The results of this practice analysis describe distinct knowledge, skills, and behaviors specific for acute care physical therapy. The outcomes of the survey might assist in the development of professional (entry-level) acute care competencies, a petition for the recognition of specialization in acute care physical therapy, or both. In addition, the findings of this practice analysis could serve as the foundation for the development of residencies or fellowships in acute care practice.
line design across 3 subjects. OBJECTIVE:To investigate the use of a quotabased approach for prescribing a walking program for individuals with fibromyalgia (FM). BACKGROUND:Exercise has been found to be beneficial for individuals with FM. What has not been determined is the best way to implement an exercise program that does not increase FM symptoms. METHODS AND MEASURES: Three womenwith FM were randomly assigned a baseline period of 5, 6, or 7 weeks, which served as the control phase, followed by an intervention period consisting of an 8-week walking program. The walking program progression was prescribed using a quota-based approach. Weekly outcome measures were the Fibromyalgia Impact Questionnaire (FIQ), Arthritis Scale (ASES), and SF-36v2 (acute). A 6-minute walk test was recorded twice: at the start of the baseline phase (after a trial phase) and at the end of the intervention phase.RESULTS: Subjects 1 and 3 had a significant decrease in the symptoms associated with FM during the intervention phase (FIQ, P .05), but no significant increase in (ASES). They increased their walking distances used for exercise by 640 and 480 m, respectively. Subject 2 had no significant improvements in her symptoms of FM. Despite a significant decrease in ASES (P .05), walking distance used for exercise by subject 2 increased by 2080 m. Six-minute walk test distances increased 76, 32, and 106 m for subjects 1, 2, and 3, respectively. CONCLUSIONS:Prescribing a walking program using a quota-based exercise prescription resulted in increasing the distance walked for 3 subjects. It also decreased symptoms associated with FM in 2 of the 3 subjects, but did not increase
Background and Purpose. This case report describes the physical therapist examination, evaluation, and intervention for a patient with bilateral lower-extremity lymphedema who received complete decongestive physical therapy 2 days per week instead of the recommended daily frequency. Case Description. The patient was a 55-year-old woman who developed bilateral lower-extremity grade II lymphedema 3 years after surgery and radiation for cervical cancer. She had impairments in hip and knee flexion range of motion and functional limitations in transfers, gait, and activities of daily living. Intervention. A twice-weekly intervention program was implemented consisting of education in skin care, manual lymph techniques, compression, and exercise. Outcomes. Outcomes related to the lymphedema were measured using the sum of the circumference of each limb. At discharge, the patient had reductions in lymphedema of 9% for the left lower extremity and 10% for the right lower extremity. Her hip flexion range of motion increased from 95 degrees to 110 degrees, and her knee flexion range of motion increased from 95 degrees to 130 degrees. She had resumed all premorbid activities and was independent in self-management. Discussion. Twice-weekly management of lymphedema using a program of skin care, manual lymph techniques, compression, and exercise was followed by reduction of the impairments and functional limitations in a patient with bilateral lower-extremity lymphedema.
Purpose: The purpose of this paper is to present teaching strategies to enhance students’ cultural competence in non-diverse educational settings. Methods: Utilizing Purnell’s cultural competence model and Lattanzi’s cultural ladder the authors describe teaching strategies used to promote students’ understanding of the complex nature of culture and how the multiple layers of culture influence the healthcare professional-client relationship. Teaching strategies and subsequent student reflections are presented. Results: Students adjusted client interventions and plans of care when confronted with various cultural characteristics of their clients. Integrating cultural issues in non-diverse academic settings challenges faculty to create situations that include cultural differences. The Purnell model demonstrates the complex nature of culture and the difficulties in understanding the various dimensions of culture. Lattanzi provides a framework for applying Purnell’s model, beginning with cultural sensitivity and awareness, then working toward integration of cultural concepts in clinical interactions. Combining aspects of these cultural models, the authors layered cultural dimensions to course and clinical activities thereby increasing students’ awareness of culture’s influence on clinical interactions.Conclusion: While selection of diverse clinical settings provides invaluable immersion experiences for cultural competence, faculty in non-diverse academic settings can incorporate diversity dimensions within the academic curriculum to prepare students for the multicultural client population they may encounter as healthcare practitioners.
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