Defining, Agreeing on, and Testing an International Physical Therapy Core Data Set: Results of a Feasibility Study Involving Seven Countries

Background To date, there has been no attempt to describe or compare physical therapy as practiced globally, nor any evidence that an international data set exists to support this effort. It is known that research evidence can be used in strategic and tactical ways, especially within the highly politicized context of the policy arena. The International Private Practitioners Association recognized the potential value a global evidence base could have in influencing policy and supporting professional development in a number of countries, yet it lacked a mechanism to achieve these aims. Objectives The purposes of this study were: (1) to identify and test an international data set, definitions, and means of data collection and (2) to establish views in relation to the value of international collaborations. Design A mixed, prospective design was used in the study. Method Phase 1 (2006–2007) involved the development of a data set, definitions, and Web-based and paper-based data collection options involving 98 physical therapists from 68 physical therapy practices in 7 countries. Phase 2 (2008–2009) involved testing of the data set in 34 practices involving 3,195 patient episodes and included physical therapist feedback of experience, local relevance of the data set, and value of international collaborations. Results Testing confirmed the relevance and reliability of the data set and definitions and a preference for Web-based data collection (74.0%). Physical therapist feedback supported these findings. Most respondents (60.0%–100.0%) reported the value of further international collaborations for their profession nationally or internationally. Limitations Although a true international collaboration, the limited sample size should be recognized. Conclusions It is possible to develop an agreed-upon international data set and means of data collection. Testing appears to support its acceptability and relevance for use in practice. Participants highly valued the opportunity to undertake international collaborations that may benefit their profession nationally and internationally. Further testing and use of the data set are advocated before final validation is sought.

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Management of Sternal Precautions Following Median Sternotomy by Physical Therapists in Australia: A Web-Based Survey

Physical Therapy ◽

10.2522/ptj.20100373 ◽

2012 ◽

Vol 92 (1) ◽

pp. 83-97 ◽

Cited By ~ 16

Author(s):

Lara J. Tuyl ◽

Jennifer H. Mackney ◽

Catherine L. Johnston

Keyword(s):

Patient Outcomes ◽

Physical Therapists ◽

Physical Therapist ◽

Median Sternotomy ◽

Evidence Base ◽

Cross Sectional ◽

Web Based ◽

Wound Breakdown ◽

Observational Design ◽

Midline Sternotomy

Background Sternal precautions are utilized within many hospitals with the aim of preventing the occurrence of sternal complications (eg, infection, wound breakdown) following midline sternotomy. The evidence base for sternal precaution protocols, however, has been questioned due to a paucity of research, unknown effect on patient outcomes, and possible discrepancies in pattern of use among institutions. Objective The objective of this study was to investigate and document the use of sternal precautions by physical therapists in the treatment of patients following median sternotomy in hospitals throughout Australia, from immediately postsurgery to discharge from the hospital. Design A cross-sectional, observational design was used. An anonymous, Web-based survey was custom designed for use in the study. Methods The questionnaire was content validated, and the online functionality was assessed. The senior cardiothoracic physical therapist from each hospital identified as currently performing cardiothoracic surgery (N=51) was invited to participate. Results The response rate was 58.8% (n=30). Both public (n=18) and private (n=12) hospitals in all states of Australia were represented. Management protocols reported by participants included wound support (n=22), restrictions on lifting and transfers (n=23), and restrictions on mobility aid use (n=15). Factors influencing clinical practice most commonly included “workplace practices/protocols” (n=27) and “clinical experience” (n=22). Limitations The study may be limited by response bias. Conclusions Significant variation exists in the sternal precautions and protocols used in the treatment of patients following median sternotomy in Australian hospitals. Further research is needed to investigate whether the restrictions and precautions used are necessary and whether protocols have an impact on patient outcomes, including rates of recovery and length of stay.

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The Process of Creating and Disseminating Exercise Programs by Physical Therapists for Older Adults With Chronic Back Pain

Physical Therapy ◽

10.1093/ptj/pzaa202 ◽

2020 ◽

Author(s):

Melissa E Hay ◽

Denise M Connelly

Keyword(s):

Older Adults ◽

Back Pain ◽

Physical Therapy ◽

Data Collection ◽

Chronic Back Pain ◽

Physical Therapists ◽

Physical Therapist ◽

Clinical Practices ◽

Exercise Programs ◽

Care Clinic

Abstract Objective The purpose of this study was to enhance the understanding of the process that physical therapists undertake when creating and disseminating exercise programs for older adults with chronic back pain. Methods Constructivist grounded theory methodology was used as an accessible mode of researching pragmatic clinical practices. Physical therapists from outpatient, ambulatory care clinic settings participated in in-depth, individual interviews (n = 9) and in-clinic observations (n = 5). Data collection and analysis were iterative processes. Codes were generated based on recurrent themes, and constant comparative analysis was used to compare data. Analysis and data collection were concluded when theoretical sufficiency was reached. Results Physical therapist participants described the process of creating and implementing exercise plans as involving listening to the patient’s story, determining function, physical therapy care, supported integration, and, ultimately, returning back to living and life with chronic back pain. Participants worked through the 5 phases at different rates, often recurrently, when treating older adults with chronic back pain. The phases are positioned within a shared alliance between physiotherapy provider and patient, with a transfer of responsibility occurring throughout treatment and follow-up sessions, progressing toward patient independence. This transfer of responsibility served as the core category for the process herein. Conclusions This research highlights the importance of listening to patients’ stories when engaging in physical therapy care. Focusing on function, providing education and exercise as components of care, and supporting integration of exercise into everyday life are considerations for providing care for older adults with chronic back pain in physical therapist practice, and, ultimately, for returning to life. Impact With aging populations and with the increasing prevalence of chronic conditions, this research offers insight into a process for physical therapists to enact exercise engagement for improved health and quality of life for older adults with chronic back pain.

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Patient Participation in Physical Therapy Goal Setting

Physical Therapy ◽

10.1093/ptj/81.5.1118 ◽

2001 ◽

Vol 81 (5) ◽

pp. 1118-1126 ◽

Cited By ~ 75

Author(s):

Susan M Baker ◽

Helen H Marshak ◽

Gail T Rice ◽

Grenith J Zimmerman

Keyword(s):

Patient Satisfaction ◽

Physical Therapy ◽

Elderly Patients ◽

Goal Setting ◽

Patient Participation ◽

Physical Therapists ◽

Physical Therapist ◽

Assessment Instrument ◽

Initial Examination ◽

Goals And Objectives

Abstract Background and Purpose. An important part of treatment planning in physical therapy is effective goal setting. The Guide to Physical Therapist Practice recommends that therapists should identify the patient's goals and objectives during the initial examination in order to maximize outcomes. The purpose of this study was to examine whether therapists seek to involve patients in goal setting and, if so, what methods they use. Therapists' attitudes toward participation and patient satisfaction with the examination were also examined. Subjects and Methods. Twenty-two physical therapists audiotaped the initial examination of 73 elderly patients (X̄=76.4 years of age, SD=7.1, range=65–94). The audiotaped examinations were then scored using the Participation Method Assessment Instrument (PMAI) to determine the frequency of attempts made by therapists to involve patients in goal setting. Therapists and patients completed surveys following the examinations. Results. Therapists' use of participation methods during examinations ranged from a minimum of 1 to a maximum of 19 out of 21 possible items on the PMAI. The therapists stated that they believed that it is important to include patients in goal-setting activities and that outcomes will be improved if patients participate. Patients also indicated that participation is important to them. Discussion and Conclusion. In most cases, the therapists did not fully take advantage of the potential for patient participation in goal setting. Patient and therapist education is needed regarding methods for patient participation during initial goal-setting activities.

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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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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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Value-Based Care for Musculoskeletal Pain: Are Physical Therapists Ready to Deliver?

Physical Therapy ◽

10.1093/ptj/pzz171 ◽

2019 ◽

Vol 100 (4) ◽

pp. 621-632 ◽

Cited By ~ 1

Author(s):

Trevor A Lentz ◽

Adam P Goode ◽

Charles A Thigpen ◽

Steven Z George

Keyword(s):

Health Care ◽

Physical Therapy ◽

Musculoskeletal Pain ◽

Clinical Decision Making ◽

Physical Therapists ◽

Physical Therapist ◽

Great Promise ◽

Health Care Environment ◽

Early Physical Therapy ◽

Analytical Approaches

Abstract Early physical therapy models hold great promise for delivering high-value care for individuals with musculoskeletal pain. However, existing physical therapist practice and research standards are misaligned with value-based principles, which limits the potential for growth and sustainability of these models. This Perspective describes how the value proposition of early physical therapy can be improved by redefining harm, embracing a prognostic approach to clinical decision making, and advocating for system-wide guideline-adherent pain care. It also outlines the need to adopt a common language to describe these models and embrace new, rigorous study designs and analytical approaches to better understand where and how early physical therapy delivers value. The goal is to define a clear path forward to ensure physical therapists are aligned within health care systems to deliver on the American Physical Therapy Association’s vision of high-value care in a rapidly changing health care environment.

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Factors Impacting Physical Therapy Utilization for Patients With Nonspecific Low Back Pain: Retrospective Analysis of a Clinical Data Set

Physical Therapy ◽

10.1093/ptj/pzaa082 ◽

2020 ◽

Vol 100 (9) ◽

pp. 1502-1515

Author(s):

Janet Dolot ◽

Matthew Hyland ◽

Qiuhu Shi ◽

Hae-Young Kim ◽

Deborah Viola ◽

...

Keyword(s):

Back Pain ◽

Physical Therapy ◽

Physical Therapist ◽

Low Cost ◽

Care Organization ◽

Data Set ◽

Individual Patient Level ◽

Episode Of Care ◽

Out Of Pocket Payments ◽

Provider Organization

Abstract Objective Factors predicting physical therapy utilization for lower back pain (LBP) remain unclear, limiting the development of value-based initiatives. The purpose of this study was to identify important factors that impact the number of physical therapist visits per episode of care for US adults with nonspecific LBP. Methods This study was a retrospective observational cohort study of a clinical dataset derived from 80 clinics of a single physical therapy provider organization. Research variables were categorized at the individual (patient) level and the organization (therapist, clinic) level. A hierarchical regression model was designed to identify factors influencing the number of physical therapist visits per episode of care. Results Higher out-of-pocket payments per visit, receipt of “active” physical therapy, longer average visit length, earlier use of physical therapy, and sex of the therapist (male) were found to predict fewer visits per episode of care. Percent change of function, prior receipt of physical therapy by the same provider organization, self-discharge from physical therapy, level of starting function, and therapist certification were found to predict more visits. Of the variance in number of visits, 8.0% was attributable to the health care organization. Conclusions Individual factors, such as higher out-of-pocket payment, have a significant impact on reducing visits per episode of care and should be considered when developing value-based initiatives to optimize clinical and utilization outcomes. Impact Payers use consumer-directed healthcare to reduce costs by discouraging utilization of low value services and encouraging use of low-cost providers. LBP is a costly condition for which physical therapy is a high-value treatment. This study shows that non-need factors predict the number of physical therapy visits per episode of care for patients with nonspecific LBP. Insurance benefit plans with lower out-of-pocket payments for physical therapy and higher reimbursement for active physical therapist interventions may facilitate appropriate utilization of high-value treatment for LBP.

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The Revised APTA Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant: Theory, Purpose, Process, and Significance

Physical Therapy ◽

10.2522/ptj.20090373 ◽

2010 ◽

Vol 90 (5) ◽

pp. 803-824 ◽

Cited By ~ 17

Author(s):

Laura Lee Swisher ◽

Peggy Hiller ◽

Keyword(s):

Physical Therapy ◽

Physical Therapists ◽

Physical Therapist ◽

Code Of Ethics ◽

Codes Of Ethics ◽

Ethical Conduct ◽

Vision 2020 ◽

Deliberative Process ◽

Physical Therapist Assistant ◽

Physical Therapist Assistants

IntroductionIn June 2009, the House of Delegates (HOD) of the American Physical Therapy Association (APTA) passed a major revision of the APTA Code of Ethics for physical therapists and the Standards of Ethical Conduct for the Physical Therapist Assistant. The revised documents will be effective July 1, 2010.PurposeThe purposes of this article are: (1) to provide a historical, professional, and theoretical context for this important revision; (2) to describe the 4-year revision process; (3) to examine major features of the documents; and (4) to discuss the significance of the revisions from the perspective of the maturation of physical therapy as a doctoring profession.Process of RevisionThe process for revision is delineated within the context of history and the Bylaws of APTA.Format, Structure, and Content of Revised Core Ethics DocumentsThe revised documents represent a significant change in format, level of detail, and scope of application. Previous APTA Codes of Ethics and Standards of Ethical Conduct for the Physical Therapist Assistant have delineated very broad general principles, with specific obligations spelled out in the Ethics and Judicial Committee's Guide for Professional Conduct and Guide for Conduct of the Physical Therapist Assistant. In contrast to the current documents, the revised documents address all 5 roles of the physical therapist, delineate ethical obligations in organizational and business contexts, and align with the tenets of Vision 2020.SignificanceThe significance of this revision is discussed within historical parameters, the implications for physical therapists and physical therapist assistants, the maturation of the profession, societal accountability and moral community, potential regulatory implications, and the inclusive and deliberative process of moral dialogue by which changes were developed, revised, and approved.

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Physical Therapy Intervention for People With Huntington Disease

Physical Therapy ◽

10.2522/ptj.20070346 ◽

2008 ◽

Vol 88 (7) ◽

pp. 820-831 ◽

Cited By ~ 31

Author(s):

Monica E Busse ◽

Hanan Khalil ◽

Lori Quinn ◽

Anne E Rosser

Keyword(s):

Physical Therapy ◽

Huntington Disease ◽

Clinical Decision Making ◽

Clinical Symptoms ◽

Physical Therapists ◽

Physical Therapist ◽

Clinical Care ◽

Future Research ◽

Therapy Intervention ◽

Physical Therapy Intervention

Background and PurposeThe clinical symptoms of Huntington disease (HD) include progressive movement disorders, cognitive deficits, and behavioral changes, all of which affect an individual's ability to participate in activities of daily living. To date, very few quantitative or qualitative studies have been conducted to guide physical therapists working with people with HD. The objective of this study was to characterize current physical therapist practice for people with HD, thus informing the development of standardized clinical care and future research studies.Subjects and MethodsConsultation with physical therapists working with people with HD was undertaken in the form of mailed questionnaires (n=49) and semistructured interviews (n=8). The development of the interview schedule was aided by consideration of the data obtained from the questionnaires. Themes identified from the interviews were considered in light of published literature and questionnaire responses.ResultsThe main issues that emerged from the interviews were classified into 3 subthemes: (1) there is insufficient use of routine physical therapy–related outcome measures at different stages of HD, (2) there is underutilization of physical therapy services in managing HD (particularly in the early stages), and (3) the management of falls and mobility deficit progression is a key treatment aim for people with HD.Discussion and ConclusionA conceptual framework for physical therapy intervention in HD was developed on the basis of the themes that emerged from the data in this study. Such a framework has utility for complex, progressive conditions such as HD and may facilitate clinical decision making and standardization of practice and affect the development of future physical therapy trials.

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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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