A pilot study of the theoretical and technical competence and appropriate education for the use of nine physical agent modalities in occupational therapy practice.

OBJECTIVE: This study described occupational therapy practitioners' perceptions about the content and method of training or education necessary for gaining theoretical and technical competence in the use of nine physical agent modalities (PAMs). METHOD: A survey was developed and sent to 543 members of the Physical Disabilities Special Interest Section of the American Occupational Therapy Association who had identified their primary area of practice as hand therapy. One hundred and fifty-one completed surveys (28% response rate) were returned. RESULTS: The respondents indicated that theoretical and technical expertise necessary for competent use of PAMs varied according to the type of modality being considered. Continuing education courses were identified as the best method for gaining theoretical and technical competence for the use of deep thermal agents, such as ultrasound and electrical stimulation agents, whereas entry-level professional education and one-the-job training were identified as most appropriate for superficial thermal agents, such as paraffin bath and hot and cold packs. CONCLUSION: The results suggest that considerations regarding the type and amount of education necessary for gaining theoretical and technical competence in the use of PAMs depend on the type of modality being addressed. These differences should be considered in the future development of competency objectives for the use of PAMs.

The use of low-load prolonged stretch devices in rehabilitation programs in the Pacific northwest.

OBJECTIVE: This retrospective study examined the use of low-load prolonged stretch (LLPS) orthoses for contracture management. METHOD: The records of 17 patients from skilled nursing facilities, hand clinics, and hospitals were reviewed. There was a total of 18 contractures (2 wrist, 12 elbow, 4 knee) secondary to neurological and orthopedic pathologies. Chart review focused on patient demographic information, range of motion (ROM) and functional outcomes, and wear schedules. RESULTS: The use of LLPS orthoses significantly increased ROM for the whole sample, which in turn significantly improved the subjects' functional outcomes. When the sample was divided into two pathology groups to compare a predominately geriatric population with neurological pathologies to a somewhat younger population with a history of musculoskeletal pathology, both groups showed a significant gain in ROM with the use of the LLPS orthoses. CONCLUSION: Use of LLPS orthoses for contractive management can mediate the losses in ROM and function that occur with joint contractures.

Reliability of Lift Alert(™) as a feedback device for detecting changes in body position.

The Lift Alert (™) is a small battery-operated unit, usually worn on the back of a worker's collar that is designed to provide a form of biofeedback about changes in trunk position during lifting tasks. The purpose of this study was to determine how consistent the Lift Alert (™) was at each of five different sensitivity settings (A-E) in detecting changes in trunk flexion in a given individual during a controlled bending maneuver. The subjects were videotaped while performing a series of trials of bending maneuvers at each of the sensitivity settings according to a specific protocol. The videotapes were then converted onto a computer program where the still images were captured and marked for data analysis. The reliability of the Lift Alert (™) was determined by calculating a coefficient of agreement, that is, the percentage of trials that were within both 10 and 15 degrees for each of the trials at a given setting for a single individual. The coefficient of agreement for all trials at all five settings was 0.76 within 10 degrees and 0.92 within 15 degrees. The results of this study suggest that the Lift Alert (™) is a reliable device for detecting changes in trunk flexion during a controlled bending maneuver for a given individual.