Measures Wanted Assess? Missing Research - Research?

¶ … measures wanted assess? Missing research - research? Avoid critical questions elements made argument clear? Elements research extremely poignant offered validity claims? Claims broad research size? Claims understated? Limitations research? leap erroneous conclusions opinion - addressed concerns claims? researchers biased-based study, funders, connections, specialities? research questions research bring merit research investigation? reasons claims made?

DeJong, Gerben, Ching-Hui Hsieh, Koen Putman, Randall J. Smout, Susan D. Horn, & Wenqiang Tian. (2010). Physical therapy activities in stroke, knee arthroplasty, and traumatic brain injury rehabilitation: Their variation, similarities, and association with functional outcomes. Physical Therapy, 91(12) 1826-1837.

Physical therapy is prescribed for a variety of conditions, spanning from knee surgery to traumatic brain injury. However, although the patient populations subjected to PT may vary, there is a certain uniformity of treatment prescription and goals of outcome. According to DeJong (et al., 2010) "certain rehabilitation principles" are thought to "generalize across populations. For example, we know that physical activity and motion are essential to prevent muscle atrophy, enhance endurance, and promote overall health and well being, regardless of the specificity of the impairment or degree of impairment" (DeJong et al. 2010: 1826). To examine the efficacy of PT, patients in three categories of very different types of illnesses (stroke, knee replacement, and traumatic brain injury) were compared. This study attempted to determine, as a means of preliminary research for further examination, if all groups received similar treatments, and if the same types of exercises were equally effective in all of these populations. All population groups in the study were classified as "severely to moderately limited" (DeJong et al. 2010: 1828).

The study compared patients at three in-patient facilities. It was found that not all patient groups received equal amounts of treatment. Total knee replacement patients received the most exercise-based therapy, and traumatic brain injury patients received the least overall. Similarities in treatment included an emphasis on gait training -- gait training consumed the majority of all patients' PT (more than half). However, the study's authors note that certain exogenous factors may influence the overall cause of PT that are not specifically related to the patients' similar needs, regardless of condition. Insurance companies have a uniform rule about the amount and type of PT a patient can receive, regardless of a patient's specific impairment. (Usually a three-hour limit in-patient settings and restrictions upon the type and use of outpatient services).

The study used a practice-based, evidence-based approach. It was a prospective observational cohort study that made use of large numbers 'in the field' to yield more accurate results. The study recorded but did not determine the course of patient treatment. Recorders of data were not researchers but clinicians who recorded data using a point of- care (POC) data collection protocol. The results were that only two physical therapy activities (gait training and community mobility) were "positively associated" with improved outcomes across all three groups and three physical therapy activities (assessment time, bed mobility, and transfers to other facilities) were actually associated with negative outcomes (DeJong et al. 2010: 1826).