Translational Research Training at Various Levels of Professional Experience to Address Health Disparities.

Translational research addressing health disparities brings interventions and medical discoveries into clinical practice to improve health outcomes. However, academic researchers' and clinicians' lack of understanding of methodologies limits the application of basic science to clinical settings. To solve the problem, a multidisciplinary collaboration from two academic institutions offered a workshop building on translational research methodologies to clarify the measures and interventions needed to address health disparities from a research perspective. Three two-day workshops targeted underrepresented minority participants whose research experience and professional development varied. The evaluation surveys administered after the three workshops indicated that workshop 1 which focused on translational and educational research increased participants' knowledge, and made all participants think critically about the subject. Training opportunities focused on translational research can enhance researchers and clinicians' confidence and capabilities to address health disparities.

A retrospective, descriptive study of shoulder outcomes in outpatient physical therapy.

STUDY DESIGN: A retrospective, descriptive study of clients with shoulder dysfunction referred to physical therapy. OBJECTIVES: To (1) describe the clinical and functional outcomes of clients with shoulder dysfunction following outpatient physical therapy, and (2) to compare the outcomes by type of shoulder dysfunction. BACKGROUND: Although individuals with shoulder dysfunction are commonly referred to physical therapy few large descriptive studies regarding outcomes following physical therapy are available. METHODS AND MEASURES: Data for 878 clients (468 female, 410 male) were retrieved and analyzed. This database was developed between 1997 and 2000 and included 4 outpatient facilities from 1 healthcare system in the southwest corner of Michigan. Clients were classified by type of shoulder dysfunction, and standardized tests were performed upon admittance and discharge to physical therapy. Descriptive and inferential statistics were calculated for all data. RESULTS: Of all clients, 55.1% had shoulder impingement, while 18.3% had postoperative repair, 8.9% had a frozen shoulder, 7.6% had a rotator cuff tear, 3.0% had shoulder instability, 2.1% were post fracture, and the remaining 4.9% had miscellaneous diagnoses. The average (+/-SD) age of the patients was 53.6 +/- 16.4 years, with an average (+/-SD) number of treatment sessions of 13.7 +/- 11.0. All groups showed significant changes following physical therapy intervention. CONCLUSIONS: Clients with diverse types of shoulder dysfunction demonstrated improvement in both clinical and functional measures at the conclusion of physical therapy, although it is not possible to determine whether these changes were due to the interventions or due to time. The type of shoulder dysfunction appears to affect the prognosis, thus expected outcomes should be based upon initial diagnosis and specific measures.

Reliability of a clinical test for deep cervical flexor endurance.

OBJECTIVE: Endurance deficiencies of the deep cervical flexors are associated with pain, increased lordosis, and headache. A need exists for reliable clinical tests of flexor endurance. This study determined intrarater and interrater reliability of such a test in persons without neck pain. METHODS: Twenty-seven subjects (aged 20-35 years) without a history of neck pain or injury were tested. Supine subjects were timed in maintaining a position involving two components: (1) craniovertebral flexion (chin tuck) and (2) lower cervical flexion (holding the occiput at a fixed height). Each subject was examined twice by 3 different examiners with 1 to 2 days between trials. RESULTS: When two values were averaged, interrater reliability for the 3 testers was 0.83, 0.85, and 0.88. Intrarater reliability values were 0.78 and 0.85 for tests 1 and 2, respectively. CONCLUSIONS: The flexor endurance test showed good intertester and intratester reliability when two values were averaged and, thus, may represent a useful clinical tool for practitioners involved in treating and preventing neck pain.