Dennis W. Fell

Mapping the core journals of the physical therapy literature

OBJECTIVES The purpose of this study was to identify (1) core journals in the literature of physical therapy, (2) currency of references cited in that literature, and (3) online databases providing the highest coverage rate of core journals. METHOD Data for each cited reference in each article of four source journals for three years were recorded, including type of literature, year of publication, and journal title. The journal titles were ranked in descending order according to the frequency of citations and divided into three zones using Bradfords Law of Scattering. Four databases were analyzed for coverage rates of articles published in the Zone 1 and Zone 2 journals in 2007. RESULTS Journal articles were the most frequently cited type of literature, with sixteen journals supplying one-third of the cited journal references. Physical Therapy was the most commonly cited title. There were more cited articles published from 2000 to 2007 than in any previous full decade. Of the databases analyzed, CINAHL provided the highest coverage rate for Zone 1 2007 publications. CONCLUSIONS Results were similar to a previous study, except for changes in the order of Zone 1 journals. Results can help physical therapists and librarians determine important journals in this discipline.

The effect of contralateral training: Influence of unilateral isokinetic exercise on one-legged standing balance of the contralateral lower extremity in adults

PURPOSE To investigate the effects of unilateral isokinetic exercises on the one-legged standing balance of the contralateral lower extremity. SUBJECTS A volunteer sample of 32 healthy adults (12 men and 20 women) was randomized to training and control groups. METHODS The training group received unilateral hip isokinetic exercises of the dominant leg for two weeks. Contralateral single-limb balance was measured before and after intervention, including three stability index scores of balance using Biodex Stability System: Anterior-Posterior Stability Index (APSI), Medio-lateral Stability Index (MLSI), and Overall Stability Index (OSI) scores. RESULTS Comparison of pre-test and post-test data revealed significant improvements in APSI, MLSI, and OSI scores in the training group (p<0.05), but not in the control group. The gains of stability scores from pre- to post-test, were also significantly greater (p<0.05) in the training group than the control group. CONCLUSION These results suggest that contralateral training with unilateral isokinetic exercises increases the one-legged standing balance of the contralateral limb following a short duration of training.

Access Is Key: Teaching Students and Physical Therapists to Access Evidence, Expert Opinion, and Patient Values for Evidence-Based Practice

Background and Purpose. Access to literature that supports evidence‐based practice (EBP), including identification and retrieval, is essential to implementation of EBP in physical therapy. This article will discuss the importance of teaching access to EBP resources, discuss resources to identify and retrieve evidence‐based literature, and outline strategies for teaching access of EBP literature in physical therapy education. With the rapid growth in physical therapy articles, access to the literature is essential, including a significant role for electronic access. Methods and Materials. A review of the physical therapy and rehabilitation literature was completed with an informal listserv survey to characterize common methods and strategies used to teach access to the EBP information in physical therapy education programs. Summary of the Literature. The importance of teaching access to EBP information is discussed. A variety of sources that can be used to identify applicable articles are summarized. Options for retrieval of those articles including specific search strategies are discussed as well as barriers to access. Specific strategies and instructional activities for teaching access to EBP information and teaching resources are described. Discussion and Conclusion. Tremendous potential exists for improved patient care as students and physical therapists are instructed in EBP. Access to evidence‐based literature is a foundational prerequisite for application of EBP and will result in optimal clinical outcomes.

Determining where physical therapists get information to support clinical practice decisions.

OBJECTIVE To determine the information sources utilised by physical therapists (PTs) to support clinical decisions. METHODS Physical therapists in the United States were invited via professional listservs and electronic newsletters to participate in an online survey. RESULTS Journal articles were the most frequently utilised source of information, followed by databases (PubMed was most frequent). The frequency of utilising evidence-based resources was not significantly affected by the number of years of experience as a physical therapist (PT), working in a state that allows direct access to PT services or doctoral vs masters/bachelors degree. CONCLUSIONS Compared with a previous study (1994), there has been a transition in physical therapy information seeking, with greater reliance on evidence-based information.

Kinematic head and trunk strategies used by hemiplegic stroke patients crossing over obstacles of different heights

[Purpose] The purpose of this study was to compare kinematic data regarding the head, trunk, and pelvis strategies used by individuals with hemiplegia when crossing over obstacles of different heights. [Subjects and Methods] Nine adults with hemiplegia from stroke (7 males and 2 females) participated in this study. A motion analysis system with six infrared cameras was used to measure the kinematic data of the head, trunk, and pelvis while the subjects crossed over obstacles of different heights. Repeated measures ANOVA analysis was performed to compare the resulting kinematic data. [Results] An increase in the magnitude of the kinematic data of the head, trunk, and pelvis of the hemiparetic stroke patients was observed when the height of the obstacles, which they crossed over, increased. [Conclusion] This study described the kinematic strategies, with regard to the head, trunk, and pelvis, used by hemiplegic patients crossing over obstacles of different heights. The results indicate that these kinematic strategies primarily change when the obstacle height was 20% of the height of the subjects.

Differential effects of ankle position on isokinetic knee extensor and flexor strength gains during strength training

OBJECTIVE: To investigate the influence of two different active ankle positions during training on the strengths of knee extensors and flexors. METHODS: A sample of 21 healthy adults was randomized into ankle dorsiflexion (AD, N = 11) and ankle plantarflexion (AP, N = 10) training groups. Subjects were trained isokinetically and concentrically in knee extension and flexion under these two actively fixed, contracted ankle conditions, four times a week for three weeks. RESULTS: AD group showed significant strength improvements in both peak moment and total work. These improvements were also higher significantly, between 29–59% compared to those gained by AP group. CONCLUSION: Active ankle dorsiflexion during concentric isokinetic knee strength training may be more efficient for improving knee extensors and flexors strength than a plantarflexed position.

An Examination of Student Contracts and Fulfillment Rates Among Physical Therapist Graduates From One Institution

ABSTRACT: Many physical therapist students sign pre‐employment contracts. Upon graduation, some graduates allow a second health care facility to buy out the contract, leaving a vacant position. The study objective was to examine the frequency of student employment contracts and trends in contract fulfillment among graduates from one Bachelor of Science in Physical Therapy degree program over five recent graduating classes as a measure of effectiveness in recruitment. A survey instrument was mailed to all 145 graduates from five previous classes, with 80 survey instruments returned. By report, 58.8% of the graduates had signed contracts. Of those respondents, 63.8% reported that they had fulfilled their contract terms and 36.4% reported nonfulfillment. Of those graduates who had signed contracts, 31.9% reported that they underwent a contract buyout process, with “personal reasons” cited most frequently as the reason. If a fulfillment rate of nearly 64% is acceptable to a facility, then pre‐employment contracts would appear to be an effective recruitment strategy targeting new graduates. The discussion may have implications for improved contract fulfillment and retention among those graduates who have signed contracts.