scholarly journals An investigation of screening for medical referral by Physical Therapists

2016 ◽  
Author(s):  
Heather Mount ◽  
Cecilia Graham ◽  
Diane Clark ◽  
David Morris ◽  
Kathleen Foley
Keyword(s):  
Physical Therapy ◽  
Health Care Providers ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Signs And Symptoms ◽  
Care Providers ◽  
Management Decisions ◽  
Clinical Vignettes ◽  
Outpatient Practice ◽  
Medical Referral

Screening for medical referral is essential to physical therapist practice; however, no studies have examined medical screening across physical therapy practice settings. The purpose of this study was to determine if physical therapists in a variety of practice settings, given brief clinical vignettes, would screen for medical referral in a similar manner. The Delphi Technique was implemented to establish content validity, although only 2 vignettes reached 100% consensus by the expert panel. After reviewing the vignettes, physical therapist subjects determined if they would provide intervention, provide intervention and refer, or refer before intervention. To determine which variables were associated with identified appropriate decisions in each category, 4 sets of logistic regressions were performed. A random sample of APTA members in targeted sections (n=214) completed the survey. Physical therapists with more than 23 years experience were 7 times more likely to make similar management decisions in noncritical vignettes then those with 11 years or less. Half of the participants practiced in outpatient practice settings. In critical medical vignettes, 86% of physical therapists made similar decisions. Physical therapists in this study made identified appropriate management decisions for 90% of the vignettes. Board certification, practice setting and highest earned degree were not found to be statistically significant. It is imperative not only to ensure that the client is appropriate for physical therapy intervention, but it is also vital to recognize and identify signs and symptoms that warrant evaluation by other health care providers.

scholarly journals Reaching the Masses: Physical Therapist Students Learn to Use YouTube to Share Clinical Information with Patients and the Public

2010 ◽  
Author(s):  
Wayne Moore
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Health Care Providers ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Clinical Skill ◽  
Care Providers ◽  
Physical Therapist Students ◽  
Educational Videos ◽  
Students Attitudes

Purposes: This pilot study (1) assessed physical therapist students’ attitudes toward using YouTube to share health-related videos on the Internet, and (2) determined whether a cohort of physical therapist students would use YouTube, or similar technologies, to share educational information with other health care providers and health care consumers once they enter practice. Methods: A cohort of 28-second-year Doctor of Physical Therapy students completed a project to produce and share educational videos on YouTube. Students, working in small groups, selected a clinical skill introduced and practiced during the Cardiopulmonary Physical Therapy course as the focus of their videos. A survey completed at the conclusion of the project collected data about students’ attitudes and experiences regarding the use of YouTube. Results: Tabulation of students’ responses revealed that 85% of the students enjoyed making videos and 96% of the students felt that physical therapists should share physical therapy-related information with the largest possible audience. Nineteen percent of the students reported that they are likely to share additional videos online. Conclusion:YouTube and other online video sites allow physical therapists to reach a large audience of people interested in the services and education they provide. However, some students may be reluctant to take advantage of this relatively new technology. Future research may focus on the relationship between the obligation students feel to produce educational videos and their reported reluctance to produce educational videos once they enter clinical practice.

scholarly journals Blood Pressure Screening by Outpatient Physical Therapists: A Call to Action and Clinical Recommendations

2020 ◽  
Vol 100 (6) ◽  
pp. 1008-1019
Author(s):  
Richard Severin ◽  
Ahmad Sabbahi ◽  
Ali Albarrati ◽  
Shane A Phillips ◽  
Sara Arena
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Physical Therapy ◽  
Health Care Providers ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Standard Of Care ◽  
Morbidity Rate ◽  
Routine Practice ◽  
Care Providers

Abstract Hypertension (HTN) is among the leading global preventable risk factors for cardiovascular disease and premature mortality. Early detection and effective management of HTN have demonstrated significant reductions in mortality, morbidity rate, and health care costs. Furthermore, screening for HTN by nonphysician health care providers improves detection rates and medical management. As physical therapist practice advances to a more independent care model, physical therapists may serve as the first point of contact into the health care system, thereby necessitating a need for routine blood pressure (BP) monitoring. This is especially relevant in the outpatient physical therapist practice setting, where there is evidence for elevated BP measures among patients, yet omission of routine screening in this setting is well documented. Leading physical therapy professional organizations include statements in their guidelines that suggest that physical therapists have a duty to provide a standard of care that protects the safety and optimizes the overall health of patients under their care. Therefore, it is imperative not only that physical therapists include BP examination into routine practice protocols but that the knowledge and skills to accurately measure and interpret BP at rest and during exercise be integrated into the standard of care. The authors suggest that the profession of physical therapy proactively embrace their potential to address the national and worldwide HTN epidemic through routine assessment of BP, appropriate referral for elevated BP measures, and exploration of HTN management by physical therapists.

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

2006 ◽  
Vol 86 (12) ◽  
pp. 1619-1629 ◽  
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.

scholarly journals Benefits of Musculoskeletal Physical Therapy in Emergency Departments: A Systematic Review

2019 ◽  
Vol 99 (9) ◽  
pp. 1150-1166 ◽  
Author(s):  
Eveline Matifat ◽  
Marianne Méquignon ◽  
Caitriona Cunningham ◽  
Catherine Blake ◽  
Oma Fennelly ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Usual Care ◽  
Health Care Providers ◽  
Emergency Departments ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Current Evidence ◽  
Care Providers ◽  
High Quality

Abstract Background Over the past few decades, physical therapists have emerged as key health care providers in emergency departments (EDs), especially for patients with musculoskeletal disorders (MSKD). Purpose The purpose of this review was to update the current evidence regarding physical therapist care for patients with MSKD in EDs and to update current recommendations for these models of care. Data Sources Systematic searches were conducted in 5 bibliographic databases. Study Selection The studies selected presented quantitative data related to the care of patients with MSKD by physical therapists in an ED setting. Data Extraction Raters reviewed studies and used the Effective Public Health Practice Project Quality Assessment Tool to assess their methodological quality. Data Synthesis Fifteen studies were included. Two studies, 1 of weak and 1 of strong quality, demonstrated that physical therapist care in EDs was as effective as or more effective than usual medical care for pain reduction, and 6 studies of varying quality reported that physical therapist care in EDs was as effective as usual care in EDs in reducing disability. Eight studies of varying quality reported that physical therapist care could significantly reduce waiting time in EDs. Four studies of varying quality reported that physical therapists ordered no more, or even fewer, medical images than physicians. In terms of health care costs, 2 studies of moderate to high quality found no significant differences in costs between physical therapist care and usual care in EDs. Finally, 6 studies of varying quality reported that patients were as satisfied or more satisfied with physical therapist care as with usual medical care in EDs. Limitations The roles of physical therapists in EDs vary depending on the setting, legislation, and training of providers. Only a limited number of high-quality studies were identified. Conclusions Although the quality of the evidence is heterogeneous, physical therapist care for patients with MSKD in EDs may be beneficial.

scholarly journals Access to Physical Therapy Services Among Medically Underserved Adults: A Mixed-Method Study

2010 ◽  
Vol 90 (5) ◽  
pp. 735-747 ◽  
Author(s):  
Christine A. McCallum
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Health Care Providers ◽  
Mixed Method ◽  
Physical Therapist ◽  
Medically Underserved ◽  
Care Providers ◽  
Health Care Clinics ◽  
Therapy Services ◽  
Physical Therapy Services

Background and Objectives This mixed-method case study examined access issues related to physical therapy services among medically underserved adults within an Ohio community. Design Three community health care clinics served as the units of analysis. Methods Eleven health care providers and 110 patients participated in the study, and documents from local, state, and national resources were reviewed. Results Results revealed that structural, utilization of care, and outcome barriers existed. A lack of accessible physical therapy providers for medically underserved adults and a lack of standardized screening or assessment processes to identify physical mobility problems among people with chronic health conditions were found. Inadequate knowledge about the full scope of physical therapist practice existed, which may impede access to those individuals most in need of services. Conclusions Opportunities are present for physical therapist involvement in screening, wellness and prevention, consultation, education, and program development among medically underserved adults. However, challenges exist due to a lack of human and financial resources and the current structure of our health care system, which focuses on acute and chronic care rather than prevention.

scholarly journals WOMEN’S HEALTH ISSUES: THE CONTINUING APPEAL FOR WOMEN HEALTH PHYSICAL THERAPY PRACTICE IN PAKISTAN

2021 ◽  
Vol 5 (2) ◽  
pp. 218-219
Author(s):  
Sidra Qureshi ◽  
◽  
Furqan Ahmed Siddiqi ◽  
Waqar Ahmed Awan ◽  
◽  
...  
Keyword(s):  
Physical Therapy ◽  
Women’S Health ◽  
Women's Health ◽  
Health Care Providers ◽  
Physical Therapist ◽  
Whole Body ◽  
Health Issues ◽  
Care Providers ◽  
Women Health

Women’s health in its widest definition includes study of whole body particularly examining biological characteristics unique to women, with a focus on reproductive organs, body structure, hormones, childhood development and genetics.1 In 2017, maternal mortality ratio was determined to be 211 deaths per 100,000 live birth globally and in Pakistan, the ratio was 186 deaths per 100,000 live births in 2021.2,3 Besides obstetrical health issues, Pakistani female are also facing gynecological maladies on a large scale as compared to other countries such as grade I and II pelvic organ prolapse that is likely to be managed through pelvic physical therapy as per National Institute for Health and Care Excellence (NICE) guidelines.4 Regrettably, the burden of disease is increased manifolds due to unavailability of expert women’s health physical therapist.5 Like many countries, Pakistan is signatory to several international commitments till now to empower the women. To overcome the lacking, women’s health issues should be fostered by a woman’s health physical therapist. A women health physical therapist evaluates, treats, and educates a woman throughout the stages of life starting form active child-bearing years, pregnancy, postpartum, perimenopause and post menopause.6 The area of practice has now spread to encompass all health concerns of a woman namely infertility, osteoporosis, fibromyalgia, rehabilitation following gynecological surgery, breast cancer rehabilitation, incontinence, dyspareunia, vulvodynia, pregnancy related musculoskeletal pain, lymphedema, wellness and exercise. A woman throughout the life span whether a childbearing woman, a menopausal and a young athlete or an elderly woman can obtain benefit from women’s health physical therapy (WHPT). The American College of Obstetricians and Gynecologists (ACOG) claims that conjoint care provided by physician and physical therapist can enormously improve treatment prognosis.7 An optimal quality of life for a woman can be ensured through clinical evaluation and assessment to plan physical therapy interventions incorporated with various modalities that are cautiously prescribed according to an individual’s scenario.8 It is about time to emphasize WHPT practice throughout the country. There is a prolonged schedule to fulfil all fundamental components of women’s health issues which demands the joint collaboration of health-care providers, governments, policy makers, and the overall population. This article shout-out to novice physical therapy professionals to get themselves enrolled in WHPT specialty degree for the betterment of women. It is the need of hour to incorporate the services of qualified and expert WHPT professional in large tertiary care hospitals whether public or private, so that the premium quality of medical services pertaining to women health is available to the masses of all walks of life.

scholarly journals Concussion Attitudes and Beliefs, Knowledge, and Clinical Practice: Survey of Physical Therapists

2016 ◽  
Vol 96 (7) ◽  
pp. 1018-1028 ◽  
Author(s):  
Amy M. Yorke ◽  
Sheila Littleton ◽  
Bara A. Alsalaheen
Keyword(s):  
Physical Therapy ◽  
Health Care Providers ◽  
Current Practice ◽  
Clinical Decision Making ◽  
Physical Therapists ◽  
Return To Play ◽  
Attitudes And Beliefs ◽  
Care Providers ◽  
Clinical Scenarios ◽  
Concussion Knowledge

Abstract Background A concussion is considered a mild traumatic brain injury that may cause physical, cognitive, affective, and sleep dysfunction. Physical therapists have been identified as health care providers involved in the multidisciplinary care of a patient with concussion. Objective The purpose of this study was to describe the current attitudes and beliefs, knowledge, and practice of physical therapists in the treatment of patients with concussion. Methods A 55-question electronic survey divided into 6 sections—(1) demographics, (2) current practice in concussion, (3) youth concussion legislation, (4) attitudes and beliefs toward concussion management, (5) concussion knowledge, and (6) clinical decision making—was developed and distributed online through selected American Physical Therapy Association sections. Results A total of 1,272 physical therapists completed the survey. Seventy percent of the respondents (n=894) reported having concussion training. Although supportive of the role of the physical therapist in the treatment of a person with concussion, the respondents demonstrated less confidence when making return-to-play decisions. Respondents correctly answered, on average, 13 (out of 15) concussion knowledge questions, with gaps exhibited in understanding the clinical utilization of concussion severity scales, the conservative treatment of youth who sustain a concussion, and anticipated normal computed tomography and magnetic resonance imaging after a concussion. When provided with clinical scenarios, respondents were able to recognize when a referral to a physician was indicated; however, they demonstrated variability in identifying a need for vestibular or manual physical therapy. Limitations Convenience sampling was utilized, limiting generalizability of the results of the study to the physical therapy profession as a whole. Conclusion Physical therapists demonstrated a solid foundation of concussion knowledge, but gaps still existed. Future professional development opportunities should be developed to target identified gaps in knowledge and current practice patterns.

scholarly journals Adding a Physical Therapist to the Health Care Team in an HIV Clinic Increases Physical Therapy Referrals and Reduces Opioid Prescriptions Provided for Chronic Musculoskeletal Pain in Patients Living With HIV

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Vinoja Sebanayagam ◽  
Nichole Chakur ◽  
Nana Ama Baffoe ◽  
Brian Reed ◽  
Jarrett Weinberger ◽  
...  
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Health Care Providers ◽  
Physical Therapist ◽  
Health Care Team ◽  
Care Team ◽  
People Living With Hiv ◽  
Care Providers ◽  
Living With Hiv ◽  
The Impact

Abstract Background Musculoskeletal (MSK) pain is common in people living with HIV (PLWH). Health care providers sometimes prescribe opioids to control pain, which may lead to opioid misuse. An interdisciplinary approach that includes physical therapy has been successful in managing MSK pain in various health care settings. Therefore, we sought to find the impact of recruiting a physical therapist (PT) on the number of opioid prescriptions and physical therapy referrals made by physicians in training to manage MSK pain in PLWH. Methods We performed a retrospective chart review of patients seen by Internal Medicine physicians in training in an HIV clinic in Detroit before (2017) and after (2018) recruiting a PT to the health care team and collected demographic and clinical data. We also surveyed the trainees to assess how the PT addition influenced their learning. Institutional review board waiver was obtained. Results Results showed that of all PLWH seen at the clinic, 28/249 (11%) and 37/178 (21%) had chronic MSK pain in the 2017 and 2018 data sets, respectively. In 2017, all 28 patients with MSK pain were prescribed opioids. This decreased in 2018 after the PT addition (10/37 patients; P < .0001). The number of physical therapy referrals significantly increased after the PT addition (2017: 5/28 patients; 2018: 17/37 patients; P = .03). Trainees felt that the PT helped improve their examination skills and develop a treatment plan for patients. Conclusions The addition of a PT encouraged physicians in training to utilize nonopioid management of MSK pain in PLWH and enhanced their learning experience, as perceived by the trainees.

scholarly journals Misdiagnosis of Serotonin Syndrome as Fibromyalgia and the Role of Physical Therapists

2008 ◽  
Vol 88 (6) ◽  
pp. 757-765 ◽  
Author(s):  
Gregory M Alnwick
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Serotonin Syndrome ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Diagnostic Testing ◽  
Signs And Symptoms ◽  
Activity Level ◽  
Medical Evaluation ◽  
Successful Recovery

Background and Purpose With increased use of serotonergic medications, a condition triggered by serotonin excess within the brain and spinal cord has emerged and may be gaining prevalence. The purposes of this case report are to describe how to identify serotonin syndrome in a patient who is taking citalopram (a selective serotonin reuptake inhibitor) on the basis of signs and symptoms and to promote the ability of physical therapists to recognize such signs and symptoms. Case Description The patient was a 42-year-old woman referred for physical therapy with a diagnosis of fibromyalgia. The physical therapist recognized that the patient's symptoms did not resemble those of fibromyalgia and recommended referral to a neurologist for further diagnostic testing. Outcomes The patient was referred to a neurologist, who diagnosed serotonin syndrome related to the use of citalopram. The patient was weaned off citalopram and made a successful recovery, with scores on the Oswestry Disability Index decreasing from 70% to 28% at discharge from the physical therapy treatment and to 0% at the 6-month follow-up. The patient has since returned to her prior activity level, which includes skiing, motorcycle riding, and working at her consulting firm. Discussion This case report demonstrates how careful evaluation by the physical therapist indicated that signs and symptoms were not consistent with fibromyalgia, and further medical evaluation revealed the actual diagnosis of serotonin syndrome.

scholarly journals Conceptual Model for Physical Therapist Management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

2010 ◽  
Vol 90 (4) ◽  
pp. 602-614 ◽  
Author(s):  
Todd E. Davenport ◽  
Staci R. Stevens ◽  
Mark J. VanNess ◽  
Christopher R. Snell ◽  
Tamara Little
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Conceptual Model ◽  
Health Care Providers ◽  
Clinical Management ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Care Providers ◽  
Fatigue Syndrome

Fatigue is one of the most common reasons why people consult health care providers. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is one cause of clinically debilitating fatigue. The underdiagnosis of CFS/ME, along with the spectrum of symptoms that represent multiple reasons for entry into physical therapy settings, places physical therapists in a unique position to identify this health condition and direct its appropriate management. The diagnosis and clinical correlates of CFS/ME are becoming better understood, although the optimal clinical management of this condition remains controversial. The 4 aims of this perspective article are: (1) to summarize the diagnosis of CFS/ME with the goal of promoting the optimal recognition of this condition by physical therapists; (2) to discuss aerobic system and cognitive deficits that may lead to the clinical presentation of CFS/ME; (3) to review the evidence for graded exercise with the goal of addressing limitations in body structures and functions, activity, and participation in people with CFS/ME; and (4) to present a conceptual model for the clinical management of CFS/ME by physical therapists.

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