Abstract:
BACKGROUND AND PURPOSE:Little is known about organizational and service delivery factors related to quality of care in physical therapy. This study sought to identify characteristics related to differences in practice outcomes and service utilization. SUBJECTS:The sample comprised 114 outpatient clinics and 1,058 therapists who treated 16,281 patients with low back pain syndromes during the period 2000-2001. Clinics participated with the Focus on Therapeutic Outcomes, Inc (FOTO) database. METHODS:Hierarchical linear models were used to risk adjust treatment outcomes and number of visits per treatment episode. Aggregated residual scores from these models were used to classify each clinic into 1 of 3 categories in each of 3 types of performance groups: (1) effectiveness, (2) utilization, and (3) overall performance (ie, composite measure of effectiveness and utilization). Relationships between clinic classification and the following independent variables were examined by multinomial logistic regression: years of therapist experience, number of physical therapists, ratio of physical therapists to physical therapist assistants, proportion of patients with low back pain syndromes, number of new patients per physical therapist per month, utilization of physical therapist assistants, and setting. RESULTS:Clinics that were lower utilizers of physical therapist assistants were 6.6 times more likely to be classified into the high effectiveness group compared with the low effectiveness group, 6.7 times more likely to be classified in the low utilization group compared with the high utilization group, and 12.4 times more likely to be classified in the best performance group compared with the worst performance group. Serving a higher proportion of patients with low back pain syndromes was associated with an increased likelihood of being classified in the lowest or middle group. Years of physical therapist experience was inversely associated with being classified in the middle utilization group compared with the highest utilization group. DISCUSSION AND CONCLUSION:These findings suggest that, in the treatment of patients with low back pain syndromes, clinics that are low utilizers of physical therapist assistants are more likely to provide superior care (ie, better patient outcomes and lower service use).
journal_name
Phys Therjournal_title
Physical therapyauthors
Resnik L,Liu D,Mor V,Hart DLdoi
10.2522/ptj.20070110subject
Has Abstractpub_date
2008-09-01 00:00:00pages
989-1004issue
9eissn
0031-9023issn
1538-6724pii
ptj.20070110journal_volume
88pub_type
杂志文章相关文献
PHYSICAL THERAPY文献大全abstract:BACKGROUND AND PURPOSE:There has been an increasing focus on vestibular rehabilitation (VR) after traumatic brain injury (TBI) in recent years. However, detailed descriptions of the content of and patient responses to VR after TBI are limited. The purposes of this case series are (1) to describe a modified, group-based...
journal_title:Physical therapy
pub_type: 杂志文章,随机对照试验
doi:10.2522/ptj.20150095
更新日期:2016-06-01 00:00:00
abstract::Forty-nine adults who had undergone cardiopulmonary bypass surgery were randomly assigned to one of three exercise programs to determine if either maximal inspiratory breathing exercises or incentive spirometry offered a therapeutic advantage over early mobilization alone. After extubation, the patients started their ...
journal_title:Physical therapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ptj/63.5.655
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The purpose of this study was to determine whether subjects with asymptomatic carotid artery stenosis and occlusion demonstrate deficits in physical performance compared with a comparison group. These deficits may indicate that a person is demonstrating preclinical disability. SUBJECTS:Seventy-o...
journal_title:Physical therapy
pub_type: 杂志文章
doi:
更新日期:2006-04-01 00:00:00
abstract::The purposes of this retrospective study were to document productivity-relevant measurements, describe the relationships between these measurements, and discuss the implications of the relationships in one physical therapy department. The department's inputs (clinician and staff hours worked), outputs (patient visits,...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.1093/ptj/67.10.1553
更新日期:1987-10-01 00:00:00
abstract::Diabetic peripheral neuropathy (DPN) occurs in more than 50% of people with diabetes and is an important risk factor for skin breakdown, amputation, and reduced physical mobility (ie, walking and stair climbing). Although many beneficial effects of exercise for people with diabetes have been well established, few stud...
journal_title:Physical therapy
pub_type: 杂志文章,评审
doi:10.2522/ptj.20160124
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Recent evidence suggests that childhood obesity is increasing in children with typical development (TD) and in children with autism spectrum disorders (ASD). The associations between physical activity (PA) levels and physical fitness components have not yet been objectively examined in this population but ma...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20140353
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Whole-body vibration (WBV) has gained increasing popularity in rehabilitation. Recent studies have investigated the application of WBV in individuals with chronic illnesses, including stroke. PURPOSE:The purpose of this study was to compare WBV exercise with the same exercise condition without WBV and with ...
journal_title:Physical therapy
pub_type: 杂志文章,评审
doi:10.2522/ptj.20130366
更新日期:2014-09-01 00:00:00
abstract::The physiological and anatomical properties of mammalian motor units are discussed, and the results of human and animal studies are compared. A physiological organization of motor units based on the mechanical properties of their associated muscle units is examined. It is concluded that such an organizing principle ha...
journal_title:Physical therapy
pub_type: 杂志文章,评审
doi:10.1093/ptj/62.12.1763
更新日期:1982-12-01 00:00:00
abstract:BACKGROUND:Step-up exercises often are suggested for strengthening the hip abductor muscles and improving balance in older adults. Little is known, however, about whether the forward or lateral version of these exercises is best for activating the hip abductor muscles. OBJECTIVE:The purpose of this study was to examin...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20080229
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Each of the 4 randomized clinical trials (RCTs) hosted by the Physical Therapy Clinical Research Network (PTClinResNet) targeted a different disability group (low back disorder in the Muscle-Specific Strength Training Effectiveness After Lumbar Microdiskectomy [MUSSEL] trial, chronic spinal cord injury in th...
journal_title:Physical therapy
pub_type: 杂志文章,随机对照试验
doi:10.2522/ptj.20110024
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The modified Dynamic Gait Index (mDGI) measures the capacity to adapt gait to complex tasks utilizing 8 tasks and 3 facets of performance. The measurement stability of the mDGI in specific diagnostic groups is unknown. OBJECTIVE:This study examined the psychometric properties of the mDGI in 5 diagnostic gro...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20130294
更新日期:2014-07-01 00:00:00
abstract::Sixty-two physical therapy schools were surveyed reageding their teaching of cardiopulmonary resuscitation. Eighty-two percent of the schools responded to the questions and 27 percent indicated no such instruction. Included in this report is a copy of the questionnaire and the results of the survey. The recommendation...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.1093/ptj/55.7.744
更新日期:1975-07-01 00:00:00
abstract::This article presents spinal dysfunction (as opposed to disease) as being an altered state of mechanics demonstrating either an aberrant motion or an increase or decrease from the expected range. Examination techniques, including passive intervertebral motion testing, are outlined, as is the grading system for recordi...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.1093/ptj/59.8.988
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Physical therapists strive to promote children's motor function and the parents' abilities to interact with their children, thus aiming to positively influence the parent-child relationship. This study examined a model for provision of home-based physical therapy within the context of motor play ...
journal_title:Physical therapy
pub_type: 临床试验,杂志文章
doi:10.1093/ptj/78.2.180
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:This study investigated changes in the kinematics of elderly people who experienced at least one fall 6 months prior to data collection. The authors hypothesized that, in order to decrease variability of walking, people with a history of falls would show different kinematic adaptations of their w...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20050387
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Perceived ability or confidence plays an important role in determining function and behavior. The modified Gait Efficacy Scale (mGES) is a 10-item self-report measure used to assess walking confidence under challenging everyday circumstances. OBJECTIVE:The purpose of this study was to determine the reliabil...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20110053
更新日期:2012-02-01 00:00:00
abstract::Chronic lung disease is a major health problem among children. Estimates suggest that one child in six has a chronic respiratory condition. This article reviews three common chronic respiratory conditions occurring in childhood for which physical therapy is usually recommended. The cause, pathophysiology, and medical ...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.1093/ptj/61.12.1774
更新日期:1981-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to identify core journals in physical therapy by identifying those that publish the most randomized controlled trials of physical therapy interventions, provide the highest-quality reports of randomized controlled trials, and have the highest journal impact factors. DESIGN:Thi...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20090419
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The Movement Continuum Theory (MCT) provides a potential basis for movement assessment and intervention, but "movement" lacks specificity. The purposes of this study were to propose and evaluate a subdivision of movement into multiple dimensions. SUBJECTS:A convenience sample of 318 adults compl...
journal_title:Physical therapy
pub_type: 杂志文章,评审
doi:10.2522/ptj.20060182
更新日期:2007-07-01 00:00:00
abstract::Exercise can be sustained only if there is increased blood flow to those tissues with increased metabolic needs. Blood flow to particular working muscles can be increased either by increasing cardiac output or by redirecting peripheral blood flow. The nature and extent of changes in cardiovascular function that occur ...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.1093/ptj/61.9.1260
更新日期:1981-09-01 00:00:00
abstract::Twenty subjects were followed up to three months after microneurographic recording of sympathetic nerve fiber activity to determine the nature and incidence of sequelae to the invasive microneurographic procedure. Skin or muscle parethesias lasting two weeks on the average were reported by the majority of subjects. Ni...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.1093/ptj/61.11.1585
更新日期:1981-11-01 00:00:00
abstract:BACKGROUND:Overall functional ability declines over time in people with Parkinson disease (PD). Established benchmarks are needed to allow clinicians and researchers to facilitate meaningful interpretation of data. OBJECTIVE:The purposes of this study were: (1) to report typical values for standard measures of functio...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20100236
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:There is limited understanding of the utilization of and perceived need for physical therapy services among middle-aged and older adults with multiple sclerosis (MS). The resulting knowledge gap compromises efforts for physical therapy service planning for this population. OBJECTIVE:The purpose of this stud...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20100072
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Traditionally, rehabilitation programs emphasize training balance under single-task conditions to improve balance and reduce risk for falls. The purpose of this case report is to describe 3 balance training approaches in older adults with impaired balance. CASE DESCRIPTIONS:Three patients were r...
journal_title:Physical therapy
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:How people think and talk about weight is important because it can influence their behavior toward people who are overweight. One study has shown that physical therapists have negative attitudes toward people who are overweight. However, how this finding translates into clinical practice is not well understo...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20150286
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Neuromuscular electrical stimulation (NMES) has demonstrated efficacy in improving quadriceps muscle strength (force-generating capacity) and activation following knee replacement and ligamentous reconstruction. Yet, data are lacking to establish the efficacy of NMES in people with evidence of early radiogra...
journal_title:Physical therapy
pub_type: 杂志文章,随机对照试验
doi:10.2522/ptj.20090330
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Functional impairment is common in people with chronic liver disease (CLD), and improvement is expected following liver transplantation (LT). The Six-Minute Walk Test (6MWT) is an objective measure of functional performance. OBJECTIVE:The aims of this study were: (1) to evaluate the feasibility of 6MWT perf...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20150376
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Little is known about the functional performance of patients after revision total hip arthroplasty with major acetabular bone impaction grafting. In general, these patients are assumed to perform worse due to a more advanced stage of periarticular tissue degeneration and multiple surgeries compared with pati...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.2522/ptj.20090376
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Tuberculous arthritis is not commonly seen by physical therapists in the United States. The purpose of this case report is to describe a case of tuberculous arthritis of the elbow. CASE DESCRIPTION:The patient was a 36-year-old man referred for physical therapy evaluation and intervention for ch...
journal_title:Physical therapy
pub_type: 杂志文章
doi:
更新日期:2001-06-01 00:00:00
abstract::Electrical stimulation reduces hypertonicity, but the mechanism for the effectiveness is not well understood. In this particular case, electrical stimulation to the toe extensors resulted in inhibition of the toe-flexor hypertonicity. This phenomenon may be explained by Sherrington's theory of reciprocal inhibition. L...
journal_title:Physical therapy
pub_type: 杂志文章
doi:10.1093/ptj/64.4.523
更新日期:1984-04-01 00:00:00