The COVID-19 pandemic led to a global transition from in-person to online instruction leaving many higher education faculty with little time or training for this responsibility. Physical therapist education programs were especially impacted since a large part of the development of skills rely on face-to-face onsite practice. This phenomenological study explored the perceptions of physical therapist educators in three countries—Brazil, Cyprus, and the United States, who transitioned to an entirely virtual medium of teaching during the pandemic. Sixteen faculty participated in 1:1 semi-structured interviews. Trustworthiness of qualitative inquiry was ascertained using triangulation, thick descriptions, and peer reviews. Four major themes emerged from analysis of participants’ interview data: adapting pedagogy in real-time, expected excellence, limitations of the medium, and informing future teaching practice. All participants described teaching during the pandemic as one of the most challenging experiences of their professional careers. Despite available resources, faculty noted challenges in making authentic connections with students, adapting to technological interruptions, assessment of student understanding of content, and managing work-life balance. Despite the challenges, faculty worked collaboratively with peers to innovate new approaches of creating social, cognitive, and teaching presence. Unique opportunities arose from the pandemic to enhance future teaching practice.

Minoritized health sciences students report experiencing social isolation and discrimination, and cite the lack of faculty representation as barriers to their success. While virtual mentoring can increase sense of belonging and connectedness, these effects have not been examined in minoritized health sciences students. The purpose of this study was to investigate whether virtual mentoring from faculty and peers could decrease social isolation and promote social belonging among minoritized first-year physical therapy and nursing students. Using a mixed methods explanatory sequential design, racial and ethnic minority physical therapy and nursing students (n = 8) received virtual mentoring and attended virtual networking events while students from across the health profession programs served as a comparison group (n = 16). While virtual mentoring relationships took longer to establish, there was an increase in satisfaction with mentoring for the intervention group compared with no improvement for the comparison group who received traditional academic advising. Qualitative data analysis revealed that mentors served as role models who had overcome barriers and persevered, decreasing feelings of isolation, and bolstering mentee confidence. A virtual multiple-mentor model can decrease isolation and promote social belonging for minoritized students and offer support for students even after the pandemic.

Purpose: The purpose of this study was to systematically review and conduct a meta-analysis to examine the impact of comprehensive outpatient cardiac rehabilitation on exercise capacity, functional status, and quality of life in patients with heart failure. Methods: PubMed, Embase, and CINAHL were searched using keywords and MeSH terms on heart failure and cardiac rehabilitation. Randomized clinical trials published in English using outpatient exercise-based cardiac rehabilitation in patients with heart failure were included. The Grading of Recommendations Assessment, Development, and Evaluation was utilized for quality appraisal. Pooled estimates were computed using standardized mean differences (SMDs) and 95% CIs. Primary outcomes were functional status (6-minute walk distance, quality of life, exercise capacity using peak oxygen consumption, muscle strength, and endurance). Results: Eleven randomized controlled trials including 1523 participants ranging from 45 to 80 years old and an intervention duration ranging from 2 to 26 weeks were analyzed. Pooled results indicated significant improvements with comprehensive cardiac rehabilitation on 6-minute walk distance (SMD = 0.30; 95% CI = 0.06 to 0.54) and oxygen consumption (SMD = 0.23; 95% CI = 0.06 to 0.40). However, there was no additional benefit for the quality of life beyond that seen in the comparison groups. Conclusion: Results of this study suggest that comprehensive outpatient cardiac rehabilitation is associated with significantly better clinical outcomes than single-component exercise programs in cardiac rehabilitation settings, multicomponent exercise in noncardiac rehabilitation settings, or no exercise. Impact: Heart failure is significantly associated with an increased risk of poor exercise tolerance. Despite the proven benefit of cardiac rehabilitation on exercise tolerance and physical activities from individual randomized clinical trials, questions regarding its impact on clinical outcomes such as exercise capacity, functional status, and quality of life remain inadequate. This systematic review and meta-analysis provides strong evidence supporting comprehensive outpatient cardiac rehabilitation for improving clinical outcomes in heart failure.

In March 2020, most physical therapy schools across the globe transitioned to online learning in response to the COVID-19 pandemic. This change posed unique challenges not only because it required adapting to new technology in a short period but, more importantly, it involved developing ways to teach hands-on psychomotor and clinical skills virtually while maintaining the quality of instruction. In response to the rapid transition, the physical therapy program at MGH Institute of Health Professions (IHP)designed and implemented a novel and effective coaching model to address the challenges. The model was developed based on experiential learning theory, constructivism, a coaching framework, and andragogical principles of feedback and reflection. Not only did the model meet its objectives of effectively teaching basic psychomotor skills in the virtual environment, but it may also have andragogical benefits that can be applied to traditional face-to-face methods. This case study describes the theoretical underpinning of the model, its development and implementation, the perceived effectiveness for learning psychomotor skills in a virtual environment, and the potential for broader relevance to future models of physical therapy education.

Background and Purpose: Older adults with chronic obstructive pulmonary disease (COPD) are at risk for physical and cognitive impairment. Cognitive function is associated with falls in older adults. However, it is unknown whether a relationship exists between cognitive function and falls in patients with COPD. The aim of this study was to examine the relationships between cognitive function, balance, and gait speed in older adults with COPD. Patients and Methods: A secondary analysis was performed using data from the 2010 wave of the Health and Retirement Study (HRS). Cognitive (immediate and delayed recall, executive function) and physical (gait speed, tandem balance time) measure data were extracted for older adults with COPD (n = 382) and an age-matched control group without COPD (n = 382) who met inclusion/exclusion criteria. Multivariate linear regression modeling was performed to examine associations between cognitive function and mobility or balance while controlling for age, gender, body mass index, grip strength, and education. Results: In older adults with COPD, delayed recall was significantly associated with tandem balance performance (β= 1.42, P < .05). Other cognitive measures were not associated with gait speed or balance. Conclusion: In older adults with COPD, one of four cognitive functions was associated with a static standing balance task. Screening of cognitive function, specifically delayed recall, should be a part of the management of falls in this population.

Objective: The purpose of this study was to investigate the physical therapy process of care, clinical practices, and the self-reported psychosocial impact of working during the 2020 pandemic on physical therapists and physical therapist assistants. Methods: An electronic survey including closed and open-ended questions was distributed to physical therapists employed in a range of health care settings across the United States. Results: Physical therapy use and process of care varied across settings. Feasibility of performing an assessment was the main driver for selection of outcome measures. Interventions were mainly geared toward improving respiratory function and deconditioning. Prone patient positioning, now commonplace, was used infrequently by therapists in acute care prior to coronavirus disease 2019 (COVID-19). Similarly, outpatient and home care settings noted an increase in the use of respiratory-driven interventions such as incentive spirometry and breathing exercises. Qualitative data analysis revealed both physical barriers (personal protective equipment [PPE]) and social barriers to care. Therapists noted challenges in discharge planning and patient/family education due to the impact of social isolation. They also noted difficulty maintaining productivity standards because of additional time spent in changing PPE and following safety measures. Participants dealt with rapid changes in their role, changing productivity standards, and needing to increase their knowledge in a short amount of time. Conclusion: Physical therapy use varied widely across settings. Despite some concern for personal health, respondents felt that the COVID-19 pandemic increased a sense of togetherness among team members and promoted greater appreciation for life and work. Impact: This exploration of the process of care and current clinical practices across settings provides important knowledge about the role of physical therapists and physical therapist assistants in the care of patients with COVID-19. Gaining an understanding of the psychosocial impact of the pandemic among therapists could assist in creating solutions to better support clinicians’ well-being.