Research and Critical Thinking : An Important Link for Exercise Science Students Transitioning to Physical Therapy

Int J Exerc Sci 5(2) : 93-96, 2012. Critical thinking skills are increasingly necessary for success in professional health care careers. Changes in the contemporary healthcare system in the United States arguably make these critical thinking skills more important than they have ever been, as clinicians are required on a daily basis to evaluate multiple bits of information about patients with multiple-systemic health concerns and make appropriate treatment decisions based on this information. We believe the IJES, with its emphasis on engaging undergraduate and graduate students in research and scholarly activity, is a valuable resource for promoting the higher-order critical thinking skills necessary for preparing exercise science students with an interest in professional healthcare careers such as physical therapy

Comparison of Elderly Non-Fallers and Fallers on Performance Measures of Functional Reach, Sensory Organizations, and Limits of Stability

OBJECTIVE: The purpose of this study was to compare elderly non-fallers and fallers for differences in the following: (1) mean functional reach (FR), (2) mean anterior limits of stability (LOS), (3) mean posterior LOS, and (4) mean sensory organization test (SOT) composite score. The following correlations were tested for significance separately in the sample of non-fallers and the sample of fallers: (1) FR and anterior LOS, (2) FR and posterior LOS, (3) FR and SOT composite score, (4) anterior LOS and the SOT composite score, and (5) posterior LOS and the SOT composite score. DESIGN: Two group comparison design. SETTING: A university physical therapy research laboratory. PARTICIPANTS: The 25 participants recruited for this study included 15 elderly non-fallers and 10 idiopathic fallers. MEASUREMENTS: Outcome measures included FR and forceplate measures from the LOS test and the SOT. The forceplate measures, obtained using the NeuroCom Smart® Balance Master system, included maximum end point excursion for anterior, posterior, right, and left movements for the LOS test and a composite score for the SOT. The composite score consisted of sway area using six different sensory conditions with eyes open and closed. RESULTS:There was no significant difference in mean FR distance between elderly non-fallers and fallers. FR distance did not correlate with anterior displacement on the LOS test. There was a significant difference in mean composite score on the SOT between non-fallers and fallers as well as a significant positive correlation between the composite score and anterior displacement on the LOS test for fallers. Age showed a significant negative correlation with the composite score for both non-fallers and fallers. CONCLUSION: The results suggested that FR measures do not appear to differentiate non-fallers from fallers, as they both attained nearly the same mean FR distance. In contrast, this study demonstrated that using the SOT protocol can differentiate non-fallers from fallers for balance impairment. Caution should be used when interpreting information from the FR test in determining a balance-impaired population

The Effects of Whole Body Vibration on the Limits of Stability in Adults With Subacute Ankle Injury

# Background Limited research exists on the effects of both high and low frequency whole body vibration (WBV) on individuals with subacute lateral ankle sprains. # Hypothesis/Purpose To examine the difference in the effects of high and low frequency WBV on limits of stability (LOS) in adults with a subacute ankle sprain. It was hypothesized that WBV would improve effects on outcome variables for LOS as a component of dynamic balance. # Study Design Quasi-experimental, pretest-posttest design. # Methods Fifteen participants ages 19-27 years (Mean age 22±2.36) with either a Grade I or Grade II lateral ankle sprain received WBV in bilateral stance under three randomized conditions (high frequency-25 Hz, low frequency-6 Hz, and control, which consisted of bilateral stance with machine off) for six minutes over three sessions (one time per week). The LOS test, consisting of 5 variables, were assessed using the NeuroCom® Balance Manager-SMART EquiTest® (Natus Medical Incorporated, Pleasanton, CA) at baseline and after the intervention period. The participants completed a practice LOS test and then had a six-minute standing rest break. After the rest break, they completed the pre-LOS (baseline) test. Intervention was administered using the Galileo® Med L Chip Research (Novotec Medical GmbH, Pforzheim, Germany) for six minutes for the appropriate condition of either high or low frequency WBV or control. Data analysis was performed using 2-Way (2x3) Repeated Measures ANOVAs with additional post hoc testing as needed. # Results Significant interactions were found for reaction time (RT), movement velocity (MVL), and maximal excursion (MXE) composite scores with a decrease in RT of 0.117 seconds (p=0.022) between control and high frequency conditions during the post LOS. For composite MVL, an increase of 0.547 degrees/second (p=0.002) between pre- and post-high frequency WBV occurred. For composite MXE, an increase of 2.13% p=0.031 (when comparing pre- and post-high frequency WBV. # Conclusion Findings suggest that a single session of high frequency WBV in individuals with a subacute lateral ankle sprain may result in improvement in several components of postural stability. WBV is a quick intervention that could be implemented in physical therapy clinics, athletic training rooms, and workout facilities to improve an individual's LOS as a component of dynamic balance one to eight weeks post lateral ankle sprain. # Level of Evidence 2

Self-reported Vital Sign Assessment Practices of Neurologic Physical Therapists

Purpose: This study\u27s purpose was to describe the vital sign assessment (VSA) practices of physical therapists (PTs) during evaluation and treatment of patients with neurologic conditions. Methods: A survey was distributed to clinicians from a clinical site database and the Academy of Neurologic Physical Therapy\u27s list serve. Respondents included US licensed PTs who treat patients with neurologic conditions. Results: Usable surveys included 133 US PTs with 69.2% doctorally prepared and 79.7% American Physical Therapy Association (APTA) members. Although 58.6% of survey respondents indicated that VSA is an essential part of the PT evaluation, at evaluation, only 37.6% and 39.1% of respondents always take heart rate (HR) and blood pressure (BP), and only 8.3% of respondents always take respiratory rate (RR). During treatment, only 14.3% of respondents report taking HR or BP at each session, while only 5.3% always take RR. Board certification was correlated with an increased frequency of HR assessment (P = .0027) and BP (P = 0.038) at evaluation, while importance of VSA strongly correlated with increased assessment of HR (P = 0.000), BP (P = 0.000), and RR (P = 0.003) at evaluation and with HR (P = 0.000) and BP (0.000) during treatment. Conclusions: Although VSA by neurologic PTs is higher than other identified PT groups, it is still below-recommended assessment guidelines