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Contract Services↗
PubMed2005

Implementation of clinical guidelines on physical therapy for patients with low back pain: randomized trial comparing patient outcomes after a standard and active implementation strategy.

BACKGROUND AND PURPOSE: An active strategy was developed for the implementation of the clinical guidelines on physical therapy for patients with low back pain. The effect of this strategy on patients' physical functioning, coping strategy, and beliefs regarding their low back pain was studied. SUBJECTS: One hundred thirteen primary care physical therapists treated a total of 500 patients. METHODS: The physical therapists were randomly assigned to 1 of 2 groups. The control group received the guidelines by mail (standard passive method of dissemination). The intervention group, in contrast, received an additional active training strategy consisting of 2 sessions with education, group discussion, role playing, feedback, and reminders. Patients with low back pain, treated by the participating therapists, completed questionnaires on physical functioning, pain, sick leave, coping, and beliefs. RESULTS: Physical functioning and pain in the 2 groups improved substantially in the first 12 weeks. Multilevel longitudinal analysis showed no differences between the 2 groups on any outcome measure during follow-up. DISCUSSION AND CONCLUSION: The authors found no additional benefit to applying an active strategy to implement the physical therapy guidelines for patients with low back pain. Active implementation strategies are not recommended if patient outcomes are to be improved.

Education, Continuing↗
PubMed2005

Association of importance of the doctoral degree with students' perceptions and anticipated activities reflecting professionalism.

BACKGROUND AND PURPOSE: The American Physical Therapy Association (APTA) has identified the Doctor of Physical Therapy (DPT) degree as 1 of 6 elements necessary to transition the physical therapy profession to a fully professionalized discipline. However, there have been no data to determine whether physical therapist students who place importance on the DPT degree perceive physical therapy to be more professionalized or anticipate participation in activities reflecting professionalism more than those who do not place importance on the DPT degree. SUBJECTS: The subjects were 919 professional physical therapist students. METHODS: Faculty members at 34 physical therapist education programs distributed questionnaires to 1,172 professional physical therapist students and returned 919 questionnaires, for a response rate of 78.4%. The data were statistically analyzed using chi-square analysis and logistic regression. RESULTS: There were few differences between students who place importance on the DPT degree (DPT-I students) and those who do not place importance on the DPT degree (DPT-NI students) regarding how professionalized they perceive physical therapy to be relative to other health care professions or regarding their anticipated participation in activities reflecting professionalism. The one potential distinction found when controlling for other variables was that DPT-I students were more likely than DPT-NI students to anticipate becoming faculty members. DISCUSSION AND CONCLUSION: When beginning their professional education, there are few differences between DPT-I and DPT-NI students' perceptions of the professionalization of physical therapy or anticipation of activities reflecting professionalism.

Attitude of Health Personnel↗
PubMed2005

Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis?

The aim of this study was to compare the efficacy of sodium hyaluronate (SH) injection with the most common treatment methods, intraarticular steroid injection and physical therapy modalities in patients with adhesive capsulitis (AC). A total of 95 shoulders of 90 patients were included in the study and were randomized in four groups. The patients were treated with SH injection (group 1), triamsinolone acetonide (group 2) or physical therapy modalities (group 3). Group 4 patients were served as controls. Pain severity, passive ranges of motion and functional considerations were measured before, and 15 days and 3 months after the treatments. In all treatment groups, there were significant improvements at both the 15th day and third month in all parameters (for each, p<0.001). The passive abduction values on the 15th day was found significantly higher in group 3 when compared with group 1 and controls (for each, p<0.001). At the third month, the passive abduction values of the groups 2 and 3 were improved when compared with the control group (p<0.001). Constant score was higher in group 3 on 15th day when compared with group 1. At the third month, all treatment groups were improved significantly compared with control group (p<0.001). We provided the best results in physical therapy modalities applied group for AC treatment. However, we think that SH injection may be administered as an alternative treatment method.

Adjuvants, Immunologic↗
PubMed1997

Rehabilitation of foot and ankle injuries.

Rehabilitation of foot and ankle injuries is essential for full functional recovery and prevention of chronic disease. Rehabilitation includes the usage of physical therapy modalities and rehabilitative exercise whose goals are the reduction of pain and edema and the increase of strength and proprioception. Physical therapy modalities may be classified as thermal, mechanical or electrical agents and include the use of ice, heat, ultrasound, phonophoresis, iontophoresis, intermittent compression, therapeutic massage and a variety of electrical currents. Rehabilitative exercises are primarily designed to increase flexibility, range of motion, strength, proprioception and sport-specific development prior to resumption of full activity. Proper rehabilitation of the lateral ankle (inversion) sprain is critical due to its frequency and potential for chronic pain and recurrence.

Ankle Injuries↗
PubMed1979

A question of professional boundaries: implications for educational programs.

During recent on-site visits a curriculum fieldwork coordinator learned that occupational therapy students were expected to use physical therapy modalities in the treatment of patients. Since the students had no academic preparation in the use of these modalities, the curriculum committee of the academic program was advised of the situation. Two academic occupational therapy programs collaborated in sending out a 48-item questionnaire to the centers currently cooperating in their fieldwork programs with the purpose of determining the kinds of modalities being used in treatment. Results of the survey showed that there was self-reported use of physical therapy modalities by occupational therapists throughout the country with greater use in some regions. The survey also showed occupational therapy involvement in new treatment areas but diminished use of some traditional therapeutic media. Guidelines are suggested regarding student involvement in new treatment areas.

Curriculum↗
PubMed1997

A pilot study of the theoretical and technical competence and appropriate education for the use of nine physical agent modalities in occupational therapy practice.

OBJECTIVE: This study described occupational therapy practitioners' perceptions about the content and method of training or education necessary for gaining theoretical and technical competence in the use of nine physical agent modalities (PAMs). METHOD: A survey was developed and sent to 543 members of the Physical Disabilities Special Interest Section of the American Occupational Therapy Association who had identified their primary area of practice as hand therapy. One hundred and fifty-one completed surveys (28% response rate) were returned. RESULTS: The respondents indicated that theoretical and technical expertise necessary for competent use of PAMs varied according to the type of modality being considered. Continuing education courses were identified as the best method for gaining theoretical and technical competence for the use of deep thermal agents, such as ultrasound and electrical stimulation agents, whereas entry-level professional education and one-the-job training were identified as most appropriate for superficial thermal agents, such as paraffin bath and hot and cold packs. CONCLUSION: The results suggest that considerations regarding the type and amount of education necessary for gaining theoretical and technical competence in the use of PAMs depend on the type of modality being addressed. These differences should be considered in the future development of competency objectives for the use of PAMs.

Adult↗
PubMed1985

Assessment of resident physicians' knowledge of physical therapy.

Half of all US medical schools offer courses in rehabilitation medicine; however, 46 states require physician referrals for physical therapy services. The purpose of this study was to identify areas of deficit in resident physicians' knowledge of selected physical therapy modalities and evaluative procedures and to determine if resident physicians perceived themselves to have adequate background to refer patients to physical therapy effectively. We mailed a questionnaire to 345 resident physicians chosen from area hospitals and obtained a response rate of 32 percent. The demographic portion of the questionnaire was analyzed by the use of descriptive and chi-square statistics. We tested knowledge of modalities and evaluative procedures through matching of treatment referrals with specific patient diagnoses and analyzed the data in terms of chi-square, frequencies, and correlated statistics. The results indicated that the majority of respondents refer patients to physical therapy (98%) and feel adequately informed to do so (54%). Test results, however, ranged from 1 to 73 percent correct, with only one score above 70 percent correct. This finding indicated a deficit in resident physicians' knowledge of physical therapy. We also identified a need for physical therapists to educate physicians about treatment modalities and evaluative procedures through continuing education programs.

Boston↗
PubMed1978

Prevention of electrical shock hazards in physical therapy.

Basic electrical safety information for the physical therapist is presented, and the most hazardous areas in a physical therapy clinic are identified. Physical therapy modalities are no safer than the power receptacle (wall outlet) into which they are plugged. High frequency physical therapy equipment should never be operated without a three-prong polarized plug and a matching polarized wall receptacle. Three-to-two prong adapters must never be used. Hydrotherapy is an especially dangerous area and should be equipped with ground fault detector receptacles with ground fault interrupters that cut the current when the electrical ground is lost. Ultrasound leakage current measurements on many older ultrasound units may now exceed today's acceptable standards. An external isolation transformer may be required to modify older ultrasonic units before they meet present standards. Physical therapists must never assume that rountine electrical safety inspections are being conducted by hospital maintenance personnel. The physical therapist is responsible for ensuring that all hazardous areas are rountinely checked for electrical safety.

Accident Prevention↗
PubMed2003

[Conservative therapy in painful shoulder syndrome].

Shoulder pain is a common complain, estimates of the annual incidence in general practice very from 7 to 25 cases per 1000 patients. Monoarticular involvement of shoulder does occur. Pain is the major complaint and is aggravated by movement, followed by decreased range of motion and functional capacity. There may be concomitant gross swelling about the shoulder as result of synovial inflammation and sub-deltoid or scapulothoracic bursitis. Physical therapy modalities, as conservative treatment, is the best way to help ameliorate some symptoms and prevent disability.

Humans↗