Physical Therapy Scope Of Practice Research Articles

Improving Patient Access to Musculoskeletal Treatments and Medical Student Musculoskeletal Education via Free Clinic Services.

Introduction Homeless patients are at higher risk for musculoskeletal conditions but have limited access to treatments. Physical therapy (PT) and osteopathic manual therapy (OMT) are treatments for acute and chronic musculoskeletal conditions. Here, we outline establishing a free specialty clinic to provide PT and OMT to underserved patients. Methods At Eastern Virginia Medical School's Health Outreach Partnership of EVMS Students (HOPES) free clinic, we established a volunteer student, resident, and attending-led specialty clinic to provide exercise therapy, manual therapy, and injections to underserved patients. Results Student volunteering resulted in significant improvement in student confidence with musculoskeletal physical exam skills and their ability to diagnose musculoskeletal conditions. Patients of the clinic reported significant improvement in pain and mobility. Discussion This clinic is a novel activity that improves student musculoskeletal medical education and patient access to musculoskeletal condition treatments. Exposing students to PT and OMT services increased student awareness of the PT scope of practice, OMT's use as a component for patient treatment increased confidence in the appropriate applications of OMT for patient care. Implementing a free PT and OMT clinic at an established free clinic can improve musculoskeletal medical education and enhance patient care for underserved populations.

Efficacy of Exercise Interventions Applied to Populations Diagnosed With Eating Disorder(s) on Health Outcomes.

<h3>Objective(s)</h3> Investigate the impact of resistance training, yoga, and aerobic exercise on perceived quality of life and physiological function for individuals with eating disorders. <h3>Data Sources</h3> EBSCO-PsycINFO, EBSCO-Health Source, PubMed, and CINAHL were searched in September 2021 and January 2022. Indexing terms used for article retrieval included the combination of: physical therapy, physiotherapy, rehabilitation, eating disorder, anorexia nervosa, bulimia nervosa, binge eating, exercise, exercise interventions, resistance training, yoga, and aerobic exercise. <h3>Study Selection</h3> Eligible articles included English translation, peer-reviewed, publication date after 2009, subjects < 50 years old, interventions within physical therapy scope of practice including resistance training, yoga, or aerobic training, and PEDro score ≥ 3. Seventy articles were retrieved for evaluation. Studies were selected following consensus by multiple researchers. Eleven articles met inclusion criteria. <h3>Data Extraction</h3> Articles were analyzed for quality and validity using the PEDro scale and a hierarchy of evidence scale. Data extracted from each article included subject demographics, interventions provided, assessment tools, outcomes, limitations, and conclusions. <h3>Data Synthesis</h3> Researchers found that for all participants diagnosed with eating disorders, high intensity resistance training was more effective in improving and maintaining QOL and functional strength measures as compared to low/moderate intensity exercise. Experimental groups who performed yoga or received cognitive behavioral therapy with resistance interval training demonstrated increased psychological well-being and emotional regulation. Exercise had a positive effect on BMI and frequency of binge-eating behaviors in individuals with binge eating disorder. Physiological measures were also improved in subjects who engaged in physical activity alongside counseling with a mental health physical therapist. <h3>Conclusions</h3> Inclusion of exercise for individuals receiving eating disorder treatment can positively affect perceived quality of life, body composition, and physiological function. Future research is recommended to explore the role of physical therapy in eating disorder treatment including investigation of long-term intervention effects and treatment along the continuum of recovery. <h3>Author(s) Disclosures</h3> No conflicts of interest present.

Nurses' Perspectives of the Need for Physical Therapy Services During an Acute Postpartum Stay: A Focus Group

Hypothesis/Purpose: Complications in the postpartum period can include pain, urinary incontinence, diastasis recti abdominis, and pelvic floor injury. Physical therapists are in a unique position to address these concerns during the acute postpartum stay. However, there is a lack of consensus regarding the role of physical therapy (PT) in this patient population. Mother-Baby (MB) nurses work closely with postpartum mothers; therefore, the purpose of this study was to gain nurses' perspectives of their knowledge of and need for PT in the acute postpartum setting. Subjects: Nine MB nurses and 1 newly graduated nurse with MB experience from 2 hospitals near Winchester, Virginia, participated. Materials/Methods: Contact was made with nurse managers to arrange a time for the focus group. A demographic questionnaire was distributed prior to the session. A student moderator led the semistructured interview with preselected open-ended questions. The focus groups were audio/video recorded and transcribed. Transcriptions were used for theme coding and concept map development. Results: Five participants were present for each focus group. Four main themes and 1 subtheme emerged. These included lack of understanding of PT scope of practice with a subtheme of special circumstances, limited time, role overlap, and appropriate timing of PT. Lack of understanding of PT scope of practice was the overarching theme. Conclusion: MB nurses demonstrated a limited understanding of the PT scope of practice and their potential role postpartum. Further education and interdisciplinary collaboration may be beneficial to enhance postpartum care in the United States.

Do Physical Therapy Interventions Improve Urinary Incontinence and Quality of Life in patient with Multiple Sclerosis: A systematic Literature Review

Background: Multiple sclerosis (MS) presents with many symptoms, including urinary incontinence (UI) that physical therapy can play very important role, which is widely prevent, but the physical therapy management for UI in MS population lacks consensus. We analyzed the current evidence for effectiveness of physical therapy to decrease UI and improve quality of life (QOL) in population with MS. Purpose: To systematically review the literature and present the best available evidence for the efficacy and effectiveness of physical therapy intervention in treating the urinary incontinence for MS population and improve QOL. Data Source: Pub Med, Cochrane library, BMJ Group, BioMed Central, Wiley online library, Cumulative Index to Nursing and Allied Health Literature, and PEDro. Study Selection: 5 randomized, control trials (RCTs) and one clinical trial published in English from 2006- May 2019. Data Extraction: Any study concentrated on surgical or pharmaceutical treatment interventions, focused on bowel incontinence or were not within the physical therapy scope of practice. Data Synthesis: The study focuses on physical therapy intervention for MS patients with UI and randomized control study. Limitation of the Study: The reviewed study is limited to 6 randomized control trials. Conclusion: There is significant evidence that physical therapy interventions in MS patients with urinary incontinence are very effective and had significant change in reducing UI and increasing QOL.

Perceived Barriers Among Healthcare Professionals for Access to Physical Therapy Service in Saudi Arabia

Abstract Objective To examine physical therapy scope of practice and to describe the barriers and facilitators for access to physical therapy services as reported by healthcare professionals in Saudi Arabia. Methods Ninety physical therapists from the 6 hospitals in the cities of Riyadh, Jeddah, and Dammam were surveyed by the cross-sectional questionnaire. The questionnaire was distributed through email invitation or in-person. The questionnaire was developed to determine the perceived barriers to direct access to physical therapy service among healthcare professionals. Results The present study had a response rate of 77.7% (70 out of 90 physical therapists). Majority of the participants were in the age group range of 21–30 years (41.4%) and 68.6% of the respondents’ highest educational qualification is a Baccalaureate degree. The gender distribution showed that the majority of the respondents were female (51.4%). More than a quarter of the participants had a clinical experience that ranges from 6 to 10 years. Majority of the participants were working in the city hospital (88.6%). Most of the participants strongly agreed or -agreed that the factors included in the questionnaire such as geographical accessibility, availability, affordability, and acceptability of services were barriers to provide access to physical therapy services in Saudi Arabia. Conclusions This study documents many of the perceived barriers for access to providing physical therapy services in Saudi Arabia such as geographical accessibility, availability, affordability, and acceptability of services. Furthermore, the identified barriers could be used as a framework by policymaker and the third party payment system in order to further improve access to physical therapy services in Saudi Arabia.

The perception of physical therapy leaders in Saudi Arabia regarding physical therapy scope of practice in primary health care.

[Purpose] To explore the views of the physical therapy service leaders in Saudi Arabia regarding the integration of physical therapy service in primary health care settings. [Subjects and Methods] A self-administered questionnaire consisting of both open and closed ended questions was distributed during May–July 2013 via email to physical therapy leaders representing different regions and health care providers in Saudi Arabia. [Results] Twenty-six participants answered the questionnaire. Eighty five percent of the sample had ≥ 10 years of experience with 57.6% of them holding a post-graduate degree. Participants were from different health care providers and represented different geographical regions of Saudi Arabia. Eighty one percent of the sample reported that the adoption of physical therapy services in primary health care would be advantageous, as it would offer earlier access to health care and would be more cost-effective. The respondents also stated that such a service would contribute towards the prevention of common non-communicable health diseases. [Conclusion] The results of this survey provide generally positive recommendations for the provision of physical therapy service in Saudi Arabia primary health care centers. However, challenges and barriers identified by this study require consideration during the development of the service.

P03.11. Should Acupuncture be within the Scope of Physical Therapy Practice in the United States?

Focus Areas: Integrative Approaches to CareA growing number of physiotherapists around the globe have begun incorporating acupuncture into their treatment plans for patients with neuromuscular conditions. Acupuncture has been established as being safe and effective within the 11 countries forming the International Acupuncture Association of Physical Therapists (IAAPT), allowing for acupuncture to be practiced by physiotherapists and integrated into their school curriculum. The objective of this evidence-based review is to analyze evidence on several aspects of acupuncture: (1) clinical evidence and effectiveness, (2) physiological foundation, (3) placebo effect, (4) safety, (5) educational requirements, and (6) cost effectiveness. This review will provide a framework for discussion regarding whether acupuncture should be included in the scope of physical therapy practice in the United States. All levels of the evidence hierarchy, as described by the Oxford Centre for Evidence-Based Medicine, were included in this report. Intervention studies (levels 1-3) were further rated (strong, moderate, or weak) based on a quality scoring system developed by the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM). Inclusion criteria included articles relating to physiological effects of acupuncture, clinical relevance of acupuncture, safety of acupuncture, interventions related to acupuncture, and cost effectiveness.The research suggests that acupuncture, when combined with other physical therapy interventions, is safe and cost effective due to the reported reduction in pain level, faster healing times, and greater increases in range of motion. Although additional research should be conducted, current evidence supports that a discussion should take place about adding acupuncture into the physical therapy scope of practice in the United States.