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Feldman DE, Orozco T, Bernatsky S, Desmeules F, El-Khoury J, Laliberté M, Légaré J, Perreault K, Woodhouse L, Zummer M. Do physical therapists follow evidence-based practices for treatment of inflammatory arthritis? Results from an online survey. Physiother Theory Pract 2024; 40:637-646. [PMID: 36238986 DOI: 10.1080/09593985.2022.2135150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Physical therapists (PTs) should know how to best treat patients with inflammatory arthritis. OBJECTIVE To document interventions chosen by PTs for patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and whether choices follow evidence-based practice. METHODS Licensed musculoskeletal PTs in Quebec, Canada responded to an online survey. Descriptive statistics illustrated proportions for each treatment choice and inferential statistics explored associations with demographic and practice-related factors. RESULTS There were 298 PTs who responded to the survey. For both RA and AS respectively, most common interventions were mobility exercises (91.0%; 98.3%) and patient education (90.1%; 92.8%). For both cases, slightly >60% selected strengthening exercises. Passive forms of therapy were chosen by 36% of PTs for RA and 58% for AS. Aerobic exercise was rarely selected. PTs working in the public sector were less likely to use manual therapy for both RA (Odds Ratio (OR) 0.43, 95% confidence interval (CI) 0.22,0.86) and AS (OR 0.46, 95% CI 0.22,0.97). CONCLUSIONS Most PTs chose mobility exercises and patient education, representing evidence-based approaches. Despite current recommendations, strengthening and especially aerobic exercises were not used as much. There is a need to increase awareness regarding the benefits of strengthening and aerobic exercise for these patients.
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Affiliation(s)
- Debbie Ehrmann Feldman
- Physiotherapy Program, Université de Montréal École de Readaptation, Pavillon 7077 Avenue du Parc, C.P. 6128, Succ. Centre-Ville, H3C 3J7, Montreal, Qc, Canada
- Centre for Interdisciplinary Research in Rehabilitation, 6363, Hudson Road, Office 061, Lindsay Pavilion of the IURDPM, H3S 1M9, Montreal, QC, Canada
- Center for Public Health Research, Université de Montréal, 7101 Av du Parc, H3N 1X9, Montréal, QC, Canada
| | - Tatiana Orozco
- Physiotherapy Program, Université de Montréal École de Readaptation, Pavillon 7077 Avenue du Parc, C.P. 6128, Succ. Centre-Ville, H3C 3J7, Montreal, Qc, Canada
| | - Sasha Bernatsky
- McGill University Department of Rheumatology and Clinical Epidemiology, McGill University Health Centre, 5252 de Maisonneuve O, H4A3S5, Montreal Qc, Canada
| | - François Desmeules
- Physiotherapy Program, Université de Montréal École de Readaptation, Pavillon 7077 Avenue du Parc, C.P. 6128, Succ. Centre-Ville, H3C 3J7, Montreal, Qc, Canada
- Research Institute of Hôpital Maisonneuve , Rosemont 5451 de l'Assomption, H1T2M4, Montreal, Qc, Canada
| | - Jonathan El-Khoury
- Université de Sherbrooke et Université du Québec à Chicoutimi Programme de Formation Médicale à Saguenay, Pavillon du Grand Séminaire, 555 Boul de l'Université, G7H2B1, Chicoutim Qc, Canada
| | - Maude Laliberté
- Physiotherapy Program, Université de Montréal École de Readaptation, Pavillon 7077 Avenue du Parc, C.P. 6128, Succ. Centre-Ville, H3C 3J7, Montreal, Qc, Canada
| | - Jean Légaré
- Patients Intéressés par la Recherche en Arthrite, CHU de Québec Université Laval, Arthritis Research, Qc, Canada
| | - Kadija Perreault
- School of Rehabilitation, Université Laval; Center for Interdisciplinary Research in Rehabilitation and Social Integration, 525 Bd Wilfrid-Hamel bureau H-1300, G1M 2S8, Québec, QC, Canada
| | - Linda Woodhouse
- Tufts University School of Medicine Department of Public Health and Community Medicine Doctorate of Physical Therapy Program, 101 E. Washington St., Suite 950, 85004, Phoenix, AZ, USA
| | - Michel Zummer
- Université de Montréal and Hôpital Maisonneuve Rosemont 5451 de l'Assomption, H1T2M4, Montréal, Qc, Canada
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Zheng L, Hawke AL, Evans K. Critical review on applications and roles of exoskeletons in patient handling. INTERNATIONAL JOURNAL OF INDUSTRIAL ERGONOMICS 2022; 89:10.1016/j.ergon.2022.103290. [PMID: 35924209 PMCID: PMC9345507 DOI: 10.1016/j.ergon.2022.103290] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Musculoskeletal Disorders (MSDs) remain a major concern for workers in the healthcare industry. Healthcare workers are at high risk of work-related MSDs mainly caused by overexertion from manually handling patients. Exoskeletons may be a useful tool to help reduce the risk of MSDs during patient handling. As a review study, we surveyed articles focusing on applying exoskeletons to patient handling tasks specifically. We also reviewed relevant government databases and other studies related to Safe Patient Handling and Mobility (SPHM) programs and exoskeleton applications in general. The exoskeletons specifically designed for patient handling were found to be sparse. To have a better understanding of the needs and challenges of developing and using exoskeletons for reducing risks of work-related MSDs in healthcare workers during patient handling, this critical review (1) provided an overview of the existing issues and projected future burdens related to work-related MSDs during patient handling tasks, (2) recognized current and potential roles and applications of existing exoskeletons, and (3) identified challenges and needs for future exoskeleton products. In conclusion, we do not expect exoskeletons to replace the existing SPHM programs, but rather play a complementary role to these multi-pronged programs. We expect that emerging exoskeleton products can be introduced to uncontrolled or specialized healthcare environments. There are various expectations and requirements for an exoskeleton used in different healthcare settings. Additionally, introducing certain types of exoskeletons for patients to assist them during treatment and rehabilitation may help reduce the MSD risks to the healthcare workers.
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Affiliation(s)
- Liying Zheng
- Health Effects Laboratory Division, National Institute for
Occupational Safety and Health, Morgantown, WV, USA
| | - Ashley L. Hawke
- Health Effects Laboratory Division, National Institute for
Occupational Safety and Health, Morgantown, WV, USA
| | - Kimeran Evans
- Division of Physical Therapy, School of Medicine, West
Virginia University, Morgantown, WV, USA
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Rugs D, Powell-Cope G, Campo M, Darragh A, Harwood K, Kuhn J, Rockefeller K. The use of safe patient handling and mobility equipment in rehabilitation. Work 2021; 66:31-40. [PMID: 32417811 DOI: 10.3233/wor-203148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Increasingly, occupational and physical therapists are using safe patient handling and mobility (SPHM) equipment, such as mechanical lifts, in rehabilitation. However, there is little guidance in the literature on how SPHM equipment can be used to assist patients to reach rehabilitation goals. The purpose of this projectwas to document and categorize common and innovative ways rehabilitation therapists use SPHM equipment in their clinical practice. OBJECTIVE This article investigates common and innovative uses of SPHM equipment in rehabilitation practice. METHODS Occupational, physical and kinesio therapist employed at the Veterans Health Administration wrote narratives and took photos describing rehabilitation therapy activities where they used SPHM equipment in their clinical practice. The authors used a systematic process to review and categorize the narratives and subsequent photos by using the World Health Organization's International Classification of Functioning, Disability and Health (ICF). RESULTS Thirty narratives (13 innovative and 17 common) were coded into four categories on the ICF section of mobility. The most common category was "changing and maintaining basic body position"(21) followed by "walking and moving" (5). The category "carrying, moving and handling objects" garnered two narratives and there were no narratives for "using transportation." CONCLUSIONS Project findings may serve as a guide for therapists who would like to enhance their use of SPHM equipment in rehabilitation. Additional research is needed to expand the use of SPHM in rehabilitation practice and evaluate the impact on patient rehabilitation outcomes and therapist safety outcomes.
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Affiliation(s)
- Deborah Rugs
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans' Hospital and Clinics, Tampa, FL, USA.,Research and Development Services, James A. Haley Veterans' Hospital and Clinics, Tampa, FL, USA
| | - Gail Powell-Cope
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans' Hospital and Clinics, Tampa, FL, USA.,Research and Development Services, James A. Haley Veterans' Hospital and Clinics, Tampa, FL, USA
| | - Marc Campo
- Physical Therapy Department, Mercy College, Dobbs Ferry, NY, USA
| | - Amy Darragh
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Kenneth Harwood
- Department of Clinical Research & Leadership, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Judy Kuhn
- Safe Patient Handling Facility, Clement J Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA
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Awareness of Patient Physical Handling Issues Associated with Routine Nursing Care. NURSING REPORTS 2020; 10:56-65. [PMID: 34968350 PMCID: PMC8608131 DOI: 10.3390/nursrep10020009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: Physical handling (PH) of patients is an essential component of nursing care. It is an intervention that is troublesome for patients and strenuous for general nurses and other nursing staff. Handling techniques and mechanical aids for PH have improved through the years; however, they are not routinely used in nursing practice. Aim: The aim of this research was to determine (1) the level of awareness of PH issues within the management of South Bohemian hospitals, (2) how management perceives, organizes and implements PH protocols, and (3) how PH protocols are applied in everyday nursing practice. Method and Research Sample: Two qualitative methods were used: a semi-structured interview and observation. The participants were management representatives of South Bohemian hospitals in Czech Republic. Fifty nurses were observed during PH at the same hospitals. Results: The study found that PH was not monitored, nor was it provided systematically. In spite of this, no serious drawbacks were found; nonetheless, many areas were identified where the quality of PH could be improved. For example, awareness of PH issues by management, educational programs teaching new handling techniques, and provision of state-of-the-art PH aids. Several issues related to PH were found to be related to staff shortages, which remains a major problem. Conclusion: This issue needs more attention; it should be addressed by both those doing nursing research as well as those engaged in everyday nursing practice. Both will require the assistance of hospital staff and management.
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Hospitalized Adults With Intellectual and Developmental Disabilities: Confronting Challenges. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2020. [DOI: 10.1097/jat.0000000000000136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Healthcare Workers and Manual Patient Handling: A Pilot Study for Interdisciplinary Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144971. [PMID: 32664243 PMCID: PMC7399987 DOI: 10.3390/ijerph17144971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 11/20/2022]
Abstract
Manual patient handling (MPH) is a major occupational risk in healthcare settings. The aim of this study was to propose an MPH training model involving interdisciplinary aspects. A scheduled training program was performed with 60 healthcare workers (HCWs) from a hospital in Naples, Italy, providing training divided into three sections (occupational health—section one; physical therapy—section two; psychosocial section—section three) and lasting six hours. Fifty-two HCWs performed the training session. In section one, a questionnaire about risk perception related to specific working tasks was administered. Section two provided specific exercises for the postural discharge of the anatomical areas most involved in MPH. The last section provided teamwork consolidation through a role-playing exercise. The training program could also be useful for risk assessment itself, as they can examine the perceptions of the specific risk of the various workers and incorrect attitudes and therefore correct any incorrect procedures, reducing exposure to specific risks in the field. This pilot study proposes a training model that explores all aspects related to MPH risk exposure and also underlines the need for standardization of this formative model, which could represent a useful tool for studying the real effectiveness of training in workplaces.
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Falvey JR, Burke RE, Ridgeway KJ, Malone DJ, Forster JE, Stevens-Lapsley JE. Involvement of Acute Care Physical Therapists in Care Transitions for Older Adults Following Acute Hospitalization: A Cross-sectional National Survey. J Geriatr Phys Ther 2020. [PMID: 29533283 DOI: 10.1519/jpt.0000000000000187] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Recent evidence has suggested physical therapist involvement in care transitions after hospitalization is associated with reduced rates of hospital readmissions. However, little is known about how physical therapists participate in care transitions for older adults, the content of care communications, and the facilitators and barriers of implementing evidence-based care transition strategies into practice. Thus, the purpose of this article is to evaluate participation in care transition activities known to influence readmission risk among older adults, and understand perceptions of and barriers to participation in these activities. METHODS We developed a survey questionnaire to quantify hospital-based physical therapist participation in care transitions and validated it using cognitive interviewing. It was introduced to a cross-sectional national sample of physical therapists who participate in the Academy of Acute Care Physical Therapy electronic discussion board using a SurveyMonkey tool. RESULTS AND DISCUSSION More than 90% of respondents agreed they routinely recommended a discharge location and provided recommendations for durable medical equipment for patients at the time of hospital discharge. Respondents did not routinely initiate communication with therapists in other care settings, or follow up with patients to determine whether recommendations were followed. A majority of respondents agreed their facilities would not consider many key care transition activities to count as productive time.This survey provides a novel insight into how hospital-based physical therapists participate in care transitions. Communications between rehabilitation providers across care settings are infrequent, even though those communications are recommended to help reduce readmissions. However, administrative barriers were elucidated in this study that may help explain lack of therapist involvement. CONCLUSIONS Physical therapists' communications across health care setting about older adults discharging from acute care hospitalization are infrequent, but may represent a meaningful intervention target for future studies. Future research is needed to evaluate best practices for hospital-based physical therapists during care transitions.
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Affiliation(s)
- Jason R Falvey
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora
| | - Robert E Burke
- Denver Veterans Affairs Medical Center, Denver, Colorado
| | - Kyle J Ridgeway
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora
| | - Daniel J Malone
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora
| | - Jeri E Forster
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora.,Denver Veterans Affairs Medical Center, Denver, Colorado
| | - Jennifer E Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora.,Veterans Affairs Geriatric Research, Education and Clinical Center, Denver, Colorado
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Nurses and nursing assistants decision-making regarding use of safe patient handling and mobility technology: A qualitative study. Appl Nurs Res 2018; 39:141-147. [DOI: 10.1016/j.apnr.2017.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/19/2017] [Accepted: 11/02/2017] [Indexed: 11/19/2022]
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Reports From RNs on Safe Patient Handling and Mobility Programs in Acute Care Hospital Units. ACTA ACUST UNITED AC 2016; 46:566-573. [DOI: 10.1097/nna.0000000000000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Integrating Safe Patient Handling Into Physical Therapist Education: Reducing the Incidence of Physical Therapist Injury and Improving Patient Outcomes. ACTA ACUST UNITED AC 2016. [DOI: 10.1097/00001416-201630020-00007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Policy-Making Theory as an Analytical Framework in Policy Analysis: Implications for Research Design and Professional Advocacy. Phys Ther 2016; 96:101-10. [PMID: 26450973 DOI: 10.2522/ptj.20150032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 10/04/2015] [Indexed: 11/17/2022]
Abstract
Policy studies are a recent addition to the American Physical Therapy Association's Research Agenda and are critical to our understanding of various federal, state, local, and organizational policies on the provision of physical therapist services across the continuum of care. Policy analyses that help to advance the profession's various policy agendas will require relevant theoretical frameworks to be credible. The purpose of this perspective article is to: (1) demonstrate the use of a policy-making theory as an analytical framework in a policy analysis and (2) discuss how sound policy analysis can assist physical therapists in becoming more effective change agents, policy advocates, and partners with other relevant stakeholder groups. An exploratory study of state agency policy responses to address work-related musculoskeletal disorders is provided as a contemporary example to illustrate key points and to demonstrate the importance of selecting a relevant analytical framework based on the context of the policy issue under investigation.
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Author response. Phys Ther 2014; 94:1054-5. [PMID: 25115013 DOI: 10.2522/ptj.2014.94.7.1054.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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