Osteoporosis Knowledge in Licensed Physical Therapists and First-Year Doctor of Physical Therapy Students: A Gap in Physical Therapy Education?

Background: A lack of osteoporosis knowledge has been found in a variety of healthcare providers. No previous studies have evaluated osteoporosis knowledge between physical therapists and first-year doctor of physical therapy students. Purpose- To assess the knowledge of participants attending the course “Innovative Strategies for Preserving Bone Health: A Closer Look at Osteoporosis Management Across the Lifespan”. Methods: Twenty-one participants participated in a 12.5 hour continuing education course. Eleven licensed physical therapists with an average of 19 years clinical experience and 10 first year Doctor of Physical Therapy students. Outcomes were evaluated using statistical analysis from data collected: demographic questionnaire, pre/post course test, course evaluation survey. Results: Difference between median scores was statistically significant (Z(26) = -4.468, p \u3c 0.0001), indicating that a learning effect occurred as a result of course instruction. No statistical difference between the knowledge of the therapists and students at the pre-course test (U(21) = 38.00, p = 0.251) or post-course test (U(21) = 39.50, p = 0.282) Conclusion: The improved mean from the pre-course test to the post-course test demonstrates that a learning effect occurred. The lack of statistical difference between seasoned physical therapy clinicians and first-year DPT students indicates that there may be a gap in osteoporosis education among physical therapists. More research should be done to determine where this gap occurs in the education process and how it can be improved

Does ethnicity impact DPT students’ clinical readiness and performance? An exploratory study

The purpose of this study was to explore the influence of ethnicity on clinical readiness and performance among DPT students as determined by (1) clinical reasoning Physical Therapist Self-Efficacy (PTSE) score during clinical experiences(2) self-confidence rating treating patients, and (3) final APTA Clinical Performance Instrument (CPI) clinical reasoning and summative ratings by clinical instructors. A 28 question survey was administered to 211 second- and third-year students in a Doctor of Physical Therapy program at mid-term of their clinical experience. Survey scores, PTSE scores, and CPI scores were analyzed using a Kruskal-Wallis test for differences between groups. All ethnic groups demonstrated strong clinical readiness and performance during all clinical experience levels. Ethnic groups did not differ in clinical reasoning self-efficacy or confidence treating patients. Although the gap appears to be closing, there continues to be underrepresentation of ethnic groups in DPT academic programs

Clinical Reasoning Readiness and Confidence of DPT Students with PT Interventions Using Telehealth

Telehealth service-delivery content has an emerging footprint on entry-level physical therapy programs. This study evaluated clinical reasoning readiness and confidence in third-year DPT students during clinical experiences with and without telehealth. Students’ clinical reasoning readiness and confidence were determined using the Physical Therapist Self-Efficacy (PTSE) score, self-confidence rating treating patients, and final APTA Clinical Performance Instrument (CPI) clinical reasoning and summative ratings. DPT students providing PT interventions using telehealth reported lower clinical reasoning self-efficacy (PTSE) when compared to traditional service-delivery. Confidence treating using telehealth was greater at the initial visit compared to subsequent visits, suggesting a lack of student readiness for providing subsequent telehealth visits. Final CPI ratings did not differ between DPT students with and without telehealth

Self-Efficacy with Telehealth Examination: the Doctor of Physical Therapy Student Perspective

Introduction: The shift to telehealth exposed gaps in our understanding of how physical therapy students perceive patient assessment in a remote situation using the examination component of the patient/client management (PCM) model. The purpose of the study was to compare Doctor of Physical Therapy (DPT) students’ self-efficacy performing patient assessment using the examination component of the PCM model using telehealth compared with conventional examination. To achieve the purpose of this study, the Physical Therapist Self-Efficacy (PTSE) scale was used. More specifically, self-efficacy in clinical reasoning was measured using the following items: (1) PTSE total score (2) performance of tests and measures, (3) determining when to refer to another practitioner, and (4) screening for primary medical disease. Methods: A survey-based descriptive and exploratory repeated measures design was used, with surveys distributed to entry-level DPT students during their clinical experiences in the United States during the Fall 2020 semester. A convenience sample of 35 second- and third-year entry-level DPT students who reported provided both telehealth and traditional examinations during clinical experiences was used. Descriptive and inferential statistics were used to evaluate within group differences comparing student self-efficacy using telehealth and conventional examination. Results: Wilcoxon sign ranks revealed statistically significant differences in self-efficacy scores of students conducting patient assessment using telehealth compared to conventional examination. More specifically, scores for telehealth were lower (P \u3c 0.001) compared to conventional examination in PTSE total score, performance of tests and measures, determining when to refer to another practitioner, and medical screening for primary disease. Discussion: Doctor of Physical Therapy students’ self-efficacy was lower when providing telehealth across all PTSE questions pertaining to the examination component of the PCM model. Exploring telehealth content and sequence in entry-level physical therapy curriculum may help students feel more prepared to perform telehealth examination. Key words: Examination, Physical therapy, Self-efficacy, Students, Telehealth

Ethnicity Does Not Impact Physical Therapy Students’ Clinical Readiness and Performance, a United States Exploratory Study

Purpose: To explore the impact of ethnicity on clinical readiness and performance among Doctor of Physical Therapy (DPT) students, as determined by 1) Physical Therapist Self-Efficacy (PTSE) score, 2) self-confidence treating patients, and 3) final American Physical Therapy Association (APTA) Clinical Performance Instrument (CPI) clinical reasoning and summative ratings during clinical experiences. Methods: This study is a survey-based, descriptive, and exploratory cross-sectional research design involving sample of 211 DPT students evaluated for differences across ethnic students’ groups 1) PTSE score during student clinical experiences, 2) confidence with treating initial and subsequent same-patient visits, and 3) final CPI clinical reasoning and summative scores during clinical experiences. Results: Kruskal-Wallis test showed no difference across ethnic groups (American Indian or Alaskan Native, Asian/Pacific Islander, Black or African American, Hispanic, White or Caucasian, prefer not to answer, and multiple ethnicity) in 1) clinical reasoning self-efficacy (PTSE), n=211, p=.438; 2) confidence treating at initial visit n=211, p=.088 and subsequent patient visits n=211, p=.584; and 3) clinical performance on the CPI for clinical reasoning n=211, p=.273 and summative n=211, p=.189 scores. Conclusions and Recommendations: All ethnic groups demonstrated strong clinical readiness and performance during each clinical experience level. Ethnic groups did not differ on clinical reasoning self-efficacy or confidence treating patients. Although the gap appears to be closing, there continues to be underrepresentation of ethnic groups in DPT programs. We recommend investigating factors impacting underrepresentation of ethnic groups in DPT academic programs to explore initiatives to close the diversity gap and best match societal representation

The Immediate Effects of Foam Rolling and Stretching on Iliotibial Band Stiffness:A Randomized Controlled Trial

BackgroundIliotibial Band Syndrome (ITBS) is a common clinical condition likely caused by abnormal compressive forces to the iliotibial band (ITB). Stretching interventions are common in ITBS treatment and may predominantly affect tensor fascia latae (TFL). Another ITBS treatment is foam rolling, which may more directly affect the ITB. Shear wave ultrasound elastography (SWUE) measures real-time soft tissue stiffness, allowing tissue changes to be measured and compared.PurposeTo examine effects of foam rolling and iliotibial complex stretching on ITB stiffness at 0 degrees and 10 degrees of hip adduction and hip adduction passive range of motion (PROM).Study DesignRandomized controlled trial.MethodsData from 11 males (age = 30.5 +/- 9.0 years, Body Mass Index (BMI) = 27.8 +/- 4.0) and 19 females (age = 23.5 +/- 4.9, BMI = 23.2 +/- 2.1) were analyzed for this study. Subjects were randomly assigned to one of three groups: control, stretching, and foam rolling. Shear wave ultrasound elastography measurements included ITB Young's modulus at the mid-thigh, the distal femur and the TFL muscle belly. ITB-to-femur depth was measured at mid-thigh level. Hip adduction PROM was measured from digital images taken during the movement.ResultsNo significant interactions or main effects were found for group or time differences in ITB Young's modulus at the three measured locations. The ITB stiffness at the mid-thigh and distal femur increased with 10 degrees adduction, but TFL stiffness did not increase. A main effect for adduction PROM was observed, where PROM increased 0.8 degrees post-treatment (p = 0.02).ConclusionA single episode of stretching and foam rolling does not affect short-term ITB stiffness. The lack of ITB stiffness changes may be from an inadequate intervention stimulus or indicate that the interventions have no impact on ITB stiffness.</p

Chronic sacroiliac joint and pelvic girdle dysfunction in a 35-year-old nulliparous woman successfully managed with multimodal and multidisciplinary approach

BACKGROUND AND PURPOSE: Sacroiliac joint pain and dysfunction affect 15–25% of patients reporting low back pain, including reports of spontaneous, idiopathic, traumatic, and non-traumatic onsets. The poor reliability and validity associated with diagnostic clinical and imaging techniques leads to challenges in diagnosing and managing sacroiliac joint dysfunction. CASE DESCRIPTION: A 35-year-old nulliparous female with a 14-year history of right sacroiliac joint dysfunction was managed using a multimodal and multidisciplinary approach when symptoms failed to resolve after 2 months of physical therapy. The plan of care included four prolotherapy injections, sacroiliac joint manipulation into nutation, pelvic girdle belting, and specific stabilization exercises. OUTCOMES: The patient completed 20 physical therapy sessions over a 12-month period. At 6 months, the patient’s Oswestry Disability Questionnaire score was reduced from 34% to 14%. At 1-year follow-up, her score was 0%. The patient’s rating of pain on a numeric rating scale decreased to an average of 4/10 at 6 months and 0/10 at 1-year follow-up. DISCUSSION: A multidisciplinary and multimodal approach for the management of chronic sacroiliac joint dysfunction appeared successful in a single-case design at 1-year follow-up

Lack of Standardization in Dry Needling Dosage and Adverse Event Documentation Limits Outcome and Safety Reports: A Scoping Review of Randomized Clinical Trials

Objectives: Examine: (1) whether variability in dry needling (DN) dosage affects pain outcomes, (2) if effect sizes are clinically important, and (3) how adverse events (AE) were documented and whether DN safety was determined. Methods: Nine databases were searched for randomized controlled trials (RCTs) investigating DN in symptomatic musculoskeletal disorders. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Included RCTs met PEDro criteria #1 and scored \u3e 7/10. Data extraction included DN dosage, pain outcome measures, dichotomous AE reporting (yes/no), and AE categorization. Clinically meaningful differences were determined using the minimum clinically important difference (MCID) for pain outcomes . Results: Out of 22 identified RCTs, 11 demonstrated significant between-group differences exceeding the MCID, suggesting a clinically meaningful change in pain outcomes. Nine documented whether AE occurred. Only five provided AEs details and four cited a standard means to report AE. Discussion: There was inconsistency in reporting DN dosing parameters and AE. We could not determine if DN dosing affects outcomes, whether DN consistently produces clinically meaningful changes, or establish optimal dosage. Without more detailed reporting, replication of methods in future investigations is severely limited. A standardized method is lacking to report, classify, and provide context to AE from DN. Without more detailed AE reporting in clinical trials investigating DN efficacy, a more thorough appraisal of relative risk, severity, and frequency was not possible. Based on these inconsistencies, adopting a standardized checklist for reporting DN dosage and AE may improve internal and external validity and the generalizability of results