Testing to Identify Submaximal Effort: Lifting to a Perceived 50% Effort vs. an Assigned Submaximal Load.

ABSTRACT: Swift, MC, Townsend, R, Edwards, D, and Loudon, J. Testing to identify submaximal effort: Lifting to a perceived 50% effort vs. an assigned submaximal load. J Strength Cond Res 36(8): 2115-2120, 2022-The ability to accurately measure effort during postinjury functional testing allows for the validation of displayed physical limitations by injured workers. The Cross-Reference Testing System (XRTS) has been developed to identify submaximal efforts through distraction-based dynamic material handling testing. The XRTS material handling assessment compares dynamic lifts of weights in a crate and lifts using a lever arm device. The purpose of this study was to determine whether subjects lifting an assigned submaximal load influence test results compared with subjects lifting to but not exceeding a 50% perceived effort. Subjects in group A ( n = 35) were assigned the condition to attempt to lift to but not exceed a randomly assigned weight value for both the crate lift and XRTS at 3 lifting heights. Subjects in group B ( n = 32) were asked to lift to but not exceed 37.5 lb from the same 3 lifting heights. The reproducibility of effort was measured with current validity criteria for distraction-based material handling testing. Using the percent difference values, a 2 × 3 (group, lifting height) analysis of variance (ANOVA) was performed to test the hypothesis. The alpha level was set at 0.05. The mean percent change between comparative lifts was 31.13%, 95% CI (22.51-39.75) for group A and 29.26% 95% CI (21.91-36.61) for group B. The 2 × 3 ANOVA demonstrated no significant difference ( p = 0.751) between groups. The results indicate attempting to lift to a perceived 50% effort was not significantly different from attempting to lift to but not exceed an assigned submaximal load.

Interprofessional Simulation and Education: Physical Therapy, Nursing, and Theatre Faculty Work Together to Develop a Standardized Patient Program.

A well-conceived training program for standardized patients (SPs) can increase their effectiveness in portraying actual patients This article describes the development of an SP program that allows graduate and undergraduate students to engage in interprofessional experiences in a multifunctional simulation center. Three academic programs at a midwestern university developed an interdisciplinary course that trains undergraduate students as SPs for nursing and physical therapy simulation experiences. The SP program has opened doors for interprofessional collaboration beyond current simulation experiences and has exposed the university community to simulation.

Use of the Hypothesis-Oriented Algorithm to Prepare Students for an Objective Structured Clinical Examination in Physical Therapy Education.

OBJECTIVE: The purpose of this study is to examine the effect of using the Hypothesis-Oriented Algorithm for Clinicians (HOAC II) on student satisfaction and performance scores in a physical therapy Objective Structured Clinical Examinations (OSCE). METHODS: Forty-three Doctor of Physical Therapy students were recruited to participate in two exam preparation groups. One group (n=21) was assigned to study the HOAC II and the other group (n=22) was assigned to a control group. An independent t-test was used to assess the effect of group assignment on performance scores and satisfaction scores. RESULTS: The results of the independent t-test showed no significant difference in performance scores between groups. The results of the independent t-test were significant for question 2 on the student satisfaction survey, with the HOAC II group expressing more satisfaction, p=0.01. Additionally, the total satisfaction of the OSCE experience was significantly different between groups, p=0.03, with the HOAC II group expressing more satisfaction. CONCLUSION: The HOAC II has been shown to enhance the experience of completing an OSCE in second-year Doctor of Physical Therapy students.

Nursing Program Outcome Improves with Interprofessional Simulation.

AIMS: Simulation-based education in nursing education has been shown to be as effective as experiences in the actual clinical environment; however, little evidence exists on the assessment of simulation in multidisciplinary teams to assess program outcomes. The purpose of this research study was to investigate nursing program outcome data specific to interprofessional collaboration in a simulation experience involving nursing and physical therapy (PT) compared to data from this same simulation experience involving nursing only. METHODS: Senior nursing students from two different cohorts, cohort A (n=58) and cohort B (n=47), and 14 PT students participated as learners in the simulation investigated in this research study. Three to 4 nursing students and 1 PT student were randomly placed into an interprofessional team to care for two patients. Nursing students were evaluated on program outcome competencies by nursing educators. RESULTS: The Mann Whitney U-test indicated a significant difference in performance scores for the program outcome specific to interprofessional collaboration between nursing students in cohort A (+PT) and nursing students in cohort B (-PT), p<0.05. CONCLUSIONS: The results of this study demonstrate that two professions are more effective when they work together as a team because they have multiple perspectives from which to collect information.

Decision-Making Data: Expectations for Reproducibility of Lifting on Separate Days.

PURPOSE: The purpose of this study was to explore the difference in maximal lifting capability between 2 modes of lifting (traditional crate and XRTS Lever Arm) over multiple days. The differences in absolute strength values were compared with existing criteria for sincere effort during distraction-based lifting. In addition, rate of perceived exertion (RPE) is presented for the 2 modes of lifting on each day. PRIMARY PRACTICE SETTING: Workers' compensation. METHODOLOGY AND SAMPLE: Forty-four subjects between the ages of 20 and 44 years participated in this study. Investigators established 1 repetition maximum (RM) for each subject performing the crate lift. Subjects were randomly assigned 5 weights ranging from 10% to 100% of their determined 1RM and asked to give their rating of perceived exertion after each lift. The same procedure was repeated 2-5 days later using the XRTS Lever Arm. Paired t tests and Spearman's correlation coefficient were used for data analysis. Alpha was set at less than .05. RESULTS: There was a statistically significant difference (p < .04) between maximal lift values for the 2 lifting modes. The percent difference between the modes of lifting was 10.5% ± 6.4%. In addition, there was a positive correlation between the RPE on the 2 modes of lifting (p = .87). IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: A functional capacity evaluation (FCE) is typically ordered after the completion of physical rehabilitation and before releasing a patient to full or modified duty. In addition to assessing the ability to function within normal job demands, an assessment of effort by the participant typically takes place during an FCE. Case managers and physicians are presented with information, allowing them to make comparisons between functional lifting abilities displayed during treatment sessions and the FCE. These comparisons may often take place with the subpoena of medical records and may be discussed during the deposition or trial process. If an FCE takes place at a different facility than the physical therapy or work conditioning treatment, 2 different modes of lifting may take place based on the equipment within each facility. The results of this study indicate that the 2 modes of lifting on separate days meet established criteria for lift comparison testing during FCEs.