Improving the Readability of Patient Education Materials in Physical Therapy.

Introduction Printed patient educational materials (PEM) are often written above the recommended sixth- to eighth-grade reading levels, resulting in decreased client understanding and subsequent poor health literacy. Researchers have demonstrated that it is possible to improve readability to enhance clients' understanding and health literacy. The purpose of this study was to evaluate the readability of physical therapy (PT) PEM with and without modifications for improvement. Methods A convenience sample of 38 PT PEM of at least 10 sentences was obtained from a large suburban hospital system in the Midwestern region of the United States. Original and three modified versions (exclusion, revision, and combined exclusion/revision of words with >3 syllables) of the documents were assessed with the Simple Measure of "Gobbledygook" (SMOG). All document means were compared to the recommended reading levels, and the original document means were compared with modified conditions. Results A majority of the documents were above an eighth-grade reading level. All modified conditions resulted in statistically significant reading level decreases, but only the combined modified condition decreased to the eighth-grade level. Conclusion Even with modifications, most PEM were above the recommended reading levels. Additional methods for improving readability and increased education about health literacy for healthcare professionals may be necessary to improve client comprehension.

School-Based Physical Therapists' Perceptions about Becoming Effective Practitioners through Professional Development.

AIMS: The aims of this study were to explore perceptions of school-based physical therapists (SBPTs) about professional development and effective practice and to create a conceptual framework to help understand how SBPTs become effective practitioners who continue to learn and grow professionally as clinicians in an educational setting. METHODS: Twenty school-based physical therapists completed a demographic questionnaire and a semi-structured interview. Guiding interview questions focused on SBPTs' perceptions of roles and responsibilities, professional development, barriers, and recommendations. RESULTS: Participants identified roles and personal qualities of effective SBPTs. Three concepts for the process of professional development were developed: educational context and culture, barriers to effective practice, and strategies for professional development. CONCLUSION: The development of effective practice for SBPTs is a multifaceted, iterative process involving a unique set of knowledge, skills, and behaviors that allow them to fulfill their roles. The process takes time and effort to understand the self within the educational context and culture, recognize barriers to effective practice, and develop strategies for success. A conceptual framework was developed to assist SBPTs in implementing a plan for professional development that leads to effectively providing services to students and functioning as essential members of the educational team.

Physical therapists in integrated palliative care: a qualitative study.

OBJECTIVES: The purpose of this study was to explore the perceptions and experiences of physical therapists (PTs) regarding their role in palliative care (PC) when practising in nations with advanced integration of PC into mainstream healthcare. METHODS: This qualitative study included an electronic demographic survey and semistructured interview. Data analysis included descriptive statistics for demographics and the constant comparative method for interview results. RESULTS: Thirteen PTs from eight nations identified four categories of roles and responsibilities: (1) working with patients and families, (2) being an interdisciplinary team (IDT) member, (3) professional responsibilities beyond direct patient care and (4) factors influencing the role of PTs in PC. Concepts identified were shifting priorities (increased family involvement, emphasis on psychosocial aspects and differences in care philosophy), care across the continuum (accommodating changes in patient status, increasing awareness of PTs' role in varying disease states and working with the IDT) and changing perceptions about PT in PC (perceptions of PTs/others regarding PTs' role in PC and professional responsibilities of the PT in PC). CONCLUSIONS: Based on participant responses, a previously published conceptual framework by Wilson et al in 2017 was updated and included an increased emphasis on patient wishes and dignity, treating breathlessness, patient advocacy within their family and use of technology and networking. Within PC, PTs play a key role on the IDT and can improve quality of life; however, multiple barriers exist to providing PT care within PC. Further advocacy is needed from PTs and professional organisations to integrate these services.

The Role of Physical Therapists Within Hospice and Palliative Care in the United States and Canada.

PURPOSE: Little is known regarding the extent to which physical therapy is integrated into Hospice and Palliative Care (HPC). The purpose of this study was to describe perceptions of physical therapists (PTs) regarding their role within HPC or working with patients having life-threatening illnesses and to develop a conceptual framework depicting a PTs role within HPC and factors affecting it. PARTICIPANTS: Ten PTs, 5 from the United States and 5 from Canada, with at least 5 years of physical therapy experience and 5 years working experience with patients having life-threatening illnesses or in HPC. METHODS: Demographic data were collected by electronic questionnaire. A semistructured interview was conducted with each participant to investigate their perceptions about the role of PTs in HPC. DATA ANALYSIS: Interview results were analyzed for trends between participants, practice settings, regions, and other sociocultural aspects. The constant comparative method of qualitative data analysis was used to identify similarities and differences and to develop themes and concepts relative to the role of PT in HPC. RESULTS: Participants identified their 3 primary roles in HPC: providing patient/family care, serving as an interdisciplinary team member, and fulfilling professional responsibilities outside of direct patient care. They described factors within and outside direct patient care which influenced their roles. Concepts included shifting priorities, care across the continuum, and changing perceptions of PTs within HPC. CLINICAL RELEVANCE: This study described perceptions of the role of PTs within HPC that may be utilized when coordinating future strategies to appropriately promote and expand the role.

Perceived Leadership Practices in Year-One Students Enrolled in Professional Entry-Level Doctor of Physical Therapy Programs.

BACKGROUND: Leadership has been identified as an important attribute for health care professionals. Assessing leadership practices can help identify areas of strength or needed improvement for the development of leaders. OBJECTIVES: To describe the perceived leadership practices of year-1 Doctor of Physical Therapy (DPT) students, to determine if the participants' demographic variables were related to their perceived leadership practices, and to explore differences between participants and the general population. METHODS: The Leadership Practices Inventory (LPI Self) developed by Kouzes and Posner was used to assess leadership practices of year-1 DPT students at six Midwestern universities. RESULTS: The leadership practices of 192 DPT students in highest to lowest order were Enable, Encourage, Model, Challenge, and Inspire. Age was found to be significantly correlated with the Challenge leadership practice. The order and means of some leadership practices of the DPT students were different than the general population. CONCLUSIONS: This study provides a baseline description of how year-1 DPT students perceived their leadership behaviors and how the LPI Self can be used to facilitate the development of leadership skills.

Personal health behaviors and role-modeling attitudes of physical therapists and physical therapist students: a cross-sectional study.

BACKGROUND: Physical therapists have been encouraged to engage in health promotion practice. Health professionals who engage in healthy behaviors themselves are more apt to recommend those behaviors, and patients are more motivated to change their behaviors when their health care provider is a credible role model. OBJECTIVE: The purpose of this study was to describe the health behaviors and role-modeling attitudes of physical therapists and physical therapist students. DESIGN: This study was a descriptive cross-sectional survey. METHODS: A national sample of 405 physical therapists and 329 physical therapist students participated in the survey. Participants' attitudes toward role modeling and behaviors related to physical activity, fruit and vegetable consumption, abstention from smoking, and maintenance of a healthy weight were measured. Wilcoxon rank sum tests were used to examine differences in attitudes and behaviors between physical therapists and physical therapist students. RESULTS: A majority of the participants reported that they engage in regular physical activity (80.8%), eat fruits and vegetables (60.3%), do not smoke (99.4%), and maintain a healthy weight (78.7%). Although there were no differences in behaviors, physical therapist students were more likely to believe that role modeling is a powerful teaching tool, physical therapist professionals should "practice what they preach," physical activity is a desirable behavior, and physical therapist professionals should be role models for nonsmoking and maintaining a healthy weight. LIMITATIONS: Limitations of this study include the potential for response bias and social desirability bias. CONCLUSIONS: Physical therapists and physical therapist students engage in health-promoting behaviors at similarly high rates but differ in role-modeling attitudes.

Lower extremity muscle strength in 6- to 8-year-old children using hand-held dynamometry.

PURPOSES: The purposes of the study were to establish isometric torque reference values for healthy 6- to 8-year-old children for 6 lower extremity muscles and determine the effects of gender, age, height, weight, and physical activity upon strength. METHODS: A hand-held dynamometer was used to obtain force/torque values for 154 children. RESULTS: Age-referenced force/torque and cutoff values are provided for each muscle group. Torque increased with age and height for all muscles and with weight for all muscles except knee extensors. No gender differences were found. Children who participated in 3 or more hours per week in organized sports were stronger in 4 of 6 muscles; the number of hours spent in active play did not affect torque. CONCLUSIONS: This study provides hand-held dynamometer strength reference values to enable clinicians to determine if clients of the same age, height, and weight have muscle weakness.

Normative values for active lumbar range of motion in children.

PURPOSE: The purpose of this study was to establish normative values for active lumbar movement in children five, seven, nine, and 11 years of age. METHODS: End range active flexion, extension, and right- and left-side bending and rotation of the lumbar spine were measured for 225 normally developing children (116 girls, 109 boys) using the Back Range of Motion (BROM II) device. Means were determined for each motion by age and sex. Group relationships were explored. RESULTS: Normative values for lumbar spine cardinal plane movements were identified. Reduced lumbar movement was found in the 11-year-old group compared with the five-year-old group in active lumbar flexion in girls and in active lumbar side bending and rotation in both girls and boys. CONCLUSION: Normative data for cardinal plane movements of the lumbar spine provide therapists with a baseline for assessing spinal mobility of children of these ages.

The effect of conductive education, intensive therapy, and special education services on motor skills in children with cerebral palsy.

PURPOSE: The purpose of this study was to compare the effects of intensive therapy, conductive education, and special education on function in 19 children with cerebral palsy. METHODS: Subjects participated in a five-week program of conductive education, intensive therapy, or special education. Professionals, blinded to group assignment, administered the Pediatric Evaluation of Disability Inventory (PEDI), the Gross Motor Function Measure (GMFM), and the Fine Motor Scale of the Peabody Developmental Motor Scales before and after intervention. Professionals providing treatment and parents completed a survey about their perceptions of change in the children. RESULTS: ANOVA showed no statistically significant differences between groups before or after treatment. Using t-tests, statistically significant within group changes were found only for the intensive therapy group on the PEDI Self-care and Social Function scales and the Crawling and Kneeling scale of the GMFM. Individual changes from pre- to post-test were also examined and are discussed. Surveys revealed that both parents and professionals perceived improvement in all children. CONCLUSIONS: Greatest improvements were noted in the group receiving intensive therapy, with children in all groups showing some improvement in function.