Publisher: American Physical Therapy Association   (Total: 3 journals)   [Sort by number of followers]

Showing 1 - 3 of 3 Journals sorted alphabetically
J. of Orthopaedic & Sports Physical Therapy     Full-text available via subscription   (Followers: 67, SJR: 1.357, CiteScore: 2)
Physical Therapy     Full-text available via subscription   (Followers: 77, SJR: 1.206, CiteScore: 2)
Rehabilitation Oncology     Hybrid Journal   (SJR: 0.199, CiteScore: 0)
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Physical Therapy
Journal Prestige (SJR): 1.206
Citation Impact (citeScore): 2
Number of Followers: 77  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0031-9023 - ISSN (Online) 1538-6724
Published by American Physical Therapy Association Homepage  [3 journals]
  • Competency-Based Education: A Framework for Physical Therapist Education
           Across the Continuum

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      Authors: Tovin M.
      Abstract: Over the past several years, the number of physical therapist professional education programs has increased dramatically. There are currently 264 fully accredited and 60 developing doctor of physical therapy (DPT) programs the United States alone.1 Alongside this increase in the number of programs, many existing programs are increasing their class sizes.2 These programs implement a variety of curricular models (eg, traditional, blended/hybrid, problem-based learning [PBL], modified PBL) as well as different program lengths. Regardless of type and program length, education programs strive to prepare graduates for practice in a wide range of settings and with diverse patient populations.
      PubDate: Thu, 05 May 2022 00:00:00 GMT
      DOI: 10.1093/ptj/pzac044
      Issue No: Vol. 102, No. 5 (2022)
       
  • Physical Therapist Residency Competency-Based Education: Development of an
           Assessment Instrument

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      Authors: Harrington K; Teramoto M, Black L, et al.
      Abstract: AbstractObjectiveThe objective of this study was to develop generic domains of competence (DoC) with associated competencies and milestones for physical therapist residency education. This work was intended to culminate in establishing validity evidence to support a competency-based assessment instrument that could be used by residency programs to evaluate resident achievement of the competencies, regardless of specialty area.MethodsEmploying the modified Delphi method, a residency education work group developed an evaluation instrument that included 7 DoC and 31 associated competencies with 6 milestones as rating scales for each competency. The instrument was distributed to mentors and residents in accredited physical therapist residency programs to establish validity evidence. Evaluations (measured by milestones) and demographics were collected at 3 time points (program entry, midterm, and final). Scores across these time points were compared using Kruskal-Wallis tests. Reliability was assessed with kappa statistics (interrater reliability) and alpha reliability coefficients (internal consistency). Construct validity was examined using confirmatory factor analysis via structural equation modeling.ResultsOverall, 237 mentors and 228 residents completed 824 evaluations (460 by mentors and 364 resident self-evaluations) across the time points. Scores significantly increased from entry through final time points. The interrater reliability of the associated behaviors ranged from moderate to substantial agreement (κ = 0.417–0.774). The internal consistency was high for all DoC at every time point (α reliability coefficients = .881–.955 for entry, .857–.925 for midterm, and .824–.902 for final). After confirmatory factor analysis with structural equation modeling was performed, a model that included 7 DoC and 20 associated competencies was proposed.ConclusionsThe residency assessment instrument developed demonstrates interrater reliability and validity evidence and therefore supports competency-based assessment of resident clinical performance across specialty areas. Additionally, the instrument aligns the physical therapy profession with other professions, such as medicine, dentistry, and pharmacy, that have transitioned to competency-based education.ImpactThis study outlines the benefits of moving to competency-based education for physical therapist residents, using a sound evaluation tool that evaluates residents across specialty areas. The instrument will allow for transition to competency-based education in physical therapist residency education programs.
      PubDate: Fri, 25 Feb 2022 00:00:00 GMT
      DOI: 10.1093/ptj/pzac019
      Issue No: Vol. 102, No. 5 (2022)
       
  • Competency-Based Education and Practice in Physical Therapy: It’s
           Time to Act!

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      Authors: Timmerberg J; Chesbro S, Jensen G, et al.
      Abstract: AbstractCompetency-based education (CBE) is a concept, a philosophy, and an approach to educational design where learner progression occurs when competency is demonstrated. It assumes a set of standard defined performance outcomes for any level of professional practice—students, residents, or practicing physical therapists. Those outcomes are based on the health needs of society and guide the curricular design, implementation, and evaluation of health professions education programs. Lack of a CBE framework—with no required demonstration of competence throughout one’s career—has the potential to lead to variation in physical therapists’ skills and to unwarranted variation in practice, potentially hindering delivery of the highest quality of patient care. CBE requires a framework that includes a commonly understood language; standardized, defined performance outcomes at various stages of learner development; and a process to assess whether competence has been demonstrated. The purpose of this perspective article is to (1) highlight the need for a shared language, (2) provide an overview of CBE and the impetus for the change, (3) propose a shift toward CBE in physical therapy, and (4) discuss the need for the profession to adopt a mindset requiring purposeful practice across one’s career to safely and most efficiently practice in a given area. Utilizing a CBE philosophy throughout one’s career should ensure high-quality and safe patient care to all—patient care that can adapt to the changing scope of physical therapist practice as well as the health care needs of society. The physical therapy profession is at a point at which we must step up the transition to a competency-based system of physical therapist education.
      PubDate: Fri, 25 Feb 2022 00:00:00 GMT
      DOI: 10.1093/ptj/pzac018
      Issue No: Vol. 102, No. 5 (2022)
       
  • “I Don’t Know Why I’ve Got this Pain!” Allostasis as a Possible
           Explanatory Model

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      Authors: Rabey M; Moloney N.
      Abstract: Abstract Explaining the onset and maintenance of pain can be challenging in many clinical presentations. Allostasis encompasses the mechanisms through which humans adapt to stressors to maintain physiological stability. Due to related neuro-endocrine-immune system effects, allostasis and allostatic load (the cumulative effects on the brain and body that develop through the maintenance of physiological stability) offer the potential to explain the development and maintenance of musculoskeletal pain in certain cases. This paper outlines the concept of allostatic load, highlights the evidence for allostatic load in musculoskeletal pain conditions to date, and discusses mechanisms through which allostatic load influences pain, with particular focus on hypothalamic–pituitary–adrenal axis and sympathetic nervous system function and central, brain-driven governance of these systems. Finally, through case examples, consideration is given as to how allostatic load can be integrated into clinical reasoning and how it can be used to help explain pain to individuals and guide clinical decision-making.ImpactAwareness of the concept of allostatic load, and subsequent assessment of physical and psychological stressors potentially contributing to allostatic load, may facilitate a broader understanding of the multidimensional presentations of many people with pain, both acute and persistent. This may facilitate discussion between clinicians and their patients regarding broader influences on their presentations and drive more targeted and inclusive pain management strategies.
      PubDate: Wed, 23 Feb 2022 00:00:00 GMT
      DOI: 10.1093/ptj/pzac017
      Issue No: Vol. 102, No. 5 (2022)
       
  • Isotemporal Substitution of Sedentary Behavior With Moderate to Vigorous
           Physical Activity Is Associated With Lower Risk of Disability: A
           Prospective Longitudinal Cohort Study

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      Authors: Chiba I; Lee S, Bae S, et al.
      Abstract: AbstractObjectiveThe purpose of the study was to estimate, using an isotemporal substitution model, the effect of replacing sedentary behavior (SB) with physical activity on the incidence of disability in community-dwelling older adults.MethodsThis 2-year longitudinal cohort study enrolled 3691 community-dwelling older adults (57.2% women; mean age = 74.0 [SD = 5.0] years). Individuals with dementia, stroke, Parkinson disease, depression, low Mini-Mental State Examination scores, dependence on basic activities of daily living, and missing data were excluded. Physical activity and potential confounding factors were investigated as a baseline survey of disability incidence, defined by Japanese long-term care insurance certification, for 2 years in 2 regions. Physical activity data (SB, light-intensity physical activity, and moderate- to vigorous-intensity physical activity [MVPA]) were measured using triaxial accelerometers for 14 days, and daily mean time spent in each physical activity parameter was computed in increments of 10 minutes. The relationship between baseline physical activity and disability incidence adjusted for potential confounders was analyzed using multilevel Cox proportional hazards regression analyses with an isotemporal substitution model.ResultsThe disability incidence rate was 3.8%, excluding individuals who could not be followed-up. Replacing 10 minutes of SB per day with MVPA was associated with a decreased disability incidence (hazard ratio = 0.870; 95% CI = 0.766–0.988), whereas no evidence was found for replacing SB with light-intensity physical activity (hazard ratio = 0.980; 95% CI = 0.873–1.10).ConclusionsReplacing SB with MVPA was associated with a lower risk of disability. These findings are helpful for establishing disability prevention strategies.ImpactThese results suggest that feasible changes in daily behavior, such as replacing 10 minutes of SB with MVPA daily, might have a protective effect on disability incidence. Clarifying these associations is useful for developing disability prevention strategies and may help reduce the incidence of disability in community-dwelling older adults.
      PubDate: Thu, 13 Jan 2022 00:00:00 GMT
      DOI: 10.1093/ptj/pzac002
      Issue No: Vol. 102, No. 5 (2022)
       
  • Timing of Evidence-Based Nonsurgical Interventions as Part of Multimodal
           Treatment Guidelines for the Management of Cervical Radiculopathy: A
           Delphi Study

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      Authors: Thoomes E; Thoomes-de Graaf M, Cleland J, et al.
      Abstract: AbstractObjectiveConservative management of cervical radiculopathy (CR) is a first treatment option because the risk–benefit ratio for surgery is less favorable. Systematic reviews and clinical practice guidelines reporting on the effectiveness of nonsurgical management have not considered the timing of management. The aim of this study was to establish consensus on effective nonsurgical treatment modalities at different stages (ie, acute, subacute, or chronic) of CR using the Delphi method approach.MethodsThrough an iterative multistage process, experts within the field rated their agreement with a list of proposed treatment modalities according to the stage of CR and could suggest missing treatment modalities. Agreement was measured using a 5-point Likert scale. Descriptive statistics were used to measure agreement (median, interquartile ranges, and percentage of agreement). Consensus criteria were defined a priori for each round. Consensus for Round 3 was based on ≥2 of the following: a median Likert scale value of ≥4, interquartile range value of ≤1, and/or a percentage of agreement ≥70%.ResultsData analysis produced a consensus list of effective treatment modalities in different stages of recovery.ConclusionAccording to experts, the focus of multimodal management in the acute stage should consist of patient education and spinal manipulative therapy, specific (foraminal opening) exercises, and sustained pain-relieving positions. In the subacute stage, increasing individualized physical activity including supervised motor control, specific exercises, and/or neurodynamic mobilization could be added. In the chronic stage, focus should shift to include general aerobic exercise as well as focused strength training. Postural education and vocational ergonomic assessment should also be considered.ImpactMultimodal conservative management of individuals with CR should take the stage of the condition into consideration. The focus of therapeutic interventions should shift from passive pain-relieving intervention in the acute stage to increasingly more individualized physical activity and self-management in the chronic stage.
      PubDate: Thu, 13 Jan 2022 00:00:00 GMT
      DOI: 10.1093/ptj/pzab312
      Issue No: Vol. 102, No. 5 (2022)
       
 
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