Knowledge Of Physiotherapy Research Articles

Literature Reviews and Case Reports

Literature reviews and case reports contribute uniquely to the body of knowledge in physical therapy and are essential to evidence-based practice. This editorial highlights an example of each of these types of papers, published in this month’s Journal: a literature review on patellofemoral joint pain syndrome by Bizzini et al and a case report by Peterson on the treatment of a patient with cervicogenic headache. J Orthop Sports Phys Ther 2003;33(1):2–3. doi:10.2519/jospt.2003.33.1.2

A Retrospective Analysis of Ethics Knowledge in Physical Therapy (1970–2000)

Purtilo, Guccione, and others have noted that increased clinical autonomy for physical therapists presents more complex ethical dilemmas. The body of literature examining physical therapy ethics, however, is relatively small and has not been analyzed. The primary purposes of this research were: (1) to use multiple perspectives to describe and analyze literature examining ethics in physical therapy from 1970 to 2000, (2) to develop a model to describe the evolution of knowledge of ethics in physical therapy during this period, and (3) to compare the proposed model with the evolutionary models proposed by Purtilo in physical therapy and by Pellegrino in bioethics. The sample consisted of peer-reviewed journal articles cited in the MEDLINE or Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases between 1970 and 2000 or referenced in Ethics in Physical Therapy. A two-phase mixed quantitative and qualitative method was used to analyze publications. In the quantitative phase, the author sorted publications into a priori categories, including approach to ethics, author, decade, country of publication, role of the physical therapist, and component of morality. During the qualitative phase of the research, the author analyzed and sorted the publications to identify common themes, patterns, similarities, and evolutionary trends. These findings were compared with the evolutionary models of Pellegrino and Purtilo. The 90 publications meeting inclusion criteria were predominantly philosophical, using the "principles" perspective; focused on the patient/client management role of the physical therapist; and addressed the moral judgment component of moral behavior. As predicted by Purtilo's model, the focus of identity evolved from self-identity to patient-focused identity, with increasing representation of societal identity. Recurrent themes included the need to further identify and clarify physical therapists' ethical dilemmas, the interrelationship between clinical and ethical decision making, and the changing relationship with patients. Although knowledge of ethics grew steadily between 1970 and 2000, this retrospective analysis identified gaps in our current knowledge. Further research is needed to address the unique ethical problems commonly encountered in all 5 roles of the physical therapist; patient perspectives on ethical issues in physical therapy; variety in ethical approaches; factors affecting moral judgment, sensitivity, motivation, and courage; and cultural dimensions of ethical practice in physical therapy.

Work-Related Musculoskeletal Disorders and the Culture of Physical Therapy

Knowledge, skills, relationships, and attitudes of caring and working hard are all thought to be valued by physical therapists. This article explores how physical therapists see themselves, in light of some of these values, when they experience work-related musculoskeletal disorders (WMSDs). The article also explores the ways in which these values may compete with each other, and it suggests how this may contribute to the onset of WMSDs and to therapists' behavior following a WMSD. Eighteen therapists who had made a career change after a WMSD participated in interviews that were designed to gain insight into the attitudes and beliefs of therapists who had had a WMSD. Participants did not anticipate WMSDs, and they typically believed their physical therapy knowledge and skills would have prevented WMSDs from occurring. They saw themselves as knowledgeable and caring and indicated that these characteristics were highly valued by the profession. Their need to demonstrate these attributes sometimes resulted in behaviors that contributed to the development of their WMSDs and made them worse after their onset. The cultural values of physical therapists may make it difficult for them to do their jobs in a way that minimizes the risk of WMSDs. The study identified a potential conflict between the therapists' need to (1) demonstrate their ability to work hard and care for their patients and (2) appear knowledgeable and skilled by remaining injury free.

Do Prospective Physiotherapy Students Have Sufficient Awareness of their Future Course and Career?

E Fox Sheffield Hallam University Introduction There is both enormous competition for places and a significant drop-out rate on physiotherapy courses. Observations and relevant literature have suggested that the general population and even other healthcare professionals have little knowledge of physiotherapy. It should be considered whether these are related. The purpose of this undergraduate study was to assess the knowledge of physiotherapy courses and profession among prospective students.

An Assessment of High-School Studentsʼ Knowledge of Physical Therapy and the Factors That Influence Their Knowledge

ABSTRACT: A survey was administered to 575 students in six different public high schools in Texas to determine the students ' knowledge of physical therapy and the factors that influenced their knowledge. A majority of the students surveyed knew of or had heard about physical therapy. The task that most students (91%) identified physical therapy with was instructs a patient in exercises. Two other tasks commonly recognized as those performed by physical therapists were works with joints to decrease pain and stiffness (88%) and evaluates a patients need for treatment (85%). The task with which the students were least familiar, with only 37% answering correctly, was `provides wound care. Sources that the students reported using the most to learn about physical therapy were television (66%); teacher, counselor, or coach (51%); and movies (44%). Significant differences were found within the demographic variables of school (urban versus rural), gender, grade, and prospective career in students ' identification of the individual tasks of physical therapy and the sources from which they had obtained their knowledge of physical therapy. Because the majority (>85%) of the students in the urban schools surveyed were representatives of minority groups, the results yield important implications for the recruitment of minority students into the profession. Career development is an important part of the high-school years. Researchers have shown that it is during this time when students begin to consider career choices. To ensure successful choices, students need accurate knowledge and information about their options. The results from this study may assist universities interested in recruiting physical therapy students and the profession with the development of strategies to provide high-school students with sufficient and accurate information about physical therapy. INTRODUCTION Career development is a process that a person addresses throughout life. A person chooses not only a career but also a lifestyle, and in doing so makes an important life decision. According to Freud, laying stress upon importance of work has a greater effect than any other technique of living in the direction of binding the individual more closely to reality.1In making this statement, Freud realized the importance of a career in reflecting on ourselves, shaping who we are, providing us with colleagues and friends, and helping us find our place in this world.l In the process of career decision making, many people experience indecision, an uncertainty about which career options to pursue. Savickas2 suggested that those people with career indecision can be divided into three subgroups. Group 1 includes people who feel no pressure to make a decision. This group has the confidence to make a rewarding choice, but lacks information about the options. Group 2 is made up of those people who harbor some immaturity and anxiety about their career. Group 3 is the undecided people who are unable to make decisions, even though they have the necessary information. Each of these groups need some guidance and intervention to help simplify the career decision-making process.2 Other researchers3-9 have suggested that influential factors on career decision making include family support, role models, childhood experiences, college advisors, and the availability of factual information. Career development matures with age and becomes an important consideration by the time an individual enters high school.3,4, 10-13 Individuals first begin to learn about careers during this time, and most adolescents have expressed occupational preferences by the time they reach high school. They continue, however, to be unclear about skills and abilities needed for their prospective profession.to It is appropriate for professions, such as physical therapy, and universities conducting recruitment efforts to help prepare and provide individuals with information to assist in the career decision-making process. …

A Multitrack Inquiry Model for Physical Therapist Professional Education

ABSTRACT: The purpose of this article is to describe the design and implementation of a multitrack option students enrolled in a graduate physical therapist (PT) professional preparation program. Students could select one of three inquiry tracks to satisfy program and university requirements for involvement in disciplined inquiry and scholarly writing and the granting of the Master of Science in Physical Therapy degree: (1) an independent research and thesis track, (2) a collaborative research project track, or (3) a case report track. Early experiences and outcomes with the multitrack inquiry option are discussed, with particular attention to the case report option because there is no published literature describing the use of this alternative to research requirements in PT professional preparation programs in the United States. Advantages and benefits of the model as well as disadvantages and challenges encountered in the first 2 years of experience with the model are described. INTRODUCTION In recent years, the professional journal of the American Physical Therapy Association (APTA), Physical Therapy, has issued a call for an increasing number of submissions of case reports in addition to research reports and other forms of manuscripts.1,2 Rothstein1,3 and McEwen2,4 have suggested that, although case reports have appeared relatively rarely in Physical Therapy, case reports can constitute an important contribution to the literature and add to our body of knowledge in physical therapy through careful documentation of everyday and clinical decision-making processes. Rothstein also points out that case reports can lay the groundwork for experimental studies ... [and] share many of the characteristics of more formal scientific inquiry.'(p492) Harris,5 Schon,6- 8 and Shulman9.io also claim that a case literature contributes to a body of professional knowledge by codifying and articulating the understandings, assumptions, principles, and strategies of skilled practice.5(p48) That is, detailed case descriptions and analyses of professional help make tacit aspects of (often referred to as art, craft, or practical knowledge) explicit and elucidate practice theories.5(P49) In this way, the preparation of, and dialogue about, case reports constitutes an important form of reflective and scholarly activity for the ongoing development of professionals and the profession of physical therapy itself. This important function of case reports is captured in the mission statement of a new peerreviewed journal, Physical Therapy Case Reports, which uses clinical case reports to foster the exchange of ideas and to promote professional development of practitioners, educators, and researchers I(page i) Concurrent with the call for an expanded case report literature in physical therapy, health care consumers, providers, and reimbursers are demanding increasing documentation of treatment outcomes and effectiveness at the level of the individual patient. Such documentation is something that well-written case reports can provide. Furthermore, current evaluative criteria for accreditation of physical therapist education programs12 and professional expectations for physical therapists13 urge physical therapy educators to provide students with multiple opportunities for engaging in critical inquiry, clinical problem solving and decision making, and reflective practice. Several authors representing a variety of disciplines have pointed out that thoughtful case selection and analysis and the preparation of oral and written case reports offers fertile ground for the teaching and development of these essential skills and habits of thought and can provide a much-needed vehicle for bridging theory-practice gaps for students, educators and practitioners.5-10 In the past decade, Rothstein1,3,14 and other physical therapy educators have begun to question the by many physical therapy professional preparation programs of mandating that entry-level students conduct traditionally defined research projects as a requirement for graduation. …

The Concept of Balance

This article discusses the importance of defining balance and other concepts relevant to physiotherapy for the development of the profession. It addresses the following factors, using the concept of balance as an example: identification of physiotherapy problems, the need to anchor generally accepted constitutively and operationally defined concepts to these problems, and the need to formulate new physiotherapy theories and develop clinical and laboratory tests based on recent knowledge. The difference between constitutive and operational definitions of concepts is explained as well as the division of the balance into static and dynamic. The idea of balance as an umbrella concept and the variety of motor skills included in it is introduced together with a rough scale to assess them. Past and present theories on balance are mentioned and the importance of conveying the newly gained physiotherapy knowledge as fast as possible to clinical physiotherapists is emphasised. This article discusses the importance of defining balance and other concepts relevant to physiotherapy for the development of the profession. It addresses the following factors, using the concept of balance as an example: identification of physiotherapy problems, the need to anchor generally accepted constitutively and operationally defined concepts to these problems, and the need to formulate new physiotherapy theories and develop clinical and laboratory tests based on recent knowledge. The difference between constitutive and operational definitions of concepts is explained as well as the division of the balance into static and dynamic. The idea of balance as an umbrella concept and the variety of motor skills included in it is introduced together with a rough scale to assess them. Past and present theories on balance are mentioned and the importance of conveying the newly gained physiotherapy knowledge as fast as possible to clinical physiotherapists is emphasised.

Ginger Rogers Did Everything Fred Astaire Did Backwards and in High Heels

Summary This article presents a slightly maverick view of the emergence and development of the profession, looking at the progress and evolution of physiotherapy as a 20th century phenomenon and an example of the status and ambitions of women. The occupation and history of physiotherapy are not gender-free and historical constraints on the construction of knowledge in and about physiotherapy and the development of a research culture are identified with regard to the reasons that the Founders of the profession were happy to trade autonomy for orthodoxy, to carry out ancillary and subordinate tasks and explain physiotherapy in terms of ‘the medical model' in exchange for recognition and patronage. Electrotherapy is used as an example of lack of coherence and entropy in knowledge in physiotherapy. Constraints of the current structure and culture of the NHS are also identified, in particular exclusion from decision-making structures and managerial perceptions that the therapy professions and other professions allied to medicine ‘serve' medicine. The main thesis is that the therapy professions have uniquely developed sets of intellectual capabilities and independent knowledge which are inseparable from professional autonomy and which management needs in order to deliver a high quality service. The discourse concludes with the need to provide valid evidence of present and potential contributions to the health of society in order to retain professional independence in the face of the management model being imposed on much of the NHS and carry it into the next century.

Research and the Cumulation of Knowledge in Physical Therapy

Published research contributes to the knowledge base that distinguishes one discipline from another. More research is now published in the physical therapy journals, but concerns with the profession's knowledge base continue. The study examined citations from 78 clinical articles published and indexed on three thematic areas in Physical Therapy between 1951 and 1990. Unique items and multiple-cited items were identified and counted and their sources ascertained. Linkages among multiple-cited items in each thematic area were identified and described. Most cited items were unique and not from the physical therapy literature. Few linkages were identified among the clinical articles. The lack of evidence of cumulation or of coherence among the articles examined and the extent of reliance on non-physical therapy sources suggest that concerns with the knowledge base of the profession are well founded.

Sources of knowledge in physical therapy

Sources of knowledge in physical therapy

Physiotherapy Journals — Why bother?

<h2>Summary</h2> Editors may be damned because they do publish and damned because they do not. The small proportion of physiotherapists writing for publication suggests that the majority of them also fear being damned or rejected. Both the history and the present of writing about physiotherapy appear to be inseparable from women's perceptions of their capacity for constructing knowledge and their silence in literature in general. Physiotherapists must become more aware of the power of words for transmitting knowledge, sharing experiences and creating frames of reference for knowledge. They must acknowledge a crisis of identity, which verges on extreme denial of self and dependence on external approval, emerge from it and refuse to play the conventional female role that depends on external authority for direction and patronage. The struggle is one of conflicting world views. Physiotherapists try to get their voices heard in a world that values only dispassionate reason, rationalisation and scientific thought. However, all knowledge is constructed and all theories are only models for approximating experience. They can create a system of authority for physiotherapy based on personal and individual experience as well as scientific sources. Writing and publishing are the major ways in which they can all gain access to and connect the knowledge and ideals of physiotherapists worldwide in order to reveal the kind of truth they value. Today's physiotherapists are responsible for constructing the knowledge of physiotherapy and using their journals to articulate a position that will enable physiotherapists to play a key role in shaping provision of care in the 21st century. This paper was read as a plenary lecture at the international conference on ‘The Science and Art of Physiotherapy', Hong Kong Convention and Exhibition Centre, July 23–25, 1993.

Capturing the Basics: The Development of an Expert Computer System for Physiotherapists

Summary Can physiotherapists describe their core skills? How do they make clinical decisions? What are their sources of knowledge? What are the ‘rules’ of practice? These are some of the questions which are being addressed by the project described in this paper. Physiotherapists are utilising computerised systems to record their work for Korner purposes. This project turns to a more novel application of computers: the development of an expert system which can give students and newly qualified practitioners access to expert advice and may be seen as a means of sharpening expertise by experienced practitioners themselves. The paper outlines briefly what an expert system is and the kinds of situations in which it can be useful. This is then related to a core area of physiotherapy and the choice of electrotherapy as the initial area of study is explained. Historically, computer software development has failed to live up to expectations because the purpose for which it has been designed has been poorly defined. The reseachers' attempt to define a good specification for a computer system by paying attention to the nature of physiotherapy knowledge is described; the methodology used for eliciting knowledge from practitioners is discussed; and there is some analysis of the knowledge base of electrotherapy drawn from the preliminary results. Finally, some of the ethical and practical problems of developing a computer system which tries to emulate how physiotherapists make decisions and solve problems are raised as the basis of further discussion.

Physical therapy refresher courses: A follow-up of participants

Refresher courses have emerged as a particular kind of continuing education activity designed to help professionals who are, or who perceive themselves to be, out of the mainstream of practice. This project surveyed individuals who had completed a two-week physical therapy refresher course. The purposes were 1) to identify the primary motivation for enrolling in a refresher course, 2) to describe the demographic characteristics of participants, and 3) to determine the effect of the refresher course on participants' professional activities. Seventy-five percent of respondents took the course to refresh or update their knowledge of physical therapy. The remaining twenty-five percent were interested in preparing to take the licensure examination. Participants were primarily female, in their early forties. Of 39 individuals taking the licensure examination, 31 became licensed physical therapists following completion of the refresher course. While half of the respondents were working prior to the course, more than three-fourths were working at the time of the survey. Ninety-six percent of the respondents reported that the refresher course was worthwhile. Refresher courses may therefore be one option for helping to meet the need for adequate numbers of well-qualified health professionals, especially in those fields with acute manpower shortages.

Referrals to physiotherapy: The relation between the number of referrals, the indication for referral and the inclination to refer

This article studies the relation between the referral rate and the type of patients general practitioners refer for physiotherapy. The study population consists of GPs participating in the Netherlands' Sentinel Stations Network, who recorded data on all referrals to physiotherapy during one year and filled in a questionnaire. Results show that the pattern of referral indications of high referring GPs does not differ systematically from that of low referring GPs. High referring GPs evaluate their patients complaints more as purely or mainly somatic. High referring GPs were no more inclined to give in to their patients demands, had busier practices, closer relations with physiotherapists and viewed their knowledge of physiotherapy as more satisfactory than low referring GPs. Some policy implications are discussed in respect to these results.

Survey of Orthopaedic Residents' Exposure to Physical Therapy During Residency

The purpose of this study was to assess orthopaedic surgery residents' exposure to physical therapy in their training to date. A questionnaire was sent to 30 orthopaedic residents at two residency programs in Kentucky. The residents' clinical and didactic exposure to physical therapy, their knowledge of the therapist's educational background, the significance of physical therapy to their orthopaedic patients, and their confidence in the therapist's skills were assessed by the questionnaire. Twenty five of the residents responded and frequency distributions were used to assess the data. Twenty-one residents had no courses or in-services in medical school or residency that discussed how physical therapy is useful to their patients, yet only 13 residents perceived an inadequacy in their knowledge of physical therapy. The residents were well-informed of the therapist's educational background, yet 6 residents believed that the education for a therapist was insufficient to enable the therapist to choose a specific treatment for orthopaedic patients. J Orthop Sports Phys Ther 1986;7(6):335-338.

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.

Editor's Note

Once again, we take pleasure in presenting an in-depth review of a priority topic. Movement, the common denominator of our body of knowledge in physical therapy, is the basis for this special issue. Any influence on movement is of primary concern to us whether the factors involved relate to the musculoskeletal, neurological, cardiovascular, or integumentary system. For us to be effective therapists, it is imperative that we understand the myriad of factors that influence movement and that cause muscle dysfunction. The authors in this issue have provided us with extremely valuable information about muscle biology as the key to understanding and managing muscle dysfunction. They are to be commended for their insights in reviewing and selecting the specific materials, for their clinical and practical approaches in organizing and discussing the pertinent findings, and for their astute observations and careful analyses of the research data.

A Textbook of Orthopædic Nursing.

This is a concise presentation of the subject of nursing of orthopedic diseases that result in deformities. The material is well arranged and presented in simple language. It presents the essential facts and avoids confusing the student by detail. Enough description of the disease is given to explain the symptoms and to offer a basis for intelligent nursing. It includes instruction in anatomy and physiology, and the working of splints and the application of plaster supports, as well as a practical working knowledge of physical therapy in its various branches. Some of the illustrations are not as good as they should be, for this subject is peculiarly adapted for photographic illustration.

THE COUNCIL ON PHYSICAL THERAPY

The editor's occupation affords him opportunity to display either broad and comprehensive ignorance or erudite knowledge of many topics before audiences composed of specialists in various fields. Following his glittering generalizations he is likely to become the recipient of anathema and vituperation for his disagreements with long-held opinions. Obviously, the knowledge of physical therapy which forms the basis of the considerations here presented is not derived from personal observation of the devices used in physical therapy, from an intimate study of their effects on animals or on patients, or even from their trial on a physical constitution inured to punishment by the trials of numerous tooth pastes, breakfast foods, condensed, dried and powdered milks, or other samples conferred on editors by earnest manufacturers and a progressive advertising department. Such statements as are here made public result from the reading of innumerable manuscripts submitted by aspirants for fame in the field