Reasoning In Physical Therapy Research Articles

Walker Integrated with IOT Based Fall Detection, Emergency Response System with Haptic Feedback System for Muscle Relief

In the last decade, the clinical reasoning in physical therapy has been to develop systems for physiotherapists to make clinical decisions rapidly, effectively and efficiently, in response to the increasingly complex needs of health and rehabilitation units. Some studies show the importance of walking aids during rehabilitation from some diseases, and after surgery for arthroplasty in the elderly population, and elderly patients with balance disorders, muscle weakness. Walkers are important devices that aid the rehabilitation process. The use of a walker is recommended for gait changes and imbalance due to various factors, such as surgery of the lower limbs or neurodegenerative changes, especially in the early recovery period. In this project we design a solution for the patient using walkers, this device helps them to maintain the proper balance. The system's foundation lies in a network of strategically placed sensors, including gyroscopes, accelerometers, and pressure sensors, meticulously capturing data on the user's body posture and gait patterns. Employing advanced algorithms, the gathered data is processed and analyzed in real-time to evaluate the user's alignment and identify any deviations from the ideal posture. Furthermore, the system facilitates seamless data recording and analysis, enabling healthcare professionals and physiotherapists to access valuable insights on International Journal of Scientific Research in Engineering and Management (IJSREM) Volume: 07 Issue: 08 | August - 2023 SJIF Rating: 8.176 ISSN: 2582-3930 © 2023, IJSREM | www.ijsrem.com DOI: 10.55041/IJSREM25086 | Page 2 the user's progress and performance. The accumulated data assists in developing personalized rehabilitation plans and tracking the user's improvements over time. Index Terms— Microcontroller, LCD, Movement Detection, Accelerometer sensor, ultrasonic sensor, GSM, GPS.

What methods are being used to teach clinical reasoning in physical therapy education and are they effective? A systematic review of literature

IntroductionDevelopment of clinical reasoning (CR) is a critical skill for physical therapy (PT) students. A consensus of the most effective way to teach CR is lacking. The purpose of this study was to identify educational methods that PT education programs in the United States and abroad are utilising to develop CR skills and compare the effectiveness of those methods.MethodsPreferred Reporting Items for Systematic Review (PRISMA) guidelines were followed. A literature search was conducted in September 2021 and March 2022 in the following databases: PubMed, CINAHL, Health Source: Nursing/Academic Edition, and Academic Search Ultimate (EBSCO). Articles that investigated instructional methods used to teach and measure CR in PT students were included. Data extracted included instructional method details and results of outcome measures used to assess CR.ResultsOf 324 articles, 12 met eligibility. Instructional methods included simulated patients (n = 3), case activities (n = 6), patient care activities (n = 2), and curriculum design considerations (n = 2). Results suggested that CR performance improved with all but was better when students worked in dyads or groups (n = 3). A variety of outcome measures were used to assess CR, the majority relying on student self-assessment of CR skills.ConclusionsThis systematic review illustrates great variety in the methods used to teach and measure CR in PT education, all of which resulted in improved CR. Further research comparing the effectiveness of teaching methods and the reliability and validity of outcome measures of CR is needed.

Assessing clinical reasoning in physical therapy: discriminative validity of the Reasoning 4 Change instrument

ObjectivesTo evaluate discriminative validity of the Reasoning 4 Change (R4C) instrument by investigating differences in clinical reasoning skills between first semester, final semester physical therapy students and physical therapy experts. DesignCross-sectional design SettingUniversity and physical therapy practice ParticipantsStudents from the first (n = 87) and final semester (n = 47) of an entry-level physical therapy program and experts in physical therapy with a behavioral medicine approach (n = 14). MethodsThe students and experts answered the web-based R4C instrument on one occasion. The R4C instrument includes four domains designed to assess physical therapists’ clinical reasoning skills with a focus on supporting clients’ behavior change and has demonstrated acceptable content validity, convergent validity and reliability. Data was analyzed with one-way analysis of variance and Games-Howell post hoc test. ResultsDifferences in all domains and subscale scores were found between the three groups. Pairwise comparisons demonstrated that experts scored higher (better clinical reasoning skills) than first semester students in all domains and subscales; and higher scores than final semester students, except for two subscales. Final semester students scored higher than first semester students, except for one subscale. ConclusionsThe findings highlight differences in clinical reasoning skills focusing on clients’ behavior change among physical therapy students with different degrees of training and education in clinical reasoning and physical therapists with extensive experience and expertise. The results provide evidence for the discriminative validity of the R4C instrument which support the use of the R4C instrument in education, research and clinical practice. Contribution of the Paper•The study results provide evidence for the discriminative validity of the R4C instrument, thus strengthening its validity evidence.•The findings highlight the differences in clinical reasoning skills focusing on clients’ behavior change amongst first semester students, final semester students and physical therapy experts.•The R4C instrument may be used as part of regular quality assurance of physical therapy curricula and investigations of students’ and practitioners’ client-centered approach and behavioral considerations in clinical reasoning. For example, repeated measures over time may reveal changes in students’ learning and comparisons between groups may identify strengths and weaknesses in students’ and practitioners’ clinical reasoning, which may guide curricula modifications and interventions in practice.

Clinical Reasoning in Physical Therapy: A Concept Analysis.

Physical therapy, along with most health professions, struggles to describe clinical reasoning, despite it being a vital skill in effective patient care. This lack of a unified conceptualization of clinical reasoning leads to variable and inconsistent teaching, assessment, and research. The objective was to conceptualize a broad description of physical therapists' clinical reasoning grounded in the published literature and to unify understanding for future work related to teaching, assessment, and research. The design included a systematic concept analysis using Rodgers' evolutionary methodology. A concept analysis is a research methodology in which a concept's characteristics and the relation between features of the concept are clarified. Based on findings in the literature, clinical reasoning in physical therapy was conceptualized as integrating cognitive, psychomotor, and affective skills. It is contextual in nature and involves both therapist and client perspectives. It is adaptive, iterative, and collaborative with the intended outcome being a biopsychosocial approach to patient/client management. Although a comprehensive approach was intended, it is possible that the search methods or reduction of the literature were incomplete or key sources were mistakenly excluded. A description of clinical reasoning in physical therapy was conceptualized, as it currently exists in representative literature. The intent is for it to contribute to the unification of an understanding of how clinical reasoning has been conceptualized to date by practitioners, academicians, and clinical educators. Substantial work remains to further develop the concept of clinical reasoning for physical therapy, including the role of movement in our reasoning in practice.

脳卒中理学療法におけるClinical reasoning(臨床推論)について

脳卒中理学療法におけるClinical reasoning(臨床推論)について

Clinical Reasoning in Physical Therapy

Clinical Reasoning in Physical Therapy

Systematic Clinical Reasoning in Physical Therapy (SCRIPT): Tool for the Purposeful Practice of Clinical Reasoning in Orthopedic Manual Physical Therapy

Clinical reasoning is essential to physical therapist practice. Solid clinical reasoning processes may lead to greater understanding of the patient condition, early diagnostic hypothesis development, and well-tolerated examination and intervention strategies, as well as mitigate the risk of diagnostic error. However, the complex and often subconscious nature of clinical reasoning can impede the development of this skill. Protracted tools have been published to help guide self-reflection on clinical reasoning but might not be feasible in typical clinical settings. This case illustrates how the Systematic Clinical Reasoning in Physical Therapy (SCRIPT) tool can be used to guide the clinical reasoning process and prompt a physical therapist to search the literature to answer a clinical question and facilitate formal mentorship sessions in postprofessional physical therapist training programs. The SCRIPT tool enabled the mentee to generate appropriate hypotheses, plan the examination, query the literature to answer a clinical question, establish a physical therapist diagnosis, and design an effective treatment plan. The SCRIPT tool also facilitated the mentee's clinical reasoning and provided the mentor insight into the mentee's clinical reasoning. The reliability and validity of the SCRIPT tool have not been formally studied. Clinical mentorship is a cornerstone of postprofessional training programs and intended to develop advanced clinical reasoning skills. However, clinical reasoning is often subconscious and, therefore, a challenging skill to develop. The use of a tool such as the SCRIPT may facilitate developing clinical reasoning skills by providing a systematic approach to data gathering and making clinical judgments to bring clinical reasoning to the conscious level, facilitate self-reflection, and make a mentored physical therapist's thought processes explicit to his or her clinical mentor.

Smart walker solutions for physical rehabilitation

In the last decade, the clinical reasoning in physical therapy has been to develop systems for physiotherapists to make clinical decisions rapidly, effectively and efficiently, in response to the increasingly complex needs of health and rehabilitation units [1]–[3]. Some studies show the importance of walking aids during rehabilitation from some diseases, and after surgery for arthroplasty in the elderly population [4], and in elderly patients with balance disorders, muscle weakness [5] or in people with diabetes mellitus [6]. Walkers are important devices that aid the rehabilitation process. The use of a walker is recommended for gait changes and imbalance due to various factors, such as surgery of the lower limbs or neurodegenerative changes, especially in the early recovery period [7].

Embodied-enactive clinical reasoning in physical therapy

Clinical reasoning is essential in physical therapy practice. Instrumental approaches and more recent narrative approaches to clinical reasoning guide physical therapists in their understanding of the patient’s movement disturbances and help them to plan strategies to improve function. To the extent that instrumental and/or narrative models of clinical reasoning represent impairments as mere physical disturbances, we argue that such models remain incomplete. We draw on a phenomenologically inspired approach to embodied cognition (termed “enactivism”) to suggest that the dynamics of lived bodily engagement between physical therapist and patient contribute to and help to constitute the clinical reasoning process. This article outlines the phenomenologically informed enactive perspective on clinical reasoning, with special reference to clinical work that addresses impairments as sequelae of neurological diseases.

Tracking Change in Critical-Thinking Skills

Background and Purpose. Critical thinking, knowledge, skill, and self-reflection are the hallmarks of clinical reasoning in physical therapy. Teaching and measuring a highly complex entity such as clinical reasoning is a challenging task and often requires multiple pedagogies and assessments. Knowledge and skill are frequently assessed by educators, but critical thinking and skills of reflection are not. Previous studies have used standardized tests to assess clinical reasoning skills of physical therapist students. These studies report conflicting findings potentially due to the fact that neither test was designed to test critical thinking of allied health practitioners. The Health Sciences Reasoning Test (HSRT) was designed specifically for health science students with questions written in a health care context.Participants. In 2008, 63 students, 37 from a public East Coast university and 26 from a private Midwest university were recruited to complete the HSRT.Method. The students completed the HSRT at 3 points in their education: upon entry to the program, prior to final affiliations, and again just prior to graduation.Outcomes. Analysis indicated a statistically significant change for the total score as well as the deductive and analysis subscales. Post-hoc analysis indicated these differences occurred between times 1 and 2 for the total score as well as both subscales. There was a significant difference between the 2 schools after adjusting for variance in initial test scores. The Midwest school's mean score (24.85) was greater than the east coast school's (22.42), and this difference was significant F^sub l^ = 12.65; P Conclusion. The HSRT was able to detect change in critical thinking scores. This finding, coupled with those of a previous study in which the HSRT was able to detect differences between experts and novices, indicate the HSRT may have validity and therefore may be a useful tool for assessing the critical thinking skills of physical therapist students.Key Words: Assessment, Clinical reasoning, Critical thinking.INTRODUCTIONThe Commission on Accreditation of Physical Therapy Education (CAPTE) requires physical therapist education programs to develop and assess students' clinical reasoning skills.1 While clinical reasoning skills have always been an important component of physical therapist education, this mandate, coupled with direct access and the move to a doctoring profession, increases the importance of teaching and assessing clinical reasoning skills of physical therapist students.Clinical reasoning refers to the thinking and decision-making process used during examination and management of patients.2 It is a complex mechanism that requires basic scientific knowledge, clinical competence, the ability to self-reflect, and critical thinking skills. Critical thinking is the disciplined, intellectual process of applying skillful reasoning as a guide to belief or action and involves the cognitive abilities of analysis, interpretation, inference, evaluation, and explanation.3 The relationship between critical thinking and clinical reasoning is poorly understood and the terms are often interchanged. Clinical reasoning can be conceptualized as critical thinking within a specific domain or a particular point of view of a field, in this case the field of physical therapy. Physical therapists apply the components of critical thinking about and within the field of physical therapy, which has a certain point of view. This point of view is based on the objects, events, and investigations we consider in our area of expertise.4 The result of this critical thinking within our domain of practice and within the point of view of the field can be considered clinical reasoning. If one accepts this postulate then the skills required for critical thinking (ie, analysis, interpretation, inference, evaluation, and explanation) would be considered inherent in the clinical reasoning process but would be used contextually within the domain of physical therapy. …

K-005 Clinical Reasoning in Physical Therapy : It's Importance to Learning, Practice and Physical Therapists' Contribution to Society

K-005 Clinical Reasoning in Physical Therapy : It's Importance to Learning, Practice and Physical Therapists' Contribution to Society

Modelling diagnosis in physical therapy: a blackboard framework and models of experts and novices

The primary objective of this study was to explore clinical reasoning in physical therapy and to highlight the similarities and differences by modelling the diagnostic phase of clinical reasoning. An experimental design comparing expert and novice physical therapists was utilized. Concurrent verbal protocols detailing the clinical reasoning about standardized case material were elicited. A framework for modelling diagnosis was specified and provided the parameters for analysis. The diagnostic utterances were classified as cues or hypotheses and the knowledge utilized was identified. The experts recruited significantly more knowledge than the novices (p = 0.01) and used more cues (p < 0.01). Their diagnoses were more accurate when compared to the original diagnosis. This difference between the experts and novices was reflected in the differences shown in the models (p < 0.01). The differences between these subjects focused upon the knowledge recruitment, which impacted on the accuracy of the diagnosis. The novices' inaccurate or non-existent diagnoses led to poor quality of treatment prescription. Modelling proved to be a useful way of representing these differences.

Clinical Reasoning Strategies in Physical Therapy

Clinical reasoning remains a relatively under-researched subject in physical therapy. The purpose of this qualitative study was to examine the clinical reasoning of expert physical therapists in 3 different fields of physical therapy: orthopedic (manual) physical therapy, neurological physical therapy, and domiciliary care (home health) physical therapy. The subjects were 6 peer-designated expert physical therapists (2 from each field) nominated by leaders within the Australian Physiotherapy Association and 6 other interviewed experts representing each of the same 3 fields. Guided by a grounded theory method, a multiple case study approach was used to study the clinical practice of the 6 physical therapists in the 3 fields. A model of clinical reasoning in physical therapy characterized by the notion of "clinical reasoning strategies" is proposed by the authors. Within these clinical reasoning strategies, the application of different paradigms of knowledge and their interplay within reasoning is termed "dialectical reasoning." The findings of this study provide a potential clinical reasoning framework for the adoption of emerging models of impairment and disability in physical therapy.

Diagnosis In Physical Therapy: Insights From Medicine And Cognitive Science

This review focuses upon diagnosis, an example of human problem-solving, identifiable in many different fields. Generally, diagnosis involves inferences that are made about the cause(s) of alterations in normal function. In medicine, diagnosis is an important stage in the planning and implementation of treatment programmes. Research on medical diagnostic reasoning has suggested the hypothetico-deductive and pattern recognition models of reasoning. Advances in computer technology have led to research into expertise in order to construct computer programmes capable of problem-solving. Such research identifies the content and representation of the expert's knowledge as key to expertise. However, less emphasis on the diagnostic stage is identifiable in physical therapy. It is therefore suggested that work from other related fields may help advance knowledge and understanding of clinical reasoning in physical therapy. Such insights should support improvements in the planning and delivery of appropriate treatment programmes.

Clinical Reasoning in Physical Therapy

Clinical Reasoning in Physical Therapy

Ethical reasoning in physical therapy and occupational therapy.

The purpose of the study was to describe and then compare ethical dilemmas reported by eight physical therapists and eight occupational therapists. A co-operative research method was adopted with the therapists participating in the analysis of the transcripts of the interviews. The analysis was carried out using a 'multiple' readings methods taken from hermeneutic phenomenology. Results showed that the context or setting of the dilemma had a major effect on the therapists' reasoning. Features which emerged from the context were the site of the dilemma, the work group, the patient group and the hierarchical or power relations in operation. Physical therapists and occupational therapists showed differences in reasoning style with the former more likely to adopt a diagnostic or procedural style, and the latter a narrative style. Dealing with ethical dilemmas was found to be a skilled and stressful aspect of practice. Capacity to deal with the dilemmas was negatively influenced by uncertainty of outcome, emotional sequelae of the event, and social pressure to behave in certain ways. Positive influences included previous experience with similar dilemmas, time for reflection, and support from peers.