Effects of adherence to treatment for repositioning therapy, physical therapy, and cranial remolding orthoses in infants with cranial deformation.

Deformational head shapes are most often treated through repositioning therapy (RT) and/or cranial remolding orthotic (CRO) treatment. However, there is conflicting evidence about the effectiveness of each method, and treatment compliance is suspected to affect treatment effectiveness. This study examines participant adherence with these treatment methods and explores if cranial correction is related to compliance. This study also reviews effects of developmental milestones and explores other potential impacts on compliance. A total of 45 infants with cranial deformation were consented and those with congenital muscular torticollis (CMT) concurrently received physical therapy. Infants were followed from 2 to 12 months of age and initially assigned to RT. Caregivers continued RT until the head shape corrected, caregivers chose to switch to a CRO, or infants turned 12 months of age. All participants were scheduled for a final visit at 12 months of age. Throughout treatment, caregiver surveys were used to examine compliance and developmental milestones. Results show promise for future investigation into the relationship between treatment modalities and adherence with treatment for deformational head shapes. Our findings provide preliminary support that treatment adherence may be linked with treatment success and concurrent enrollment in physical therapy increases patient compliance.

The Journey: Parental Expectations and Perceptions of Therapy Services for Children With Down Syndrome.

PURPOSE: The researchers sought to identify and describe parents' expectations and perceptions of therapy services received by their children with Down syndrome. METHODS: This study used a qualitative descriptive approach conducted in 2 phases: individual semi-structured parent interviews followed by focus groups. Analysis of interview transcripts served as the basis for development of codes, categories, and themes describing parents' beliefs, values, and opinions of their children's therapy. RESULTS: Within the metaphor of The Journey, 3 major themes emerged: Where are we going? Who's driving the car? What I really need for this trip. CONCLUSIONS: Parents value the principles of family-centered care and want a partnership with therapists in caring for their children. Therapists can help parents of children with Down syndrome navigate their children's therapy services by establishing a relationship of trust and by communicating with respect, understanding, and compassion.

Physical Therapists' Perspectives on Lifelong Learning.

INTRODUCTION: In today's healthcare environment, it is critical that allied health professionals maintain and grow the requisite knowledge and skills that defined their competence upon entering the field. Despite a strong emphasis on the attribute of lifelong learning in the physical therapy profession, no psychometrically sound instrument has been developed to assess it. METHODS: The Jefferson Scale of Physical Therapist Lifelong Learning (JSPTLL) was adapted from the Jefferson Scale of Physician Lifelong Learning. A national survey of physical therapists was conducted using mailing lists from state licensure boards from a geographically diverse sample. RESULTS: Out of 7,654 survey invitations sent, 540 complete surveys were returned. The mean score of the JSPTLL was 55.13 (SD 7.4), ranging from 19 to 68. Commitment to lifelong learning had a large correlation to the JSPTLL score (rs=0.51, p<0.0001). A medium correlation exists between the JSPTLL and the level of career satisfaction (rs=0.32, p<0.0001). A small correlation exists between commitment to lifelong learning and levels of career satisfaction (r=0.27). CONCLUSION: The JSPTLL provides a means to objectify the aptitude and beliefs of the physical therapist lifelong learner. Applicability to other health professions can be established with further research.

Imperfect physician assistant and physical therapist admissions processes in the United States.

We compared and contrasted physician assistant and physical therapy profession admissions processes based on the similar number of accredited programs in the United States and the co-existence of many programs in the same school of health professions, because both professions conduct similar centralized application procedures administered by the same organization. Many studies are critical of the fallibility and inadequate scientific rigor of the high-stakes nature of health professions admissions decisions, yet typical admission processes remain very similar. Cognitive variables, most notably undergraduate grade point averages, have been shown to be the best predictors of academic achievement in the health professions. The variability of non-cognitive attributes assessed and the methods used to measure them have come under increasing scrutiny in the literature. The variance in health professions students' performance in the classroom and on certifying examinations remains unexplained, and cognitive considerations vary considerably between and among programs that describe them. One uncertainty resulting from this review is whether or not desired candidate attributes highly sought after by individual programs are more student-centered or graduate-centered. Based on the findings from the literature, we suggest that student success in the classroom versus the clinic is based on a different set of variables. Given the range of positions and general lack of reliability and validity in studies of non-cognitive admissions attributes, we think that health professions admissions processes remain imperfect works in progress.

Practice characteristics and lifestyle choices of men and women physician assistants and the relationship to career satisfaction.

With 60% of practicing physician assistants (PAs) being women, it is critical to identify any gender-related differences in career satisfaction. The purpose of this study was to identify practice characteristics and lifestyle choices of men and women practicing PAs, determine any gender-related differences, and identify whether a relationship exists between gender and career satisfaction. This descriptive study used a survey addressing career satisfaction, lifestyle choices, professional practice characteristics, and gender concerns. Randomly selected PAs completed an on-line survey. Nonparametric testing was used to analyze the data. Analyses included 85 men and 97 women respondents. More men (82.4%) than women (59.8%) were married; a significant association between gender and domestic status was found (p=0.009). The way that men rated career satisfaction was not significantly different than the way women did (p=0.47). Sixty-five percent of men and women completely agreed that they are satisfied with their career. Eighty-three percent of men and women PAs believed that they can balance their personal and professional responsibilities. While the sample was small, it does represent the demographics of PAs currently in practice and thus supports the assumption that the PA profession affords the ability to balance responsibilities and promotes career satisfaction.

Effects of an inclined walking surface and balance abilities on spatiotemporal gait parameters of older adults.

BACKGROUND AND PURPOSE: To date, few studies have investigated how walking patterns on inclines change in healthy older adults. The purpose of the study was to examine the effects of an inclined walking surface and balance abilities on various spatiotemporal gait parameters of healthy older adults. METHODS: Seventy-eight self-reported independent community ambulators (mean age, 77.8 years; SD, 4.8) participated in this study. After completing the Berg Balance Scale and Dynamic Gait Index (DGI), all participants were asked to walk on the GaitRite on level and inclined surfaces (10° slope). Dependent t tests were used to determine statistical significance between level and inclined surfaces for cadence, step length, velocity, and gait stability ratio (GSR). GSR is a measure of the degree of adaptation an individual makes to increase stability during gait derived from a ratio of cadence/velocity. A 2 2 analysis of variance was performed to determine differences in means among the higher-risk participants (as determined by the Berg Balance Scale and Dynamic Gait Index) comparing their level and incline walking patterns. The level of significance was set at P 0.05. RESULTS: During incline walking a significant decrease occurred in mean step length, 63.1(8.8) cm, P 0.001, mean cadence, 111.6 (8.9) step/min, P 0.01 and mean normalized velocity, 1.4 (0.23), P 0.001. However, mean GSR increased on inclines, 1.62 (0.22) steps/m, P 0.004. Main effects were evident for both walking surface and fall risk for all gait parameters tested. CONCLUSIONS: Healthy older adults adopt a more stable gait pattern on inclines decreasing velocity and spending more time in the double support despite the increased physiological demands to perform this task. Clear changes were evident between level and incline surfaces regardless of fall risk as defined by 2 different objective balance measures [corrected].