Improvements after dry needling for craniofacial pain in a patient with chronic rhinosinusitis: a case report.

BACKGROUND: Typically treated medically, chronic rhinosinusitis (CRS) is a prevalent condition characterized by multiple craniofacial symptoms, some of which may respond favorably to dry needling intervention. OBJECTIVE: To describe the outcomes of a patient presenting with craniofacial pain and symptoms consistent with a diagnosis of CRS who was treated with dry needling. Case Description: A 41-year-old male, self-referred to physical therapy with a diagnosis of CRS, with a 20-year history of signs and symptoms associated with CRS, including craniofacial pain and headaches. The patient had been treated with multiple medication regimens over this time, including antihistamines, anti-inflammatories, decongestants, leukotriene inhibitors, and antibiotics; all of which provided only short-term relief. On initial examination, the patient was tender to palpation in multiple muscles of the head, neck, and face. Intervention consisted of dry needling to these muscular tender points once or twice weekly over 2 months. OUTCOMES: After 2 months of dry needling, the patient demonstrated clinically meaningful improvements in pain and quality of life, which included a decrease in both medication usage and the frequency of sinus infections. CONCLUSION: Although CRS is generally managed medically, we observed areas of muscular tenderness in this case, which were effectively managed with dry needling. Rehabilitative providers may consider screening CRS patients for muscular impairments that may be modifiable with dry needling. Further research should be performed to determine whether dry needling has a role in the management of CRS.

Doctor of Physical Therapy Education in a Hybrid Learning Environment: A Case Report.

OBJECTIVE: The purpose of this case report is to describe the implementation and report early outcomes of a 2-year (6-trimester), hybrid doctor of physical therapy (DPT) program. METHODS: The case report describes management of (1) academic affairs, (2) student affairs, (3) faculty affairs, and (4) institutional affairs for an accredited, fully hybrid, 2-year DPT program. In the hybrid program, students from across the country participate in synchronous and asynchronous online learning and travel to campus twice per trimester for immersive blocks of in-person laboratory instruction. The case report describes how the program structures the hybrid learning environment and reports outcomes from the first 2 graduated cohorts. RESULTS: Program outcomes assessment revealed that 97% to 98% of students/graduates reported being somewhat or very satisfied with the 2-year hybrid DPT program at the end of DPT year 1, at graduation, and at 1 year after graduation. Clinical instructors reported that 84% of students were prepared or well-prepared for clinical education. At 1 year after graduation, 20% of graduates were enrolled in or had completed residency, National Physical Therapy Examination (NPTE) pass rate was 97%, and employment rate was 99%. CONCLUSION: Hybrid DPT education is feasible and may provide opportunities for more flexible and accessible delivery of DPT education. Outcomes of this case report suggest high student satisfaction, increased student/graduate diversity, and graduate outcomes comparable with national averages as reported in the Commission on Accreditation in Physical Therapy Education aggregate data. IMPACT: This case report provides early evidence that hybrid DPT education-a type of blended learning that uses both face-to-face and online instructional strategies-is feasible, with student satisfaction and student/graduate outcomes comparable with national averages. Hybrid education may provide educators, programs, and institutions the flexibility to innovate in ways that address some of the immediate and long-term challenges facing physical therapist professional education while maintaining standards of excellence.