Purpose: Cardiorespiratory fitness tests are important for older adults to determine baseline cardiovascular fitness and appropriate aerobic exercise intensity. The Timed Up and Go (TUG) is a test that can be modified to challenge the aerobic system by performing 10 continuous repetitions (TUG-10). The TUG-10 advantages include less space and time requirements and incorporation of functional tasks with balance challenges. The purpose of this study was to relate the performance and physiologic responses of the TUG-10 to other common aerobic capacity tests. Methods: Fourteen independent community-dwelling adults performed the 6-minutewalk test (6MWT), 2-minute-step test (2MST), and TUG-10. Heart rate (HR), diastolic and systolic blood pressure, and rate of perceived exertion (RPE) were recorded before and after each test. Bland-Altman plots were used to determine the agreement between test performances. Repeated measures mixed models compared differences in the physiologic changes between the tests. Results: Participants had a clinically greater increase in the adjusted mean change in HR during the 2MST (22.5 bpm) than the 6MWT (17.0 bpm) and TUG-10 (12.3 bpm). Diastolic blood pressure response was similar across all 3 tests with no significant change. Systolic blood pressure increased less during the 6MWT (15.4 mm Hg) compared with the 2MST (33.3 mm Hg) and TUG-10 (28.7 mm Hg). Participants reported a higher RPE during the 2MST (7.9) than the 6MWT (6.1) and TUG-10 (5.2). The Bland-Altman plots indicated that participants' performance on the 3 tests was comparable. Conclusions: The TUG-10, 6MWT, and 2MST demonstrated comparable performances and clinically similar physiologic changes. Heart rate and RPE changes were greater during the 2MST than the other tests, suggesting that the 2MST was more demanding. Findings support the TUG-10 as a potential functional outcome measure to estimate cardiorespiratory fitness. Moreover, the TUG-10 required minimal space and time and may facilitate the gap in aerobic testing in physical therapy practice.
Objectives: Physical therapists (PTs) are integral team members in fall prevention in clinical settings; however, few studies have investigated PTs' engagement in pro-bono community-based falls prevention. Therefore, we aimed to describe the characteristics of PTs and physical therapist assistants (PTAs) in the United States who conduct community-based fall screenings, the reach of screenings, their knowledge and utilization of the Centers for Disease Control and Prevention's fall-risk screening toolkit (STEADI, Stopping Elderly Accidents, Deaths, and Injuries), and therapists' knowledge and referrals to evidence-based programs (EBPs) and community resources.Methods: A cross-sectional survey distributed to a convenience sample of PTs/PTAs in the United States through news-blasts, and social media.Results: Four hundred and forty-four therapists who worked with older adults completed the survey. Approximately 40% of the respondents (n = 180) conduct screenings, most frequently annually. People who screen tend to be PTs with >20 years of experience, work in outpatient/wellness or academia, and be involved in the least amount of direct patient care. The majority (n = 344, 77.5%) of survey respondents were somewhat to very familiar with the STEADI, and ~84% (n = 114) of respondents who were very familiar with the STEADI (n = 136) use the toolkit to conduct community-based, pro-bono fall risk screenings. Twenty-six percent (n = 14) out of the 53 PTAs who responded to the survey conduct falls screenings in the community. Of the PTs/PTAs who conduct community-based fall screenings (n = 180), ~ 75% (n = 136) are aware of and refer older adults to EBPs. Over half also refer to Silver Sneakers and/or senior centers.Discussion: PTs and PTAs are key partners in evidence-based multifactorial fall prevention in the community. Data helps inform community organizations that most PTs who engage in community-based fall risk screening utilize the STEADI toolkit and refer to community-based programs. Community organizations seeking PT partners to engage in fall risk screenings and promote referrals to local resources or EBPs will likely have the most success collaborating with local physical therapy education programs or physical therapy clinic managers.
Purpose: Pulmonary embolism (PE) is a complication associated with the condition of deep vein thrombosis (DVT). Together, DVT and PE comprise the condition of venous thromboembolism (VTE). The presence of PE is a life-threatening acute complication, with the risk of death being 18-fold higher than that in patients with DVT alone. The long-term effects of VTE may influence a patient's ability to maintain appropriate levels of physical activity, resulting in impaired functional mobility, quality of life, and overall health and wellness. Physical therapists frequently work with patients who are at risk for or have a history of VTE across all practice settings and are often responsible for mobilizing patients after VTE. However, little guidance exists regarding optimal timing for initiation and intensity of treatment to combat the negative sequalae associated with PE. Methods: This case report describes the experience of a physical therapist who suffered an unprovoked submassive saddle PE. Results: The patient self-initiated and self-administered an exercise program with successful outcomes. The case provides a unique perspective of a physical therapist who used his clinical knowledge to make decisions, while experiencing the event through the lens of a patient. Conclusion: Evidence is provided to support the role of early physical therapy–directed progressive mobility to maximize long-term outcomes following PE.
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