What do patients with lumbar spinal stenosis think is physical therapy's best card? A survey of perceived message strength.

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.

Physical Therapists in Primary Care in the United States: An Overview of Current Practice Models and Implementation Strategies.

Unlabelled: In the USA, physician shortages and increases in noncommunicable disease burden have resulted in a growing demand for primary care providers (PCPs). Patients with physical and functional impairments have been especially affected by these challenges. However, physical therapists are well suited to meet patient needs in primary care settings by working alongside PCPs and other primary health care team members.

Drawing a "Perfect Circle": How Clinicians Can Become Better Communicators.

Despite the importance of communication in person-focused care, biomedical knowledge and technical skill development are often prioritized in physical therapy education. As clinicians and educators, we contend that mindfulness and reflection nurture effective communication approaches and support physical therapists in navigating the complexity and uncertainty that comprise most clinical interactions. We suggest that clinicians be mindful of the self, the patient, and the context when interacting with patients.

Referral Decision-Making and Care Continuity in Physical Therapist Practice.

Efficient 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.

The Blind Men, the Elephant, and the Continuing Education Course: Why Higher Standards Are Needed in Physical Therapist Professional Development.

Evidence-based practice and implementing clinical practice guidelines are familiar themes for musculoskeletal rehabilitation clinicians. Yet, many clinicians continue to eschew recommended treatments. One explanation could be that physical therapists largely rely on continuing education courses-not research reports or standardized postprofessional education-to learn new treatments and update their practice patterns.

A physical therapist-led clinical decision-making program reduced risk of adverse events after total knee arthroplasty over 3 years: A retrospective review.

Context: Reducing adverse events after total knee arthroplasty has implications for newly developed bundled payment models.

Objective: To examine the impact of a physical therapist-led clinical decision-making program on the risk of adverse events, function, visits used, or reaching knee range of motion (ROM) goals in patients after total knee arthroplasty.

Methods: The decision-making program consisted of quarterly meetings and recommendations for early risk identification and evidence-based intervention.

Who writes this stuff? Musculoskeletal information quality and authorship of popular health websites: A systematic review.

Background: Highly trafficked health websites are major sources of information, but the quality of their musculoskeletal information has not been thoroughly evaluated or their authorship characterized.

Objectives: To review information about common musculoskeletal conditions on highly trafficked websites and characterize their credibility, authorship, accuracy of information (as compared to treatment guidelines), and consistency with best practice recommendations.

Design: Systematic review.

From Idea Cults to Clinical Chameleons: Moving Physical Therapists' Professional Identity Beyond Interventions.

The components of clinical practice are complex, often ambiguous, and influenced by a wide variety of interrelated contextual factors. As appreciation grows for the impact of individuality, complexity, and uncertainty in health processes, effective translation into widespread clinical practice remains limited. In attempts to bring patients effective solutions, well-meaning physical therapists can get trapped in "idea cults," in which a favored idea is supported and others are disparaged.

Continuing Education Courses for Orthopedic and Sports Physical Therapists in the United States Often Lack Supporting Evidence: A Review of Available Intervention Courses.

Objective: The purpose of this study was to characterize the extent to which orthopedic and sports-related continuing education course descriptions approved for physical therapists in the United States taught interventions supported by evidence.

Methods: A review was conducted of courses available on CEU Locker from January through December 2020, estimated to represent most courses nationally available to physical therapists. This review focused specifically on courses teaching interventions for musculoskeletal conditions in adults.

Digital physical therapy practice and payment during the COVID-19 pandemic: A case series.

Background: Insurance regulation and reimbursement are barriers to physical therapy-delivered digital practice.

Objective: The present case series describes the clinical reasoning, outcomes, and practical use of digital tools to improve pain and movement of patients seen for musculoskeletal pain during the COVID-19 pandemic.

Case Description: Three patients, 2 with low back pain and 1 with cervicogenic headache, were treated at a private outpatient clinic.

Patient Expectations for Synchronous Telerehabilitation Visits: A Survey Study of Telerehabilitation-Naive Patients.

The current study evaluated patient expectations for synchronous telerehabilitation. Because the coronavirus disease 2019 (COVID-19) pandemic decreased regulatory barriers and increased accessibility of telehealth, improved understanding of expectations may direct future educational efforts, improve implementation strategies, and inform future analyses of consumer adoption and utilization of telehealth. A cross-sectional survey design was used to measure ideal expectations (what they want to happen) and realistic expectations (what they think will happen) of telerehabilitation-naive patients for synchronous telerehabilitation.

How people with lumbar spinal stenosis make decisions about treatment: A qualitative study using the Health Belief Model.

Objective: Surgery rates for lumbar spinal stenosis (LSS) have increased despite inherent risks, high reoperation rates, and a lack of evidence for benefit over conservative treatment. Scant research has investigated how people make decisions about treatment, which may help clinicians better support patients during the course of care. The purpose of the present study was to explore the beliefs of people with LSS and how they make decisions about treatment.

Alternating lumbar lateral shift: a case report.

Background: A lumbar lateral shift (LLS) is a common clinical observation in patients with low back pain (LBP), and a shift contralateral to the side of pain is the most common presentation. An LLS that can rapidly alternate sides presents several treatment difficulties and has rarely been described. The purpose of the current case report was to describe the presentation and management of a patient with an alternating LLS.

Physical therapy management of a patient with persistent groin pain after total hip arthroplasty and iliopsoas tenotomy: a case report.

: Hip impingement syndrome can occur after total hip arthroplasty (THA). Nonoperative treatment is inconsistently recommended, and surgical options include iliopsoas tenotomy. The current case report describes the unique case of a patient with persistent groin pain after THA and iliopsoas tenotomy.

An orthopedic manual physical therapy fellowship training's impact on professional development, involvement, personal lives, and income - A survey study.

: Little research exists investigating the personal and professional outcomes of postprofessional physical therapy (PT) training. Therefore, the purpose of the current descriptive, web-based survey study was to determine self-reported outcomes from a postprofessional PT fellowship program, including graduate professional, educational, and research involvement; perceptions of the impact of training on clinical and professional attributes; changes in employment and income; and barriers to training. : Graduates of a part-time, hybrid-model, multisite orthopedic manual PT fellowship program were invited to complete the web-based survey.

Short-term Response to Treatment Targeting the Thoracolumbar Junction in Patients With Hip Pain: A Case Series.

Background: In patients presenting with hip and groin symptoms, evaluation and treatment of the thoracolumbar junction (TLJ) may be underutilized. The TLJ is less recognized as a source of pain referral in these regions. The purpose of this case series was to describe the management of 3 patients with primary hip and groin pain who were treated with interventions targeting the TLJ.

Belt-Mounted Micro-Gas-Chromatograph Prototype for Determining Personal Exposures to Volatile-Organic-Compound Mixture Components.

We describe a belt-mountable prototype instrument containing a gas chromatographic microsystem (μGC) and demonstrate its capability for near-real-time recognition and quantification of volatile organic compounds (VOCs) in moderately complex mixtures at concentrations encountered in industrial workplace environments. The μGC comprises three discrete, Si/Pyrex microfabricated chips: a dual-adsorbent micropreconcentrator-focuser for VOC capture and injection; a wall-coated microcolumn with thin-metal heaters and temperature sensors for temperature-programmed separations; and an array of four microchemiresistors with thiolate-monolayer-protected-Au-nanoparticle interface films for detection and recognition-discrimination. The battery-powered μGC prototype (20 × 15 × 9 cm, ∼2.

Use of a modified treatment-based classification system for subgrouping patients with low back pain: Agreement between telerehabilitation and face-to-face assessments.

: To examine the agreement between telerehabilitation and face-to-face assessments of patients with acute and subacute low back pain (LBP) using a modified treatment-based classification (TBC) system. A secondary aim was to evaluate patient satisfaction with the telerehabilitation assessment. : Patients with LBP of less than 90 days' duration underwent both telerehabilitation and face-to-face assessments.

Telerehabilitation booster sessions and remote patient monitoring in the management of chronic low back pain: A case series.

Background: Improvements in chronic low back pain (CLBP) seen in physical therapy do not appear to be retained over the long term. Booster sessions have been proposed, but barriers exist to their implementation. Telerehabilitation (TR) and remote patient monitoring (RPM) may be ways to circumvent these barriers.

Physical Therapy Management of Patients With Chronic Low Back Pain and Hip Abductor Weakness.

Background And Purpose: Hip abductor dysfunction is common in individuals with chronic low back pain (CLBP). Previous research investigating abductor strengthening in the heterogeneous CLBP population is sparse and has failed to target those patients most likely to benefit. The aim of the current case series was to describe the physical therapy management and outcomes of 3 patients with CLBP matching a previously identified subgroup characterized by substantial hip abductor weakness.

Evaluating multiple causes of persistent low microwave backscatter from Amazon forests after the 2005 drought.

Amazonia has experienced large-scale regional droughts that affect forest productivity and biomass stocks. Space-borne remote sensing provides basin-wide data on impacts of meteorological anomalies, an important complement to relatively limited ground observations across the Amazon's vast and remote humid tropical forests. Morning overpass QuikScat Ku-band microwave backscatter from the forest canopy was anomalously low during the 2005 drought, relative to the full instrument record of 1999-2009, and low morning backscatter persisted for 2006-2009, after which the instrument failed.

Oiling accelerates loss of salt marshes, southeastern Louisiana.

The 2010 BP Deepwater Horizon (DWH) oil spill damaged thousands of km2 of intertidal marsh along shorelines that had been experiencing elevated rates of erosion for decades. Yet, the contribution of marsh oiling to landscape-scale degradation and subsequent land loss has been difficult to quantify. Here, we applied advanced remote sensing techniques to map changes in marsh land cover and open water before and after oiling.