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A clinical practice guideline on total knee arthroplasty was developed by an American Physical Therapy (APTA) volunteer guideline development group that consisted of physical therapists, an orthopedic surgeon, a nurse, and a consumer. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches to management of total knee arthroplasty., This clinical practice guideline (CPG) is based on a systematic review of published studies with regard to the physical therapist management of patients undergoing total knee arthroplasty. In addition to [...]

highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions--medications, surgery, education, nutrition, exercise--and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature. (1) Each article in this PTJ series summarizes a Cochrane review or other scientific evidence on a single topic and presents clinical scenarios based on real patients or programs to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on a patient with neck pain. Can manipulation or mobilization reduce her neck pain?, Neck pain is a common condition, with estimates of the prevalence in the previous 12 months between 30% and 50% and activity limitations from neck pain between 1.7% and 11.5%. [...]

The American Physical Therapy Association (APTA) provided funding for a series of meetings among a small group of leaders representing the research and clinical communities whose task was to plan [...]

In its recent history, the physical therapy profession embarked on at least 2 attempts to create a research agenda. The first attempt occurred in December 1993 when a panel of [...]

Clinical question: Because of the risk of developing heterotopic ossification, are passive range of motion exercises contraindicated following traumatic injuries? The purpose of 'Evidence in Practice' is to illustrate the [...]

Patient examples are designed to illustrate how evidence is gathered and used to guide clinical decision making. To view this content online, visit www.ptjornal.org ? Clinical question: Does exercise during [...]

[Scalzitti DA. Evidence-based guidelines: application to clinical practice.] Key Words: Clinical practice guidelines, Decision making, Evidence-based practice, Systematic reviews., ********** This special issue of Physical Therapy contains 4 clinical practice guidelines for physical therapist management of musculoskeletal conditions. These clinical practice guidelines were developed using systematic reviews of the [...]

For the majority of patients with low back pain (LBP), the cause of their pain is unknown.[1] Psychological factors, which may include behavioral, cognitive, or somatoform components, can be just as important as the diagnosis of pathology affecting the low back in a patient's recovery from a low back problem.[2-5] A recent US Agency for Health Care Policy and Research clinical practice guideline recommends exploration of psychological factors when an individual with an acute low back problem is having difficulty regaining his or her tolerance to activity.[4] Feuerstein and Beattie[5] discussed several biobehavioral instruments that can be used to identify psychological factors in individuals with LBP. If factors are identified that are potential contributors to the low back problem, the physical therapist can then refer the patient to the appropriate professional. Routine application of these instruments, however, may be impractical during physical therapy examinations because of the time required for administration and scoring as well as the expertise needed to interpret the results. Thus, there is a need for a brief screening tool to help identify patients who may require more detailed psychological testing. A review of the description and diagnosis of psychological disorders that may relate to LBP is beyond the scope of this update. For further information on these areas, the reader is referred elsewhere.[5-7] Signs of organic problems are findings from the physical examination that indicate the presence of pathology or disease. Paresthesia over the lateral border of the foot, for example, is a sign for S-1 nerve root involvement. Signs of nonorganic problems, in contrast, are findings that deviate from the usual presentation of disease.[8] Both organic and nonorganic signs may be present in a patient with LBP. Therefore, the presence of nonorganic signs should not be equated with malingering or the presence of a psychological problem, but only with the need for further investigation., Scalzitti DA. Screening for psychological factors in patients with low back problems: Waddell's nonorganic signs. Phys Ther. 1997;77:306-312.] Key Words: Assessment, Low back problems, Nonorganic signs, Psychosocial. Waddell et al[8] [...]

A 7-year-old boy with cerebral palsy who enjoyed fishing, hiking, and playing baseball was referred to our outpatient clinic for reexamination. He reported that he was having new difficulties playing [...]

On 'Physical therapists make accurate and appropriate discharge recommendations...' Smith BA, Fields CJ, Fernandez N. Phys Ther. 2010;90:693-703. The retrospective study by Smith et al (1) reported an odds ratio [...]

Reports on the first year anniversary of the American Physical Therapy Association's online database, Hooked on Evidence. Number of article extractions published in the database; Benefits provided by the online source to patients; Features of the online information resource. INSET: How to Become a Contributor.