Characteristics of US-based physical therapist education programs cited for core faculty deficiencies in 2019-2020.

INTRODUCTION: Changes in the accreditation standards of physical therapist education have added new levels of rigor to core faculty qualifications. This study aims to determine if any program characteristics exist that are common to core faculty deficiency citations in the 2019-2020 review cycle. Recently, more than half of all accredited physical therapist education programs (51.5%) have earned citations in core faculty standards/elements. SUBJECTS: A total of 266 Commission on Accreditation in Physical Therapy Education (CAPTE) accredited and developing physical therapist education programs were included. METHODS: A review and analysis of programs cited and programs without citation was completed in 2021, to investigate these characteristics in relation to citation status: Campus setting, Regional accreditor, Length of CAPTE accreditation, University control, Carnegie classification, Physical Therapist Centralized Application Service participant, and Program cohort size. RESULTS: A regression model was found to correctly predict with 91.3% accuracy when including common characteristics of campus setting, years of accreditation, university control, and Carnegie class in programs cited for faculty deficiency. CONCLUSION: Our results suggest that programs residing in a town or rural setting, accredited for ten years or less, housed in an institution with a Carnegie classification of Master's or Baccalaureate, within private institutions, and enroll cohorts less than 31 are more likely to receive citations related to the qualifications or adequacy of core faculty than their counterparts. The description of characteristics common to programs cited could provide guidance to other programs in factors that might predispose them to core faculty deficiencies in the future.

Adherence of stem cell transplant recipients receiving glucocorticoid therapy to an exercise-based rehabilitation program.

The high acuity of hematopoietic stem cell transplant (HSCT) recipients receiving glucocorticoid (GC) therapy for acute graft vs. host disease (aGVHD) may limit their adherence to an exercise-based rehabilitation program and hence, slow their recovery. To make this determination, the medical records of 59 subacute outpatient stem cell transplant recipients receiving methylprednisolone (MP) were reviewed for demographic, anthropometric and medical information. Performance on the repeated sit-to-stand, 50-ft walk and 6-min walk tests were determined before and after completing a 4-week progressive exercise rehabilitation program and outcomes were compared by a paired t-test (P < 0.05). Thirty-two patients (54%) finished a treatment plan (adherent group), completing 80% of the prescribed sessions and were reevaluated. Twenty-seven patients (46%) did not complete the rehabilitation program (nonadherent group), primarily because of readmission to the hospital (18 patients, 62%). The adherent group did not significantly improve their physical performance (p > 0.05). However, a subgroup of 40% of these patients did experience clinically significant improvements in their physical performance.These findings 1) support the feasibility of having HSCT recipients receiving GC therapy to participate in an exercise-based rehabilitation program and 2) suggest that to do so can result in clinically significant improvements in functional capacity.

Pulmonary rehabilitation improves functional status in oncology patients.

OBJECTIVE: To determine if participation in a pulmonary rehabilitation (PR) program improved the functional and physiologic status of oncology patients with chronic symptoms of shortness of breath, fatigue, and/or exercise intolerance. DESIGN: Retrospective chart review. SETTING: Comprehensive cancer center. PATIENTS: Oncology patients (N=30) (either a solid or a hematologic malignancy) with chronic dyspnea, exercise intolerance, and/or decreased functional status who had participated in an outpatient PR program. INTERVENTIONS: The PR program used an individualized, progressive aerobic exercise program (2-3 sessions/wk for 8-12 weeks) that consisted of treadmill walking, riding on a bicycle ergometer and exercising on a sliding board. This program also included a didactic educational and psychosocial component. MAIN OUTCOME MEASURES: Functional status and exercise tolerance was assessed by the 6-minute walk test (6MWT) conducted at the beginning and end of the program. Self reports of perceived exertion and dyspnea were collected during and after these tests. Physiologic status was assessed by calculating 6-minute walk work (body mass x 6-minute walk distance). RESULTS: Participation in the outpatient PR program significantly increased the 6-minute walk distance (21%, P<.05) and 6-minute walk work (17%, P<.05). Dyspnea and perceived exertion scores were similar at the pre- and postrehabilitation 6MWT despite the greater physiologic demand of the post-rehabilitation 6-minute walk. No adverse events occurred during the study. CONCLUSIONS: The current study, although limited in size, suggests that participation in a comprehensive outpatient PR program is safe and of benefit in a heterogeneous population of oncology patients with pulmonary symptoms.

Negative pressure wound therapy achieved by vacuum-assisted closure: Evaluating the assumptions.

Wounds and the accompanying loss of skin integrity often place a patient at increased risk for disability or death. Billions of dollars are spent each year to treat wounds and the effectiveness of these different treatments is highly variable. Following a 1997 publication describing a new treatment therapy that involved creating negative pressure over the wound, many publications have described the purported mechanism of action by which negative pressure may help wounds heal. Although this therapy appears effective, it remains unknown whether it is more effective than other wound closure techniques. In addition, although many uncontrolled, non-randomized studies describing the effectiveness of this therapy have been published, few prospective randomized trials have been conducted. Small sample sizes, variable outcome measures across studies, and significant methodological problems in the available randomized control trials further limit the conclusions that can be drawn regarding the relative effectiveness of vacuum-assisted wound closure. Analysis of these data provides weak evidence to suggest that negative pressure therapy is superior to saline gauze dressings in healing chronic wounds. Randomized controlled trials comparing healing, costs of care, patient pain, and quality-of-life outcomes of this treatment to non-gauze type dressings and other treatment modalities are needed.

A pilot study on continuous femoral perineural catheter for analgesia after total knee arthroplasty: the effect on physical rehabilitation and outcomes.

Two techniques of postoperative analgesia for primary total knee arthroplasty were compared retrospectively. Twenty-four patients received a femoral nerve catheter with continuous infusion of ropivacaine (FNC group), whereas 26 patients received intravenous (IV) opioids (IV opioid group). Pain and rehabilitation scores and hospital length of stay (LOS) were compared. On the first postoperative day, both groups reported similar pain scores. After 4 sessions of twice-daily rehabilitation, the FNC group used less IV patient-controlled opioids (29.1% vs 84.5%, P = .0001) and demonstrated better performance with knee flexion and mobility. Hospital LOS was significantly less in the FNC group (3.6 vs 4.2 days, P = .034). Femoral nerve catheters with continuous infusion of ropivacaine provide satisfactory analgesia, improve rehabilitation, and shorten hospital LOS.