A description of physical therapists' knowledge in managing musculoskeletal conditions

BACKGROUND: Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. However, further evidence is needed to determine if physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions. Therefore, the purpose of this study was to describe physical therapists' knowledge in managing musculoskeletal conditions. METHODS: This study utilized a cross-sectional design in which 174 physical therapist students from randomly selected educational programs and 182 experienced physical therapists completed a standardized examination assessing knowledge in managing musculoskeletal conditions. This same examination has been previously been used to assess knowledge in musculoskeletal medicine among medical students, physician interns and residents, and across a variety of physician specialties. RESULTS: Experienced physical therapists had higher levels of knowledge in managing musculoskeletal conditions than medical students, physician interns and residents, and all physician specialists except for orthopaedists. Physical therapist students enrolled in doctoral degree educational programs achieved significantly higher scores than their peers enrolled in master's degree programs. Furthermore, experienced physical therapists who were board-certified in orthopaedic or sports physical therapy achieved significantly higher scores and passing rates than their non board-certified colleagues. CONCLUSION: The results of this study may have implications for health and public policy decisions regarding the suitability of utilizing physical therapists to provide direct access care for patients with musculoskeletal conditions

Brittle fracture to recoverable plasticity: Polytypism-dependent nanomechanics in todorokite-like nanobelts

Atomic force microscopy (AFM) based nanomechanics experiments involving polytypic todorokite-like manganese dioxide nanobelts reveal varied nanomechanical performance regimes such as brittle fracture, near-brittle fracture, and plastic recovery within the same material system. These nanobelts are synthesized through a layer-to-tunnel material transformation pathway and contain one-dimensional tunnels, which run along their longitudinal axis and are enveloped by m × 3 MnO6 octahedral units along their walls. Depending on the extent of material transformation towards a tunneled microstructure, the nanobelts exhibit stacking disorders or polytypism where the value for m ranges from 3 to up to ∼20 within different cross-sectional regions of the same nanobelt. The observation of multiple nanomechanical performance regimes within a single material system is attributed to a combination of two factors: (a) the extent of stacking disorder or polytypism within the nanobelts, and (b) the loading (or strain) rate of the AFM nanomechanics experiment. Controllable engineering of recoverable plasticity is a particularly beneficial attribute for advancing the mechanical stability of these ceramic materials, which hold promise for insertion in multiple next-generation technological applications that range from electrical energy storage solutions to catalysis