Role Of Physiotherapist Research Articles

On "Role of Physical Therapists in the Management of Individuals at Risk for or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline 2022." Hillegass E, Lukaszewicz K, Puthoff M. Phys Ther. 2022;102:pzac057. https://doi.org/10.1093/ptj/pzac057.

Journal Article Accepted manuscript On “ Role of Physical Therapists in the Management of Individuals at Risk for or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline 2022.” Hillegass E, Lukaszewicz K, Puthoff M. Phys Ther. 2022;102:pzac057. https://doi.org/10.1093/ptj/pzac057 Get access Kenny Venere, PT, DPT, Kenny Venere, PT, DPT Department of Rehabilitation Medicine, New York University Langone Medical Center, New York, New York Address all correspondence to Dr Venere at: kenny.venere@nyulangone.org Search for other works by this author on: Oxford Academic Google Scholar Kyle Ridgeway, PT, DPT, CCS, Kyle Ridgeway, PT, DPT, CCS Rehabilitation Therapy Services, University of Colorado Hospital, University of Colorado Health, Aurora, Colorado Search for other works by this author on: Oxford Academic Google Scholar Robert L Page, II, PharmD, MSPH, Robert L Page, II, PharmD, MSPH Department of Pharmacy, University of Colorado Hospital, University of Colorado Health, Aurora, CO Search for other works by this author on: Oxford Academic Google Scholar Mikita Fuchita, MD Mikita Fuchita, MD Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado Search for other works by this author on: Oxford Academic Google Scholar Physical Therapy, pzad035, https://doi.org/10.1093/ptj/pzad035 Published: 06 April 2023 Article history Received: 10 October 2022 Revision received: 07 January 2023 Accepted: 03 April 2023 Published: 06 April 2023

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. With physical therapists in some states obtaining explicit imaging privileges and a renewed focus on the physical therapist's role in primary care and patient management over the lifespan, it is time to focus on this underappreciated area of practice. This perspective discusses referral decision-making and provides recommendations for making a high-value referral and improving care continuity. Improving referral and care continuity has potential to enhance clinical outcomes and patient satisfaction and to reduce costs. This perspective explicitly defines and describes strategies to improve physical therapist decision-making about referral and care continuity to improve overall patient management.

Physiotherapists’ attitudes and beliefs about self-management as part of their management for low back pain

BackgroundPerceptually, there is a discrepancy between research evidence and clinical physiotherapy practice for supporting self-management in people with low back pain (LBP). ObjectiveThis study aimed to explore physiotherapists’ understanding of LBP; ascertain their knowledge of self-management concepts; and explore their attitudes and beliefs about supporting self-management for LBP within present physiotherapy practice in private and hospital settings. DesignInterpretive Description qualitative methodology, involving in-depth data interpretation to clinical practice, was used. MethodsSemi-structured interviews with physiotherapists throughout New Zealand were conducted via video conferencing. Data was analysed and themes were defined. ResultsSeventeen physiotherapists (24–65 years old), with between one and 40+ years of experience, participated. Four main themes were defined: 1) Evolving understanding of LBP, 2) apportioning responsibility, 3) self-management is important, 4) understanding self-management. ConclusionNovel findings from this research demonstrate examples of attitudes and beliefs that determine when and how self-management for people with LBP is implemented. Due to these attitudes and beliefs, physiotherapists may not consistently provide supported self-management for people with LBP. Participants had good understanding of LBP but lacked a contemporary knowledge of the natural history and tended to apportion responsibility for persistent or recurrent episodes to the person with LBP. Physiotherapists should be encouraged to assimilate more contemporary research evidence into their expectations of recovery for LBP. Further education about the role of physiotherapists in supporting self-management, the core components of self-management, including engagement, and reflection upon individual unconscious bias should be encouraged.

Views of physiotherapists on factors that play a role in ethical decision-making: an international online survey study

BackgroundThere is a lack of knowledge about the ways physiotherapists around the world learn about professional code of ethics and ethical decision-making frameworks. The profession has a gap in the understanding about physiotherapists’ views on factors that play a role in ethical decision-making and whether these views differ between World Physiotherapy regions.MethodsAn online survey study in English was conducted from October 2018 to October 2019. Participants included 559 physiotherapists located in 72 countries. The self-designed survey questionnaire contained 13 items asking about demographic information and means of learning about ethical codes and decision-making frameworks. A further 30 items were presented which included statements underpinned with individual, organisational, situational and societal factors influencing ethical decision-making. Participants were asked to express their level of agreement or disagreement using a 5-point-Likert-scale.ResultsParticipants’ highest rated responses endorsed that the professional role of physiotherapists is linked to social expectations of ethical behaviour and that ethical decision-making requires more skills than simply following a code of ethics. A recognisable organisational ethical culture was rated as supporting good ethical decisions. Comparing responses by World Physiotherapy regions showed significant differences in factors such as culture, religion, emotions, organisational values, significant others, consequences of professional misconduct and professional obligations. Entry level education was not perceived to provide a solid base for ethical decision-making in every World Physiotherapy region. Participants reported multiple sources for learning about a professional code of ethics and ethical decision-making frameworks. What’s more, the number of sources differed between World Physiotherapy regions.ConclusionsMultiple factors play a role in physiotherapists’ ethical decision-making internationally. Physiotherapists’ ethical knowledge is informed by, and acquired from, several learning sources, which differ in both quality and quantity amongst World Physiotherapy regions. Easily accessible knowledge and education about professional codes of ethics and ethical decision-making can foster continuing professional development for physiotherapists. The establishment of constructive ethical cultures in workplaces can improve ethical decision-making, and should acknowledge the influence of individual, organisational, situational and societal factors. The establishment of collaborative learning environments can support knowledge translation which acknowledges practice-based methods of knowing and learning.

The Role of Physiotherapists in Smoking Cessation Management: A Scoping Review.

Physiotherapy (PT) is a profession that includes education and close contact for long periods of time with patients for treatment sessions. Globally, smoking is prevalent and is expected to increase in the next decades; thus, smoking cessation (SC) is an important management strategy to mitigate further escalation. Little is known about PT practice in SC, and therefore, this study aimed to systematically review and discuss the published literature about the role of physiotherapists in smoking cessation management, opinions, and prevalence of SC counselling in physiotherapy practice; and to explore barriers towards smoking cessation counselling within physiotherapy practice. A systematic search was conducted through EBSCO, and articles were included if they assessed the role of PTs in SC management. The databases were searched for studies published between 1 January 1970 to 1 April 2022. Articles were excluded if they did not include PTs, if they did not include assessment of SC management/counselling, if they were not cross-sectional studies, if they were not written in the English language, or if they were conference abstracts. Seven studies were included in the review. The search identified no studies that have investigated the role of PTs in vaping cessation. It was found that PTs are not addressing SC counselling and management enough in their practice. In addition, the search revealed that lack of training, time, and knowledge are the most common barriers against including SC counselling in physiotherapy practice and rehabilitation programs. Exploring possibilities of including SC counselling according to the clinical guidelines is encouraged. Additionally, establishing solutions to overcome barriers against SC counselling as part of physiotherapy practice is essential.

Characteristics of Population-Based Practice in Physical Therapy.

Physical therapy is placing new emphasis on how the profession might contribute to improving population health. However, little is known about the nature of population-based practice (PBP) of physical therapists. Therefore, the purpose of this study was to develop a view of PBP from the perspective of physical therapists engaged in it. Twenty-one physical therapists participating in PBP were interviewed. Qualitative descriptive analysis was used to summarize results. Most of the reported PBP was at the community and individual level, and the most common types of PBP were health teaching and coaching, collaboration and consultation, and screening and outreach. Three topic areas were identified (with respective themes): characteristics of PBP (meeting group or community needs, promotion and prevention, access, and movement), preparation for PBP (core vs elective, experiential learning, social determinants of health, and health behavior change), and rewards and challenges of PBP (intrinsic rewards, funding and resources, professional recognition, and complexity of behavior change). PBP in physical therapy presents practitioners with rewards and challenges as they work to improve the health of populations. Physical therapists who are currently engaged in PBP are, in effect, defining the role of the profession in improving health at a population level. The information in this paper will help the profession move from a theoretical view of the role of physical therapists in improving population health to understanding what this role looks like in practice.

Facilitators and barriers regarding the implementation and interprofessional collaboration of a first contact physiotherapy service in primary care in Wales: a qualitative study

Background/Aims Future primary care services in Wales are likely to face higher demand for musculoskeletal ailments because of an ageing population and difficulties retaining and recruiting general practitioners. First contact physiotherapists provide specialist musculoskeletal management within primary care and offer a solution to this issue; however, no studies have yet explored first contact physiotherapist services in Wales. Consequently, little is known about the experience of working as a first contact physiotherapist in Wales. The aim of this study was to explore the experiences of first contact physiotherapists in primary care in south east Wales regarding the implementation, interprofessional collaboration and the facilitators and barriers to providing the service. Methods A qualitative, Heideggerian hermeneutical phenomenological study was performed. A purposive sample of eleven physiotherapists were recruited for the study from an NHS health board in south east Wales, comprising three different first contact physiotherapist models. Data were collected through individual semi-structured interviews. Data analysis was conducted via a three-step format. Results Participants viewed the first contact physiotherapist role as positive as it represented role and career advancement. Adequate training and mentorship were not provided to support the role. Participants perceived that patients and the wider multidisciplinary team did not fully understand the role of the first contact physiotherapist. Inappropriate use of services was common, with first contact physiotherapists often acting as the second contact practitioner, leading to duplication of effort and the development of unnecessary waiting lists. The degree of interprofessional collaboration appeared to influence the clarity of the role of the first contact physiotherapist, with a reduced clarity of role in models where first contact physiotherapists were not often present. Burnout was perceived as a risk for participants with low levels of experience in advanced practice and was dependent on the model worked in. Participants perceived a lack of specific aims for the first contact physiotherapy service and ambiguity over who was responsible for service leadership, leading to inappropriate use of services. Conclusions Clear operational leadership and strategies to increase interprofessional collaboration are required to increase the clarity about the roled of the first contact physiotherapist and ensure service efficacy. There is a need in Wales for a professional development, mentorship and governance framework to ensure sustainability and efficacy of first contact physiotherapy services.

Performance and labor conditions of physiotherapists in Brazilian intensive care units during the COVID-19 pandemic. What did we learn?

To describe the role of physiotherapists in assisting patients suspected to have or diagnosed with COVID-19 hospitalized in intensive care units in Brazil regarding technical training, working time, care practice, labor conditions and remuneration. An analytical cross-sectional survey was carried out through an electronic questionnaire distributed to physiotherapists who worked in the care of patients with COVID-19 in Brazilian intensive care units. A total of 657 questionnaires were completed by physiotherapists from the five regions of the country, with 85.3% working in adult, 5.4% in neonatal, 5.3% in pediatric and 3.8% in mixed intensive care units (pediatric and neonatal). In intensive care units with a physiotherapists available 24 hours/day, physiotherapists worked more frequently (90.6%) in the assembly, titration, and monitoring of noninvasive ventilation (p = 0.001). Most intensive care units with 12-hour/day physiotherapists (25.8%) did not apply any protocol compared to intensive care units with 18-hour/day physiotherapy (9.9%) versus 24 hours/day (10.2%) (p = 0.032). Most of the respondents (51.0%) received remuneration 2 or 3 times the minimum wage, and only 25.1% received an additional payment for working with patients suspected to have or diagnosed with COVID-19; 85.7% of them did not experience a lack of personal protective equipment. Intensive care units with 24-hour/day physiotherapists had higher percentages of protocols and noninvasive ventilation for patients with COVID-19. The use of specific resources varied between the types of intensive care units and hospitals and in relation to the physiotherapists' labor conditions. This study showed that most professionals had little experience in intensive care and low wages.

Physiotherapists’ Perspectives on Type 2 Diabetes Management and as a Primary Condition for Referral to Physiotherapy Services: A Qualitative Descriptive Study

Purpose: We explored the current and potential role of physiotherapists in the management of people with type 2 diabetes (T2D) and T2D as a primary condition for physiotherapy referral. Method: We conducted a qualitative descriptive study. Participants were physiotherapists practicing in community and outpatient settings across Canada. One-on-one telephone interviews were completed to explore provision of physiotherapy care for people with T2D, including current practices and readiness of physiotherapists to provide direct care. We employed thematic analysis for generation of themes from interviews. Results: We interviewed 21 participants from eight provinces and territories. Three themes were generated from the data: current approach to T2D management; challenges for physiotherapy integration; and merits of physiotherapy and needed evolution. Participants described that physiotherapists are not part of the healthcare team for T2D management. There is a gap in medical management of T2D that physiotherapy would fill, that is, education and prescription for exercise participation. Conclusions: Our findings support a gap in the management of T2D in Canadian healthcare, particularly in reference to physiotherapy. Further, our findings support the need for greater inclusion of physiotherapists for lifestyle counseling with an emphasis on physical activity and exercise for patients at risk of and with T2D to maximize health and improve/maintain function. Studies focusing on accessibility and funding of physiotherapy services are needed to validate these findings.

Identifying airway obstruction in primary care: is there a role for physiotherapists?

AimsTo examine the implementation of a physiotherapist-driven spirometry case finding service in primary care to identify new cases of COPD and confirm diagnosis of existing cases of COPD.MethodsFour general practices were recruited. ‘At risk’ participants (aged ≥ 40 years, current/ex-smoker) and people with ‘existing’ COPD were identified from practice databases and invited to attend an assessment with a cardiorespiratory physiotherapist in each general practice. The physiotherapist performed pre/post-bronchodilator spirometry to identify or confirm a diagnosis of COPD (FEV1/FVC < 0.7). Outcome measures included number (%) of new cases of COPD, number (%) confirmed diagnosis of COPD and number (%) of high quality spirometry assessments with accurate interpretation.ResultsOne hundred forty eight participants (mean age 70 years (SD 11.1), 57% female) attended a baseline assessment (117 ‘at risk’, 31’existing’ COPD) from 748 people invited. Physiotherapists performed 145 pre/post bronchodilator spirometry assessments. Obstruction on post-bronchodilator spirometry was confirmed in 17% (19/114) of ‘at risk’ and 77% (24/31) of ‘existing’ COPD. Majority of cases were classified as GOLD Stage II (63%, n = 27). Quality of pre/post bronchodilator spirometries for FEV1 were classified as A (68%), B (19%) and C (5%).ConclusionPhysiotherapists integrated into primary care performed high quality spirometry testing, successfully case finding ‘at risk’ patients and identifying potential misdiagnosis of obstruction in some ‘existing’ COPD cases.Trial registrationANZCTR, ACTRN12619001127190. Registered 12 August 2019 – Retrospectively registered, http://www.ANZCTR.org.au/ACTRN12619001127190.aspx

Future-proofing the Profession: Physiotherapists’ perceptions of their current and emerging role

As healthcare systems continue to modernise, physiotherapists are required to transform their practice to remain contemporary and meet future population needs. The study aims to gain an insight into physiotherapists' perceptions of their current and emerging future role. The intention is to develop an understanding of the physiotherapist's role and how it can continue to evolve to support populations' needs in more sustainable and innovative ways. A qualitative design using semi-structured interviews was undertaken informed by Gadamerian hermeneutic philosophy. Participants were gained from a postgraduate physiotherapy programme in Northwest England that recruits physiotherapists from across the UK; via the research teams' professional networks and using snowball sampling. Interviews were digitally recorded and transcribed verbatim. Thematic analysis was undertaken. Ethical approval and informed consent was obtained. 23 participants (15 female). 4 themes were identified: 'An underpinning philosophy of practice' that promotes holistic care and supports patient wellbeing. An 'evolving role broadening the scope of practice' with many 'agents of change shaping the profession'. When 'preparing the future workforce and their transition into practice', graduates were seen as more adaptable and resilient. However, more affiliation between the university and placement providers to enhance learning environments is needed. Physiotherapists need to re-evaluate their role so a clear vision for the future can be co-created to ensure they remain contemporary and continue to optimise their potential. An emerging role that re-envisages a holistic approach that incorporates health promotion as fundamental to this role could support physiotherapists' transformation in practice. CONTRIBUTION OF THE PAPER.

Expanded central role of the respiratory physiotherapists in the community setting.

The development of community hubs through the Slaintecare initiative will rely on respiratory physiotherapists and clinical nurse specialists for the management of chronic respiratory diseases. The role of the respiratory physiotherapist has evolved dramatically over the last decade. We review the increasing scope of practice of the physiotherapist and the evidence base for same. We pay particular attention to the role of the physiotherapist in areas such as pulmonary rehabilitation, sputum clearance, neuromuscular disease, chronic respiratory failure, ambulatory oxygen assessments and dysfunctional breathing. We give an in depth review of sputum clearance techniques. We also address areas of potential future expansion for the role of the physiotherapist such as prescription and initiation of non-invasive ventilation.

Characterization of the procedures and professional practices of primary care physiotherapists in Brazil.

Physiotherapy interventions are well known and established in secondary and tertiary care. However, within the Brazilian primary health care (PHC), the role of physiotherapists is still under development, and there is a lack of representative data showing how and what is being implemented by these professionals. The aim was to characterize the professional practices of physiotherapists working at PHC in Brazil. This is an exploratory study that adopted a descriptive analysis based on the records of physiotherapists, considering assistance and sociodemographic aspects, in the period from 2016 to 2017. The following variables were extracted: region, federative unit and municipality, age group and sex of the attended user, condition/problem, procedure and place of attendance. A total of 318,780 procedures were recorded, concentrated in the South and southeast regions, with a predominance of clinical-assistance procedures and a higher frequency of attendance in Basic Health Units. Among the assisted users, the female gender prevailed in the age group of 20 to 59 years. Low back pain was the most frequently treated condition. The professional practices of physiotherapists working at PHC in Brazil were characterized by healthcare, clinical-assistance, preventive and health promotion activities, with emphasis on clinical-assistance practices focused on musculoskeletal conditions, especially low back pain.

Hospital discharge planning: a qualitative study of new-graduate physiotherapists' experiences

Purpose: Discharge planning constitutes a large part of a physiotherapist's role when working in hospital settings. The challenges of decision-making relating to discharge planning have been identified by experienced physiotherapists. Despite known challenges associated with the transition from student to clinician, the experiences of new-graduates undertaking discharge planning are largely unknown. Therefore, this study aimed to explore:1) new-graduate physiotherapists' experiences of discharge planning in hospital settings, and2) the influence of pre-professional training on their perceived preparedness for discharge planning.Design: A qualitative general inductive approach using semi-structured interviews. New-graduate physiotherapists (n = 14) working in hospital settings were recruited.Finding: Four themes were generated: 1) responding to the pressures associated with discharging patients, 2) complex decision-making, 3) the role of the interprofessional team, and 4) desiring additional context and complexity from pre-professional training.Practice Implications: The study has identified that new-graduates underestimate the extent to which discharge planning features in their roles within hospital settings, and are unaware of the interprofessional practice required. Whilst they felt that their pre-professional training provides the technical skills required for their roles, they felt that they were not prepared for their role within the broader healthcare system, nor the complexity of clinical practice. This study encourages education providers to emphasise the role of physiotherapists within the broader health care system, through highlighting contexts where physiotherapy knowledge can be applied (i.e., discharge planning) and understanding the role of the physiotherapist within the interprofessional team.Limitations: Important perspectives of mentors and other members of the interprofessional team involved in discharge planning have not been included in this study which may have impacted the interpretation of the results.

Introducing a Guide in Physical Therapy Addressing Sexual Function in Adults with Neuromuscular Disorders

ABSTRACT Introduction Physical therapists are part of the rehabilitation team following individuals with neuromuscular disorders (NMD). Due to their impairments, people with NMD can have difficulties engaging in sexual activities. One study reported that 70% of people living with chronic disorders present difficulties related to sexuality and only 18% can overcome them by themselves [1]. Objective The guide has 3 main objectives: 1) To document interventions regarding sexual impairments in people with NMD that can be applied by physical therapists in clinical practice; 2) To propose approaches for addressing sexuality with their clients; 3) To highlight issues that require advanced physical therapy expertise in pelvic floor rehabilitation. Methods The guide is based on a review of the literature and the clinical experience of physical therapists with expertise in NMD or sexuality in Canada. It was developed using the “Rare knowledge mining methodological framework” [2]. Two frameworks were also followed: “Essential Competency Profile for Physiotherapists in Canada (2017)” [3] and the “EX-PLISSIT model” [4, 5]. Results A total of 75 articles retrieved were considered in our review. Twelve physical therapists and four other health professionals were consulted for this guide. It is recommended to introduce the topic of sexuality early in therapy and follow the steps of the EX-PLISSIT model [4, 5] before offering specific suggestions. Physical therapists should address different aspects in their assessment: interpersonal relationships, assistance required or not during sexual activities, urinary, vaginal or anorectal symptoms, erectile dysfunction, pain, fatigue and impact of the disease on sexuality. Some of the impairments or limitations that may be identified during an objective assessment can have an impact on sexual function and it is important to be aware of these issues: strength, grip, dexterity, sensibility, pain, bed mobility, motor control, etc. Interventions are presented in detail in the guide regarding physical activity, positioning, muscle weakness, fatigue, decreased mobility, erectile dysfunction, sensitivity disorders, lubrication, pain, incontinence, and cardio and respiratory implications. Conclusions To the best of our knowledge, this is the first guide on the role of physical therapists in sexuality. Physical therapists should integrate sexual function into their assessments and interventions. They are an essential part of the rehabilitation team, and they should collaborate with other health professionals to have a multidisciplinary approach, especially in NMD patients. More studies are needed to evaluate the effects of intervention on sexual function in this population. Disclosure No

Assessment of pain management strategies and perception of the role of physiotherapists in the management of low back pain among motorcycle riders in south-eastern Nigeria

Introduction: LBP is the most common cause of activity restriction and work absence in much parts of the world, putting a heavy financial burden on people. This study is aimed at determining the management practices and the knowledge and utilization of physiotherapy services among commercial motorcycle riders in Nnewi north. It is very essential with the long-term objective of increasing the level of knowledge of physiotherapy and promote its utilization among motorcycle riders and general public. Methodology: This was a cross-sectional study that involved commercial motorcycle riders that ply within the four major villages of Nnewi town in Nnewi-North local government area of Anambra state. An interviewer based semi-structured questionnaire was administered to the respondents at their muster points. Results: One hundred and fifty-four riders were recruited and all were male. 76% of the respondent for their low back pain is pain relief (drugs) such as Paracetamol 15.6%, while 44.2% of the respondent used drugs unknown to them, 19.5% reported that only stretching was their home management for their pain, majority 96.8% had never utilized their services, most 68.8% accepted to utilize it if the need arises. Conclusion: Our study suggests that only few riders sought proper medical care for their low back pain. Majority chose over-the-counter medications while others went for other home management for pain such as stretching, use of ointments etc. Also, most of the riders lack a good knowledge of physiotherapy and their roles in pain management. Although, majority had never utilized their services, most accepted to utilize it if the need arises.

Assessment of pain management strategies and perception of the role of physiotherapists in the management of low back pain among motorcycle riders in south-eastern Nigeria

Assessment of pain management strategies and perception of the role of physiotherapists in the management of low back pain among motorcycle riders in south-eastern Nigeria

Navigating the Grey Zone of Physiotherapy Assistant Autonomy in Home Care: Perspectives of Physiotherapists and Physiotherapy Assistants.

Purpose: To explore perspectives and experiences regarding the autonomy of physiotherapist assistants (PTAs) among physiotherapists and PTAs providing home care services in Ontario since the introduction of PTAs into home care rehabilitation teams. Method: For this qualitative study, we conducted semi-structured interviews with 10 physiotherapists and 5 PTAs working in home care. We analyzed interview transcripts using the DEPICT model. Results: Participants described navigating a grey zone characterized by a lack of clarity about acceptable levels of PTA autonomy. Four interrelating factors shaped the extent to which PTAs practised with autonomy: system influences (number of physiotherapy visits, professional guidelines), patient complexity (status, comorbidities), perceived PTA competence (skills, training), and the physiotherapist-PTA relationship (trust, communication). Conclusions: New practice models in home care have impacted the role of both physiotherapists and PTAs. Home care agencies should facilitate emerging professional relationships and address autonomy-related challenges, such as trust and competence, to promote high-quality client-centred care.

Role of Physical Therapists in the Management of Individuals at Risk for or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline 2022.

No matter the practice setting, physical therapists work with patients who are at risk for or who have a history of venous thromboembolism (VTE). In 2016, the first clinical practice guideline (CPG) addressing the physical therapist management of VTE was published with support by the American Physical Therapy Association's Academy of Cardiovascular and Pulmonary Physical Therapy and Academy of Acute Care, with a primary focus on lower extremity deep vein thrombosis (DVT). This CPG is an update of the 2016 CPG and contains the most current evidence available for the management of patients with lower extremity DVT and new key action statements (KAS), including guidance on upper extremity DVT, pulmonary embolism, and special populations. This document will guide physical therapist practice in the prevention of and screening for VTE and in the management of patients who are at risk for or who have been diagnosed with VTE. Through a systematic review of published studies and a structured appraisal process, KAS were written to guide the physical therapist. The evidence supporting each action was rated, and the strength of statement was determined. Clinical practice algorithms based on the KAS were developed that can assist with clinical decision-making. Physical therapists, along with other members of the health care team, should implement these KAS to decrease the incidence of VTE, improve the diagnosis and acute management of VTE, and reduce the long-term complications of VTE.

PHYSICAL THERAPY IN DIABETIC PATIENTS INFECTED WITH COVID-19 ACUTE AND POST-ACUTE RECOVERY

Diabetes is the second highly prevalent disease among chronic diseases in patients with COVID-19 and is responsible for high morbidity and mortality in COVID-19 patients. Diabetic patients with uncontrolled glycemic levels have a worse prognosis than patients who have strict glycemic controls. During the COVID-19 pandemic, the importance of social distancing measures has reduced physical activity in people due to home quarantine and lockdowns. COVID-19 disease can affect the functional capacity and occupational health of diabetic patients. This fact urges the need for physical therapy during the active and recovery phase of COVID-19 disease. This review study has analyzed the effects of physical therapy in COVID-19 patients previously suffering from diabetes during the active and recovery phases. Different articles were retrieved from PubMed and a literature review was conducted. A complete evaluation of different studies revealed four topics that correspond to the results of this study. 1) Physical therapy in non-hospitalized diabetic patients suffering from COVID-19 disease 2) Physical therapy in hospitalized and ICU diabetic patients suffering from COVID-19 disease 3) Physical therapy in diabetic patients recovering from COVID-19 disease 4) Role of physical therapists in the battle against COVID-19. The findings of the previous studies showed that COVID-19 has significant effects on the physical capacity of sufferers especially those with a chronic disease like diabetes. This fact implies that physical therapists should also be involved in the battle against COVID-19 diseases for improving the functional capacity during both the active and recovery phase of the illness.