Objective The purpose of this study was to investigate the physical therapy process of care, clinical practices, and the self-reported psychosocial impact of working during the 2020 pandemic on physical therapists and physical therapist assistants. Methods An electronic survey including both closed and open-ended questions was distributed to physical therapists employed in a range of health care settings across the United States. Results Physical therapy utilization and process of care varied across settings. Feasibility of performing an assessment was the main driver for selection of outcome measures. Interventions were mainly geared toward improving respiratory function and deconditioning. Prone patient positioning, now commonplace, was used infrequently by therapists in acute care prior to COVID-19. Similarly, outpatient and home care settings noted an increase in the use of respiratory driven interventions such as incentive spirometry and breathing exercises. Qualitative data analysis revealed both physical barriers (personal protective equipment [PPE]) and social barriers to care. Therapists noted challenges in discharge planning and patient/family education due to the impact of social isolation. They also noted difficulty maintaining productivity standards due to additional time spent in changing PPE and following safety measures. Participants dealt with rapid changes in their role, changing productivity standards, and needing to increase their knowledge in a short amount of time. Conclusion Physical therapy utilization varied widely across settings. Despite some concern for personal health, respondents felt that the COVID-19 pandemic increased a sense of togetherness among team members and promoted greater appreciation for life and work. Impact This exploration of the process of care and current clinical practices across settings provides important knowledge about the role of physical therapists and physical therapist assistants in the care of patients with COVID-19. Gaining an understanding of the psychosocial impact of the pandemic among therapists could assist in creating solutions to better support clinicians’ well-being.

Background and Objective: Sudden transition to telerehabilitation during the coronavirus disease 2019 (COVID-19) pandemic was challenging for pediatric therapists, including physical therapists and occupational therapists, due to lack of prior experience and knowledge. The primary goal of the current study was to survey the pediatric therapists regarding the practice trends and specific challenges/strengths of delivering telerehabilitation during the pandemic. Materials and Methods: An electronic survey was developed by the research term and validated through cognitive interviews with three pediatric therapists. A total of 107 therapists completed the survey. Descriptive statistics were used to summarize the trends for the survey questions. Results: The majority of therapists (92.5%) reported no prior experience with telerehabilitation. When comparing telerehabilitation with standard-of-care, the therapists reported similar session durations and frequencies, but greater caregiver-initiated cancellations of telerehabilitation sessions. Furthermore, a greater percentage of therapists modified the intervention activities compared with assessments, which impacted therapists' perceptions about quality of telerehabilitation as a greater percentage of therapists expressed confidence in treating children compared with assessing children virtually. One of the commonly reported telerehabilitation challenges was reduced virtual engagement of children, and strength was better assessment of home environment. Lastly, a greater percentage of therapists relied on consultations and fewer therapists used empirical evidence to guide their delivery of virtual care. Conclusions: Telerehabilitation is a cost-effective health care model that offers remote accessibility and flexible scheduling. However, several limitations in the current pediatric telerehabilitation model, including lack of teleassessments and empirical evidence, could limit post-COVID use of telerehabilitation.

Background/Aims Although strength, power and balance are associated with the Five-Times-Sit-to-Stand Test in older adults, the relative contribution of each to sit-to-stand performance is unclear. This study compared the strength of association between the Five-Times-Sit-to-Stand Test and measures of balance, knee extensor strength, and lower limb power in older adults. Methods A total of 41 community-dwelling older adults completed the Five-Times-Sit-to-Stand Test and tests of balance, knee extensor strength, and lower limb power. Results The strongest association observed was between the Five-Times-Sit-to-Stand Test and dynamic balance (rs= −0.61, P<0.001), with a moderate association observed between the Five-Times-Sit-to-Stand Test and power (rs= −0.52, P=0.001). Conclusions Dynamic balance and lower limb power are determinants of, and play roles in the Five-Times-Sit-to-Stand Test performance in community-dwelling older adults. Dynamic balance was the strongest determinant of Five-Times-Sit-to-Stand Test performance, suggesting that the Five-Times-Sit-to-Stand Test should not be viewed solely as a proxy measure of knee extensor strength in community-dwelling older adults.

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Adolescents with traumatic brain injury (TBI) are often discharged from physical therapy (PT) services without transitioning into exertional conditioning programs. Active participation in physical activities with peers at school is essential to achieve a sense of accomplishment and acceptance. Factors such as reduced aerobic fitness and residual gait impairments can lead to limited participation and peer interaction. The purpose of this case report was to describe the impact of home-based circuit training (HBCT) focusing on strength and balance on gait speed (GS), energy expenditure, and functional performance in a 17-year-old female with severe TBI. The participant sustained a TBI from a motor vehicle crash. Although she was ambulatory and independent with the basic activities of daily living following two years of rehabilitation, she presented with activity limitations and participation restrictions at school. The participant performed a 4-week HBCT program developed by a school physical therapist that focused on strength and balance. At the end of 4 weeks, improvements were observed in 6 MWT (change = 79.7 m), GS (change = 0.22 m/s), and the COPM scores (performance score change = 2.8, satisfaction score change = 2.2, MCID = 2). Improvements in functional performance, gait speed, and self-perception of occupational performance were observed following 4-week HBCT. Future clinical trials on short duration, HBCT program for children and young adults with TBI are recommended in order to establish effectiveness of HBCT.