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  • News From NEXT: McMillan Lecturer Outlines Keys to Excellence in the Physical Therapy Profession

    Tom McPoil, PT, PhD, FAPTA, said he intentionally structured the title of the 50th McMillan Lecture—"Is Excellence in the Cards?" as a question "to raise an element of doubt or uncertainty in our quest to achieve excellence." After all, he said during his delivery of the lecture on June 13 as part of the APTA NEXT Conference and Exposition in Chicago, he has several concerns regarding the profession's ability to achieve excellence.

    Before describing the reasons for his uncertainty, McPoil did recognize some of the profession's remarkable accomplishments since he began his career in 1973. "We no longer serve as a subservient technician in the health care system, our students now obtain an exceptional education and are granted a doctoral degree, we can practice in a variety of specialty areas in multiple practice environments, and we have achieved the ability to practice autonomously with patients having direct access to our services," he noted.

    But he said there still is room for improvement from both clinical and academic perspectives, and the remainder of his lecture outlined those perspectives. From the clinical standpoint, he described 3 areas.

    First, McPoil questioned continued acceptance of examination and management methods that may have been proven to have no evidence to support their use. As an example, he identified what is known as the podiatric model, which classifies foot types based on the concept of subtalar joint neutral position. McPoil said that subsequent studies—including those he and colleagues conducted—showed that "subtalar joint neutral position had no relevance to the typical pattern of rearfoot motion. In short, our results challenged the validity of the podiatric model." Yet, he continued, many physical therapist education programs and postprofessional continuing education courses still teach the model. McPoil expressed his hope that the profession will continue to stress the importance of using methods that have been validated with basic science and clinical evidence, especially at entry-level and in education programs, "as it is our new doctor of physical therapy graduates who must serve as our profession's change agents."

    Second, McPoil expressed concern over a lack of acknowledgment of historical research studies that provide evidence for a practice's continue use. He quoted a 2009 article by Mary Halefi ("Forget This Article: On Scholarly Oblivion, Institutional Amnesia, and Erasure of Research History," Studies in Art Education) that "recurring themes, issues, and concerns are part of any field" and failing to cite them along with more contemporary studies risks the loss of past scholarly endeavors upon which current research may be based. "Hopefully," McPoil said, "our professional journals will always perform their due diligence" to retain the contributions of past scholars and researchers in the profession.

    Inconsistence in the level of care was McPoil's third area of needed improvement. He noted some probable causes for inadequate care, such as limited patient time resulting from low payment rates, some highly specialized areas of practice that not all PTs are familiar with, and lack of clinical practice guidelines (CPGs) that address needed services. As for specialized areas of practice, he said that physical therapist-to-physical therapist referral was "rare," and the need for intraprofessional referral needs more emphasis during entry-level education. Concerning CPGs, McPoil argued that while important, they cannot always guide the clinician to an appropriate decision and "cannot replace the need for clinical reasoning and practice knowledge." He continued that such knowledge "can be achieved only through residency or fellowship training."

    To that end, McPoil said that it may no longer be feasible to train a generalist at the entry-level, and the profession must consider allowing specialization to begin before graduation. He identified challenges to developing residency and fellowship programs, such as student loan debt, salaries not commensurate with advanced clinical specialization, and a lack of federally funded support. He expressed his hope that the profession will prioritize development of these programs, as needed funding for them won't occur until they are the expected route following professional graduation. "Our pathway to excellence demands no less!" he said.

    McPoil followed up with his thoughts on achieving academic excellence, specifically the need for every faculty member to have "a personal agenda for scholarship that includes publication."

    News From NEXT: Building Wellness Programs in the Least Likely Places

    Sometimes, basic assumptions beg to be questioned. Just ask physical therapists (PTs) in the oncology rehabilitation department of Froedtert Hospital and Medical College of Wisconsin, who wondered why prevention and wellness couldn't be a part of the patient experience from the moment they entered the facility's doors.

    That questioning led to the development of an innovative group exercise program for patients checked in to the hospital for chemotherapy and other treatments primarily related to blood cancers—and so far, the program seems to be allowing many patients to leave as mobile, if not more so, than when they arrived. On June 13, the PTs shared their story of how they established and grew the program, known as the "Strength in Numbers" exercise class, as part of APTA's NEXT Conference and Exhibition in Chicago.

    The idea behind the program was based on a reality check of the typical path of an oncology patient visiting the hospital for treatment, explained Kelly Colgrove, PT. Unlike patients who arrive with other conditions such as congestive heart failure, "our patients walk in strong and independently." During the course of treatment, however, they often experience decreased muscle strength, challenging PTs to play catch-up before the patient is discharged.

    The Froedert PTs wanted to "Strength in Numbers" change that. As it now operates, the program—known as "SIN" to the amusement of patients—offers a 1-hour group circuit training class 2 times a week. Colgrove describe SIN as "a fun environment based on camaraderie and music, but all within the acute care setting."

    Patients are selected for the voluntary program based on their health at the time of check-in, Colgrove explained. Those whose condition is more fragile receive more typical 1-on-1 physical therapy. But the patients who qualify for SIN are assessed, given goals, and scheduled to participate in the group. Once the SIN group, patients still can choose to return to the more traditional therapy program.

    Besides the direct physical benefits to patients, the SIN program has helped to reinforce what the presenters call a "culture of mobility" at the hospital.

    The presenters led attendees through their process of developing and maintaining the program, encouraging audience members to think about similar possibilities in their own practice settings. They explained the importance of a solid basis in research, careful consideration of stakeholder concerns, evaluation of current and needed resources, and program metrics to evaluate outcomes, among other areas.

    Through their recaps, the presenters demonstrated how flexibility and creativity are key elements in all areas of development, implementation, and evaluation. "Being able to adapt and evolve is going to be key," explained Alyssa Kelsey, PT, DPT. For the SIN program, that means seeking ongoing input from patients and staff, as well as monthly check-in meetings to monitor operations and identify future goals.

    That flexibility should also include the capacity to question your own assumptions and evaluative measures, explained Colgrove. "Sometimes, the questions you think you want to answer at the beginning of the program may not be the questions you want to answer after a year," she said.

    One question has been consistent throughout the SIN program: Does is work? So far, the answer seems to be yes. Outcome measures for patients with a length of stay longer than 20 days and more than 50% participation in SIN found that 72% maintained or improved their 5-time sit-to-stand scores, 64% maintained or improved on Functional Gait Assessment, and 53% maintained or bettered their scores related to self-perceived deficits at discharge.

    And if patient enthusiasm for the program is any measure, the SIN program also seems to be doing well: according to the presenters, patients frequently have the same criticism of the offering—that the classes only occur 2 days a week.

    News From NEXT: How One Hospital Implemented Direct Access

    A panel of PTs from the Hospital for Special Surgery (HSS) in New York explained how that institution implemented direct access (DA) to physical therapist services during a June 13 session at APTA's 2019 NEXT Conference and Exposition. They then advised attendees how to operationalize DA at their own institutions.

    Presenters from HSS were Carol Page, PT, DPT; Mary Murray-Weir, PT, MBA; Robert Turner, PT, DPT; and Jaime Edelstein, PT, DScPT. Also presenting was Aaron Keil, PT, DPT, from the University of Illinois at Chicago.

    Keil noted that DA was achieved in all 50 states and the District of Columbia in 2015, but only 18 states have unrestricted access. The others include limiting or restrictive provisions, meaning there still are barriers to DA.

    He cited a 2015 APTA survey for which nearly 65% of respondents said the major administrative barrier to DA implementation was "My supervisor/facility requires all patients to have a referral." Keil noted that this is especially true in hospital-based inpatient and outpatient facilities, as hospitals tend to be more risk averse and "may be more restrictive than state law."

    Page said that an essential first step to achieving DA was getting buy-in. One key group was physicians—particularly surgeons—who were concerned that their patient levels would drop. Page explained, "We showed that direct access would 'widen the funnel' and actually provide them more patients," while at the same time screening to avoid sending inappropriate patients to the surgeons.

    Administrative staff was taught how to screen patients and schedule them with appropriate PTs. They also were made responsible for tracking timing and number of permissible visits for adherence to state provisions, building on an HSS foundation of training and competency programs it conducts for all staff.

    The hospital established criteria for DA PTs that were more stringent than required by the state. For example, while New York requires 3 years of clinical experience, HSS required that experience to be at outpatient facilities. It also required CEUs in certain areas, such as spine, manual therapy, and differential diagnosis.

    Turner described the development of a written exam for aspiring DA PTs. Questions were developed following the same item-writing guidelines used by the American Board of Physical Therapy Specialties. A score of 80% is required to pass the test.

    HSS also developed a practical examination involving an actual patient. The primary question to be answered is: "Can you take this patient and treat him or her? Or do you refer to a physician?"

    The program was made voluntary for PTs since some didn't initially feel comfortable with it. "Not everyone fits the mold," Turner said.

    Page addressed operationalizing DA, which she divided into 4 categories. The first was resources. She said, "APTA has amazing resources." She advised those in the audience to search APTA's website for "direct access" and browse the resources. The second category is billing, which she made clear "is different in a hospital setting" from a private practice and requires a hospital-wide effort. The team leading the DA program at HSS made a conscious decision not to contact insurance companies in advance and announce their intentions. "We did a soft launch with a small number of patients. We let them know that their interventions might or might not be covered," Page said, but he found that most insurers did cover the services, and HSS now contacts insurers in advance.

    The other elements of operationalizing DA were documentation and marketing. These included developing specific policies and procedures, providing notice of advice for patients, identifying common ICD-10 codes, and developing tip sheets for patients and physicians.

    The panel listed a series of lessons learned—things to do and things not to do. For example, don't:

    • Assume people understand what DA is.
    • Give up.
    • Be mean, defense, argumentative, or otherwise difficult to deal with.

    On the other hand, do:

    • Assume some people will think DA is illegal and/or unsafe.
    • Highlight improved patient access and patient care.

    Ask "How can we?" rather than "Can we?"

    News From NEXT: A Moving Account of a Journey Out of Pain and Addiction—And a PT's Crucial Role

    "I failed my marriage. I failed as a father. I failed my career. And I didn't even know it was happening."

    That's how Justin Minyard describes the lowest point in his life, when, after experiencing 2 spine fractures and receiving multiple surgeries, he became addicted to the opioids prescribed to him. He found himself consumed by his pain and his meds—how many he had on hand, when he could take the next one, where he needed to go to get refills. His addiction led to a suicide attempt and 2 accidental overdoses. But most devastating for Minyard was that his addiction hurt the people he loved the most.

    "I let them down," Minyard said. "You didn't want to be around me at that time."

    Now things are different. With the help of an interdisciplinary care team that included a physical therapist (PT), Minyard said he learned how to "make pain a footnote, not the header" of his life and defeat his addiction. He'll be 8 years' clean in July.

    Minyard's moving story was delivered as the keynote address at the opening event for APTA's NEXT Conference and Exposition, held June 12-15 in Chicago. The retired Army Master Sergeant recounted the injuries he received—first during a rescue attempt at the Pentagon during the 9-11 attacks and then while on a mission in Afghanistan—but focused more on what happened afterward: the multiple fusion and other surgeries, the intense pain, and his eventual slide into addiction.

    "I didn't wake up one day and say, 'this sounds great,'" Minyard said of his use of opioids; however, he believes his passive approach to exploring treatment options played a role in his use of drugs.

    "I was not an educated patient; I didn't ask questions," he told the audience.

    After more than 2 years of attempting to manage his pain through opioids and other medications—and becoming addicted along the way—Minyard began to see options for change.

    His last fusion surgery kept him in the hospital for 3 months. Then a physician who called Minyard a "hot mess" offered him another avenue: a pain management program that involved 9 different professionals including a psychologist, psychiatrist, a pharmacologist—and a PT. Minyard took him up on the offer, and moved from what he describes as a "pain-centric to a patient-centric model of care."

    Minyard credits his PT as helping him to accept the idea that, yes, he may be in pain for the rest of his life, but he could work to find ways to manage the pain to make it "more of a footnote, less of a header." Now Minyard says that on most days his pain level is moderate but manageable, around a 3 on the pain scale.

    Minyard also feels that it wasn't just about the physical therapy itself. He thinks his relationship with his PT was also a major factor in his recovery.

    "She wasn't just my PT, but my psychologist, my sounding board, my marriage counselor, my educator of my options, and my kick in the ass," Minyard said. "She was all of those things."

    That recovery included taking his PT up on a suggestion that he try handcycling. He liked it—so much so that he wound up medaling in traditional upright cycling at the Invictus games.

    Even more important for Minyard is how the changed approach to pain management gave him back his life with his family.

    "I am my 11-year-old daughter's soccer coach," Minyard said. "I get to be her coach. I don't know a damn thing about soccer, but I get to be her coach. But I almost lost that. I was this close, multiple times."

    While Minyard credits a single PT with a major role in his own recovery, he told the NEXT audience that the entire profession should be proud of the life-changing work they do.

    "You're going to continue to make such a tremendous impact on countless other patients," Minyard said. "Choose PT."

    Vision in Action: 2019 House of Delegates Sees Important Role for APTA in Host of Professional, Societal Issues

    APTA's outward-facing, forward-leaning vision continues to guide APTA’s House of Delegates. The policy-making body considered 70 motions during the 75th House session addressing a wide range of issues, yet 1 overarching theme was clear: the House believes APTA has the potential to be a change agent for the profession and society at large.

    APTA as Advocate
    Delegates approved multiple motions aimed at positioning the association as an advocate for a more diverse, equitable, and inclusive profession, beginning with a general statement that APTA "supports efforts to increase diversity, equity, and inclusion to better serve the association, profession, and society." The House also unanimously adopted stronger language around the association's commitment to nondiscrimination on the basis of race, creed, color, sex, gender, gender identity, gender expression, age, national or ethnic origin, sexual orientation, disability, or health status; as well as a charge directing APTA to work with stakeholders to advance diversity, equity, and inclusion in all areas of physical therapy, including clinical, educational, and research settings.

    The House also voted to add language to the Code of Ethics for the Physical Therapist (PT) and Standards of Ethical Conduct for the Physical Therapist Assistant (PTA) that more clearly describes the duty of PTs and PTAs to report verbal, physical, emotional, or sexual harassment. In addition, delegates approved revisions to the Standards of Practice for Physical Therapy that better align the document with the APTA vision statement and more explicitly reflect the role of PTs in population health and community engagement. In addition, the House created a single set of core values for both the PT and PTA to replace separate versions for each, noting in discussion that core values are common to PTs and PTAs but discrete from behaviors, which continue to be appropriately described in the separate ethics documents.

    Other profession-focused House actions included unanimous approval of the definition of the movement system as "the integration of body systems that generate and maintain movement at all levels of bodily function," further describing human movement as "a complex behavior within a specific context…influenced by social, environmental, and personal factors." The definition will further strengthen APTA's efforts to promote the movement system as a critical component of the physical therapy profession's identity.

    Societal Issues and population health
    The House passed multiple motions related to the ways both the association and individual PTs and PTAs are connected to larger societal issues. In addition to updating positions on the association's role in advocacy for prevention, fitness, wellness, health promotion, and population health, delegates voted to broaden APTA's ability to respond to health and social issues. The House provided examples of what those broader efforts will entail, approving motions that support taking a public health approach to gun violence, promoting public participation in vaccination schedules, improving health literacy, and supporting the availability in physical therapy settings of the drug naloxone to reverse the effects of an opiate overdose.

    A new area of specialization: wound management physical therapy
    Making it the 10th area of physical therapist clinical specialization, delegates approved the creation of a wound management specialty area for certification by the American Board of Physical Therapy Specialties, a proposal developed by the APTA Academy of Clinical Electrophysiology and Wound Management.

    Finally, in keeping with APTA’s ongoing efforts to follow best practices in governance, the motions deliberated at the House included the second phase of a complete review of all House-generated documents. The review, conducted by a special committee of the House over the course of 2 years, focused on updating, consolidating, and sometimes rescinding documents, resulting in recommendations for changes to more than 100 House policies, positions, directives, and other guidance.

    APTA Board Member Sheila Nicholson Dies

    Sheila Nicholson, PT, DPT, JD, MBA, MA, a member of the APTA Board of Directors and passionate advocate for the physical therapy profession, died on June 12, after a more than 2-year battle with cancer. She was 57.

    A physical therapist (PT) for more than 30 years, Nicholson dedicated herself to serving the physical therapy profession and its patients. After working solely as a PT for more than a decade, she earned a law degree and a master's degree in business administration and worked as a health care defense attorney while continuing to see physical therapy patients on weekends. She authored a book, The Physical Therapist's Business Practice and Legal Guide, and wrote multiple articles on risk management and medical malpractice.

    Nicholson joined APTA in 1982 and devoted herself to service in the association. She was elected to the APTA Board of Directors (Board) in 2014, after serving as president of APTA's Florida Chapter since 2009. Her long history of service also included APTA's Scope of Practice Task Force and participation in the APTA House of Delegates. Most recently, she was the Board lead on the effort to develop APTA's strategic plan for 2019-2021.

    "Sheila was a mentor, an educator, an advocate, and, above all, a friend to her family, colleagues, and APTA," said APTA President Sharon Dunn, PT, DPT, board-certified orthopaedic clinical specialist. "She was tenacious, thoughtful, and heartfelt, with an indomitable spirit that allowed her to be an active member of our Board until the end of her life.

    "Along with the rest of my Board colleagues, I am devastated by her loss and overwhelmed with gratitude for the opportunity to serve with her. Sheila has helped lay a firm foundation on which future generations will stand. Our condolences go out to Sheila's family—including the so many members of Sheila's APTA family whose lives she enriched.

    "And given her love for all things 'Bama, this LSU girl says from the bottom of her heart: Roll Tide!"

    Throughout her fight with cancer, Nicholson continued to advocate for the physical therapy profession and to stay involved with the work of APTA.

    In a prerecorded video shared with the APTA House of Delegates on June 10, Nicholson said, "I can't express how proud I am to have served with the people who are so dedicated to advancing our profession and making the world a better place. I am grateful for the opportunities I have had and for all of you, my colleagues and APTA family. Thank you for all you have given me. Most importantly, thank you for caring for our profession. I encourage you to make an impact that will outlast us all."

    Nicholson is survived by her parents, 2 brothers, and several nieces and nephews.

    APTA has posted a statement of tribute that allows readers to share their thoughts and memories. That page will be updated with memorial service and donation details when available.

    Can't-Miss Special Edition of PTJ Focuses on Intersection of Pediatric Physical Therapy and Developmental Science

    The June edition of PTJ (Physical Therapy) is something special: an entire issue devoted to the ways pediatric physical therapy and developmental science are informing each other—all to the benefit of children and their families.

    The issue shouldn't be missed, say Alyssa Fiss, PT, PhD, and Anjana Bhat, PT, PhD, both of whom are board-certified pediatric clinical specialists. PT in Motion News asked Fiss, a physical therapy professor at Mercer College, and Bhat, who teaches at the University of Delaware, to share their personal highlight of the issue. Here's what they had to say:

    Alyssa Fiss: "Michele Lobo and colleagues' ‘Wearables for Pediatric Rehabilitation: How to Optimally Design and Use Products to Meet the Needs of Users’ was a favorite of mine among many very strong articles. This article provides an excellent overview of the broad spectrum of wearable clothing and devices that support pediatric rehabilitation. Specific examples of wearables, with benefits and considerations for each, provide for interesting, thought-provoking reading about the variety of options available for children. When I read it, I was inspired to think of ways to creatively and intentionally use or design wearables to support children in active engagement and participation in daily life."

    Anjana Bhat: "I think 'Feasiblity and Effectiveness of Intervention With the Playskin Lift Exoskeletal Garment for Infants at Risk' by Iryna Babik and colleagues is one of the standouts of the issue. This is a beautifully written paper describing changes in reaching and cognitive performance over a 4-month period as well as a 1-month follow-up in infants born preterm or with birth injury, or both. This paper is unique in its use of a Playskin Lift garment to improve reaching and object exploration skills of young infants. Clinicians who work with challenging and highly diverse populations will gain a lot from this paper, including some new ideas on how to broaden their therapeutic toolbox. Parents should also be encouraged to explore what Babik and her coauthors have to say."

    But wait, there's more: in addition to the articles highlighted above, the special issue includes perspectives and original research on topics ranging from the ways motor skills development is connected to social skill development, to neonatal abstinence syndrome, as well as a case study on the use of electrical stimulation in gait training of adolescents with cerebral palsy. In all, 17 articles are included in the special issue.

    "Pediatric physical therapy and developmental science share a fundamental concern—the optimization of developmental outcome," write special issue coeditors Jill Heathcock, PT, PhD, and psychologist Jeffrey Lockman, PhD. "We believe this issue contains 'something for everyone'—practical information for clinicians in the trenches and intriguing trends in research for investigators."

    Attending the 2019 APTA NEXT Conference and Exposition? Stop by the PTJ booth in the APTA pavilion to find out more about the special issue and all of the other resources available at the journal's website.

    What's New at PTNow?

    PTNow, the association's flagship site for evidence-based practice resources, continues to expand in ways that help PTs and PTAs easily access the evidence they need in just a few clicks. If you haven't visited the site lately, check it out soon. Here's a quick take on the latest additions to the site. [Editor's note: member login required to access the resources listed here.]

    Recently added clinical practice guidelines

    Exercise and Physical Activity

    Pain

    Neurological conditions

    Recently added Cochrane Systematic Reviews
    Cochrane reviews provide some of the most reliable information on evidence-based health care—thoroughly researched, carefully evaluated, and presented in a way that makes it easy to understand the effects of interventions on rehabilitation, treatment, and prevention.

    Recently, PTNow added the following 15 Cochrane systematic reviews to the more than 600 reviews already posted:

    Pelvic health

    Exercise

    Cardiopulmonary

    Other Cochrane systematic reviews

    Recently Added CPG+ resources
    APTA's CPG+ program brings in identified member experts in research methodology to review selected CPGs and grade them based on the AGREE II tool. The result? A quality ranking of the guideline with highlights, plus a “Check Your Practice” list describing how you can incorporate the guideline into your clinical care.

    Latest CPG+ additions:

    Recently Added Tests and Measures
    Although many tests and measures are easy to administer, few are easy to find in their published formats. PTNow offers members licensed access to some 270 instruments for use in the clinic, with another dozen postings in development.The following tests and measures are recommended for use within the Physical Therapy Outcomes Registry. The Registry’s Scientific Advisory Panel has reviewed these tests and measures for appropriateness in terms of reliability, validity, feasibility of use, and adoption by physical therapists or other health care providers. Final results from these tests and measures can be manually entered into the Registry or synced from an electronic health record:

    Patient-Reported Outcomes Measurement Information System (PROMIS)

    Other tests and measures

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    What's New at PTNow? More Guidelines and Systematic Reviews Enrich an Already-Robust Resource(1)

    PTNow, the association's flagship site for evidence-based practice resources, continues to expand in ways that help PTs and PTAs easily access the evidence they need in just a few clicks. If you haven't visited the site lately, check it out soon. Here's a quick take on the latest additions to the site.

    Recently added clinical practice guidelines (member login required)

    Canadian Guidelines for Physical Activity Throughout Pregnancy

    Non-specific Low Back Pain

    Clinical Guideline and Recommendations on Pre-operative Exercise Trainng in Patients

    Awaiting Major Non-Cardiac Surgery

    Non-pharmacological Management of Persistent Headaches Association with Neck Pain: A Clinical Practice Guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa)

    Collaboration

    Cerebral Palsy in Adults

    Rheumatoid Arthritis in Adults: Management

    Dementia: Assessment, Management, and Support for People Living With Dementia and Their Careers

    Practice Guideline Update Recommendations Summary: Disorders of Consciousness

    Recently added Cochrane Systematic Reviews

    Cochrane reviews provide some of the most reliable information on evidence-based health care—thoroughly researched, carefully evaluated, and presented in a way that makes it easy to understand the effects of interventions on rehabilitation, treatment, and prevention.

    Recently, PTNow added the following 15 Cochrane systematic reviews to the more than 600 reviews already posted:

    Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews

    School-based self-management interventions for asthma in children and adolescents: a mixed methods systematic review

    Interventions to promote patient utilisation of cardiac rehabilitation

    Interventions for treating urinary incontinence after stroke in adults

    Exercise for preventing falls in older people living in the community

    Aerobic physical exercise for adult patients with hematological malignancies

    Exercise training for advanced lung cancer

    Exercise-based cardiac rehabilitation for adult patients with an implantable cardioverter defibrillator

    Interventions for treating wrist fractures in children

    Yoga for treating urinary incontinence in women

    Positive end-expiratory pressure for preterm infants requiring conventional mechanical ventilation for respiratory distress syndrome or bronchopulmonary dysplasia

    Physical exercise training for type 3 spinal muscular atrophy

    Non-invasive positive pressure ventilation for prevention of complications after pulmonary resection in lung cancer patients

    Interventions to support return to work for people with coronary heart disease

    Constraint-induced movement therapy in children with unilateral cerebral palsy

    Recently Added CPG+

    APTA's CPG+ program brings in identified member experts in research methodology to review selected CPGs and grade them based on the AGREE II tool. The result? A quality ranking of the guideline with highlights, plus a "Check Your Practice" list describing how you can incorporate the guideline into your clinical care.

    Latest CPG+ additions (member login required):

    Recently Added Tests and Measures

    Although many tests and measures are easy to administer, few are easy to find in their published formats. PTNow offers members licensed access to some 270 instruments for use in the clinic, with another dozen postings in development.

    The following tests and measures are recommended for use within the Physical Therapy Outcomes Registry. The Registry’s Scientific Advisory Panel has reviewed these tests and measures for appropriateness in terms of reliability, validity, feasibility of use, and adoption by physical therapists or other health care providers. Final results from these tests and measures can be manually entered into the Registry or synced from an electronic health record (member login required):

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    APTA 2019 House of Delegates Election Results Announced

    The following members were elected to APTA's Board of Directors and Nominating Committee on Monday, June 10, at the 2019 House of Delegates in Chicago.

    Kip Schick, PT, DPT, MBA, was elected secretary.

    Kyle Covington, PT, DPT, PhD, was elected vice speaker of the House of Delegates.

    Deirdre "Dee" Daley, PT, DPT, MSHPE, Heather Jennings, PT, DPT, Board-Certified Clinical Specialist in Neurologic Physical Therapy, and Carmen Cooper-Oguz, PT, DPT, MBA, were elected director.

    Carole "Carrie" Cunningham, PT, Board-Certified Clinical Specialist in Orthopaedic Physical Therapy, and V. Kai Kennedy, PT, DPT, were elected to the Nominating Committee.

    These terms become effective at the close of the House of Delegates on Wednesday.

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