Imposter phenomenon in physical therapists: A cross-sectional observational study.

Background and Aims: Imposter phenomenon (IP), or perceived fraudulence, describes an ongoing fear of exposure as a fraud or imposter, despite objective successes and accomplishments. Although there is a growing interest of IP in medicine, IP in the physical therapy profession has been minimally examined. We aimed to determine the prevalence and predictors of IP among licensed physical therapists in the United States. Methods: This cross-sectional observational study utilized an online survey to assess levels of IP using the Clance Imposter Phenomenon Scale. We assessed degrees of emotional exhaustion and job satisfaction and collected professional and demographic information. A multivariable logistic regression model examined factors associated with IP presence. Results: The mean IP score was 60.3 (SD: 15.1, range: 19-95). Fifty-five respondents (10.7%) had low IP, 196 (38.1%) moderate, 215 (41.8%) frequent, and 48 (9.3%) intense IP. The prevalence of IP, defined as frequent or intense IP, was 51.2%. Having manager/supervisor experience (odds ratio [OR] = 0.55, 95% confidence interval [CI] = 0.34-0.90) was associated with a reduced odds of IP presence. Holding a bachelor's or master's degree (vs. Doctor of Physical Therapy (DPT); OR = 2.31, 95% CI = 1.07-5.00), a history of or current mental health diagnosis (OR = 2.77, 95% CI = 1.69-4.54), and emotional exhaustion (moderate vs. low: OR = 5.37, 95% CI = 2.11-13.69; high vs. low: OR = 14.13, 95% CI = 5.56-35.89) were each associated with an increased odds of IP presence. Conclusions: IP is highly prevalent among licensed physical therapists. Seasoned clinicians with managerial roles seemed to be less susceptible to IP, whereas those with mental health diagnoses, emotional exhaustion, and those without a DPT degree may be more susceptible. Given its high prevalence and potential negative impact on burnout and career advancement, it is crucial to increase IP awareness and provide education on management strategies.

Cervical spine thrust and non-thrust mobilization for the management of recalcitrant C6 paresthesias associated with a cervical radiculopathy: a case report.

BACKGROUND: The conservative management of cervical radiculopathy is supported by moderate evidence to include interventions such as manual therapy, traction, and therapeutic exercise. There is sparse evidence, however, to support specific manual therapy techniques, particularly thrust manipulation. CASE DESCRIPTION: A 35-year-old male presented to physical therapy with a clinical diagnosis of cervical radiculopathy. He complained of neck and upper arm pain with 1st and 2nd digit paresthesias. He was initially managed with repeated movements that restored the cervical range of motion and centralized neck and upper arm pain. Non-thrust upslope joint mobilizations resulted in improved sensation detection in the hand, but the paresthesias did not completely resolve. Immediately following cervical spine upslope thrust manipulation, symptoms fully resolved. Outcomes: The patient fully returned to prior level of function. His DASH score reduced from 40/100 to 2/100, PSFS improved from 1.66/10 to 9.66/10, and he reported to be 'a great deal better' on the GROC. DISCUSSION: This case demonstrates the safe and effective utilization of cervical spine thrust manipulation and non-thrust mobilization in the management of a patient with cervical radiculopathy with lingering paresthesias in the distal upper extremity.

Manual therapy for work-related wrist pain in a manual physical therapist.

Introduction: The wrist is a common site for work-related musculoskeletal disorders (WMSD) among physical therapists (PTs), often due to manual therapy. There are limited data on management of wrist injury in PTs. The purpose of this case is to describe the management of a PT with wrist pain.Case Description: The patient was a 28-year-old female with a 6-month history of right ulnar-sided wrist pain, aggravated by performing thoracic/lumbar posterior to anterior (PA) glides. The patient reported 7/10 on the Numeric Pain Rating Scale and 6.5/10 on the Patient-Specific Functional Scale (PSFS). Symptoms were reproduced at the lunotriquetral joint.Outcomes: The patient was seen for two visits. Following anterior to posterior non-thrust mobilization at the triquetrum on lunate, the patient improved inability to perform thoracic/lumbar PA glides. The patient was educated on manual therapy modifications, isometrics, and self-mobilization. At 2-month follow-up, the patient reported 0/10 pain, scored 10/10 on the PSFS, and +7 on the Global Rating of Change.Discussion: This case demonstrates the successful use of education, manual therapy, and exercise in the management of a PT with a wrist-related WMSD. Future research should focus on the prevention/treatment of wrist-related WMSDs in PTs who perform manual therapy.