Postural control is essential for maintaining an upright sitting position. However, children with Cerebral Palsy (CP) Gross Motor Function Classification System (GMFCS) IV-V present with impaired postural control, often limiting their daily function and environmental interaction. Most interventions targeting postural dysfunction in CP consider the trunk as a single biomechanical segment and are challenging to use in the GMFCS IV-V population. The aim of this study was to develop the Segmental Intensive Trunk Training (SITT), which uses the segmental model of trunk control. The motor learning framework was chosen for structuring SITT to be an intensive approach, with a dosage of 2hrs/day, 3days/week for 4 weeks (24 hours). The development process included the test of feasibility and the initial evidence of effects, using a single subject research design (SSRD). An A-B-A design was used, where the first phase A included 4 baseline assessments, and phase B included the 4 weeks of SITT intervention. The second phase A was the withdrawal period including an immediate posttest, post 1 week test and a 3 month follow up evaluation. Postural control and reaching behavior were assessed during all 3 phases, using the Segmental Assessment of Trunk Control (SATCO) and Seated Postural and Reaching Control Test (SP&R-co). Hand dexterity and function was measured using the Box and Block test, and ABILHAND-kids questionnaire. Gross motor function was measured using the Gross Motor Function Measure Item Set (GMFM-IS). Performance on functional goals was assessed using the Canadian Occupational Performance Measure (COPM). Data analysis was descriptive, including visual analysis and the two standard deviation band method. One participant (11 years, GMFCS V) participated in the study with a 100% completion rate and 88% participation rate. SITT was a feasible approach for training segmental postural control and reaching behavior in children with CP GMFCS V. The improvements in postural control were associated with an improvement in manual dexterity, gross motor function, functional goal performance, and performance-related satisfaction. The gains in static control and COPM performance and satisfaction were retained at 3 months. These improvements were seen in the areas of body structure and function, and activity domains. Progress in motor performance in response to SITT was established at an individual level; however, more evidence is needed to establish the external validity of the approach.

ABSTRACT: The purpose of this study was to investigate and describe the student composition of accredited physical therapist assistant (PTA) programs located in the United States to determine if there were any significant differences between racial and ethnic minority and non-minority groups. Additionally, this study attempted to address gaps in discovering and understanding which program, and cohort variables may have been related to program graduation and ultimate NPTE(R) pass rates. Previous reports have acknowledged that racism exists and is being sustained in healthcare education and practice (Sullivan, 2004). This study was a quantitative retrospective secondary analysis of de-identified institutional, program, student, and faculty characteristics from all accredited PTA programs in the United States. The data were provided from the Commission on Accreditation in Physical Therapy Education (CAPTE) Annual Accreditation Reports (AAR) and National Physical Therapy Examinations (NPTE(R)) data collected by the Federation of State Boards of Physical Therapy (FSBPT). There was a total of 309 included PTA programs. Descriptive results indicated that there was an underrepresentation of racial and ethnic minority students in PTA educational programs when compared to the general population, public two-year colleges, and the professional association. Factors with a positive influence on NPTE(R) pass rate percentage for all PTA programs included public institutions, longer total length of program, and having previously earned a baccalaureate. Factors with a negative influence on NPTE(R) pass rate percentage included percentage Hispanic, percentage African American, faculty to student ratio, percentage of applicants enrolled, and public in-state tuition. The only factor found to be significant and positive for minority serving programs (MSP) was that of longer total length of program. Additional research is needed to examine other diversity factors in an attempt to account for a greater proportion of variance in students’ success for all PTA students and underrepresented racial and ethnic minority students in particular. / Educational Leadership

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Developing and implementing a research agenda can be challenging, but identifying the ultimate destination and defining the intermediate steps along the path are critical. The purpose of this session is to help early-career researchers (including graduate students, postdocs, junior faculty, and those considering transitioning into academics) identify key considerations and strategies for the development and implementation of their own research agenda. The speakers will discuss identifying research topics, designing a strong research program, and building evidence of effectiveness around the agenda. The speakers represent a range of settings and experiences, allowing attendees to appreciate the diversity of types of research agenda that exist within the profession. Attendees will leave the session with specific tools and resources to help them begin to develop a research agenda that will be appropriate for a range of settings.

In this climate of increasing diversity in the population of patients requiring Physical Therapy (PT) services, PT educators should prepare students and future clinicians to work competently in culturally diverse environments. To be able to achieve this goal, PT educators should be culturally competent as well. The purpose of this study was to develop and implement a workshop aimed at improving cultural diversity awareness of the University of the Pacific (UOP) PT educators. The seminar content and class materials were developed by the author in close consultation with the workshop facilitator, who is an expert on cultural diversity. These materials were validated by Physical Therapists and cultural diversity experts. To determine the effectiveness of the workshop in improving cultural diversity awareness, the Cultural Diversity Awareness Questionnaire (CDAQ) was developed, validated for content, analyzed for reliability, field tested and pilot tested. Results indicated that the instrument was valid and reliable. The one-day workshop was presented to twelve academic and clinical faculty of the UOP PT Department. The one group pretest-posttest experimental design was used, with the participants completing the CDAQ before and after the workshop. The attendees also completed a course evaluation at the conclusion of the seminar. Results showed a statistically significant positive change in the pretest/posttest results. This indicated that the workshop was effective in improving cultural diversity awareness of the participants. Results of the workshop evaluation affirmed the achievement of the educational objectives and effectiveness of the facilitator. This study provided-a-solid-initial-foundation-on-which a-comprehensive cultural competence program can be developed.

The flipped classroom method is a popular way to use technology to assist with the delivery of educational experiences. Yet there is insufficient information regarding student opinions or outcomes about the flipped classroom method within physical therapy. The purpose of this case report was to describe student opinions and outcomes of the flipped classroom teaching and traditional lecture/lab methods of teaching within musculoskeletal physical therapy. Thirty-six (36) first-year physical therapy students enrolled at a regional physical therapy program completed an anonymous internet-based survey regarding their impressions of traditional and flipped classroom teaching methods. Flipped classroom and traditional teaching methods were both used within the same musculoskeletal course. The survey was created to aid in planning subsequent courses and asked questions about student's preferred teaching method (flipped, traditional, or both equal) across a variety of categories. Student exams scores, using the same question bank, were compared to the year prior as a quantitative outcome measure. Twenty-nine (29) students (81%) completed the survey. Generally, students preferred the flipped classroom. Compared to the previous year, test scores for all content areas were similar (± 4%) except cervical spine which was improved (>10%). When asked outright, 28/29 students preferred the flipped teaching method. Student opinions indicate the flipped classroom is preferable to traditional methods yet objective outcomes appear similar. Physical therapy educators seeking ways to improve the student experience using technology in the classroom may consider utilizing the flipped classroom method.

The purpose of this project was to create a business plan for a profitable, self-sustaining, program to build a bridge between physical therapists and fitness professionals. The Quick Fit Program was a new service for the existing business San Luis Sports Therapy. The program was designed to be implemented within each of the company’s physical therapy clinics in California using existing personnel and resources. The Quick Fit Program is one way in which physical therapy practices can diversify the services they offer to keep pace with the changing landscape of healthcare. Clients in the Quick Fit Program would receive an assessment of basic health and fitness during their initial visit. After the assessments, a licensed physical therapist debriefs each client and offers recommendations or referral to a physician or gym program as appropriate. Staff in the Quick Fit Program would also schedule a follow-up appointment three to six months from the date of the initial visit to assess any changes or improvements in health and fitness measures since the initial visit.

Low back pain (LBP) has a global impact on health and is a substantial contributor to long term disability. The economic burden of LBP is immense and it is advancing annually. Costs attributing to LBP in the United States is about $84.1 to $624.8 billion. Physical therapy is commonly recommended for those with LBP since it is linked to improved clinical outcomes. However, patient perceptions can influence how this treatment approach is perceived. It is unclear if these perceptions can influence outcomes for patients suffering from LBP. Therefore, the purpose of this study is to identify the factors associated with positive or negative perceptions of physical therapy care in those with LBP. This was accomplished by developing and administering a comprehensive Qualtrics survey to participants in the Orlando area. Participants who took the survey were screened for eligibility requirements with exclusion criteria being those from vulnerable populations including pregnant women, minors, prisoners, and any person unable to provide informed consent. Screening, demographic, clinical, and perception questions were embedded within the online survey. Those who participated had to be 18 years or older, located within the Orlando area, able to provide informed consent, and speak English. Results from the data identified the five top key indicators which included clear explanation by the physical therapist on the treatment plan, how clear the physical therapist is in explaining the problem, friendliness of the physical therapist, patients perceive physical therapy is very effective in treatment of knee, and patients perceive physical therapy is very effective in treatment of lower back.

The following work presents a novel, overground robotic gait trainer: the mobile Tethered Pelvic Assist Device, or mTPAD. The mTPAD is a parallel, cable-driven platform that can apply three-dimensional forces and moments to the user’s pelvis as they walk overground. These forces and moments applied to the pelvis can be timed to the user’s gait and motivated through gait deficits to target specific motions or gait adaptations. An overview of both traditional and robotic gait training is given as an introduction in Chapter 1. The state-of-the-art pelvic robotic gait trainers are discussed, and the need for an overground device that can apply timed forces and moments to the pelvis is highlighted. The design of the mTPAD is covered in Chapter 2. The mechanical structure and the novel controller are discussed and validated through experiments with human participants. The mTPAD device is evaluated on its transparency, accuracy of pelvic localization, and ability to apply specific forces. Chapter 3 illustrates a continuous moment that is applied to the pelvis and synchronized with the user’s gait cycle. The controller is evaluated on its accuracy and ability to alter pelvic kinematics and muscle activations in a group of neurotypical adults. Chapters 4 and 5 highlight the mTPAD’s ability to alter gait characteristics and muscle responses of two groups that exhibit gait deficits: stroke survivors and children with Cerebral Palsy. By evaluating the effects of different force and moment profiles on individuals who may benefit from gait training, this work aims to illustrate the mTPAD’s potential as an overground gait training tool.