Objectives: Rising surgical rates for lumbar spinal stenosis (LSS) and underutilization of physical therapist services for this condition may increase patient risks and healthcare costs. Patient beliefs may also contribute to this problem. Therefore, our objective was to determine which messages about physical therapy were perceived as strongest by patients with LSS and whether those messages were influenced by patient factors.
View Article and Find Full Text PDFHome Healthc Now
September 2024
Atrial fibrillation (AF) is a common and persistent cardiac arrhythmia that impacts morbidity, mortality, disability, quality of life, and healthcare costs. Typically, AF is managed using a three-pillar approach of rate control, rhythm control, and anticoagulation. However, these interventions fail to address the underlying pathophysiological factors that contribute to AF.
View Article and Find Full Text PDFPhysiother Theory Pract
February 2025
Introduction: Patients presenting to direct access physiotherapists may present with a serious pathology that mimics a musculoskeletal condition. Recognition of atypical clinical patterns allows for referral to an appropriate provider when a serious pathology is present. This case report details a patient with a pulmonary pathology who presented to a physiotherapist with a complaint of neck and chest pain following medical consultations.
View Article and Find Full Text PDFInt J Sports Phys Ther
January 2024
Background: A concussion is a traumatic brain injury that can result in vestibular and oculomotor dysfunctions. The Head Shake-Sensory Organization Test was developed from the original Sensory Organization Test to measure a subject's ability to maintain balance while moving their head.
Purpose: The purpose of this study was to compare the performance of adults with no history of concussion to those with a history of concussion on the Head Shake-Sensory Organization Test to determine if long-standing balance deficits are present after concussion.
Direct access in physiotherapy (DAPT) occurs when a patient has the ability to self-refer to physical therapy without physician referral. This model of care in musculoskeletal diseases (MSDs) has shown better outcomes than the traditional-based medical model of care that requires physician referral to access physiotherapist services. This traditional physician referral often results in a delay in care.
View Article and Find Full Text PDFEfficient referral pathways have held promise in improving clinical outcomes, raising patient satisfaction, and reducing costs. Referral decision-making presents a distinct challenge because it requires the consideration of such variables as technology, health-care systems, and local resources. However, best practices for generating a high-value referral and improving care continuity are rarely discussed in the context of physical therapist practice.
View Article and Find Full Text PDFBackground: The prevalence of Thoracic Pain (TP) is estimated to be low compared to other common musculoskeletal disorders such as nonspecific low back pain (LBP). Notably, compared to LBP, TP or referral pain to the thoracic area potentially may involve serious pathologies. Visceral referral of pain may present to the thoracic spine or anteriorly in the abdomen or chest.
View Article and Find Full Text PDFBackground: In orthopaedic practice, it is well established that weak scapular stabilizers and an unstable scapula is related to shoulder dysfunction. Faulty scapular position has been linked to decreased scapular stability and is thought to be a result of weak or unbalanced timing in the recruitment of scapulothoracic dynamic stabilizing muscles. Kibler has described a four-type classification of scapulothoracic dysfunction.
View Article and Find Full Text PDFThe American Physical Therapy Association has supported the development of clinical practice guidelines to promote and support evidence-based practice and reduce unwarranted practice variation. Essential to the success of this effort is the generation of knowledge translation, a concept that emphasizes the translation of global knowledge to an application that can be effectively integrated into clinical practice. The Physical Therapy Clinical Practice Guideline for the Management of Individuals with Heart Failure published in the Physical Therapy Journal in January 2020 provides a broad base of knowledge related to evidence-based treatment interventions for patients with heart failure.
View Article and Find Full Text PDFInt J Sports Phys Ther
February 2021
Background: Near point of convergence (NPC), a component of the Vestibular Ocular Motor Screening (VOMS) assessment, may be helpful in diagnosing concussion. The VOMS uses a standardized approach to measure NPC; however, methods of screening for NPC are not standardized.
Purpose: The purpose of this study was to determine whether four different methods of measuring NPC yielded different estimates.
Int J Sports Phys Ther
December 2020
Background: Inability to maintain proper alignment of the pelvis and femur due to gluteal muscle weakness has been associated with numerous lower extremity pathologies. Therefore, many lower extremity rehabilitation and injury prevention programs employ exercises that target gluteal muscle strength and activation. While information regarding muscle activation during exercises that are typically done in the beginning stages of rehabilitation is available, evidence regarding the gluteal muscle activity during more functional and advanced exercises used during later stages of rehabilitation is sparse.
View Article and Find Full Text PDFBackground: Sport-related concussion is a public concern with between 1.6 and 3.8 million sport- and recreation-related injuries occurring annually.
View Article and Find Full Text PDF. Shoulder pain is a common symptom of musculoskeletal disorder about the shoulder. However, shoulder pain can also be symptomatic of other non- musculoskeletal disease.
View Article and Find Full Text PDFThe American Physical Therapy Association (APTA), in conjunction with the Cardiovascular and Pulmonary Section of APTA, have commissioned the development of this clinical practice guideline to assist physical therapists in their clinical decision making when managing patients with heart failure. Physical therapists treat patients with varying degrees of impairments and limitations in activity and participation associated with heart failure pathology across the continuum of care. This document will guide physical therapist practice in the examination and treatment of patients with a known diagnosis of heart failure.
View Article and Find Full Text PDF: Running is one of the most popular sports worldwide due to its low costs and its beneficial impact on health. Recent evidence suggests 11% to 85% of recreational runners experience at least one running-related injury each year and most of these are related to musculoskeletal conditions. The aim of this case report is to describe the clinical decision-making process that guided a physiotherapist to suspect a non-musculoskeletal cause in a recreational runner presenting with low back pain and calf pain secondary to Peripheral Artery Disease.
View Article and Find Full Text PDFCycling is a popular source of recreation and physical activity for children and adults. With regard to the total number of sports injuries, cycling has the highest absolute number of injuries per year in the United States population. Cycling injuries can be classified into bicycle contact, traumatic, or overuse injuries.
View Article and Find Full Text PDFBackground: Oculomotor function is impaired when an individual has a concussion and as such, it is important to identify tests that are able to assess oculomotor impairment. The King-Devick (K-D) test assesses horizontal saccadic eye movement and attention. The Developmental Eye Movement (DEM) test is designed to identify oculomotor dysfunction in children.
View Article and Find Full Text PDFBackground: When paired together, manual therapy and exercise have been effective for regaining range of motion (ROM) in multiple conditions across varied populations. Although exercise in an aquatic environment is common, research investigating manual therapy in this environment is limited. There is little evidence on AquaStretch an aquatic manual therapy technique, but anecdotal clinical evidence suggests its effectiveness.
View Article and Find Full Text PDFInt J Sports Phys Ther
August 2017
Background: Disruption of the visual and vestibular systems is commonly observed following concussion. Researchers have explored the utility of screening tools to identify deficits in these systems in concussed patients, but it is unclear if these tests are measuring similar or distinct phenomena.
Purpose: To determine the relationships between common vestibular tests including the King-Devick (K-D) test, Sensory Organization Test (SOT), Head Shake-Sensory Organization Test (HS-SOT), and Dynamic Visual Acuity (DVA) test, when administered contiguously, to healthy recreational athletes aged 14 to 24 years.
Physiother Theory Pract
September 2017
Background: The use of evidence-based practice (EBP) is encouraged in the physical therapy profession, but integrating evidence into practice can be difficult for clinicians because of lack of time and other constraints.
Objective: To survey physical therapy clinical instructors and determine the methods they use for screening for deep vein thrombosis (DVT), a type of venous thromboembolism (VTE) in the lower extremities.
Design: Exploratory survey.
Physiother Theory Pract
January 2014
Background: Hip pain in the absence of trauma is difficult to diagnose due to the number of structures that refer pain to the hip and thigh. When identifying the origin of pain, the ability to increase or decrease the patient's pain level with rest, posture or movement is important to determine a clinical pattern. If that pattern does not make sense, other causes of the onset of pain need to be considered.
View Article and Find Full Text PDFStudy Design: Patient case report.
Background: Clinical reasoning associated with patient evaluation leads physical therapists to one of three choices: 1) treat; 2) treat and refer; or 3) refer. Patients seen postoperatively require screening for potential complications, including infection.