reliability of the scapular posture and scapular dyskinesis tests in rugby union players

OBJECTIVES: To determine the reliability of static scapular posture (SP), clavicular tilt angle (CTA) and the scapular dyskinesis (SD) assessments by expert and student therapists. DESIGN: inter-rater and intra-rater reliability study. SETTING: University level male rugby union club PARTICIPANTS: Four sport rehabilitation students and one experienced physiotherapist evaluated the position of the scapular and clavicle of male university-level rugby union players (inter-rater participants: session 1: n=17, session 2: n=12 and session 3: n=16; intra–rater participants: n = 12). MAIN OUTCOME MEASURESː Participants attended 3 testing sessions, each 1 week apart. Scapular orientation and motion were assessed in five planes of movement and using the Scapular Dyskinesis Test (SDT) respectively. RESULTSː Kappa coefficient values and percentage agreement ratings for students compared to the experienced therapist were: SP=poor to fair (-0.01-0.33), (27% - 94%); SDT=slight (0.16) (41%); CTA=fair (0.21) (59%). Test-retest (intra-rater) agreement was fair to moderate (0.22 – 0.44) (69% -95%), slight (0.12) (47%), and fair (0.39) (77%) for the SP, SDT, and CTA, respectively. CONCLUSIONSː Static and dynamic evaluation of the shoulder by students and an experienced therapist has poor to moderate reliability and should not be used to make clinical decisions based on observation alone.

Mental Health Literacy and Confidence in a Sample of Student Athletic Therapists

Intercollegiate student-athletes appear to be a high-risk population with respect to mental health. Student athletic therapists are one of the groups with whom these athletes may be comfortable disclosing concerns. The current study investigated the relationship between mental health literacy and mental health referral efficacy in a sample of intercollegiate student therapists. One hundred and eleven student athletic therapists (81 female, 29 male, 1 nondiscloure) competed a revised version of the multicomponent mental health literacy measure and a four-item measure of mental health referral efficacy. T tests revealed statistically significant differences in mental health literacy by gender and personal history, and a multiple linear regression revealed a significant model predicting referral efficacy from mental health literacy. There are several implications of these results, particularly when working with a high-risk population of student-athletes.

Assessing and Harnessing the Power of Intergenerational Interactions in Mindfulness-Based Treatment Groups

Mindfulness-based interventions (MBIs) in individual and group formats, have been shown to be effective for a variety of psychological disorders. Due to the promising evidence supporting the wide applicability of mindfulness skills, graduate student therapists were trained to deliver groups that attracted diverse individuals across the lifespan. In these groups, therapists noted how intergenerational dynamics facilitated group cohesion and allowed for increased normalization of common challenges related to practicing mindfulness skills. Therapists’ prior training on cohort differences and treatment recommendations for older adults served as an important foundation to navigating these group interactions. Barriers to simultaneously collecting data and delivering intervention components were noted by the student therapists. Future research and therapist training gaps in knowledge related to effectively facilitating intergenerational groups were identified.

Training Through Naming: A Process of Psychotherapist Skill Development Utilizing Recursive Frame Analysis

Recursive frame analysis (RFA) is both an advanced qualitative research method and a therapeutic tool that is used to map psychotherapy discourse. RFA tracks the therapeutic conversation to show how the therapy talk moves from one act to another. This paper describes the implementation of a training process for family therapy students in a family therapy clinic and the student therapists’ experiences of learning through this process, called Naming the Session. We present the organic development of the training process, its roots in RFA, and the student therapists’ perceptions of how Naming the Session impacted them as trainees. We further present how Naming the Session was useful in the growth of supervisors-in-training who were also a part of this training process.

Developing occupation kits in a Hand Therapy Student Experiential Learning Clinic

Introduction Combining occupation-based and biomechanical approaches is effective to increase function after hand injury. This project developed and evaluated occupation kits as a means to increase occupation-based practice. Methods Descriptive study that utilized existing Disabilities of the Arm, Shoulder and Hand data from 642 patients treated by hand surgeon and patients in our Hand Therapy Student Experiential Learning Clinic (HTSELC) to identify difficult activities. These data informed the selection of occupational areas to address with the kits. Biomechanical demands of each kit developed were quantified by 10 student therapists using the Abilities Questionnaire. Fourteen occupational therapists reviewed and rated the usefulness of each kit by survey. Kits were piloted in the HTSELC, and student therapists documented the percentage of time delivering each intervention type: activity/occupation, preparatory methods and tasks, education, advocacy, and group. The degree of occupation-based practice was compared using intervention type percentages before and after introduction of the kits. Results Ten kits were created to address most occupation categories within occupational therapy’s scope of practice. Kits include procedures, safety precautions, and a standardized scale to objectively measure performance. Clinicians noted that kits reflected each occupation well (3.7/5) and 45% reported they were likely to use the kits. After the kits became available in the HTSELC, the percentage of interventions at the occupation/activity level increased from 19% to 26% and biomechanical interventions, including preparatory methods and tasks, decreased from 61% to 49%. Conclusion This research suggests that occupation kits can be a first step to help therapists deliver occupation-based interventions in hand therapy settings.