A Transformative Leadership Journey: Experiences of Graduates of the American Physical Therapy Association Fellowship in Education Leadership.

INTRODUCTION: Physical therapy education has an acute need for effective leaders due to multiple factors, including increasing numbers of programs and retirement of experienced leaders. Recognizing the need for formal leadership education, the American Physical Therapy Association (APTA) developed a fellowship in physical therapy educational leadership in 2011. This study aimed to understand participants' perceptions of their leadership experience and the role of the APTA fellowship. LITERATURE REVIEW: A commonly reported approach to evaluating leadership education programs was designed by Kirkpatrick. PARTICIPANTS: Twenty-five fellowship graduates from 2012 to 2019 participated. METHODS: We used a qualitative methodological approach incorporating a heuristic technique to gain an understanding of fellowship graduates' long-term perspectives. Semi-structured interviews were conducted via Zoom. Data were analyzed using thematic analysis. RESULTS: Three themes were constructed using a journey metaphor: embarking on the journey, engaging in the journey, and realizing the effects of the journey. 1) Embarking on the journey included 2 subthemes: a) participants' personal aspirations as career planners, reluctant leaders, or explorers; and b) institutions' goals for a change in leadership or intentional succession planning. 2) Engaging in the journey included 3 subthemes: a) the fellowship learning environment builds a sense of community; b) consideration of leadership frames influences participants' thinking about leadership; and c) participants' institutional environment influences their learning. 3) Effects of the journey included 3 subthemes: a) personal growth as a leader including personal awareness and confidence; b) institutions' benefits from participants' leadership projects and increased engagement in institutional leadership; and c) physical therapy professions' gains from participants' seeking leadership positions in professional organizations. DISCUSSION/CONCLUSIONS: The APTA Fellowship in Educational Leadership results in transformative change of participants as leaders. Findings offer guidance to individuals considering embarking on a leadership journey and institutions considering how to prepare and support emerging leaders in physical therapy education.

Effects of a moving target versus a temporal constraint on reach and grasp in patients with Parkinson's disease.

The reaction times and kinematics of reach and grasp were analyzed for eight subjects with Parkinson's disease (PD) and eight healthy subjects during three variations of a maximal speed prehension task: (a) grasping a stationary ball as fast as possible, (b) grasping a stationary ball within specific time constraints (520 ms and 450 ms), and (c) grasping a moving ball within the same time constraints. Subjects with PD exhibited bradykinesia when reaching for a stationary ball. When reaching for a moving or stationary ball with temporal constraints, subjects with PD moved as fast as healthy subjects. The reaction times of both groups were shorter when reaching to a moving ball than to a stationary ball, regardless of the time constraint. Subjects with PD had a slower velocity of hand opening and closing, a smaller maximal aperture, and a longer time to maximal aperture than healthy subjects in all task conditions. Thus, visual motion cues and external temporal constraints had a greater effect on reach than on grasp. The results suggest that the bradykinesia observed in individuals with PD during self-determined maximal speed prehension may reflect a strategy used to compensate for deficiencies in the grasp component of the task.

The effects of a progressive exercise program with surface electromyographic biofeedback on an adult with fecal incontinence.

BACKGROUND AND PURPOSE: Fecal incontinence often compromises a person's ability to participate in work and recreational activities. Incontinence may also diminish a person's willingness to take part in social events, leading to feelings of isolation. This case report describes physical therapy designed to reduce a patient's pelvic-floor muscle dysfunction and fecal incontinence. CASE DESCRIPTION: The patient was a 30-year-old woman whose fecal incontinence began after the complicated vaginal birth of her first child that required a vacuum extraction and episiotomy. Intervention included soft tissue techniques, electromyographic biofeedback, strength training, relaxation training, patient education, and a home program. The patient completed a questionnaire at initial evaluation and at discharge to assess her perceived limitations in functional activities. Electromyographic analysis was used to measure changes in the patient's pelvic-floor muscle control. OUTCOMES: The social, occupational, and sexual domains, which the patient initially judged to be the most compromised, showed the greatest improvement. Electromyographic data for the final treatment session indicated improved strength, endurance, and control of her pelvic-floor muscles. The patient reported no episodes of fecal incontinence over the last month of the 3 months of therapy. DISCUSSION: The physical therapy program may have led to improved bowel continence and greater control of the pelvic-floor muscles, resulting in greater confidence and comfort in social and work situations and less restriction in the patient's physical relationship with her spouse.

Application of Motor Learning Principles to the Stroke Population.

The physical rehabilitation of patients with stroke is shifting from a medical model of treating neurophysiological impairment to an educational model that emphasizes the reeducation of patients in motor tasks. This greater focus on patient learning requires knowledge not only in how to assist patients in the restoration of efficient movement patterns, but also in how to help patients learn to create and modify movement strategies to solve the functional problems they encounter in daily tasks. This article provides an overview of principles to be considered when attempting to optimize the motor learning of stroke patients. A model of motor learning is presented, followed by a discussion of contemporary research and clinical issues in the areas of information processing and practice. It is proposed that only through the combination of clinical research and critical introspection of our treatment practices can we gain a more complete insight to the motor learning behavior of stroke patients.