Excessive frontal plane motion and valgus torques have been linked to knee injuries, particularly in women. Studies have investigated the role of lower extremity musculature, yet few have studied the activation of trunk or "core" musculature on hip and knee kinematics. Therefore, this study evaluated the influence of intentional core engagement on hip and knee kinematics during a single leg squat.
Introduction. Health informatics curricular content, while beneficial to the spectrum of education in physical therapy, is currently only required in physical therapist education programs, and even there, it is only crudely defined. The purpose of our study was to use the techniques of concept analysis and concept mapping to provide an outline of informatics content that can be the foundation for curriculum development and the construction of informatics competencies for physical therapy. Review of Literature. There is no established consensus on the definition of health informatics. Medical and nursing informatics literature that clarifies and agrees on the attributes of health informatics is insufficient for curriculum development. Concept analysis is an approach commonly used in nursing and other health professions to analyze and deconstruct a term, in this case, health informatics, in order to provide clarity on its meaning. Subjects. A total of 73 definitions of health informatics were extracted from articles that met search criteria. Methods. We used an 8-step methodology from the literature for concept analysis, which included 1) selecting a concept; 2) determining the aims of the analysis; 3) identifying uses of the concept; 4) determining the defining attributes of the concept; 5) identifying a model case; 6) identifying related and illegitimate cases; 7) identifying antecedents and consequences; and 8) defining empirical referents. In addition, concept mapping was used to develop a visual representation of the thematic attributes and the elements that make them up. Results. We provide a visual map of the concept we now term “informatics in human health and health care” and clarify its attributes of data, disciplinary lens, multidisciplinary science, technology, and application. We also provide clarification through the presentation of a model case and a contrary case. Discussion and Conclusion. Concept analysis and mapping of informatics in human health and health care provided clarity on content that should be addressed across the continuum of physical therapy education. The next steps from this work will be to develop competencies for all levels of physical therapy education.
Widespread cooperation between domain experts and front-line clinicians is a key component of any successful clinical knowledge management framework. Peer review is an established form of cooperation that promotes the dissemination of new knowledge. The authors describe three peer collaboration scenarios that have been implemented using the knowledge management infrastructure available at Intermountain Healthcare. Utilization results illustrating the early adoption patterns of the proposed scenarios are presented and discussed, along with succinct descriptions of planned enhancements and future implementation efforts.
The knee is the most commonly injured joint. The ACL is routinely injured, with risk of injury per exposure 2 to 8 times greater in females than in males. Excessive medial-lateral motion and valgus forces have been shown to be a major contributor to knee injury. While many researchers have studied the influence of knee and hip musculature, less has been studied about the influence of the trunk or "core" musculature on knee kinematics. PURPOSE: To determine the influence of core musculature engagement of females on triplanar motion of the knee during a single leg squat. METHODS: All subjects were evaluated for core strength using Sahrmann's physical therapy evaluation model. Four reflective markers were positioned on the left and right ASIS, right lateral femoral condyle, and right lateral malleolus of 14 female subjects (mean age 22.13 ± 2.87 years). Each subject performed a single leg squat from a six inch step under 2 conditions: core engaged (CORE) and no core engaged (NOCORE). Knee motion was sampled using an APAS motion analysis system. All data were processed using MATLAB. After scaling and time-normalizing, correlation coefficients were determined for knee marker trajectories between individual subjects' CORE trials and the group's mean NOCORE trial. A correlation coefficient of 0.9 was used as a threshold to define similarity between conditions. RESULTS: Similarities were found between CORE and NOCORE conditions in subjects' vertical and anterior-posterior knee motion (CC = 0.952 and 0.941, respectively). In contrast, greater differences were found between CORE and NOCORE conditions in subjects' medial-lateral knee motion (CC = 0.700). Participants showed greater variability in medial-lateral motion during the NOCORE condition. CONCLUSIONS: Core engagement did influence the medial-lateral motion of the knee during single leg squats. This information may have implications for preventing, predicting, and/or rehabilitating knee injuries of females.
Background and objectives: Striking a balance between maximizing performance and preventing injury remains elusive in many professional sports. The purpose of this study was to assess the relative risk of non-contact injuries in professional basketball players based on predictive cut scores on the Functional Movement Screen™ (FMS). Materials and Methods: Thirty-two professional basketball players from the National Basketball Association (NBA) and Women’s National Basketball Association (WNBA) participated in this study. This observational pilot cohort study assessed and scored each participant using the FMS during training camp. Each athlete was then tracked throughout the season while recording the number, type, and time lost due to injuries. Possible exposures, actual exposures, and exposures missed due to non-contact injury (NCI) for each athlete were calculated and then used to determine the crude and specific incident rates for exposures missed due to NCI per 1000 exposures. Results: Linear regression models were used to evaluate the predictive ability of the FMS score for total missed exposures, NCI, and CI missed exposures. In all models, the FMS total score failed to attain significance as a predictor (p > 0.05). FMS scores ranged from 5 to 18. The recommended cut score of 14 showed a sensitivity of 0.474 and a specificity of 0.750. The cut score of 15 showed the best combination, exhibiting a sensitivity of 0.579 and specificity of 0.625. A total of 5784 exposures to NCI were possible for the men and women combined, and 681 possible exposures were missed. Of these, 23.5% were due to NCI, 16.5% were due to contact injuries (CI), and 60% were due to illnesses and personal reasons. Conclusions: The FMS proved to be a measure that was not associated with any injury measure in this sample of professional basketball players, suggesting the instrument lacks predictive validity in this population.
Abstract
Change is a necessary function of good medicine and quality health care and will undoubtedly be vital for the future. As advances in medicine continue, so will change, requiring the need for maintenance of existing knowledge as well as the need for integrating new knowledge. In order to understand the current process at Intermountain Health Care and to see how we might improve this process, we retrospectively studied the changes made to a knowledge base during the year 2001. The findings discovered have implications that are guiding our efforts in designing a knowledge management infrastructure. Additionally, we propose to integrate recommendations from other researchers into the design that will not only assist in the development and maintenance of knowledge, but will also support change tracking and version control.
Background and Purpose. Physical therapists increasingly struggle to manage the vast amount of information required to make sound clinical decisions. This struggle occurs, in part, because of a lack of knowledge and skills needed to effectively use the potent tool of information technology for systematically processing data and supporting information and knowledge. The field of health informatics has emerged as an interdisciplinary science that evaluates how health information and knowledge can be effectively used for clinical decision making. Health care leaders have recognized informatics competencies as essential in other health care education programs, especially as a foundation for evidence-based practice. The purpose of this article is to describe the current state of health informatics in physical therapist education, to summarize the rationale for incorporating informatics in physical therapist education, and to propose a framework for incorporating this content into physical therapist education. Position and Rationale. Physical therapist education should identify and incorporate health informatics as a foundational domain. Failing to prepare clinicians with technology competencies will hamper progress towards our profession's goals of fully availing ourselves of technol ogies that can facilitate more effective and efficient care. Because adopting health information technology is a top national priority, we must move quickly to ensure that physical therapists can continue to thrive in the emerging electronic infrastructure. Discussion and Conclusion. Although some concepts of health informatics are incorporated in physical therapist education program's core documents, this inclusion was not based on the perspective of health informatics as an applied scientific discipline. In conjunction with the APTA's concerted effort to adopt interoperable electronic health record systems, the profession should develop a strategic plan for ensuring that physical therapists have the knowledge and skills to use the tools of informatics effectively. We present specific recommendations to help strengthen the centrality of informatics within physical therapist education, such as including health informatics as a foundational domain and fully developing the set of core informatics competencies for physical therapy. We encourage the academic community to engage in activities and dialog that clarify the role of informatics in physical therapist education.
