American Physical Therapy Association

Gait analysis using three-dimensional motion capture systems (3D motion capture) provides a combination of kinematic and kinetic measurements for quantifying and characterizing the motion and loads, respectively, of lower extremity joints during human movement. However, their high cost and limited accessibility impact their utility. Wearable inertial motion sensors offer a cost-effective alternative to measure simple temporospatial variables, but more complex kinematic variables require machine learning interfaces. We hypothesize that kinematic measures about the knee collected using motion capture can be replicated by coupling raw data collected from inertial measurement units (IMUs) to machine learning algorithms. Data from 40 healthy participants performing fixed walking, stair climbing, and sit-to-stand tasks were collected using both 3D motion capture and IMUs. Sequence to sequence convolutional neural networks were trained to map IMU data to three motion capture kinematic outputs: right knee angle, right knee angular velocity, and right hip angle. Model performance was assessed using mean absolute error. The convolutional neural network models exhibited high accuracy in replicating motion capture-derived kinematic variables. Mean absolute error values for right knee angle ranged from 4.30 ± 1.55 to 5.79 ± 2.93 degrees, for right knee angular velocity from 7.82 ± 3.01 to 22.16 ± 9.52 degrees per second, and for right hip angle from 4.82 ± 2.29 to 8.63 ± 4.73 degrees. Task-specific variations in accuracy were observed. The findings highlight the potential of leveraging raw data from wearable inertial sensors and machine learning algorithms to reproduce gait lab-quality kinematic data outside the laboratory settings for the study of knee function following joint injury, surgery, or the progression of joint disease.

The purpose of this study was to explore the perceived ability of sports medicine physicians to effectively treat and manage the preventative and rehabilitative care of adaptive athletes. Exploratory mixed-methods, survey-based study. Online, United States. The survey was conducted using a sample of 2728 physicians. A total of 286 responded to the invitation and the response rate was 10% (286 of 2728). One hundred thirty (45.5%) of 286 physicians completed the survey. Survey. Knowledge of adaptive athlete care and perceived confidence. Most respondents were willing to accept adaptive athletes into their clinical practice, and there were no significant associations between their willingness and if (χ 2 = 5.487, P = 0.139) or at what point (χ 2 = 4.463, P = 0.878) they received education about adaptive athletes. Those who received education about adaptive athletes during training reported feeling moderately to very confident in caring for adaptive athletes in an outpatient setting (χ 2 = 36.906, P < 0.001). When considering the areas of knowledge lacking to appropriately manage a competitive adaptive athlete, multiple areas named as deficits were identified. Themes centered on increasing hands-on experience, understanding of the adaptive athlete's disability and its impact on participation in adaptive sports, the physical demand of adaptive sports, and equipment. Our results indicate that most physicians are willing to accept adaptive athletes into their practice; however, they acknowledge more education and training is needed to feel comfortable and confident when working with this population. Further educational interventions are needed to ensure equitable care for adaptive athletes.

Background It is unclear how back squat depth influences muscle activation and should be considered when designing strength training programs. Current evidence suggests this relationship is population-specific and should be examined in different populations to optimize strength training outcomes. This study examined the effect of different squat depths on muscle activation in college football players. Methods Sixteen Division II college football players performed back squat at three depths (C1 = 65°, C2 = 90°, and C3 = 115° knee flexion). During the descent and ascent phases, five-trial averages of mean gluteus maximus (GM), semitendinosus (ST), biceps femoris (BF), vastus medialis (VM), and vastus lateralis (VL) activation were calculated. Phase-specific differences were examined by calculating one-way repeated analyses of variance (α=0.05) and Bonferroni-corrected paired t-tests for post-hoc comparisons. Results Compared to C1, activation increased during C2 and C3 for the VM, VL, and BF during the descent and ascent phases. Additionally, during ascent, the greatest VM, VL, and BF activation occured during C3. Semitendinosus activation increased during C2 and C3 compared to C1 during the ascent phase, but it was not affected during the descent phase. Similarly, no GM activation changes were observed in either phase. Conclusions These findings indicate back squat depth influence on muscle activation is phase- and muscle-specific and should be considered when designing strength training programs for college football players.

BackgroundTreatment adherence is central to treatment success in rehabilitation for musculoskeletal conditions, including low back pain (LBP). Unfortunately, non-adherence to prescribed treatment is common and undermines treatment success.ObjectiveTo identify predictors of treatment adherence in physical therapy for patients with LBP.Methods209 cases of patients receiving physical therapy for a chief complaint of centralized LBP were retrospectively analyzed for predictors of treatment adherence. Symptom duration, pain intensity, level of disability, the presence of an opioid prescription, and patient cost were assessed as predictors of treatment adherence. Patients who completed their prescribed plan of care were classified as adherent.ResultsLogistic regression analysis revealed that individuals who had an opioid prescription were 2.56 (95% CI = 1.25-5.24, p = 0.010) times less likely to be adherent with treatment compared to individuals without an opioid prescription. Individuals who had symptoms for less than 1 month were 3.21 (95% CI = 1.12-9.24, p = 0.030) times less likely to be adherent with treatment compared to individuals who had experienced symptoms for 4 months to 1 year. Finally, individuals who paid greater than $40 per visit were 3.45 (95% CI = 1.31-9.09, p = 0.011) times less likely to be adherent with treatment compared to individuals who did not have to pay each visit.ConclusionThe results of this study may help clinicians quickly identify and address risk factors for lower treatment adherence in patients with LBP to mitigate the impact of suboptimal treatment adherence on patient outcomes.

Preterm neonates are particularly vulnerable to respiratory complications, including pneumonia, due to their underdeveloped lungs and immature immune systems. These vulnerabilities significantly contribute to high morbidity and mortality rates in this population. Effective management of neonatal pneumonia is critical for improving survival rates and minimizing long-term respiratory sequelae. Chest physical therapy (CPT) serves as a valuable adjunctive treatment, complementing medical interventions to enhance respiratory function in preterm neonates with pneumonia. To enhance mucus clearance and maximize lung function, conventional CPT procedures such postural drainage, percussion, and vibration have been used extensively. However, these methods may have limitations in addressing the unique needs of preterm infants. In recent years, innovative CPT techniques, including reflex rolling and lung squeezing, have emerged as promising alternatives. These techniques are designed to provide gentler, more targeted interventions, aligning with the physiological requirements of preterm neonates. Ongoing research is crucial to establish the safety, efficacy, and long-term benefits of these advanced approaches in neonatal care.

Purpose To examine the ability of the Sitting Balance Scale (SBS) and Function In Sitting Test (FIST) to predict functional level at discharge, length of stay, and discharge placement in patients with stroke in skilled nursing facilities. Methods This prospective cohort study included 40 patients with stroke across multiple facilities, excluding those with other neurological or orthopedic conditions. The SBS (11 items) and FIST (14 items) were administered at admission and discharge, with the Functional Independence Measure assessed at discharge. Data analysis involved Linear Regression and Receiver Operating Characteristic. Results The SBS had stronger predictive power for functional level at discharge (SBS, R2 = 0.53; FIST, R2 = 0.43). Both scales equally predicted discharge placement (area under the curve >0.81). Neither scale predicted length of stay. Conclusions The SBS and FIST are effective in predicting functional outcomes and discharge placement, aiding clinicians in early rehabilitation decision-making for patients with stroke.

While the public health emergency is over, telehealth and telepractice will continue to play a pivotal role in supporting health equity for diverse and vulnerable individuals in underserved communities. The American Occupational Therapy Association, the American Physical Therapy Association, the American Speech-Language-Hearing Association, and the American Telemedicine Association are professional associations representing the interests of more than 564,000 rehabilitation services professionals in the United States. These organizations have shared priorities including legislative, regulatory, and state-based advocacy efforts. Continued advocacy and promotion by professional organizations, providers and patients alike is necessary to ensure that all rehabilitation providers are included in any telehealth lists of federally and state approved providers. In addition, key health care industry stakeholders want telehealth to be a permanent option for care delivery and ensure that telehealth will remain widely available to support health equity and access to critical rehabilitation services for all.

Recurrent sports injuries present complex challenges that extend beyond the playing field, impacting athletes' physical well-being, mental resilience, and financial stability. This review outlines a comprehensive framework designed to prevent and manage these setbacks, empowering athletes to achieve sustained performance and recovery. This multidimensional issue requires an integrative approach encompassing physical rehabilitation, psychological resilience, and nutritional strategies. Physically, injury prevention relies on tailored rehabilitation programs that address athletes' specific injury histories and sport-related demands. Techniques such as biomechanical assessments and neuromuscular training correct faulty movement patterns, while workload monitoring ensures a balance between training and recovery. Strength and conditioning programs have demonstrated success in reducing injury rates and enhancing musculoskeletal resilience. Psychologically, reinjury anxiety and mental disengagement are key barriers to recovery and performance. Interventions such as goal setting, mindfulness, and cognitive restructuring rebuild confidence and foster readiness to return to play. Addressing psychological well-being is as critical as physical health in promoting sustained performance. Nutrition is equally pivotal, with balanced macronutrient intake supporting energy and tissue repair and micronutrients (magnesium, manganese, vitamin D, selenium, zinc, coenzyme Q10, etc.) bolstering bone health. Anti-inflammatory nutrients and proper hydration reduce muscle strain and aid recovery, while personalized dietary strategies meet the specific demands of individual sports. By integrating these physical, psychological, and nutritional dimensions, this framework empowers athletes, coaches, and medical teams to minimize injury recurrence and enhance long-term performance, ensuring athletes remain competitive and resilient in their sporting pursuits.