The struggle of dealing with uncertainty: a qualitative, phenomenological study about how Dutch novice physical therapists experience their transition from student to professional.

OBJECTIVE: To explain how Dutch novice physical therapists experience their transition from student to physical therapist in private practice. METHODS: A qualitative, phenomenological study was performed in The Netherlands to collect personal experiences from novice physical therapists who graduated <1 year ago. Data were collected with semi-structured interviews and analyzed using interpretative phenomenological analysis. RESULTS: The transition experience from student to novice physical therapist is a personal, complex, and context-dependent phenomenon. Sixteen novice physical therapists (of whom 10 were still working in private practice) said their transition was liberating, stressful, insecure, unexpected, chaotic, and challenging. The variety in experiences occurred from the fact that the impact of an experience varies from one individual to the other, depending on their previous (life) experiences, uncertainty tolerance, coping, and personal and professional environment. Four overarching themes emerged: (1) 'Suddenly, I was on my own', (2) 'I was unprepared for the hassle and demands of clinical practice', (3) 'I couldn't make the impact I expected', and (4) 'I had to find a new me'. CONCLUSIONS: A novice physical therapist's transition is a context-related phenomenon, unique for each individual and determined by individual experiences and coping strategies. Novice physical therapists described a feeling of 'faking': they had to pretend to know what they were doing [while treating a patient] while in reality, they felt like they did not. For some novice physical therapists, a primary reason to leave the profession.

Physical Therapists in Primary Care in the United States: An Overview of Current Practice Models and Implementation Strategies.

In the United States, physician shortages and increases in noncommunicable disease burden have resulted in a growing demand for primary care providers (PCPs). Patients with physical and functional impairments have been especially affected by these challenges. However, physical therapists are well suited to meet patient needs in primary care settings by working alongside PCPs and other primary health care team members. When included in a primary care team, physical therapists can improve patient access to care, optimize care navigation, and reduce the overall cost of care. Therefore, the purpose of the current perspective was to (1) provide an overview of established integrated primary care models in the United States that include physical therapists in the care team and (2) outline operational and practice considerations for health care administrators and professionals interested in integrating physical therapists into primary care teams. IMPACT STATEMENT: Given physician shortages and increasing burden in primary care in the United States, inclusion of a physical therapist in a primary care team can improve patient access to care, optimize care navigation, and reduce the overall cost of care for patients with physical and functional needs.

[Job satisfaction and violence in the clinical relationship in Physical Therapists in Spain]. / Satisfacción laboral y violencia en la relación clínica en Fisioterapia en España.

OBJECTIVE: To assess the job satisfaction (JS) of physiotherapists in Spain and their relationship with occupational violence, as with other socio-demographic, health, and occupational factors. DESIGN: A cross-sectional study was conducted. Setting Primary, community, and hospital attention level at public and private care in Spain. PARTICIPANTS: Physiotherapists in Spain who have been working for at least 3months during the last year, and with complete answer to the required variables (n=2,590). MAIN MEASUREMENTS: Information was collected through a questionnaire distributed online. A descriptive quantitative analysis and 3 logistic regression models were performed. In the first model, sociodemographic and violence variables were included as independent variables, in the second, health-related variables, and in the third, occupational variables. RESULTS: The average JS of physiotherapists is 7.26 points, being 8 or more in 46.8% of the cases, with a higher percentage in men". Referring not having suffered psychological violence was related to a higher probability of having JS, even controlling for the rest of the variables studied (OR1=0.485; OR2=0.611; OR3=0.697, respectively for each model). Variables related to health (state of health, symptoms, consumption of tobacco/alcohol/other substances) and to the work environment (working day, work area, autonomy, relationship with superiors/colleagues) were statistically significantly related to JS. CONCLUSIONS: Almost 47% of the respondents had very high JS values. Certain areas of work as well as positive health factors have been linked to very high JS. Psychological violence is the form of violence that, independently of the other factors analysed, leads to lower JS.

Knowledge, Attitude, Beliefs, and Practice Related to Concussion Injury Among Sports Physical Therapists in Riyadh, Saudi Arabia. A Cross-sectional Analysis.

Background and Objective: Sport-related concussions (SRC) are estimated to affect more than 55 million individuals annually. Physical therapists ought to have fundamental knowledge regarding the evaluation and treatment of SRC. Thus, this study aims to evaluate the knowledge, attitude, and practice of the physical therapists regarding SRC management in Riyadh, Saudi Arabia. Materials and Methods: The cross-sectional study enrolled 83 sports physical therapist who had atleast undergraduate degree and above in physical therapy from Riyadh region. The participants who worked outside the Riyadh region were excluded. A validated adopted questionnaire was used to evaluate the outcome measures. Results: The study showed that sport physical therapists have a good understanding and knowledge about concussions having 3.91 ± 0.98 scores on the five-point Likert scale. In addition, participants were able to recognize concussion signs and symptoms correctly; however, they felt that they lacked confidence to make a decision regarding return to play. Conclusion: Our study revealed important knowledge gaps regarding the utilization of concussion severity scales, management of youth concussion, and/or the use of neurological imaging modalities for diagnosing concussion cases.

Exploring the role of healthcare partners in referrals to a community-based exercise program with a healthcare-community partnership designed for people with balance and mobility limitations.

PURPOSE: To explore how healthcare partners in community-based exercise programs for people with balance and mobility limitations perceive and enact referral in the context of their role. MATERIALS AND METHODS: We conducted a descriptive, qualitative study involving semi-structured interviews and reflexive thematic analysis. RESULTS: Twelve healthcare partners from the Together In Movement and Exercise (TIMETM) program completed interviews. Seven (58%) participants were clinicians and 5 (42%) held non-clinical roles. The most common professional background of participants was physical therapy (n = 9, 75%). Clinicians made direct referrals while non-clinical participants facilitated referral by promoting the program. The main theme was healthcare partners perceive their role in referrals as secondary to their role as educators and trainers. Subthemes were: (1) healthcare partners fulfill educator and trainer roles when conducting formal training of instructors, educating instructors during program visits, and fielding questions; (2) almost all healthcare partners facilitate referral by sharing program information formally and informally; and (3) healthcare partners in clinical practice make direct referrals depending on the clientele. CONCLUSIONS: Healthcare partners perceive their roles as educators and trainers as taking precedence over their role in referrals. Findings can be used to guide selection and training of healthcare partners, design of clinical education programs, and research on competencies.

Healthcare partners involved in supporting community-based exercise programs with healthcare-community partnerships (CBEP-HCPs) perceive their role in referrals as secondary to their roles in education, training, and overseeing the programCBEP-HCP program implementation may benefit from the inclusion of additional training and resources for supporting healthcare partners in non-clinical and clinical roles for facilitating referralEntry-to-practice healthcare professional education programs, particularly physical therapy programs, should consider including training on boundary-spanning competencies to prepare healthcare professional students for roles like being a healthcare partner.

Health behaviours and work-related musculoskeletal pain among polish physiotherapists and nurses.

BACKGROUND: Physiotherapists and nurses play crucial roles in healthcare, often requiring them to adopt physically demanding positions. However, these positions can lead to joint stress and an increased risk of injury, as well as work-related musculoskeletal disorders (WRMSDs). These disorders can significantly impact the performance of their duties, which can negatively affect patient recovery. OBJECTIVE: This study assessed and compared health behaviour and work-related musculoskeletal pain among Polish physiotherapists and nurses. METHODS: The study encompassed a group of 304 participants. The methodology consisted of a survey addressing pain-related questions and the Health Behaviour Inventory (HBI). The HBI evaluates health behaviour in four categories. RESULTS: The average HBI score was 5.05 (±1.96) points for physiotherapists and 4.50 (±1.86) points for nurses (P = .01). When analysing the HBI components, a statistically significant difference was observed in positive mental attitude and health practices (P <  .05). Regarding work-related musculoskeletal pain, 92% of nurses and 79% of physiotherapists reported experiencing pain while working (P <  .01). Pain intensity, measured with the VAS, was 3.77 (±2.37) for physiotherapists and 4.73 (SD 2.04) for nurses (P <  .01). Physiotherapists more often suffered from upper limb pain (57% vs 49%), while nurses experienced middle/lower back pain (82% vs 63%) and lower extremity pain (38% vs 23%) more frequently. CONCLUSIONS: Both professional groups experience WRMSDs, with nurses suffering more regularly and severely. In contrast, physiotherapists exhibit superior health behaviour practices, potentially mitigating musculoskeletal pain. Nonetheless, the prevalence of pain related to WRMSDs remains alarmingly high in both professions.

Comparing Physical Activity and Exercise Experiences, Values, and Beliefs of Latino, Latina, and/or Latine People and Non-Latino, Non-Latina, and/or Non-Latine People with Parkinson Disease: A Qualitative Study.

OBJECTIVE: The objective of this study was to examine and compare the beliefs, values, experiences, and barriers to and facilitators of exercise in Latino/a/e (Latino, Latina, and/or Latine) people and non-Latino/a/e (non-Latino, non-Latina, and/or non-Latine) people with Parkinson disease (PD). METHODS: This study involved a qualitative research design, with data collection via focus groups of Latino/a/e and non-Latino/a/e people with PD. A semistructured interview protocol was used, and a theoretical (social ecological model) thematic analysis was used for data analysis. RESULTS: Twenty-five individuals (15 non-Latino/a/e and 10 Latino/a/e) participated across 5 focus groups. While there were several common themes among both groups, 7 themes related to exercise in the management of PD were unique to Latino/a/e participants: generalized versus specific knowledge of exercise components; family can have both facilitating and impeding roles; finances influence access to exercise and physical therapy; prior emotional experiences related to exercise and PD affect the future use of exercise; group exercise can have both facilitating and impeding roles; availability and access to a variety of modes and stratification of exercise classes for people with PD facilitate exercise; and cultural beliefs and expectations can impede the use of exercise at the population level. CONCLUSION: Latino/a/e people with PD have overlapping and unique themes related to the use of exercise. Distinctive factors must be addressed in physical activity interventions and during physical therapists' care of people with PD to maximize the use of exercise and ultimately improve health equity in this overburdened and underserved population. IMPACT: Physical therapists should provide information and education to their Latino/a/e patients with PD and family members on the frequency, intensity, type, and time of exercise and how to safely participate in physical activity in the home and community to best manage PD. Physical therapists and exercise professionals should work at the environmental level to increase access to affordable, culturally tailored, PD-specific exercise services and enhance community knowledge of PD.

Diversifying the Physical Therapist Workforce through Holistic Hiring, Admissions, and Retention Processes.

In 2002, the Institute of Medicine's recommendations emphasized diversifying the health care workforce to reduce racial and ethnic health disparities. Despite these efforts, the physical therapist profession remains predominantly White. The College of Saint Mary (CSM) Doctor of Physical Therapy program employs deliberate strategies through 2 committees, faculty search and admissions, to foster diversity in both faculty and student populations. The CSM DPT Program Faculty Search Committee, in collaboration with the CSM Human Resource Department, devised a comprehensive 3-phase recruitment process aimed at attracting qualified candidates from diverse backgrounds. Through purposeful mission-driven and equity-focused strategies, this approach has yielded a faculty body characterized by diversity, with 80% of faculty members self-identifying as belonging to historically excluded groups. Similarly, the Admissions Committee has adopted proactive measures to ensure a diverse student body. By implementing a holistic admissions process recommended by the Association of American Medical Colleges, including evaluating prerequisite courses and eliminating the Graduate Record Examination requirement, the committee has facilitated more equitable access to the program. Virtual interviews and thorough candidate assessments are conducted to mitigate potential biases in the selection process. As a result, these efforts have allowed us to maintain diverse cohorts, with 20-30% of our student body identifying as members of historically excluded groups. Impact. Developing and sustaining a physical therapist workforce that reflects the communities it serves necessitates purposeful, mission-driven, and equitable strategies. These strategies aim to broaden the diversity of both faculty and student populations. Through such initiatives, we aim to foster an inclusive environment that reflects our society's richness, enabling us to better understand society's complex needs and mitigate health disparities.

Work-related musculoskeletal complaints of physiotherapists working in intensive care units: Frequency analysis, risk factors, management and prevention strategies.

BACKGROUND: Intensive care physiotherapists are exposed to situations that may cause physical and mental overload, which can lead to the onset of work-related musculoskeletal complaints. OBJECTIVE: The objective was to analyze these complaints and to identify activities causing greater overload, factors associated with complaints, and management and prevention strategies. METHODS: Cross-sectional study. Data were collected from 125 physiotherapists in the Intensive Care units (ICU) of a tertiary hospital. The questionnaire used was formulated from questionnaires validated in the literature such as Nordic Questionnaire and Bork Questionnaire. Chi-square test was performed to compare the groups with and without complaints. Logistic regression was used to assess the association effects of the variables on the presence of complaints. RESULTS: Of those interviewed, 76% had a work-related complaint in the last year, with the "lower back" being the most affected region. Eighty percent had complaints for more than one site. "Transfer" was considered the activity causing the greatest overload. Female sex (p = 0.023), lack of physical activity (p = 0.028), inadequate ventilation (p = 0.001) and inadequate furniture (p = 0.006) showed a statistically significant association effect with the presence of complaints. Inadequate ventilation (p = 0.003) and female sex (p = 0.004) influenced the number of affected areas. Physical activity was considered the main strategy for prevention. CONCLUSION: Musculoskeletal complaints accounted for a high percentage of the analyzed sample, mainly in the lower back. The extent of complaints suggests that strategies should be developed and changes in work dynamics should be carried out.

Patients', physiotherapists' and other stakeholders' experiences and perceptions about supported home physiotherapy for people with musculoskeletal conditions: a qualitative study.

OBJECTIVES: Exercise, support and advice are the key treatment strategies of musculoskeletal problems. The aims of this study were to determine patients', physiotherapists', and other stakeholders' perspectives about supported home physiotherapy for the management of musculoskeletal problems and to identify the barriers and facilitators to rolling out this model of physiotherapy service delivery. METHODS: This study was conducted as part of a process evaluation run alongside a large trial designed to determine whether supported home physiotherapy is as good or better than a course of in-person physiotherapy. Forty interviews were conducted with 20 trial participants, 15 physiotherapists, and 5 other stakeholders. The interviews were semi-structured and based on interview guides. Each interview was transcribed and a three-tiered coding tree was developed. RESULTS: Six key themes were identified. Supported home physiotherapy (i) is convenient for some patients, (ii) does not always align with patients' and therapists' expectations about treatment (iii) is suitable for some but not all, (iv) can reduce personal connection and accountability, (v) has implications for physiotherapists' workloads, and (vi) has barriers and facilitators to future implementation. CONCLUSIONS: Findings suggest that patients are far more accepting of supported home physiotherapy than physiotherapists assume. This model of service delivery could be rolled out to improve access to physiotherapy and to provide a convenient and effective way of delivering physiotherapy to some patients with musculoskeletal conditions if our trial results indicate that supported home physiotherapy is as good or better than in-person physiotherapy. CLINICAL TRIAL REGISTRY NUMBER: ACTRN12619000065190 CONTRIBUTIONS OF THIS PAPER.

Effect of a 4-Week Telerehabilitation Program for People with Post-COVID Syndrome on Physical Function and Symptoms: Protocol for a Randomized Controlled Trial.

OBJECTIVE: COVID-19 has led to significant morbidity and mortality globally. Post-COVID sequelae can persist beyond the acute and subacute phases of infection, often termed Post-COVID Syndrome (PCS). There is limited evidence on the appropriate rehabilitation for people with PCS. The aim of this study is to evaluate the effect on exercise capacity, symptoms, cognition, anxiety, depression, health-related quality of life (HRQoL), and fatigue, of a 4-week, twice-weekly supervised pulmonary telerehabilitation program compared to usual medical care for people with PCS with persistent respiratory symptoms. METHODS: The study will be a multi-site randomized controlled trial (RCT) with assessor blinding. Participants with confirmed previous COVID-19 infection and persistent respiratory symptoms who attend a post-COVID respiratory clinic will be randomized 1:1 to either an intervention group (IG) of 4 weeks, twice-weekly pulmonary telerehabilitation or a control group (CG) of usual medical care. Participants in the CG will be invited to cross-over into the IG after the week 4 assessment. Primary outcome: exercise capacity measured by the 1-minute sit-to-stand test. Secondary outcomes: 5 repetition sit-to-stand test; Montreal Cognitive Assessment; COVID-19 Yorkshire Rehabilitation Scale; COPD Assessment Test; 36-Item Short-Form Health Survey; Hospital Anxiety and Depression Scale; Fatigue Severity Scale; and the Kessler Psychological Distress Scale. Outcomes will be collected at baseline, after 4-weeks intervention or control period, after intervention in the cross-over group, and at 12-month follow-up. IMPACT STATEMENT: Research into effective rehabilitation programs is crucial given the substantial morbidity associated with PCS and the lack of long-term data for COVID-19 recovery. A short duration pulmonary telerehabilitation program, if effective compared to usual care, could inform practice guidelines and direct future clinical trials for the benefit of individuals with persistent respiratory symptoms post-COVID.

Navigating the layers of concern for safe dry needling of the rectus abdominis: a cadaveric study.

OBJECTIVES: To assess needle placement accuracy in the rectus abdominis (RA) muscle during dry needling (DN) without entering the peritoneum. METHODS: Two physical therapists performed DN on a cadaver, making 10 attempts each to needle the RA without entering the peritoneum. Techniques followed two common DN approaches. Ultrasound verified needle depth and safety. RESULTS: Seventy percent of attempts were recorded as safe needle placement, while 30% were unsafe. Accurate RA needle placement without peritoneal entry occurred in 55% of attempts. DISCUSSION/CONCLUSION: Inadvertent peritoneal needle placement during RA DN poses risks regardless of experience. Ultrasound guidance may enhance safety and precision in clinical practice.

Rehabilitative Health Care Professionals' Perceptions of Appearance-Based Professionalism.

CONTEXT: Professionalism has been discussed and defined in a variety of ways, including attire and other forms of self-expression. OBJECTIVES: To determine athletic trainer (AT), physical therapist (PT), and athletic training or PT students' perceptions of appearance-based professionalism in the workplace and, secondly, to ascertain how perceptions differed across professions. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: Athletic trainers, PTs, and athletic training and PT students who were predominantly White, non-Hispanic, female, aged 30 ± 9 years, and recruited via listservs and social media. DATA COLLECTION AND ANALYSIS: The independent variables were participant demographics. The dependent variables were self-reported perceptions of professionalism for each photo. The survey consisted of 3 sections: demographics, 8 photos of ATs or PTs with depictions of patient-provider interactions, and open-ended responses. For each photo, participants selected yes, no, or unsure regarding the photo. An open-ended response was prompted with a no or unsure selection. The participant further described the reason for that choice. RESULTS: Most participants determined the health care provider depicted in 7 photos appeared professional. Only 1 photo was deemed unprofessional by the professional majority. Significant differences existed between students and professionals for 5 photos. The proportion of participants who reported the photos were unprofessional differed among professions for 2 photos. From our qualitative analysis, we found 6 domains: (1) unprofessional attire and hair, (2) situation-dependent attire, (3) role confusion and health care employer or employee identification, (4) nonappearance related, (5) tattoo-related bias, and (6) rethinking after question is displayed. CONCLUSION: What is considered appropriate and professional is not concrete. Differing concepts of professionalism generated biased judgments and criticisms. CLINICAL RELEVANCE: Our findings should lead providers to reexamine the definition of professionalism. The past should not dictate the future, and today's social mores can help shape the definition as it should be considered in today's settings.

Collaboration in the midst of chaos: perspectives of inpatient occupational and physical therapists during the COVID-19 pandemic.

The COVID-19 pandemic has affected over 700 million people globally, straining healthcare systems and highlighting the need for interprofessional collaboration. The aim of this study was to describe interprofessional collaborative practice (IPCP) experiences from the perspectives of occupational therapists (OTs) and physical therapists (PTs) who were employed in a medical center both before and during the COVID-19 pandemic. This qualitative study, conducted from July 2020-November 2021, delved into the lived experiences of occupational and physical therapists in an inpatient setting during the pandemic through analysis of semi-structured interviews and journal entries. The pandemic prompted fear, uncertainty, and ethical dilemmas among therapists, affecting patient-centered care. Roles expanded, and teamwork challenges emerged in defining boundaries, while communication dynamics were transformed by virtual technologies. The pandemic affected therapists' values and ethics, and evolving roles brought expanded tasks. The crisis showcased both collaboration potential and the need to address team disparities. This study highlights the significance of values, roles, teams, and communication for occupational and physical therapists during the COVID-19 pandemic providing valuable insights into interprofessional collaboration's effect on healthcare delivery in times of crisis and beyond.

Work-related musculoskeletal pain among physical therapists: a cross-sectional study in Kyoto and Shiga prefectures, Japan.

OBJECTIVES: This study aimed to determine the actual working conditions and prevalence of musculoskeletal pain among physical therapists in Japan, and the risk factors associated with low back pain (LBP) and upper limb pain (ULP). METHODS: A cross-sectional study of physical therapists in the Kyoto and Shiga prefectures was conducted using a self-administered questionnaire. The survey contents included questions regarding personal, work-related, and musculoskeletal pain factors. Logistic regression models were used to analyze factors associated with LBP and ULP. RESULTS: Responses from 1479 participants were included in the analyses. The prevalence of LBP at the time of the survey and in the past year was 40.1% and 74.3% in females, and 37.8% and 69.9% in males, respectively. The prevalence of ULP was 34.8% and 64.2% in females, and 27.2% and 53.3% in males. The numbers of patients who performed manual therapy per day, worked using a fixed-height bed, performed manual therapy, had job dissatisfaction and stress, were over 40 years old, and slept less than 6 hours were associated with LBP and ULP. Assistance task was a risk factor only for LBP, and female sex a risk factor only for ULP. CONCLUSIONS: The prevalence of LBP and ULP among physical therapists in Japan was as high as that in nurses and care workers. Work-related factors associated with LBP and ULP were identified among physical therapists. Thus, to prevent work-related musculoskeletal disorders, measures to reduce the physical burden from the perspective of occupational health are required.

Unintended consequences - A qualitative exploration of baseline testing in community rugby concussion management.

OBJECTIVES: Understanding key stakeholders' perceptions around the value of baseline testing, as well as barriers or facilitators experienced as part of the process, may assist with the decision-making process of whether to implement baseline testing in community sport. This study explored coaches', players' and physiotherapists' perceptions of the perceived value, barriers and facilitators of baseline testing as part of New Zealand Rugby's (NZR) community concussion initiative. DESIGN: The study employed a pragmatic, qualitative descriptive design. METHODS: Semi-structured interviews were used to explore participants' perceptions. In total, 73 individual interviews were conducted. The sample consisted of 36 players, 13 coaches and 24 physiotherapists involved in NZR's concussion management pathway. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis. RESULTS: In terms of perceived value, baseline testing was reported to play a role in i) facilitating a positive concussion culture; ii) positive perceptions of rugby and player safety and iii) enhancing concussion management as part of the pathway. Barriers and facilitators of the baseline testing process included i) stakeholder buy-in as critical driver of the process and ii) contextual and operational factors. Although contextual and operational challenges exist, these participants, as key stakeholders in the process, perceived the value of baseline testing to be more important than the barriers experienced. CONCLUSIONS: The value of baseline testing extends beyond concussion assessment and management, by enhancing community concussion awareness, attitudes and player safety. The findings of this study may assist in the decision-making process around inclusion of pre-season baseline testing in community rugby.

Diversity, Equity, Inclusion, and Antiracism Research in Physical Therapy over the Last 25 Years: A Scoping Review.

OBJECTIVE: Discussions of the root causes of health disparities and educational inequities often neglect to identify racism as a primary factor. Researchers must take a systems perspective in order to identify the effects of racism and other forms of systemic oppression on health. It is unclear to what extent this perspective exists in the physical therapy research literature. We conducted a scoping review to quantify and describe the volume of research in physical therapy pertaining to diversity, equity, and inclusion that specifically examines race and/or ethnicity and references racism or antiracism. METHODS: A systematic search of PubMed and Scopus databases for articles published between 1997 and 2021 was conducted. Articles were screened to ensure they were focused exclusively or primarily on physical therapy and used diversity, equity, and inclusion terms in the context of personal identity factors. This resulted in 158 relevant articles. Each was tagged with an article type and personal identity factor focus. RESULTS: A majority of the included articles were descriptive/observational in nature. The included articles explored various personal identity factors, with race and ethnicity being the most common focus followed by culture, disability, and socioeconomic status. A small proportion of articles explicitly discussed racism or antiracism. CONCLUSION: These findings highlight the need in physical therapy research for greater attention to racism as a fundamental cause of health disparities and educational inequities. Addressing this gap is crucial for promoting diversity, equity, and inclusion within the field and ultimately achieving optimal health outcomes for marginalized populations. IMPACT: Including consideration of racism and other forms of systemic oppression in the motivation, design, and interpretation of research in physical therapy will help to make more visible the root causes of inequity and improve our ability to develop effective, multi-level interventions.

Feasibility of Physiotherapist-Led Rheumatology Triage: A Randomized Study.

OBJECTIVE: Given global shortages in the rheumatology workforce, the demand for rheumatology assessment often exceeds the capacity to provide timely access to care. Accurate triage of patient referrals is important to ensure appropriate utilization of finite resources. We assessed the feasibility of physiotherapist (PT)-led triage using a standardized protocol in identifying cases of inflammatory arthritis (IA), as compared to usual rheumatologist triage of referrals for joint pain, in a tertiary care rheumatology clinic. METHODS: We performed a single-center, prospective, nonblinded, randomized, parallel-group feasibility study with referrals randomized in a 1:1 ratio to either PT-led vs usual rheumatologist triage. Standardized information was collected at referral receipt, triage, and clinic visit. Rheumatologist diagnosis was considered the gold standard for diagnosis of IA. RESULTS: One hundred two referrals were randomized to the PT-led triage arm and 101 to the rheumatologist arm. In the PT-led arm, 65% of referrals triaged as urgent were confirmed to have IA vs 60% in the rheumatologist arm (P = 0.57), suggesting similar accuracy in identifying IA. More referrals were declined in the PT-led triage arm (24 vs 8, P = 0.002), resulting in fewer referrals triaged as semiurgent (6 vs 23, P = 0.003). One case of IA (rheumatologist arm) was incorrectly triaged, resulting in significant delay in time to first assessment. CONCLUSION: PT-led triage was feasible, appeared as reliable as rheumatologist triage of referrals for joint pain, and led to significantly fewer patients requiring in-clinic visits. This has implications for waitlist management and optimal rheumatology resource utilization.

Attitude Toward Virtual Rehabilitation and Active Video Games Among Therapists in Korea: A Nationwide Survey.

In this study, we conducted a survey targeting 191 physical therapists (PTs) and 159 occupational therapists (OTs) in South Korea to explore attitudes toward virtual rehabilitation. Utilizing the Korean version of the ADOPT VR by Glegg et al., OT exhibited significantly more experience with virtual reality (VR) and active video games (AVG) than PT. Therapists with VR/AVG experience scored significantly higher in most categories, and the scores in each category were significantly correlated with the Behavioral Intention category, reflecting the willingness to use VR/AVG. The biggest barriers identified were insufficient funds and setup assistance for the equipment. Differences in responses between the groups with and without VR/AVG experience were most prominent in terms of lack of interest and funding. Therapists' attitudes, perceptions, and intentions toward VR/AVG are crucial factors in the establishment and implementation of VR/AVG; thus, the results of this study provide valuable evidence for future policies related to VR/AVG in rehabilitation medicine.

The Musculoskeletal 30-question multiple choice questionnaire (MSK-30): a new assessing tool of musculoskeletal competence in a sample of Italian physiotherapists.

BACKGROUND: The prevalence and cost of musculoskeletal diseases increased dramatically over the past few decades. Therefore, several institutions have begun to re-evaluate the quality of their musculoskeletal educational paths. However, current standardized questionnaires inadequately assess musculoskeletal knowledge, and other musculoskeletal-specific exams have limitations in implementation. The musculoskeletal 30-question multiple choice questionnaire (MSK-30) was proposed as a new tool for assessing basic musculoskeletal knowledge. AIM: To analyse basic musculoskeletal knowledge in a sample of Italian physiotherapists by administering the MSK-30 questionnaire. METHODS: After a transcultural adaptation process, the MSK-30 was developed and administered to Italian physiotherapists to assess their musculoskeletal knowledge. Participants were invited to participate in the survey via the SurveyMonkey link. Mann-Whitney test and the Kruskal-Wallis test with Bonferroni correction were used to observe the differences between groups in the MSK-30 scores. RESULTS: Four hundred-fourteen (n=414) physiotherapists participated in the survey. The median MSK-30 value was higher in physiotherapists who attended the International Federation of Orthopaedic Manipulative Physical Therapists postgraduate certification than in those who attended unstructured postgraduate training in musculoskeletal condition or in those who had not completed any postgraduate training in this field (p<0.001). CONCLUSIONS: This work demonstrates significant differences in the management of musculoskeletal disorders between those with specific postgraduate university education and those without. The findings can contribute to the advancement of the physiotherapy profession in Italy. Authors recommend further research with more robust methodologies to deeper understand this topic. Musculoskeletal conditions will continue to represent a significant portion of primary care visits, and future generations of physiotherapists must be prepared to address this challenge.