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Journal of Acute Care Physical Therapy
Number of Followers: 4  Hybrid journal (It can contain Open Access articles)ISSN (Print) 2158-8686 - ISSN (Online) 2159-0524 Published by LWW Wolters Kluwer  [330 journals]
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- Frequent Error Augmentation Training in Physical Therapy Post Stroke
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Authors: Farrelly; Sinead; Boan, Andrea D.; Hartnett, John; Monsch, Emily; Hartis, Audrey; Bowden, Mark; Kautz, Steve; Holmstedt, Christine
Abstract:
Background: The purpose of this pilot trial was to evaluate the impact of increased frequency of physical therapy sessions with error augmentation on functional mobility and disability outcomes in patients with acute stroke. We hypothesized that participants receiving frequent error augmentation physical therapy interventions (F-EA-PT) would demonstrate a higher degree of improvement on functional mobility and disability measures from admission to two post-intervention time points (treatment day 3, discharge, or 90-day follow-up).Methods: We allocated 100 individuals to receive either F-EA-PT or standard-of-care physical therapy (SOC-PT). The F-EA-PT group received physical therapy with error augmentation twice daily for 3 out of the first 5 days of hospitalization, and daily treatment sessions thereafter. Error augmentation training emphasizes impairments throughout mobility to challenge the individual, rather than facilitating normal movement patterns. The SOC-PT group received treatment once daily for 3 to 5 days per week. Assessments included National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Activity Measure for Post-Acute Care (AM-PAC), and Postural Assessment Scale for Stroke (PASS). A repeated measures mixed model approach compared treatment groups for all outcomes.Results: The F-EA-PT group demonstrated larger magnitudes of reduction of − 1.34 on NIHSS (P = .0426) and − 0.81 on mRS (P = .0037) from admission to 90-day follow-up compared to the SOC-PT group. The F-EA-PT group demonstrated larger magnitudes of change in AM-PAC of 2.12 at treatment day 3 (P = .0009) and 2.75 at discharge (P
PubDate: Fri, 21 Jun 2024 00:00:00 GMT-
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- A Novel Approach to Safe Patient Handling and Mobility Training in
Physical Therapist Education-
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Authors: Tautonico; Michael; Voltmer, Christopher; Lee, Timothy; DiCandia, Erin; Silberman, Nicki
Abstract:
Background: Safe patient handling and mobility (SPHM) training is prevalent in health care education and practice. However, there is limited evidence of this training in physical therapist education programs.Purpose: To determine if a single training session with a mobile laboratory equipped with SPHM equipment increases the knowledge of SPHM principles and techniques and is valuable to students prior to their first clinical experience.Methods: Training included a 1-hour lecture on SPHM principles, research, and techniques, followed by two 50-minute SPHM practice stations. One session was conducted using a mobile laboratory. Students completed a pretest/posttest measuring knowledge of SPHM principles. Students completed a survey regarding the perception and placement of SPHM training within the curriculum.Results: A total of 129 students in a physical therapist education program were invited to participate; 59 from first-year cohorts and 70 from second- and third-year cohorts. Eighty-seven students volunteered to participate, including all 59 students from the first-year cohorts receiving training as the experimental group, and 28 from the other cohorts receiving no training as the control group. Seventy students met the criteria for survey data analysis; 42 experimental and 28 control. Of those who received training, 90.5% reported that SPHM training improved their confidence prior to their inpatient clinical experience; 85.5% in the control group would have felt more confident being placed in an inpatient facility if they received SPHM training, and 85.7% of the experimental group and 89.3% of controls agreed that SPHM training should be performed prior to the first clinical experience. A paired t test showed that first-year students reported a statistically significant increase in knowledge of SPHM principles (P
PubDate: Fri, 21 Jun 2024 00:00:00 GMT-
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- Consistency of Physical Therapist Discharge Recommendations in Acute Care:
A Pilot Study-
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Authors: Widenhoefer; Tricia; Dickman, Kendall; Meara, Grace; Liter, Donovan; Schoonveld, Sarah; Almonroeder, Sarah; Almonroeder, Thomas Gus
Abstract:
Introduction: Physical therapists assist with discharge planning for hospitalized patients by making recommendations regarding a patient’s optimal discharge location and ongoing rehabilitation needs. The purpose of this study was to examine the consistency of discharge recommendations made by physical therapists with experience working in an acute care setting, when provided with a set of clinical vignettes describing hospitalized patients.Review of Literature: Considering the complex/multifactorial nature of making discharge recommendations, one would expect there to be inconsistencies among physical therapists. However, we are not aware of a previous study examining the level of consistency for discharge recommendations made by physical therapists, when reviewing a set of clinical vignettes.Subjects: Nineteen physical therapists working in an acute care setting.Methods: The physical therapists were provided with 10 clinical vignettes describing hospitalized patients via an electronic survey distributed across three rehabilitation departments. Each vignette described the patient’s medical condition, past medical history, prior level of function, living situation, key examination findings, and other general characteristics. After independently reviewing each case, the physical therapists selected a discharge recommendation from a list of standard options. Fleiss’ kappa was examined to assess the level of agreement among the physical therapists.Results: Overall, Fleiss’ kappa was 0.28, which reflects fair agreement among the physical therapists.Discussion and Conclusion: The 19 physical therapists who participated in this study only exhibited fair agreement with respect to their discharge recommendations. This relatively low level of agreement suggests that efforts to improve the consistency of discharge recommendations should be explored.
PubDate: Fri, 21 Jun 2024 00:00:00 GMT-
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- Reduced Functioning After Hospitalization for COVID-19 Infection:
Systematic Review and Meta-Analysis-
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Authors: Smith; James M.; Smith, Ellen M.T.; Zafron, Michelle L.; Bohannon, Richard W.; Miller, Kenneth; Thiele, Alecia; Zeleznik, Hallie; Ohtake, Patricia J.
Abstract:
Background and Purpose: COVID-19 infection is associated with persistent physical problems, and approximately 2% of the>100 million people in the United States with COVID-19 infection have required hospitalization. The purpose of this review is to identify problems with activity and participation persisting during the first 6 months after hospitalization for COVID-19.Methods: A comprehensive search of 5 bibliographic databases was performed for cohort studies examining activity limitations and participation restrictions assessed within 6 months of hospitalization in adults hospitalized with COVID-19 infection. Two reviewers screened titles, abstracts, and full text to determine eligibility. Study methodological quality was assessed using the SIGN Methodology Checklist 3. Study methods, design, and participant outcomes were extracted. Results were summarized in narrative synthesis, and meta-analysis was conducted for 6-minute walk test.Results: Titles (n = 2670) were screened, and 26 acceptable to high-quality studies satisfied all eligibility criteria. Within the first 6 months following hospitalization for COVID-19 people experienced activity limitations and participation restrictions, including 16% reduction in 6-minute walk test distance (compared to age and gender-matched norms) and 59% return to employment rate.Discussion and Conclusion: The first 6 months following hospitalization for COVID-19 infection are associated with significant reductions in exercise capacity and return to work. Problems associated with post-intensive care syndrome cannot be ruled out as contributing to these findings. Recognition of these problems is essential and should inform hospital discharge planning and rehabilitation services.
PubDate: Fri, 21 Jun 2024 00:00:00 GMT-
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