapy ◽

10.2522/ptj.20050393 ◽

2006 ◽

Vol 86 (12) ◽

pp. 1619-1629 ◽

Cited By ~ 136

Author(s):

Diane U Jette ◽

Kerry Ardleigh ◽

Kellie Chandler ◽

Lesley McShea

Keyword(s):

Physical Therapy ◽

Confidence Interval ◽

Physical Therapists ◽

Physical Therapist ◽

Direct Access ◽

Medical Conditions ◽

Musculoskeletal Conditions ◽

Logistic Regressions ◽

American Physical ◽

Medical Referral

Abstract Background and PurposeOpponents of direct access to physical therapy argue that physical therapists may overlook serious medical conditions. More information is needed to determine the ability of physical therapists to practice safely in direct-access environments. The purpose of this study was to describe the ability of physical therapists to make decisions about the management of patients in a direct-access environment. Subjects. Of a random sample of 1,000 members of the Private Practice Section of the American Physical Therapy Association, 394 participated. Methods. A survey included 12 hypothetical case scenarios. For each case, participants determined whether they would provide intervention without referral, provide intervention and refer, or refer before intervention. The percentage of correct decisions for each group of scenarios was calculated for each participant, and participants were classified as having made correct decisions for 100% of cases or less for each group. Three sets of logistic regressions were completed to determine the characteristics of the participants in relation to the decision category. Results. The average percentages of correct decisions were 87%, 88%, and 79% for musculoskeletal, noncritical medical, and critical medical conditions, respectively. Of all participants, approximately 50% made correct decisions for all cases within each group. The odds of making 100% correct decisions if a physical therapist had an orthopedic specialization were 2.23 (95% confidence interval=1.35–3.71) for musculoskeletal conditions and 1.89 (95% confidence interval=1.14–3.15) for critical medical conditions. Discussion and Conclusion. Physical therapists with an orthopedic specialization were almost twice as likely to make correct decisions for critical medical and musculoskeletal conditions.

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Administration and Management Skills Needed by Physical Therapist Graduates in 2010: A National Survey

Physical Therapy ◽

10.2522/ptj.20060003 ◽

2007 ◽

Vol 87 (3) ◽

pp. 261-281 ◽

Cited By ~ 5

Author(s):

D Sue Schafer ◽

Rosalie B Lopopolo ◽

Kathleen A Luedtke-Hoffmann

Keyword(s):

Physical Therapy ◽

Skill Acquisition ◽

Financial Analysis ◽

Physical Therapists ◽

Physical Therapist ◽

Management Skills ◽

Health Care Environment ◽

Doctor Of Physical Therapy ◽

Skill Groups ◽

American Physical

Background and Purpose Administration and management (A&M) skills are essential to physical therapist practice. This study identified which A&M skills will be most critical for future Doctor of Physical Therapy (DPT) graduates to possess upon entry into clinical practice. Subjects and Methods Using a 7-point scale, 435 randomly selected American Physical Therapy Association members (physical therapists) rated 121 A&M skills based on expectation of the level of independence required by a new DPT graduate. Results No differences among respondents based on role, work setting, or experience were found, so the data were combined for factor analyses, producing 16 A&M skill groups. The most independence was expected in skills related to self-management, compliance with rules, ethical behavior, and insurance coding. Skills requiring the most assistance were marketing and strategic planning, financial analysis and budgeting, and environmental assessment. Discussion and Conclusion This study has identified the level of independence for the A&M skills needed by new DPT graduates, provided empirical evidence suggesting which A&M skills should be included in DPT curricula, and suggested a pattern of A&M skill acquisition that applies first to the new therapist and the patient, then to the organization, and finally to the health care environment.

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Referral for Imaging in Physical Therapist Practice: Key Recommendations for Successful Implementation

Physical Therapy ◽

10.1093/ptj/pzab013 ◽

2021 ◽

Author(s):

Aaron Paul Keil ◽

Charles Hazle ◽

Amma Maurer ◽

Connie Kittleson ◽

Daniel Watson ◽

...

Keyword(s):

Physical Therapy ◽

Diagnostic Imaging ◽

Physical Therapists ◽

Physical Therapist ◽

The United States ◽

Successful Implementation ◽

Program Accreditation ◽

Therapy Program ◽

Normative Practice ◽

American Physical

Abstract In recent years, the use of diagnostic imaging in physical therapist practice in the United States (US) has gained considerable interest. In several countries around the world and in the US military, patient direct referral for diagnostic imaging has been considered normative practice for decades. US physical therapy program accreditation standards now stipulate that diagnostic imaging content must be included in physical therapist educational curricula. The American Physical Therapy Association (APTA) has made efforts to pursue practice authority for imaging referral. A recent review of state practice acts and other statutory language concluded that many states have no prohibitions against physical therapists referring for imaging studies. Additionally, physical therapists can now pursue certification as musculoskeletal sonographers. In light of these advances, and with a growing number of PTs serving patients who have not yet seen another healthcare provider, it may be helpful for those who have been actively involved in the use of imaging in PT practice to provide their collective recommendations to serve as a guideline to those interested in incorporating this practice privilege. The purpose of this perspective article is to provide an overview of the key elements necessary for effective implementation of referral for imaging in physical therapist practice while emphasizing the cornerstone of effective communication.

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Guide to Physical Therapist Practice

Physical Therapy ◽

10.1093/ptj/77.11.1163 ◽

1997 ◽

Vol 77 (11) ◽

pp. 1163-1650 ◽

Cited By ~ 41

Keyword(s):

Health Care ◽

Physical Therapy ◽

Professional Education ◽

Health Care Services ◽

Physical Therapists ◽

Physical Therapist ◽

Daily Practice ◽

Care Services ◽

Provision Of Services ◽

American Physical

Preface All health care professions are accountable to the various publics that they serve. The American Physical Therapy Association (APTA) has developed Guide to Physical Therapist Practice (“the Guide”) to help physical therapists analyze their patient/client management and describe the scope of their practice. The Guide is necessary not only to daily practice but to preparation of students. It was used as a primary resource by the Commission on Accreditation in Physical Therapy Education (CAPTE) during its revision of evaluative criteria for physical therapist professional education programs and is an essential companion document to The Normative Model of Physical Therapist Professional Education, Version 97. Specifically, the Guide is designed to help physical therapists (1) enhance quality of care, (2) improve patient/client satisfaction, (3) promote appropriate utilization of health care services, (4) increase efficiency and reduce unwarranted variation in the provision of services, and (5) promote cost reduction through prevention and wellness initiatives. The Guide also provides a framework for physical therapist clinicians and researchers as they refine outcomes data collection and analysis and develop questions for clinical research.

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“Choose Physical Therapy” for Neonatal Abstinence Syndrome: Clinical Management for Infants Affected by the Opioid Crisis

Physical Therapy ◽

10.1093/ptj/pzz039 ◽

2019 ◽

Vol 99 (6) ◽

pp. 771-785 ◽

Cited By ~ 3

Author(s):

Dana B McCarty ◽

Jennifer R Peat ◽

Shannon O'Donnell ◽

Elisabeth Graham ◽

William F Malcolm

Keyword(s):

Physical Therapy ◽

Parent Education ◽

Physical Therapists ◽

Physical Therapist ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome ◽

Safe Alternative ◽

Pharmacological Management ◽

Opioid Crisis ◽

American Physical

Abstract In response to the opioid crisis, the American Physical Therapy Association has strongly advocated for physical therapy as a safe alternative to pharmacological pain management through the “#ChoosePT” campaign and the dedication of a PTJ special issue to the nonpharmacological management of pain. Physical therapists not only play an important role in the rehabilitation of the nearly 2 million adolescents and adults addicted to prescription opioids but also provide care to infants born to mothers with various drug addictions. This Perspective article explores the incidence, pathophysiology, and risk factors for neonatal abstinence syndrome and describes the clinical presentations of withdrawal and neurotoxicity in infants. Discipline-specific recommendations for the physical therapist examination and plan of care, including pharmacological management considerations, are outlined. Nonpharmacological management, including supportive care, feeding, parent education, social aspects of care, and follow-up services, are discussed from a physical therapy perspective. Finally, this article reviews developmental outcomes in infants with neonatal abstinence syndrome and reflects on challenges and future directions of research in this area.

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Preface

Physical Therapy ◽

10.1093/ptj/77.11.1167 ◽

1997 ◽

Vol 77 (11) ◽

pp. 1167-1170

Keyword(s):

Health Care ◽

Physical Therapy ◽

Professional Education ◽

Health Care Services ◽

Physical Therapists ◽

Physical Therapist ◽

Daily Practice ◽

Care Services ◽

Provision Of Services ◽

American Physical

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Physical Therapist Practice in the Intensive Care Unit: Results of a National Survey

Physical Therapy ◽

10.2522/ptj.20140417 ◽

2015 ◽

Vol 95 (10) ◽

pp. 1335-1344 ◽

Cited By ~ 30

Author(s):

Daniel Malone ◽

Kyle Ridgeway ◽

Amy Nordon-Craft ◽

Parker Moss ◽

Margaret Schenkman ◽

...

Keyword(s):

United States ◽

Intensive Care Unit ◽

Intensive Care ◽

Physical Therapy ◽

Acute Care ◽

National Survey ◽

Physical Therapists ◽

Physical Therapist ◽

Community Hospitals ◽

American Physical

Background Early rehabilitation improves outcomes, and increased use of physical therapist services in the intensive care unit (ICU) has been recommended. Little is known about the implementation of early rehabilitation programs or physical therapists' preparation and perceptions of care in the United States. Objective A national survey was conducted to determine the current status of physical therapist practice in the ICU. Design This study used a cross-sectional, observational design. Methods Self-report surveys were mailed to members of the Acute Care Section of the American Physical Therapy Association. Questions addressed staffing, training, barriers, and protocols, and case scenarios were used to determine perceptions about providing rehabilitation. Results The response rate was 29% (667/2,320). Staffing, defined as the number of physical therapists per 100 ICU beds, was highest in community hospitals (academic: median=5.4 [range=3.6–9.2]; community: median=6.7 [range=4.4–10.0]) and in the western United States (median=7.5 [range=4.2–12.9]). Twelve percent of physical therapists reported no training. Barriers to providing ICU rehabilitation included insufficient staffing and training, departmental prioritization policies, and inadequate consultation criteria. Responses to case scenarios demonstrated differences in the likelihood of consultation and physical therapists' prescribed frequency and intensity of care based on medical interventions rather than characteristics of patients. Physical therapists in academic hospitals were more likely to be involved in the care of patients in each scenario and were more likely to perform higher-intensity mobilization. Limitations Members of the Acute Care Section of the American Physical Therapy Association may not represent most practicing physical therapists, and the 29% return rate may have contributed to response bias. Conclusions Although staffing was higher in community hospitals, therapists in academic and community hospitals cited insufficient staffing as the most common barrier to providing rehabilitation in the ICU. Implementing strategies to overcome barriers identified in this study may improve the delivery of ICU rehabilitation services.

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Methods of management and motivation in personnel management of the center of physical therapy and improving the quality of services for patients with orthopedic profile at the outpatient stage

Health, sport, rehabilitation ◽

10.34142/hsr.2019.05.02.02 ◽

2019 ◽

Vol 5 (2) ◽

pp. 17 ◽

Cited By ~ 1

Author(s):

V.V. Vitomskyi ◽

О.B. Lazarіeva ◽

S.М. Fedorenko ◽

M.V. Vitomskа

Keyword(s):

Physical Therapy ◽

Physical Therapists ◽

Physical Therapist ◽

Scientific Information ◽

Quality Of Services ◽

Wide Range ◽

Therapy Services ◽

The Impact ◽

Physical Therapy Services

Objective: to identify the main approaches in the management and motivation of the staff of the center to improve the effectiveness of physical therapy in orthopedic disorders, to form ways to take these features into account in managing the process of physical therapy.Methods: theoretical analysis and generalization of literary sources, method of systematization of scientific information.Results. It is advisable to use a fairly wide range of management techniques in the management of staff to provide physical therapy services, since it is about the impact on a rather complex system - the team of physical therapists, which in turn have a controlling influence on the not less complex systems - patients. The use of management methods can potentially contribute to a number of positive changes in the activities of the staff of physical therapists. The additional impact of these methods will be directed at the patient, in particular, in improving the quality of services. The work of a physical therapist is rather debilitating both from the physical side and from the psychological one. Therefore, the motivation of the staff is important in the management of physical therapists, as well as other employees of the Center for the provision of physical therapy services to patients with orthopedic profile. The study of the problem of motivation has a significant theoretical and practical significance, since the most valuable resource in the current conditions of the market of physical therapy services is personnel, not equipment. Therefore, the responsibility of the leader of a successful center for the provision of physical therapy services is that the motivational goals of the employees are largely correlated with the interests of the center and led to the final result to success, which can be characterized as achieving a useful result immediately to all participants in the system " the head is a physical therapist - a patient. " In a team of physical therapy center, as in any enterprise, there are different types of workers, and the choice of one concept of motivation is mainly determined by the majority of employees of a certain type in the team. The paper outlines the features of the selection and use motivational concepts for the staff center physical therapy. The theory of motivation is considered. Economic and non-economic motivational factors are allocated within the framework of the center for providing physical therapy services, the model of motivation of the personnel is given.Conclusion. The quality and performance of physical therapists in today's market conditions depends not only on professionalism and competence, but also on management, motivation, satisfaction of their needs and loyalty.

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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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