Physical Therapist Management of Patients With Suspected or Confirmed Osteoporosis: A Clinical Practice Guideline From the Academy of Geriatric Physical Therapy.

A clinical practice guideline on physical therapist management of patients with suspected or confirmed osteoporosis was developed by a volunteer guideline development group (GDG) that was appointed by the Academy of Geriatric Physical Therapy (APTA Geriatrics). The GDG consisted of an exercise physiologist and 6 physical therapists with clinical and methodological expertise. The guideline was based on a systematic review of existing clinical practice guidelines, followed by application of the ADAPTE methodological process described by Guidelines International Network for adapting guidelines for cultural and professional utility. The recommendations contained in this guideline are derived from the 2021 Scottish Intercollegiate Guideline Network (SIGN) document: Management of Osteoporosis and the Prevention of Fragility Fractures. These guidelines are intended to assist physical therapists practicing in the United States, and implementation in the context of the US health care system is discussed.

Essential Components of Physical Therapist Management of Patients With Osteoporosis: A Delphi Study.

BACKGROUND AND PURPOSE: Osteoporosis is a systemic, metabolic bone disease that affects bone quality, increases susceptibility to low-trauma bone fracture, and has downstream effects on falls and fragility fractures. Osteoporosis is a multifactorial disease process that requires management from multiple health care providers including physicians, nurses, and physical therapists. However, the paucity of information regarding comprehensive physical therapist management for patients with osteoporosis indicated the need for an evidence-based document. The purpose of this document was to provide the best available expert guidance for clinicians in the selection of screening tools, essential tests and measures, treatment goals, and interventions for patients with osteoporosis. METHODS: A Delphi process was used. Thirty-one physical therapists with expertise in the care of patients with osteoporosis participated in a series of 3 sequential surveys designed to build and reach agreement on the management of patients with osteoporosis. The desired survey outcomes were to: (1) identify the range of examination and plan of care components considered important to physical therapists' care for patients with osteoporosis, (2) determine which components should be considered essential, and (3) achieve consensus on the final list of essential components and related operational definitions. RESULTS: A clear consensus on the essential components of examination and interventions was achieved. In general, there were 4 to 6 items across each category of history, tests and measures, education/goals, and treatment. CONCLUSIONS: The prioritization of these management items will better support clinicians working with adults who have osteoporosis.

Physical Therapist Management of Patients With Suspected or Confirmed Osteoporosis: A Clinical Practice Guideline From the Academy of Geriatric Physical Therapy.

A clinical practice guideline on physical therapist management of patients with suspected or confirmed osteoporosis was developed by a volunteer guideline development group (GDG) that was appointed by the Academy of Geriatric Physical Therapy (APTA Geriatrics). The GDG consisted of an exercise physiologist and 6 physical therapists with clinical and methodological expertise. The guideline was based on a systematic review of existing clinical practice guidelines, followed by application of the ADAPTE methodological process described by Guidelines International Network for adapting guidelines for cultural and professional utility. The recommendations contained in this guideline are derived from the 2021 Scottish Intercollegiate Guideline Network (SIGN) document: Management of Osteoporosis and the Prevention of Fragility Fractures. These guidelines are intended to assist physical therapists practicing in the United States, and implementation in the context of the US health care system is discussed.

How steady is the STEADI? Inferential analysis of the CDC fall risk toolkit.

INTRODUCTION: The CDC developed the STEADI toolkit to assist providers with incorporating fall risk screening, assessment of modifiable risk factors, and implementing evidence-based treatment strategies. The purpose of this study was two-fold: analyze the STEADI algorithm for strengths/weaknesses based upon inferential data and provide recommendations for additional research and possible limitations of the STEADI toolkit from a physical therapy perspective. METHODS: This investigation employed a quantitative, cross-sectional cohort design collating data from community-dwelling and retirement-facility seniors (n = 77) from two regions of the U.S. Data is reported based upon descriptive statistics, correlation, and validity of the STEADI algorithm, its subcomponent tests, and self-reported fall data. All participants completed the Stay Independent Brochure (SIB) and the algorithm's mobility, balance, and lower extremity strength tests regardless of risk categorization. RESULTS: Sensitivity of the STEADI with discriminating fallers and predicting future falls was better among community-dwellers (73-80%) versus the retirement facility-dwellers (56-62%). The STEADI demonstrated high false negative rates among those categorized as low risk as 57% community-dwellers and 24% facility-dwellers fell in the prior 12 months and several fell within 6 months following participation. Results suggest that it is important to conduct more than one mobility or balance screening test, and indicate that elevated STEADI risk classification was not associated with advancing age. CONCLUSIONS: Outcomes from this study suggest that cut-off scores and the selection of functional fall screening tests, as well as the relative weights and scoring of items on the SIB/3KQ be reevaluated to maximize discriminate and predictive validity of the algorithm.

Business Entity Selection: Why It Matters to Healthcare Practitioners. Part III--Nonprofits, Ethics, Practice Implications, and Conclusions.

The Bureau of Labor statistics indicates only a 50% four-year survivability rate among businesses classified as "education and health services." Gaining knowledge of IRS business entities can result in cost savings, operational efficiency, reduced liability, and enhanced sustainability. Each entity has unique disadvantages, depending on size, diversity of ownership, desire to expand, and profitability. Business structures should be compatible with organizational mission or vision statements, services and products, and professional codes of ethics. Healthcare reform will require greater business acumen. We have an ethical duty to disseminate and acquire the knowledge to properly establish and manage healthcare practices to ensure sustainable services that protect and serve the community.

Business Entity Selection: Why It Matters to Healthcare Practitioners. Part II--Corporations, Limited Liability Companies, and Professional Entities.

The Bureau of Labor statistics indicates only a 50% four-year survivability rate among businesses classified as "education and health services." Gaining knowledge of IRS business entities can result in cost savings, operational efficiency, reduced liability, and enhanced sustainability. Each entity has unique disadvantages, depending on size, diversity of ownership, desire to expand, and profitability. Business structures should be compatible with organizational mission or vision statements, services and products, and professional codes of ethics. Healthcare reform will require greater business acumen. We have an ethical duty to disseminate and acquire the knowledge to properly establish and manage healthcare practices to ensure sustainable services that protect and serve the community.

Business entity selection: why it matters to healthcare practitioners--part I--Conceptual framework, sole proprietorships, and partnerships.

The Bureau of Labor statistics indicates only a 50% four-year survivability rate among businesses classified as "education and health services." Gaining knowledge of IRS business entities can result in cost savings, operational efficiency, reduced liability, and enhanced sustainability. Each entity has unique disadvan- tages, depending on size, diversity of ownership, desire to expand, and profitability. Business structures should be compatible with the organizational mission or vision statement, services and products, and professional codes of ethics. Healthcare reform will require greater business acumen. We have an ethical duty to disseminate and acquire the knowledge to properly establish and manage healthcare practices to ensure sustainable services that protect and serve the community.