Evidence for electronic health record systems in physical therapy.

With increasing pressures to better manage clinical information, we investigated the role of electronic health record (EHR) systems in physical therapist practice through a critical review of the literature. We reviewed studies that met our predefined criteria after independent review by 3 authors. The investigators in all of the reviewed studies reported benefits, including improved reporting, operational efficiency, interdepartmental communication, data accuracy, and capability for future research. In 7 studies, the investigators reported barriers, including challenges with behavior modification, equipment inadequacy, and training. The investigators in all studies reported key success factors, including end-user participation, adequate training, workflow analysis, and data standardization. This review suggests that EHRs have potential benefits for physical therapists. The authors formed the following recommendations based on the studies' themes: (1) incorporate workflow analysis into system design and implementation; (2) include end users, especially clinicians, in system development; (3) devote significant resources for training; (4) plan and test carefully to ensure adequate software and hardware performance; and (5) commit to data standards.

Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume.

BACKGROUND AND PURPOSE: The volume of all limbs can be determined by water displacement methods or calculations derived from girth measurements. The purpose of this study was to determine the concurrent validity of calculated volume and water displacement volume measurements. SUBJECTS: Both upper extremities of 14 women with lymphedema were measured. METHODS: Volumetric measurements were taken with a volumeter, and circumferential measurements were taken with a tape measure. Calculated volume was determined by summing segment volumes derived from the truncated cone formula. Pearson product moment correlations, paired t tests, and linear regression tests were used to assess relative association and absolute differences between calculated and actual volumes. RESULTS: The correlation coefficient for calculated volume versus upper extremity minus fingers (UE-F) water displacement volume was.99. Paired t tests showed differences between calculated volume and UE-F water displacement volume (t=-3.88, mean difference=-95.62 mL), and the linear regression slope was 0.83 with an intercept of 255.28 mL. DISCUSSION AND CONCLUSION: Calculated volume measurements were highly associated with measurements based on water displacement; therefore, clinicians should feel confident in using either calculated volume or water displacement volume. The differences, however, indicated that the measures were not interchangeable. Thus, clinicians should not mix or substitute measurement methods with a single patient or in a single study.

The relationship between self-reported and clinical measures and the number of days to return to sport following acute lateral ankle sprains.

STUDY DESIGN: This is a prospective observational study. OBJECTIVE: To determine the relationship of self-reported and clinical measures to the number of days to return to sport following acute lateral ankle sprains. BACKGROUND: In order to direct rehabilitation, injury classification schemes should include self-reported and clinical measures that help prognosticate the number of days to return to sport (DAYS). METHODS AND MEASURES: Twenty Division II college athletes (7 men, 13 women; mean age = 19.2 +/- 1.1 years) were assessed following an acute lateral ankle sprain and upon return to sport. Athletes were assessed by three self-reported measures: global function question, Short Form-36 Physical Function scale (SF36PF), visual analog pain scale, and four clinical measures: ankle active range of motion (AROM), ankle dorsiflexion strength, ankle plantar flexion strength, ambulation status. Simple regression, multiple regression, and effect sizes (ES) were used to analyze these data. RESULTS: The simple regression revealed a statistically significant relationship between DAYS and the global function question (r2 = .22), the SF36PF (r2 = .28), and the patient's ambulation status (r2 = .27). A multiple regression using these three variables in combination was also statistically significant (P = .015) and explained approximately one-third of the variance in DAYS, (r2 = .37). All dependent variables revealed large or moderate ES. CONCLUSION: Self-reported functional measures in conjunction with the athlete's ambulation status are important factors in predicting the number of days to return to sport following acute lateral ankle sprains. Further research using large sample sizes and other clinical and functional measures is necessary.