Web Site Accessibility Among Doctor of Physical Therapy Programs in the United States.

INTRODUCTION: Given the impetus to improve accessibility for diverse learners seeking physical therapist education, it is critical that all entry points to access information have minimal barriers. This study identified Web site accessibility barriers among Doctor of Physical Therapy (DPT) programs in the United States. REVIEW OF LITERATURE: Web site accessibility has been evaluated among many institutions of higher education, but none focused on DPT education. Individuals with disabilities may be adversely affected by Web site accessibility barriers. SUBJECTS: This cross-sectional study included 262 DPT programs in the United States. Doctor of Physical Therapy program characteristics collected were geographic region, institutional control type (public/private), medical school affiliation, accreditation status, total institutional enrollment, and DPT class size. METHODS: The Web Accessibility Evaluation (WAVE) Tool assessed data related to accessibility barriers among DPT program homepage Uniform Resource Locators. Three primary outcomes from the WAVE Tool included WAVE Total Errors, Error Density, and Total Alerts. RESULTS: Web site homepage accessibility barriers varied among programs for WAVE Total Errors (range 0-150), Error Density (range 0-14.6%), and Total Alerts (range 1-331). Median Total Errors were greater among private (9.0) versus public (5.0) institution Web sites (P < .001). Median Total Errors were greater among those institutions not affiliated with a medical school (9.0) compared with those that had an affiliated medical school (7.0) (P = .04). No differences in accessibility barriers were identified according to geographic region or accreditation status (P > .05). Median Total Errors were significantly different between institutional enrollment quartiles (H[3] = 17.9, P < .001), with no differences noted between DPT class size quartiles for any outcome (P > .05). Generally, weak-fair inverse correlations were observed between student enrollment for the institution and Web site accessibility barrier outcomes. DISCUSSION AND CONCLUSION: Homepage accessibility barriers varied greatly among DPT programs in the United States. Factors, including being a private institution, no medical school affiliation, and lower institutional enrollment, were related to increased accessibility barriers.

Predictive Factors for Outcomes of Overcorrection Nighttime Bracing in Adolescent Idiopathic Scoliosis: A Systematic Review.

Predictive clinical and radiological factors can potentially identify adolescent idiopathic scoliosis (AIS) most likely to benefit from overcorrection nighttime bracing. These factors can provide helpful information in clinical decision making. However, the relationship between these factors and outcomes of overcorrection nighttime bracing is unclear. This systematic review determined the predictive factors for identifying outcomes of overcorrection nighttime bracing in AIS. A systematic search was conducted on PubMed, MEDLINE, Scopus, and Embase from January 1986 to January 2021. Studies on AIS patients, aged 10-18 years, with a Risser sign of 0-2 and an initial Cobb angle of 20°-45°, who were treated with overcorrection nighttime bracing and for whom at least one predictive factor of treatment outcome (failure and/or success) was assessed were included. Two blinded reviewers independently evaluated the studies using a quality assessment tool. To determine predictive factors, the level of evidence was rated through best-evidence synthesis. A total of nine studies met the inclusion criteria. A Providence brace was used in six of the included studies, while a Charleston bending brace was used in three. Findings from two high-quality studies provided strong evidence of the association between curve flexibility and brace treatment success. In terms of the Risser sign, this evidence was obtained from three high-quality studies. Moderate evidence indicated a positive association between premenarchal status and nighttime bracing failure. Inconclusive evidence indicated that poor brace compliance is associated with treatment failure. Conflicting evidence of treatment failure was indicated for initial curve magnitude, curve type, in-brace correction, age, Risser sign, curve apex, and sex. These findings show that greater curve flexibility and a higher Risser sign are associated with overcorrection nighttime bracing success.

Assessment of reliability and validity of the adapted Persian version of the Spinal Appearance Questionnaire in adolescents with idiopathic scoliosis.

PURPOSE: This study investigates the reliability and validity of the adapted Persian version of the Spinal Appearance Questionnaire (P-SAQ). METHODS: The stages of cross-cultural adaptation were conducted according to an internationally accepted guidelines. Reliability of the P-SAQ was measured by evaluating internal consistency and test-retest reproducibility using Cronbach's α and intraclass correlation coefficient (ICC). Validity of the P-SAQ was assessed by factor analysis, and convergent and known-groups validities. Convergent validity was assessed through participant response on the P-SAQ and the revised 22-item Persian version of the Scoliosis Research Society (SRS-22r) questionnaire. Known-groups validity was assessed by comparing the P-SAQ scores according to the patients curve magnitude and treatment type. RESULTS: A total of 106 patients with a diagnosis of adolescent idiopathic scoliosis (AIS) were included. The P-SAQ demonstrated an acceptable internal consistency with a Cronbach's α of 0.77 (range 0.65-0.72). The test-retest reliability was excellent (range ICC 0.85-0.98). There was a correlation between the total score, average scores of the general, curve, rib prominence, kyphosis, and trunk shift subscales of the P-SAQ and subtotal and total scores of the SRS-22r, r = - 0.2 to - 0.4, p < 0.05. The P-SAQ discriminated between patients with differing Cobb angle magnitudes and treatment types (p < 0.01). Factor analysis supported the use of the appearance and expectations items as separate scales for the P-SAQ. CONCLUSION: The P-SAQ is a valid and reliable tool that could be utilized to evaluate the perception of appearance for Persian-speaking AIS patients with different curve magnitude and treatment strategies. LEVEL OF EVIDENCE: Level I- diagnostic studies.

Effectiveness of cervicothoracic and thoracic manual physical therapy in managing upper quarter disorders - a systematic review.

STUDY DESIGN: Systematic review. BACKGROUND: Physical therapists often use cervicothoracic and thoracic manual techniques to treat musculoskeletal disorders of the upper quarter ,however, the overall effectiveness of this approach remains to be elucidated. OBJECTIVE: This systematic review explored studies that examined the short- and long-term effectiveness of manual physical therapy directed at the cervicothoracic and thoracic region in the management of upper quarter musculoskeletal conditions. METHODS: The electronic databases MEDLINE, AMED, CINAHL, and Embase were searched from their inception through 30 October 2020. Eligible clinical trials included those where human subjects treated with cervicothoracic and/or thoracic manual procedures were compared with a control group or other interventions. The methodological quality of individual studies was assessed using the PEDro scale. RESULTS: The initial search returned 950 individual articles. After the screening of titles and abstracts, full texts were reviewed by two authors, with 14 articles determined to be eligible for inclusion. PEDro scores ranged from 66 to 10 (out of a maximum score of 10). In the immediate to 52-week follow-up period, studies provided limited evidence that cervicothoracic and thoracic manual physical therapy may reduce pain and improve function when compared to control/sham or other treatments. CONCLUSIONS: Evidence provides some support for the short-termeffectiveness of cervicothoracic and thoracic manual physical therapy in reducing pain and improving function in people experiencing upper quarter musculoskeletal disorders. Evidence is lacking for long-term effectiveness as only two studies explored outcomes beyond 26 weeks and this was for patient-perceived improvement. PROSPERO ID: CRD42020219456.

Impact of bed height on the biomechanics of healthcare professionals during chest compressions on the neonate: a descriptive pilot study.

OBJECTIVES: The biomechanics of the healthcare professionals (HCPs) performing the life-saving intervention of chest compressions in the neonatal population is poorly understood. The aim of this pilot study was to describe the variations in body position at a self-selected and a predetermined bed height during neonatal chest compressions. Measures of joint angles, time to postural sway and number of postural adjustments were chosen as indices for the stability of the HCP's position. SETTING: Data were collected at a simulation-based research centre in which the patient care environment was replicated. PARTICIPANTS: HCPs with varying roles working in the neonatal intensive care unit and holding a current Neonatal Resuscitation Program Provider certification were recruited for this study. INTERVENTIONS: Fifteen HCPs performed two trials of chest compressions, each lasting 2 min, at a predetermined bed height and a self-selected bed height. Trials were video recorded, capturing upper and lower body movements. Videos were analysed for time to postural sway and number of postural adjustments. Joint angles were measured at the start and end of each trial. RESULTS: A statistically significant difference was found between the two bed height conditions for number of postural adjustments (p=0.02). While not statistically significant, time postural sway was increased in the choice bed height condition (85 s) compared with the predetermined bed height (45 s). After 30 s of chest compressions, mean shoulder and knee angles were smaller for choice bed height (p=0.03, 95% CI Lower=-12.14, Upper=-0.68 and p=0.05, 95% CI Lower=3.43, Upper=0.01, respectively). After 1 min and 45 s of chest compressions, mean wrist angles were smaller in the choice bed height condition (p=0.01, 95% CI Lower=-9.20, Upper=-1.22), stride length decreased between the 30 s and 1 min 45 s marks of the chest compressions in the predetermined height condition (p=0.02).

The Effect of in-Service Methodology on Learning Transfer for School Personnel Managing Students following Concussion.

BACKGROUND: It is essential to increase the knowledge base of teachers involved in facilitating return to learning in middle school students following a concussion. However, the best method to enhance the transfer of learning for teachers remains to be elucidated. Application of Adult Learning Theory (ALT) is a plausible solution to this problem. PURPOSE: The purpose of this randomized post-test study was to examine the effects of ALT on the transfer of learning in teachers who work with individuals with concussion. METHODS: A convenience sample of 169 teachers at four middle schools were randomized to receive an in-service regarding concussion management either in ALT or traditional lecture format. Vignettes approximating classroom practice evaluated learning transfer. RESULTS: one-way between subjects ANOVA revealed no significant difference between the methods of educational delivery on group assessment scores (p = .22). Additionally, a regression analysis did not identify any demographic variables that predicted learning transfer (p = .65). A statistically significant difference existed for four questions (1, 4, 7, 25) between the groups (p = .03, .02, .01, .00, respectively). These vignettes were those that assessed information that was likely novel to the learner. DISCUSSION: The current study demonstrated that ALT applied to teacher in-service did not impact transfer of learning immediately post training compared to a traditional lecture format. Future research should continue to examine the effects of various educational strategies to enhance learning transfer for teachers managing students in the classroom after concussion.

Concussion competencies: a training model for school-based concussion management.

This study reports on the use of ten knowledge competencies related to the behavioral management of concussion in schools. Trainings using these competencies as learning objectives were delivered to school personnel. This aims of the use of competencies in this way are to streamline the education of key stakeholders, to establish clear roles and responsibilities for constituents and equip individuals working with students following a concussion with the relevant knowledge to optimize outcomes. The majority of participants, primarily speech language pathologists working as related service providers in the schools where the trainings occurred, judged the use of the competencies to be informative and useful to their practice both immediately following the training and at a 5-month follow-up. The greatest gains in knowledge were noted by those participants self-reporting the least amount of knowledge pre-training. Participants also ranked the perceived value and relative importance of each of the ten competencies.