LCX: Proposal for a low-cost commercial transport

The LCX has been developed in response to a request for proposal for an aircraft with 153 passenger capacity and a range of 3000 nautical miles. The goals of the LCX are to provide an aircraft which will achieve the stated mission requirements at the lowest cost possible, both for the manufacturer and the operator. Low cost in this request is defined as short and long term profitability. To achieve this objective, modern technologies attributing to low-cost operation without greatly increasing the cost of manufacturing were employed. These technologies include hybrid laminar flow control and the use of developing new manufacturing processes and philosophies. The LCX will provide a competitive alternative to the use of the Airbus A319/320/321 and the Boeing 737 series of aircraft. The LCX has a maximum weight of 150,000 lb. carried by a wing of 1140 ft(exp 2) and an aspect ratio of 10. The selling price of the LCX is 31 million in 1994 US dollars

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

Effects of Volitional Preemptive Abdominal Contraction on Shoulder Proprioception Following Shoulder Muscle Fatigue

The abdominal bracing maneuver, a volitional preemptive abdominal contraction (VPAC) strategy, is potentially beneficial to shoulder exercise performance. It is unclear how VPAC use affects shoulder function, including proprioception and shoulder muscle function following shoulder muscle fatigue caused by upper extremity dominant sports movements. Discovering methods that reduce its effects on shoulder proprioception and shoulder muscle function is important for clinical practice in orthopedic rehabilitation. PURPOSE: To identify VPAC effects on shoulder proprioception abilities and to identify VPAC effects on shoulder muscle electromyographic amplitudes, during seated proprioception trials, both with and without muscle fatigue present. METHODS: Thirty-nine participants (26 women, 13 men) participated in this study. Shoulder proprioception was measured by shoulder flexion reproduction angles. Kinematic data were collected during the shoulder flexion trials to determine the accuracy in the subjects’ ability to reproduce a reference angle. All data were collected before and after a shoulder muscle fatigue protocol. Electromyographic data from the anterior deltoid (AD), posterior deltoid (PD), upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and infraspinatus (IF) muscles were used to observe muscle contraction amplitudes during the angle reproduction trials. RESULTS: Shoulder reproduction angles were not significantly affected by VPAC or muscle fatigue. Individually, shoulder muscle fatigue significantly increased UT muscle amplitudes (Mdn = 0.059(0.135), p\u3c.008) and LT muscle amplitudes (Mdn = 0.023(0.059), p\u3c.008). VPAC significantly increased shoulder IF muscle amplitudes (Mdn = 0.019(0.038), p\u3c.008). CONCLUSION: The VPAC did not affect shoulder proprioception in this study, showing that the strategy may not be beneficial to improving proprioception in the shoulder joint. The affects of muscle fatigue on the selected shoulder muscles supported the observations in previous literature concerning muscle fatigue effects on selected shoulder muscle. Clinicians can use this information to assist with the creation of therapeutic exercise for the shoulder joint

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

Comparison of Flex vs. residential clinical education program outcomes: physical therapy students’ self-efficacy, confidence, and clinical competence

Purpose: Alternative flexible (Flex) path Doctor of Physical Therapy (DPT) programs may have an emerging footprint. The differences between Flex and traditional residential DPT program clinical experience outcomes remain unknown. The purpose of this study was to evaluate Flex and residential DPT students’ clinical reasoning self-efficacy, confidence with treating, and Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences. Methods: A descriptive and exploratory cross-sectional survey was used with a voluntary convenience sample of 211 university DPT students during Fall 2020 full-time clinical experiences. Descriptive and inferential statistics evaluated differences in Flex and residential DPT program students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final CPI clinical reasoning and summative scores during clinical experiences. Results: Mean PTSE scores were significantly lower for Flex (x̄ = 14.2) compared to residential DPT students (x̄ = 15.2) (P \u3c 0.05). No significant student differences were found in (1) Flex (x̄ = 2.1) and residential (x̄ = 2.2) confidence with treating at the initial visit (P = 0.59), (2) Flex (x̄ = 2.8) and residential (x̄ = 3.0) confidence with treating subsequent same-patient visits (P = 0.15), and (3) Flex (x̄ = 15.8) and residential (x̄ = 16.5) CPI clinical reasoning (P = 0.17), and (4) Flex (x̄ = 16.1) and residential (x̄ = 16.7) CPI summative scores (P = 0.21). Conclusion: Clinical reasoning self-efficacy among Flex DPT students was lower, but there was no difference in CPI clinical reasoning or summative results between Flex and residential DPT students. In the university investigated, the Flex distance learning DPT program curriculum appeared effective in preparing students’ clinical reasoning readiness for the available full-time clinical experiences. We recommend academic institutions consider expanding Flex entry-level DPT program availability options because the outcomes were comparable. Additional flex entry programs may help address the underrepresentation of nontraditional students in entry-level DPT programs and societal demands for physical therapy services

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

Doctor of Physical Therapy students’ clinical reasoning readiness and confidence treating with telehealth: a United States survey

Purpose: Telehealth has an emerging footprint on entry-level physical therapy programs. Students’ readiness for clinical reasoning with virtual versus traditional face-to-face treatment remains unknown. The purpose of this study was to evaluate Doctor of Physical Therapy (DPT) students’ preparedness for clinical experiences with and without telehealth. Methods: A descriptive and exploratory cross-sectional survey was employed, with a voluntary convenience sample of 211 second- and third-year university DPT students during Fall 2020 clinical experiences. Descriptive and inferential statistics evaluated differences in DPT students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences with and without telehealth. Results: Telehealth availability was 40.3%, with 16.6% of DPT students reporting participation. Most students reported being comfortable (39.3%) or neutral (32.2%) using telehealth. DPT students’ confidence level using telehealth to treat was 74% on initial and 97% on subsequent same-patient visits. Mean PTSE scores were significantly lower during clinical experiences with telehealth (13.1) compared to traditional experiences (15.1) (PP Conclusion: While entry-level DPT programs continue to establish best practice for telehealth education, current trends in academic curriculum seem to prepare students’ clinical reasoning readiness for clinical experiences. The PTSE could be used to identify outlier students requiring additional mentoring during traditional and telehealth clinical experiences

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