Hybrid-Flexible Classroom Design in the Physical Therapist Classroom.

INTRODUCTION: Doctor of Physical Therapy (DPT) education has traditionally been delivered in a face-to-face format. However, alternative educational models are on the rise with the proliferation of hybrid programs. Although hybrid education may benefit students in unique ways, many students prefer the personal interaction afforded by a face-to-face format. An alternative model, Hybrid-Flexible (HyFlex), allows students to have the benefits of a hybrid education while allowing for face-to-face interactions. Therefore, the purpose of this study was to describe the application of an alternative educational method-HyFlex-in the DPT classroom. REVIEW OF LITERATURE: In a HyFlex model, students can choose to attend each class period in person, synchronously online, or asynchronously. Although previous research has found that hybrid programs have equivalent performance compared with traditional style, there is a paucity of published research on the effectiveness of HyFlex in the DPT classroom. SUBJECTS: Thirty-six students (n = 26 female students) enrolled in a first-year DPT kinesiology course participated in this study. METHODS: Students chose which method of engagement they preferred, and attendance choice was recorded. Students were categorized into synchronous engagement, partial asynchronous engagement, or asynchronous engagement groups. Quantitatively, grades for quizzes, tests, and the final examination were recorded and compared across the groups. Qualitatively, the students filled out a survey asking about their experience, and answers were assessed using a qualitative descriptive approach. RESULTS: Quantitative data analysis revealed no differences between the groups in academic performance. Qualitative data revealed that students felt the HyFlex model allowed for better organization, flexibility, and reduced stress. However, there were concerns about the social impact, academic loss, decreased motivation, and technological issues. DISCUSSION AND CONCLUSION: This study describes how a HyFlex model can be implemented in a DPT classroom that allows for greater flexibility and reports of improved stress reduction with no academic loss.

Task-Based Functional Connectivity and Blood-Oxygen-Level-Dependent Activation During Within-Scanner Performance of Lumbopelvic Motor Tasks: A Functional Magnetic Resonance Imaging Study.

There are a limited number of neuroimaging investigations into motor control of the lumbopelvic musculature. Most investigation examining motor control of the lumbopelvic musculature utilize transcranial magnetic stimulation (TMS) and focus primarily on the motor cortex. This has resulted in a dearth of knowledge as it relates to how other regions of the brain activate during lumbopelvic movement. Additionally, task-based functional connectivity during lumbopelvic movements has not been well elucidated. Therefore, we used functional magnetic resonance imaging (fMRI) to examine brain activation and ROI-to-ROI task-based functional connectivity in 19 healthy individuals (12 female, age 29.8 ± 4.5 years) during the performance of three lumbopelvic movements: modified bilateral bridge, left unilateral bridge, and right unilateral bridge. The whole brain analysis found robust, bilateral activation within the motor regions of the brain during the bilateral bridge task, and contralateral activation of the motor regions during unilateral bridging tasks. Furthermore, the ROI-to-ROI analysis demonstrated significant connectivity of a motor network that included the supplemental motor area, bilateral precentral gyrus, and bilateral cerebellum regardless of the motor task performed. These data suggest that while whole brain activation reveals unique patterns of activation across the three tasks, functional connectivity is very similar. As motor control of the lumbopelvic area is of high interest to those studying low back pain (LBP), this study can provide a comparison for future research into potential connectivity changes that occur in individuals with LBP.

Spinal manipulation does not affect pressure pain thresholds in the absence of neuromodulators: a randomized controlled trial.

BACKGROUND: Measurement of pressure pain threshold (PPT) is a way to determine one of the many potential treatment effects of spinal manipulative therapy. OBJECTIVE: To determine how multiple spinal manipulations administered in a single-session affected PPTs at local and distal sites in asymptomatic individuals. METHODS: Participants were randomly assigned into one of three groups: Group one (n = 18) received a lumbar manipulation followed by a cervical manipulation. Group two (n = 17) received a cervical manipulation followed by a lumbar manipulation. The control group (n = 19) received two bouts of five minutes of rest. At baseline and after each intervention or rest period, each participant's PPTs were obtained using a handheld algometer. The PPTs were tested bilaterally over the lateral epicondyles of the humerus and over the mid-bellies of the upper trapezius, lumbar paraspinal, and the tibialis anterior muscles. This study was registered with ClinicalTrials.gov, and its Identifier is NCT02828501. RESULTS: Repeated-measures ANOVAs and Kruskal-Wallis tests showed no significant within- or between-group differences in PPT. Within-group effect sizes in the changes of PPT ranged from -.48 at the left paraspinal muscles to .24 at the left lateral humeral epicondyle. Statistical power to detect significant differences at α of 0.05 was calculated to be 0.94. CONCLUSIONS: This study suggests that in young adults who do not have current or recent symptoms of spinal pain, multiple within-session treatments of cervical and lumbar spinal manipulation fail to influence PPTs. Changes in PPT that are observed in symptomatic individuals are likely to be primarily influenced by pain-related neuromodulators rather than by an isolated, mechanical effect of spinal manipulation.