The effects of combined transcranial brain stimulation and a 4-week visuomotor stepping training on voluntary step initiation in persons with chronic stroke-a pilot study.

Purpose: Evidence suggests that transcranial direct current stimulation (tDCS) can enhance motor performance and learning of hand tasks in persons with chronic stroke (PCS). However, the effects of tDCS on the locomotor tasks in PCS are unclear. This pilot study aimed to: (1) determine aggregate effects of anodal tDCS combined with step training on improvements of the neural and biomechanical attributes of stepping initiation in a small cohort of persons with chronic stroke (PCS) over a 4-week training program; and (2) assess the feasibility and efficacy of this novel approach for improving voluntary stepping initiation in PCS. Methods: A total of 10 PCS were randomly assigned to one of two training groups, consisting of either 12 sessions of VST paired with a-tDCS (n = 6) or sham tDCS (s-tDCS, n = 4) over 4 weeks, with step initiation (SI) tests at pre-training, post-training, 1-week and 1-month follow-ups. Primary outcomes were: baseline vertical ground reaction force (B-vGRF), response time (RT) to initiate anticipatory postural adjustment (APA), and the retention of B-VGRF and RT. Results: a-tDCS paired with a 4-week VST program results in a significant increase in paretic weight loading at 1-week follow up. Furthermore, a-tDCS in combination with VST led to significantly greater retention of paretic BWB compared with the sham group at 1 week post-training. Clinical implications: The preliminary findings suggest a 4-week VST results in improved paretic limb weight bearing (WB) during SI in PCS. Furthermore, VST combined with a-tDCS may lead to better retention of gait improvements (NCT04437251) (https://classic.clinicaltrials.gov/ct2/show/NCT04437251).

Misinformation and Impact on Interprofessional Healthcare Students' Knowledge, Attitudes, Perceptions, and Concerns of COVID-19.

BACKGROUND: The COVID-19 pandemic has highlighted the importance of information sources (e.g., Internet, social media) and their role in spreading misinformation. PURPOSE: To describe the information sources and frequency of use by health professional students and to compare users of dependable and nontrustworthy news sources on stressors, stress relievers, safety, and preventative activities, worries, and attitudes toward COVID-19. METHODS: 123 students from nursing (38%), medicine (33%), and health professions (28%) completed online surveys on disaster preparedness training, knowledge of the COVID-19 virus, and safety and prevention practices. Students were mostly female (81%), white (59%), and aged 21-30 yrs (72%). RESULTS: Students who relied on credible news sources scored higher on knowledge of the COVID-19 condition and reported less stress than their counterparts. CONCLUSION: The findings emphasize the importance of students avoiding untrustworthy news sources. Informed students are less stressed and can help initiate necessary safety measures in the areas they serve.

Importance of Entrance Testing in Prediction of Academic Difficulty in the First Semester of a Graduate Doctor of Physical Therapy Program.

Entrance testing has been found to predict passing on professional licensure examinations in various allied health fields. Physical therapy (PT) programs do not consistently use an entrance test for assessment of an applicant's prerequisite competence. The purpose of this study was to assess whether a correlation existed between a prerequisite entrance test and academic success measured by grade point average (GPA) in first-semester PT students. A 140-question entrance test assessing prerequisite knowledge was administered prior to matriculation to two consecutive cohorts at a medium-sized PT program in the southwestern United States. GPA was collected following completion of the first didactic semester. Inferential statistics were used including the Pearson product moment correlational coefficient (r) and a regression model. 108 students completed the entrance test and one semester of coursework. The entrance test scores ranged from 58.33-100, with a mean score of 79.71. There was a significant medium correlation between the two variables (r=0.423, p<0.001), and the exam and age contributed to the regression model. Entrance tests may provide programs with a more content-specific evaluation of graduate school readiness while providing administrators and faculty information regarding didactic areas of concern with which students may struggle.

Effectiveness of physical therapy interventions on post-stroke spasticity: An umbrella review.

BACKGROUND: Post-stroke spasticity is often one of the primary impairments addressed in rehabilitation. However, limited guidance exists on the effectiveness of physical therapy (PT) interventions for post-stroke spasticity. OBJECTIVE: To evaluate the quality of evidence of PT interventions for post-stroke spasticity. METHODS: Ovid (Medline), Cochrane Library, CINAHL, Scopus, PEDro, and PROSPERO were searched to identify reviews based on the following criteria: 1) published between 2012 and 2021, 2) participants older than 18 years old, 3) post-stroke spasticity, 4) PT interventions, 5) clinical or neurophysiological measures of spasticity as primary outcomes. Assessment of Multiple Systematic Reviews 2 and the Grades of Recommendations Assessment, Development, and Evaluation assessed methodological quality. RESULTS: Eight articles were included in the analysis. No high-quality evidence was found. Moderate quality evidence exists for transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, resistance training, and lower extremity ergometer training with or without functional electrical stimulation. Low quality evidence exists for dynamic stretching, botulinum toxin with constraint-induced movement therapy, and static stretching using positional orthoses. CONCLUSION: Findings suggest that PT should prioritize a combination of active strategies over passive interventions, but further studies are needed prioritizing analyses of the movement system in managing post-stroke spasticity in conjunction with medical therapies.

Assessment of Academic Resilience as a Non-Cognitive Variable in Entry-Level Doctor of Physical Therapy Students.

The purposes of this study were to assess whether a correlation existed between academic resilience with success in the first semester of a Doctor of Physical Therapy (DPT) program, measured by grade point average (GPA), and to understand the lived experiences of first-semester DPT students when they transition to graduate school. This was a mixed methods study using a retrospective non-experimental correlational design and sequential-explanatory research. The non-cognitive construct of academic resilience was measured by the Academic Resilience Scale-30, delivered online pre-enrollment. A list of questions was created to capture insight into the experiences of students in graduate school and delivered in two focus groups. There was an insignificant, negative correlation between the two variables, r= -0.011, p=0.912. Age demonstrated a significant medium negative correlation to first-semester DPT GPA, r= -0.32, p<0.001. Six themes emerged, which centered around workload, imposter syndrome, mental health, time management, study strategies, and life circumstances. In a sample of 108 DPT students, the overall mean score of academic resilience was lower than that for the general age-matched population. DPT students experience many challenges in the first semester that require academic resilience, and programs can assess the adaptive systems and protective factors in place to support their students in this phase.