Home Health Physical Therapists' Perceptions in Clinical Management of the Patient Following Post-Onset of COVID-19.

BACKGROUND: Rehabilitative care in the home notably declined in the early onset of the COVID-19 pandemic and has been suggested to have greatly affected patient health¬care. PURPOSE: To examine the perspectives of home health physical therapists (PTs) on the impact of COVID-19 on patient management and fall risk assessment. METH¬ODS: The study utilized a 42-question internet-based survey to collect data from home health PTs. RESULTS: A total of 116 responses were analyzed. Most PTs (68.1%) reported the belief that their patients were more impaired than prior to COVID-19, but the referral rate for physical therapy decreased (50%). PT fearfulness did not increase when in close contact with patients (62.1%) or in the home (72.4%). Patients expressed fear in engaging in close contact with PTs (49.1%) and receiving physical therapy in the home (52.6%). PTs (45.8%) believe patients experienced an increased incidence of falls, but PTs did not change their fall risk assessment methods (62.9%). CONCLUSIONS: Patients would benefit from education by PTs to allay their fears while participating in physical therapy in the home setting. This was relevant since patients were reported by many PTs to have an increase in fall risk but may not have sought medical care due to fear of contracting COVID-19.

Effect of Ulnar-Based Orthotics and Strengthening Exercises on Subjects With Ulnar Wrist Pain.

CONTEXT: In comparison with the published research on the surgical management of ulnar wrist pain, fewer studies that discuss the nonsurgical management of ulnar wrist pain exist. OBJECTIVE: The purpose of this pilot study was to investigate the effect of ulnar-based wrist orthotics and strengthening exercises on subjects with ulnar wrist pain. STUDY DESIGN: Prospective randomized controlled pilot study. SETTING: Research laboratory. PARTICIPANTS: Thirty subjects with acute and subacute ulnar wrist pain and age ranging from 18 to 53. INTERVENTIONS: Participants were randomized to receive either ulnar-based orthotics, ulnar-based orthotics plus strengthening exercises, or placebo intervention. MAIN OUTCOME MEASURES: The authors measured pain and function using the Patient-Rated Wrist Evaluation questionnaire, and grip strength using the JAMAR dynamometer, at baseline and at 2- and 4-week postrandomization. A mixed analysis of variance modeling was used to investigate the effect of the intervention over time. RESULTS: There were statistically significant differences between the 2 intervention groups and the control group regarding improvement in pain, function, and strength, whereas there were no statistically significant differences between the 2 intervention groups over the 3 measurement occasions regarding the outcome measures. CONCLUSION: Based on the results, orthotics intervention is as effective as orthotics plus strengthening exercises in improving pain, function, and grip strength in subjects with ulnar wrist pain. LEVEL OF EVIDENCE: Therapy, level 2b individual Randomized Controlled Trial.

Application of the Evidence-Based Practice Model by Physical Therapy Clinical Practitioners.

The evidence-based practice (EBP) model has served as a framework for clinical reasoning since Sackett first defined it in the late 1990s. Since then, this model has been implemented within various clinical healthcare settings by an array of healthcare practitioners including physical therapists. In the case of the latter, it is not clear how practicing physical therapists perceive the usefulness of this model within the clinical setting, nor to what extent they are able to apply it. The current study assessed practicing physical therapists on their perceptions of EBP as well as their general statistical knowledge. Although all participants agreed upon the import of the EBP model in their clinical skillset, not all could identify its common definition (75% provided correct responses), and responded their understanding of research methods were "strong" or "good" (90%), but for statistical methods were less so by comparison (76%). The majority of the respondents could not answer five questions assessing general knowledge in statistical design, with percent frequency of correct responses ranging from 7%, 24%, 0%, 31%, and 31%, respectively. These findings suggest support is warranted for practicing clinicians for appropriate application of the EBP model to occur within the clinical setting.