Successful Physical Therapy Research Articles

Neurorehabilitation in a Pediatric Stroke Patient Supported on a CentriMag.

Patients supported on ventricular assist devices (VADs) benefit from rehabilitation while awaiting heart transplantation to recover from surgery, prevent deconditioning, and, in most cases, optimize transplant candidacy. With bleeding and neurological dysfunction as the most common VAD complications, the importance of rehabilitation dramatically increases when a patient on a VAD also suffers from a neurological injury. The rehabilitation needs for cardiac conditioning and neurological reeducation are not the same. Patients with severe neurological deficits require intense rehabilitation that often includes base-of-support challenges, usage of bolsters and balls, partial weight-bearing treadmill training, and assumption of various body positions in prone, kneeling, or quadruped for neuromotor reeducation. However, some devices are more conducive to rehabilitation than others. For children supported by the CentriMag in particular, rehabilitation is challenged by short cannula tubing, an external motor, a large interface, and an intensive care unit (ICU) admission. We report a safe and successful physical therapy course of a pediatric stroke patient with a diagnosis of Ebstein's anomaly supported by a CentriMag right VAD (RVAD) while awaiting heart transplant in the ICU.

Case report: physical therapy and rehabilitation process of a patient diagnosed with achondroplasia

Achondroplasia is an autosomal dominant disorder. But 80% of cases are sporadic. Its incidence is between 1/25000 and 1.5/10000. Significant shortening of the femur and humerus occurs in patients with achondroplasia. This shortness causes the appearance of rhizomelic type of dwarfism. Since the skull of patients with achondroplasia is large during delivery, it may cause difficult delivery. During infancy, hypotonia is more dominant. Many patients also have delayed motor development. Our aim in the study is to present the successful physical therapy and rehabilitation process of our patient diagnosed with achondroplasia for one year and her condition from diagnosis to treatment. Our patient was born via cesarean section on 12.02.2020. The weight of the baby girl was 3500 grams. The mother's height was 162 cm. and the father's height was 174 cm. The mother was 23 years old and the father 27 years old. The same diagnosis was not present in any living relative of the patient. The patient was 1 year old when she applied to our center. She had completed head control and had not yet acquired the skills of rolling over, crawling, and sitting without support. Gross motor skills such as assisted standing and stepping were not developed. In this direction, after a 1-year physical therapy and rehabilitation period applied in 2 sessions a week, the patient gained the ability to walk independently.

Drivers of Successful Physical Therapy Rehabilitation Program following ACL Reconstruction: A Narrative Review

The speedy and effective return to performing activity of daily living or return to sports following an ACL reconstruction is one of the key challenges for a physical therapist in a clinical setup. Literature evidences state that drivers of a successful rehabilitation program can depend on a number of variable factors where large differences in clinical and outpatient protocols have been observed with limited consensus been formed. A range of factors including the surgery timing, choice of graft and above all the rehabilitation protocol with numerous PT interventions can influence the outcome significantly. The articular cartilage, joint capsule, menisci, and ligaments are some of the connective tissues of the knee joint involved in knee injury. Among the people of younger age group 20 years to 39 years the ACL injury has the highest prevalence. An untreated ACL tear causes knee instability, making it difficult for the affected person to return to sports. The duration and exercises used in different protocols vary significantly; hence, a review was conducted to identify the most effective techniques used by therapists to treat athletes who have undergone ACL reconstruction. An extensive literature search was conducted using Cochrane, Embase, Pedro, MEDLINE, and Saudi Digital Library to identify relevant articles published in English from January 2010 to June 2022. Most athletes underwent reconstruction surgery to improve their knee function. The current review helped us to know the various treatment strategies used for the clients who are under rehabilitation following ACL reconstruction surgery. The evidences support patient education, bracing, cryotherapy, Gait training, balance re-education, joint mobilization exercises and strength training exercises. All these interventions help the athletes to regain their functional mobility and support active participation in sports.

Improving Home-Based Physical Therapy Treatments: Examining the Doctor-Patient Relationship

While recent advancements have been made regarding physical therapy techniques and effectiveness, patient adherence to prescribed home exercise programs (HEPs)--a critical piece of successful physical therapy outcomes--remains low. There is growing evidence that establishing a good relationship and line of communication with patients is just as important as hard skill medical training when trying to improve patient adherence to treatment regimens. As more focus is given to the “human” elements of physical therapy, a vast array of training methods and programs have emerged as educators attempt to prepare their students for a career heavily contingent on creating healthy relationships between patients and their therapist. Unlike previous research meant to evaluate the efficacy of such programs, this study aims through semi-structured interviews to (a) examine the availability of such training in a particular geographic area, and (b) serve as a baseline for future research to gain a comprehensive understanding of the strengths and weaknesses different regions have in terms of relationship and communication training. Findings indicate that in Southwest Missouri, adherence to HEPs matches previous data and that little explicit educational focus is given to improving the doctor-patient relationship. However, interviewees indicated that there are many implicit elements in their education that effectively improved their relationship skills, and that explicit focus is steadily increasing. This study is successful in taking the first step in evaluating what it will take to standardize relationship and communication education among physical therapists.

Strategic Vision for Business and Marketing in the Physical Therapy Industry

A thorough overview of healthcare, physical treatment, business growth, strategic planning, marketing tactics, and personal development is provided in this document. It covers push technologies, value propositions for patients, and a business model for wellness while addressing key issues in the physical therapy sector. It examines important healthcare hazards and presents a methodology for goodwill compensation. The work presents a strategic vision for business and marketing in the physical therapy sector, highlighting the significance of management, location, competitiveness, and technology adoption. Push technologies and patient value propositions are discussed, with an emphasis on improving patient care and working with referral sources. The business plan for wellness emphasizes the significance of controlling and preventing obesity. The document also explores the fundamental principles of physical therapy organizations and proposes five potential directions for practice growth. Additionally, it discusses important healthcare dangers, patient privacy issues, workplace violence, and infection preparedness, all of which are especially pertinent given the continuing COVID-19 pandemic. The significance of developing one’s own personal capital, including ongoing education and public speaking abilities, is emphasized. The article presents a strategy plan for health and wellbeing in a physical therapy facility with an emphasis on the mission, core values, current situation, goals, structure overview, particular tactics, and management. It discusses the development of human resources and financial resources and proposes a wellness program. The value of partnerships and the necessity of providing patients with helpful information regarding home exercise regimens are both stressed in the presentation of marketing tactics to ensure customer happiness. Indicators for a successful physical therapy practice and conditions for client satisfaction are provided in the document’s conclusion. This content, which focuses on enhancing patient care, expanding services, and fostering success and satisfaction in the industry, provides a thorough manual for healthcare professionals, organizations, and individuals looking to successfully navigate the industry’s constantly evolving landscape.

Traits and Attributes of a Successful Physical Therapy Resident: A Delphi Study

Introduction. Given the limited number of positions in physical therapy (PT) residency programs, it is important to select individuals who are most likely to succeed. The purpose of the study is to obtain consensus from residency program directors regarding 1) the traits and/or characteristics that are likely to result in a successful residency experience, 2) how success in residency education is defined, and 3) what do programs aspire their residency graduates to accomplish professionally. Review of the Literature: Limited evidence exists that explores the qualities, skills, traits, or experiences that contribute to a successful PT resident or whether the current application process is able to identify these traits. Subjects: The residency directors of 246 American Board of Physical Therapy Residency and Fellowship Education-accredited programs were invited via email. One hundred nine (44.67%) residency program directors participated. Methods: Using the Delphi study design, consensus was reached after round 3 of the survey. Results: Five traits/characteristics, 9 characteristics/achievements of a successful residency graduate, and 4 postresidency aspirations reached consensus as “absolutely essential,” and 1 outcome measure reached consensus as “very useful.” Discussion/Conclusion: Residency programs may look to modify 1) their application/selection processes to identify applicants who possess desirable traits/characteristics and 2) their criteria for successful completion. Entry-level PT programs may use this information to guide what skills/traits are needed to prepare graduates for postprofessional experiences.

Cervicothoracic junction thrust manipulation in the multimodal management of a patient with temporomandibular disorder

Temporomandibular disorder (TMD) is a common condition that can be difficult to manage in physical therapy. A number of interventions, such as manual therapy, therapeutic exercise, and patient education have typically been used in some combination. However, the evidence regarding thrust manipulation of not only the local but also adjacent segments is sparse. Specifically, the use of cervicothoracic (CT) junction thrust manipulation has not previously been described in the management of individuals with TMD. In this case report, CT junction thrust manipulation, in addition to locally directed manual therapy, exercise, and postural education, was associated with immediate improvements in neck and jaw symptoms and function in a complex patient with TMD. The patient was seen for seven visits over the course of 2 months and demonstrated clinically significant changes in the neck disability index (NDI), the numeric rating of pain scale (NPRS), and the global rating of change (GROC) scale. The purpose of this report is to describe the successful physical therapy management of a patient with TMD utilizing manual therapy, including CT junction thrust manipulation, education, and exercise.

Physical Therapy Treatment Of Chronic Neck Pain A Discussion And Case Study: Using Dry Needling And Battlefield Acupuncture

Chronic mechanical neck pain can have a complex clinical presentation and is often difficult to treat. This case study illustrates a successful physical therapy treatment approach using dry needling and auricular acupuncture techniques.A 51-year-old active-duty, male US Marine was treated by a physical therapist in a direct-access military clinic for chronic neck pain poorly responsive to previous physical therapy, pharmacologic, and surgical interventions. Needling techniques were combined with standard physical therapy interventions to address the comprehensive needs of the patient. Within five treatments, the patient reported reduced pain levels from 8-9/10 to 0-2/10, improved sleep quality, and increased function with daily activities. Over several months, the patient reduced multiple medication use by greater than 85%. The effects of treatment were lasting, and the patient accomplished a successful transition to an independent maintenance program.Needling techniques have the potential to expedite favorable physical therapy outcomes for active-duty service members suffering from chronic mechanical and degenerative neck pain. The dramatic improvements observed in this case warrant additional exploration of treatment efficacy and delineation of best practices in the delivery of these techniques.

Novel use of a manual therapy technique and management of a patient with peroneal tendinopathy: A case report

Peroneal tendinopathy is an uncommon but underappreciated source of lateral hindfoot pain and dysfunction. There is a paucity of literature describing optimal intervention for those suffering with pain secondary to peroneal tendinopathy. The purpose of this case report is to describe the evaluation and treatment incorporating manual therapy and therapeutic exercise for a patient diagnosed with peroneal tendinopathy. The patient was a 50 year-old female with a history of chronic lateral ankle pain and whose presentation was consistent with peroneal tendinopathy. Despite attempts to improve pain and function with over-the-counter orthotics, manual therapy to a hypomobile talocrural joint, and strengthening of the peroneal tendons, successful response was not reported until a lateral calcaneal glide was added. Improvement in impairments (pain, talocrural dorsiflexion, unilateral heel raises, and Star Excursion Balance Test) and function (Lower Extremity Functional Scale and Global Rating of Change), were observed over a course of eight visits. The patient was able to return to work and her recreational work out routine without limitations. In conclusion a successful physical therapy intervention for a patient with peroneal tendinopathy included a unique manual therapy technique, the lateral calcaneal glide, in conjunction with other manual therapy techniques and a structured home exercise program.

Physical Therapy as Conservative Management for Cervical Pain and Headaches in an Adolescent with Neurofibromatosis Type 1: A Case Study

: Neurofibromatosis is a group of genetic disorders that affect the development and growth of nerve cell tissues. These disorders include tumors of myelin-producing supportive cells that grow on nerves and can cause changes in bone formation, skin integrity, and nerve transmission. Common musculoskeletal impairments associated with neurofibromatosis type 1 (NF 1) include cervical pain, muscle weakness, muscle stiffness, headaches, and postural deviations. : This case study describes successful physical therapy management and outcomes for cervical pain and headaches in a 17-year-old girl with a 16-year history of NF 1. Difficulties in driving, studying, lifting, and participating in recreational activities were all associated with the patient's pain, decreased cervical range of motion, decreased scapular strength, and postural deviations. : Physical therapy interventions included posture training, dynamic shoulder/scapular strengthening, cervical stabilization, stretching, ultrasound, interferential current, and a progressive home exercise program. : By the end of 13 weeks (20 sessions) of physical therapy, the patient was completely pain free, demonstrated increased cervical range of motion, and had improvements in scapular strength. She returned to full and unrestricted recreational activities, driving, studying, and household chores. Furthermore, scores on the Neck Disability Index improved from 44 of 50 (complete disability) to 2 of 50 (no disability). : Physical therapy may be a viable option for conservative management of musculoskeletal dysfunction and functional limitations resulting from NF 1.

Successful Physical Therapy for Constipation Related to Puborectalis Dyssynergia Improves Symptom Severity and Quality of Life

This study evaluated symptom severity and quality of life in patients with puborectalis dyssynergia before and after physical therapy. Twenty-two patients with puborectalis dyssynergia were prospectively enrolled into a multidisciplinary program for the treatment of pelvic floor and bowel disorders in this case series. All patients had functional constipation and evidence of puborectalis dyssynergia. Physical therapy and behavioral counseling were offered to all. Patients completed the Patient Health Questionnaire, the Patient-Assessment of Constipation Symptom Questionnaire, and the Patient-Assessment of Constipation Quality of Life Questionnaire. Sixteen patients successfully completed the program. Symptom severity decreased after physical therapy (2.1 +/- 0.7 vs. 1.3 +/- 0.9, P = 0.007). Quality of life also improved significantly (2.6 +/- 0.8 vs. 1.5 +/- 1.0, P = 0.007). Patients reported less physical discomfort, fewer worries/concerns, and indicated satisfaction with treatment. The difference in symptom severity was highly correlated with improvement in quality of life (r = 0.7, P = .005). Successful physical therapy for patients with puborectalis dyssynergia is associated with improvements in constipation-related symptoms and in quality of life.

Does Adherence to the Guideline Recommendation for Active Treatments Improve the Quality of Care for Patients With Acute Low Back Pain Delivered by Physical Therapists?

Numerous practice guidelines have been developed for patients with low back pain in an attempt to reduce inappropriate variations and improve the cost-effectiveness of care. Guideline implementation has received more research attention than the impact of adherence to guideline recommendations on outcomes and costs of care. Examine the association between adherence to the guideline recommendation to use active versus passive treatments with clinical outcomes and costs for patients with acute low back pain receiving physical therapy. Retrospective review of patients with acute low back pain receiving physical therapy in 2004-2005. Adherence to the recommendation for active treatment was determined from billing records. Clinical and financial outcomes were compared between patients receiving adherent or nonadherent care. A total of 1190 patients age 18-60 years old with low back pain of less than 90 days duration in 10 clinics in 1 geographic region. Clinical outcomes included the numeric pain rating and Oswestry disability questionnaire taken initially and at the completion of treatment. Financial outcomes included the number of sessions and charges for physical therapy care. Adherence rate was 40.4%. Adherence was greater for patients receiving workers' compensation (P < 0.05). Patients receiving adherent care had fewer visits and lower charges (P < 0.05), and showed more improvement in disability [adjusted mean difference for percentage improvement 25.8%, 95% confidence interval (CI): 21.3-30.4, P < 0.001] and pain (adjusted mean difference for percentage improvement 22.4%, 95% CI: 17.5-27.3, P < 0.001). Patients receiving adherent care were more likely to have a successful physical therapy outcome (64.7% vs. 36.5%, P < 0.001). Adherence to the guideline recommendation for active care was associated with better clinical outcomes and reduced cost.

Physical Therapy Management for Conversion Disorder: Case Series

Patients with conversion disorder present with symptoms of sensory and motor dysfunction that are not explained by known physical disorders or pathophysiological mechanisms. Correct diagnosis and prompt, effective management of patients with this disorder is essential. Healthcare providers may be unaware of the important role of physical therapy in the management of patients with conversion disorder. While numerous reports have suggested the need for physical therapy management of this disorder, there is a lack of reports outlining specific physical therapy management principles or daily treatment progression. The purpose of this series of case reports is to provide an overview of conversion disorder and describe successful physical therapy management strategies used to treat three patients with movement impairment due to this disorder. The patients were 18-, 20-, and 34-year-old women treated in a hospital inpatient rehabilitation setting. Behavioral modification and shaping techniques formed the basis for the physical therapy treatment approach. Abnormal movement patterns were ignored, and correct movement patterns were reinforced using feedback and praise. The patients advanced through a progressively more difficult therapy program based on treatment approaches used with analogous neurological conditions. All three patients showed complete resolution of their symptoms and returned to independent mobility, independent living, and to work or school.

Selected Legal Issues Influencing Evaluation of Physical Therapist Graduate Student Professional Behaviors in the Academic Environment

Background and Purpose. From an academic perspective, there exists the continuing challenge to integrate how well a physical therapist graduate student has performed in the academic course of study with how successfully the student has demonstrated appropriate professional behaviors that are consistent with professional practice standards. Potential conflict arises when a student may be progressing satisfactorily in course-work but demonstrates certain professional behaviors that the faculty deem inconsistent with successful physical therapy practice and which may suggest removal of the student from the program. It is the intent of this article to not only provide a legal framework for administrators and faculty often faced with legal issues surrounding such decisions, but to provide experienced-based recommendations regarding how best to evaluate professional behaviors within the academic program environment. Case Description, Outcomes, and Discussion. This paper presents a case study of a physical therapist graduate student who demonstrated several behaviors inconsistent with professional standards despite good academic standing with a description of the due process through which the student pursued an appeal of suspension from the program. The events of the case are presented with a discussion of those legal issues in higher education relevant to the case and lead to several recommendations for ensuring good faith and due process in maintaining professional standards.

Piriformis syndrome: Diagnosis, treatment, and outcome—a 10-year study

Fishman LM, Dombi GW, Michaelsen C, Ringel S, Rozbruch J, Rosner B, Weber C. Piriformis syndrome: diagnosis, treatment, and outcome—a 10-year study. Arch Phys Med Rehabil 2002;83:295-301. Objectives: To validate an operational definition of piriformis syndrome based on prolongation of the H-reflex with hip flexion, adduction, and internal rotation (FAIR) and to assess efficacy of conservative therapy and surgery to relieve symptoms and reduce disability. Design: Before-after trial of cohorts identified by operational definition. Setting: Outpatient departments of 2 hospitals and 4 physicians' offices. Surgery performed at 3 hospitals. Patients: Consecutive sample of 918 patients (1014 legs) with follow-up on 733. Intervention: Patients with significant (3 standard deviations [SDs]) FAIR tests received injection, physical therapy, and serially reported pain and disability assessments. Forty-three patients (6.47%) had surgery. Main Outcome Measures: Likert pain scale. Subjective estimates of disablement in activities of daily living and instrumental activities of daily living. Results: At 3 SDs, the FAIR test had sensitivity and specificity of.881 and.832, respectively. Seventy-nine percent (514/655) of FAIR test positive (FTP) patients improved 50% or more from injection and physical therapy at a mean follow-up of 10.2 months. Average improvement was 71.1%. Of 385 FTP patients with disability data, mean disability fell from 35.37% prestudy (SD =.2275) to 12.96% poststudy (SD =.1752), a 62.8% improvement. Twenty-eight surgical FTP patients (68.8%) showed 50% or greater improvement; mean improvement was 68% at a mean follow-up of 16 months. Surgery reduced the mean FAIR test to 1.35 ± 2.17 months postoperatively. FTP patients generally improved 10% to 15% more than others after conservative treatment. Conclusions: The FAIR test correlates well with a working definition of piriformis syndrome and is a better predictor of successful physical therapy and surgery than the working definition. The FAIR test, coupled with injection and physical therapy and/or surgery, appears to be effective means to diagnose and treat piriformis syndrome. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Reflex sympathetic dystrophy syndrome: an update.

RSDS is a complicated condition that requires early diagnosis and treatment for a favorable prognosis. The nurse should be alert to clinical signs in a patient with a traumatized area and report them to the physician as soon as possible. Management of the pain and establishment of trust will help promote successful physical therapy for the patient. The nurse should coordinate and manage the total care of the patient so that emotional and physical care can be at an optimum level for the patient and the patient's family.