Commissioned Corps of the U.S. Public Health Service

Therapist Professional Advisory Committee

PT

Purpose:

"Evidence Based Medicine (EBM) has been defined as "the conscientious", explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research" David Sackett et. al "Evidence Based Medicine: What it is and What it isn't" BMJ 312 No. 7023 (1996).

TopicPTOTSLP/Aud

Evidenced Based Medicine Links
Discipline Board Certifications PT OT SLP/Aud
Other Specialty Certifications PT NA SLP/Aud
Clinical Research Contributions PT OT SLP/Aud
Evidence Based CME’s PT OT SLP/Aud
CAT Express PT OT SLP/Aud
Evidence Based Medicine Links PT OT SLP/Aud
Clinical Consultation Forums PT OT SLP/Aud
Therapy Presentation Postings PT OT SLP/Aud
NA = Not Available

CERTIFIED PHYSICAL THERAPISTS From the American Physical Therapy Association

About Specialist Certification

The American Physical Therapy Association (APTA), a national professional organization representing more than 66,000 members throughout the United States, established the specialist certification program in 1978. Specialization is the process by which a physical therapist builds on a broad base of professional education and practice to develop a greater depth of knowledge and skills related to a particular area of practice. Clinical specialization in physical therapy responds to a specific area of patient need and requires knowledge, skill, and experience exceeding that of the physical therapist at entry to the profession and unique to the specialized area of practice. The specialist certification program was established to provide formal recognition for physical therapists with advanced clinical knowledge, experience, and skills in a special area of practice and to assist consumers and the health care community in identifying these physical therapists. For more information on various fields of certifications or the process on how to become certified log on to APTA.

**Upon receiving certification from the APTA, USPHS Therapist Officers are entitled to NBCP pay (Non-physician board certified pay).To apply for board certified pay please refer to CCPM regulations.

Geriatric Certified Specialists

Orthopedic Certified Specialist

Electrophysiology Clinical Specialist

Sports Certified Specialist

Neurologic Clinical Specialist

PHYSICAL THERAPISTS Certified through Other Organizations

Fellows of the American Academy in Orthopaedic Manual Physical Therapy(FAAOMPT)

Certified Wound Specialist

Certified Hand Therapist

McKenzie Certified Specialist

Certified Strength and Conditioning Specialist

Certified Correctional Health Professional

Certification in Public Health

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CLINICAL RESEARCH CONTRIBUTIONS

Armentano MJ, Brenner AK, Hedman TL, Solomon ZT, Chavez J, Kemper GB,Salzberg D, Battafarano DF, Christie DS: The effect and safety of short-term creatine supplementation on performance of push-ups. Mil Med 172(3):312-7, 2007.

Augustine E, Corn M, Danoff J: Lymphedema management training for physical therapy students in the United States. Suppl American. 83:2869-73, 1998.

Augustine E: Physical therapists play an important role in treating lymphedema. Oncology Nursing Forum 23:421-2, 1996.

Barr AE, Siegel KL, Danoff JV, McGarvey CL III, Tomasko A, Sable I, Stanhope SJ: Biomechanical comparison of the energy-storing capabilities of SACH and Carbon Copy II prosthetic feet during the stance phase of gait in a person with below-knee amputation. Physical Therapy 72:344-54, 1992.

Brenner AK: Use of lumbosacral region manipulation and therapeutic exercise for a patient with a lumbosacral transitional vertebra and low back pain. Journal of Orthopaedic and Sports Physical Therapy 35:368-376, 2005.

Brenner AK, Gill NW, Buscema CJ, Kiesel K: Improved activation of lumbar multifidus following spinal manipulation: A case report applying rehabilitative ultrasound imaging. Journal of Orthopaedic and Sports Physical Therapy 37:613-619, 2007.

Buczek FL, Kepple TM, Stanhope SJ, Siegel KL: Translational and rotational joint power terms in a six degree-of-freedom model of the normal ankle complex. Journal of Biomechanics 27:1447-57, 1994.

Cheville AL, McGarvey CL, Petrek JA: The grading of lymphedema in oncology clinical trials. Seminars in Radiation Oncology 13:214-25, 2004.

Cintas HL, Siegel KL, Furst GP, Gerber LH: Brief assessment of motor function: Reliability and concurrent validity of the gross motor scale. American Journal of Physical Medicine & Rehabilitation 82(1):33-41, 2003.

Croarkin E: Osteopenia in the patient with cancer. Physical Therapy 79:196-201, 1999.

Curtis KA, Drysdale GA, Lanza RD, Kolber M, Vitolo RS, West R: Shoulder pain in wheelchair users with tetraplegia and paraplegia. Archives of Physical Medicine and Rehabilitation 80(4):453-457, 1999.

Dahl CS: Physical therapist management of tuberculous arthritis of the elbow. Physical Therapy 81(6):1253-1259, 2001.

Gerber LH, Binder H, Berry R, Siegel KL, Kim H, Weintrob J, Lee YJ, Mizell S, Marini J: Effects of withdrawal of bracing in matched pairs of children with osteogenesis imperfecta. Archives of Physical Medicine and Rehabilitation 79(1):46-51, 1998.

Harris-Love MO: Safety and efficacy of submaximal eccentric training for a subject with myositis. Arthritis Care & Research 52(3):471-474, 2005.

Harris-Love MO, Siegel KL, Paul SM, Benson K: Rehabilitation management of Friedrich ataxia: Lower extremity force control variability and gait performance. Neurorehabilitation and Neural Repair 18(2):117-124, 2004.

Harris-Love MO, Shrader JA: Physiotherapy management of patients with HIV-associated Kaposi's sarcoma. Physiotherapy Research International 9:174-81, 2004.

Harris-Love MO: Physical activity and disablement in the idiopathic inflammatory myopathies. Current Opinion in Rheumatology. 15:679-90, 2003.

Holden JP, Orsini JA, Siegel KL, Kepple TM, Gerber LH, Stanhope SJ: Surface movement errors in shank kinematics and knee kinetics during gait. Gait and Posture 5(3):217-227, 1997.

Jain M, Smith MR, Cintas H, et al: Intra-rater and inter-rater reliability of the 10 point Manual Muscle Test (MMT) of strength in children with Juvenile Idiopathic Inflammatory Myopathies (JIIM). Physical and Occupational Therapy in Pediatrics 26(3):5-17, 2006.

Kepple TM, Sommer HJ, Siegel KL, Stanhope SJ: A three-dimensional musculoskeletal database for the lower extremities. Journal of Biomechanics 31(1):77-80, 1998.

Kepple TM, Siegel KL, Stanhope SJ: Relative contributions of the lower extremity joint moments to forward progression and support in gait. Gait and Posture, 6:(1)1-8, 1997.

Kepple TM, Arnold AS, Stanhope SJ, Siegel KL: Measurement of musculoskeletal motion from surface landmarks: A three dimensional computer graphics approach. Journal of Biomechanics 27(3):365-371, 1994.

Klaiman MD, Shrader JA, Danoff JV: Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Medicine and Science in Sports and Exercise 30:1349-55, 1998.

Knebel PT, Avery DW, Gebhardt TL, Koppenhaver SL, Allison SC, Brayn JM, Kelly A: Effects of the forearm support band on wrist extensor muscle fatigue. Journal of Orthpaedice and Sports Physical Therapy. 29:677-85, 1999.

Letocha AD, Cintas HL, Troenule JF, Reynolds JC, Cann CE, Chernoff EJ, Hill SC, Gerber LH, Marini JC: Controlled trial of pamidronate in children with types III and IV osteogenesis imperfecta confirms vertebral gains but not short-term functional improvement. Journal of Bone and Mineral Research 20(6):977-986, 2005.

McGarvey CL, Pflazer C, and Gergich N: Breast cancer metastasis and implication on activity and ambulation: A case report rehabilitation. Oncology 24(1), 2006.

Mitchell SD, Sutlive TG, Maxfield SN, McLean CL, Neumann JC, Swiecki CR, Hall RC, Bare AC, Flynn TW: Identification of individuals with patellofemoral pain whose symptoms improved after a combined program of foot orthosis use and modified activity: A preliminary investigation. Physical Therapy 84:49-61, 2004.

O'Connell PG, Siegel KL, Kepple TM, Stanhope SJ, Gerber LH: Foot deformity, pain and mobility in rheumatoid and non-arthritic subject. Journal of Rheumatology 25(9):1681-6, 1998.

Paul SM, Siegel KL, Malley R, Jaeger RJ: Evaluating interventions to improve gait in cerebral palsy: A meta-analysis of spatiotemporal measures. Developmental Medicine and Child Neurology. 49(7):542-549, 2007.

Rider LG, Giannini EH, Harris-Love M: Defining clinical improvement in adult and juvenile myositis. Journal of Rheumatology 30:603-17, 2003.

Sheehan F, Seisler A, Siegel KL: In vivo Talocrural and Subtalar Kinematics: A non-invasive 3D dynamic MRI study. Foot & Ankle International 28(3):323-335, 2007.

Shrader JA, Popovich JM, Gracey GC, Danoff JV: Measurement of navicular drop in patients with Rreumatoid arthritis: Interrater and intrarater reliability. Physical Therapy 85(7):656-664, 2005.

Shrader JA, Siegel KL: Nonoperative management of functional hallux limitus in a patient with rheumatoid arthritis. Physical Therapy 83(9):831-843, 2003.

Shrader JA: Nonsurgical management of the foot and ankle affected by rheumatoid arthritis. Journal of Orthopaedic and Sports Physical Therapy 29:703-17, 1999.

Shrader JA, Siegel KL: Postsurgical hindfoot deformity of a patient with rheumatoid arthritis treated with custom-made foot orthoses and shoe modifications. Physical Therapy 77(3):296-305, 1997.

Siegel KL, Kepple TM, Stanhope SJ: A case study of gait compensations for hip muscle weakness in idiopathic inflammatory myopathy. Clinical Biomechanics 22(3):319-326, 2007.

Siegel KL, Kepple TM, Stanhope SJ: Using induced accelerations to understand knee stability during gait of individuals with muscle weakness. Gait and Posture 23(4):435-440, 2006.

Siegel KL, Hicks JE, Koziol DE, Gerber LH, Rider LG: Walking ability and its relationship to lower extremity muscle strength in children with idiopathic inflammatory myopathies. Archives of Physical Medicine and Rehabilitation 85(5):767-771, 2004.

Siegel KL, Kepple TK, Stanhope SJ: Joint moment control of mechanical energy flow during normal gait. Gait and Posture 19(1):69-75, 2004.

Siegel KL, Metman LV: Effects of bilateral posteroventral pallidotomy on gait of subjects with Parkinson Disease. Archives of Neurology 57(2):198-204, 2000.

Siegel KL, Kepple TM, Caldwell GE: Improved agreement of foot segmental power and rate of energy change during gait: Inclusion of distal power terms and use of three-dimensional models. Journal of Biomechanics 29(6):823-827, 1996.

Siegel KL, Kepple TM, O'Connell PG: A technique to evaluate foot function during the stance phase of gait. Foot & Ankle International 16:764-70, 1995.

Smith MR, Danoff JV, Parks RA: Motor Skill Development of Children with HIV Infection Measured with the Peabody Developmental Motor Scales. Pediatric Physical Therapy 14(2):74-84, 2002.

Sparks S, Rakocevic G, Joe G, Manoli I, Shrader JA, Harris-Love M, Sonies B, Ciccone C, Dorward H, Krasnewich D, Huizing M, Dalakas M, Gahl W: Pilot study of the use of intravenous immune globulin in hereditary inclusion body myopathy. BMC Neurology. Jan 2007. link

Suskauer SJ, Cintas HL, Marini JC: Temperament and physical performance in children with osteogenesis imperfecta. Pediatrics 111:E153-61, 2003

Taylor MM, Stokes WS, Bajuscak R, Serdula M, Siegel KL, Griffin B, Keiser J, Agate L, Kite-Powell A, Roach D, Humbert N, Brusuelas K, Shekar SS: Mobilizing mobile medical units for hurricane relief: The United States Public Health Service (USPHS) and Broward County Health Department (BCHD) response to Hurricane Wilma, Broward County, Florida. Journal of Community Health Management and Practice. 13(5):447-452, 2007.

Walley DR, Augustine E, Saslow D, et al: American Cancer Society Lymphedema Workshop, Workgroup IV: Lymphedema treatment resources-professional education and availability of patient services. Suppl American 83:2886-7, 1998.

Walsworth M, Dahl C, Schneider R, Schultz J, Allison S, Freund J, Underwood F: Prediction of ten repetition maximum for short arc quadriceps exercises from hand-held dynamometer and anthropometric measurements. Journal of Orthopedic and Sports Physical Therapy 28(2):97-104, 1997.

Woodburn J, Nelson KM, Siegel KL, Kepple TM, Gerber LH: Multi-segment foot motion during gait: Proof of concept in rheumatoid arthritis. Journal of Rheumatology 31(10):1918-27, 2004.

Youdas JW, Atwood AL, Harris-Love MO: Measurements of temporal aspects of gait obtained with a multimemory stopwatch in persons with gait impairments. Journal of Orthopaedic and Sports Physical Therapy 30: 279-86, 2000.

Young B, Walker MJ, Strunce J, Boyles R: A combined treatment approache emphasizing impariment-based manual physical therapy for plantar heel pain: a case series. Journal of Orthopaedic and Sprots Physical Therapy 34: 725-33, 2004.

Youdas JW, Atwood AL, Harris-Love MO: Measurements of temporal aspects of gait obtained with a multimemory stopwatch in persons with gait impairments. Journal of Orthopaedic and Sports Physical Therapy 30: 279-86, 2000.

If you have conducted/participated in any research in the past and would like your study to be included, please forward authors names, study title, journal published, publication volume/page, and year. Submit all research contributions to CarlosEstevezPT@yahoo.com

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EVIDENCE BASED CONTINUING MEDICAL EDUCATION COURSE TITLE:

  • "OZO" Air Force Advanced Physical Therapy Course
  • JODC (Joint Deployment Course for Physical Therapists)
  • COL Kersey Neuromusculoskeletal Evaluators Course
  • Integrated DOD Wound and Ostomy Course

COURSE TITLE: AF OZO course 2011

COURSE LOCATION: Lackland AFB, San Antonio, TX

COURSE COST: $40.00, lodging was $39/daily at the Officer's Quarters, Food provided at a nominal cost (approximately $2.50 - $5.00 daily at the food hall).

COMMENTS:
This two week physical therapy course was a lecture/lab course with emphasis on orthopedic manual therapy. I was concerned initially about attending because I do not have much experience in orthopedic physical therapy or manual techniques. This course is a good refresher. This is an excellent, evidence-based course with impressive lecturers and hands-on assistance with lab practice. I would highly recommend this course for all those wanting to improve their manual skills and for a good overview of the current evidence in practice.

LT Tami Bonebrake, P.T.

COURSE TITLE: OZO (Advanced Physical Therapy Course)

COURSE DESCRIPTION: This course is an Advanced Clinical Operations and Practice Course designed for those in an orthopedic or sport medicine setting. The course emphasize the most effective treatment strategies coupled with evidence based practices a clinician should deploy to ensure maximum positive patient outcomes. The course cover reading of imaging studies, lab results as well as differential diagnosing of patients presenting with musculoskeletal disorders.

COURSE LOCATION: Wilford Hall, San Antonio, TX

COURSE COST: $40 tuition, lodging provided by hosting service. Food in hospital provided at fair rates.

COMMENTS FROM ATTENDEES: What did you think of the course overall? Very educational! Lots of information relative to manual therapy with much emphasis on evidence based practice.

Is it beneficial to PHS officers? Yes, especially those heavy into manual therapy treatments.

What types of topics are offered? (general) Evaluations for c-spine, lumbar spine, hip, elbow, and knee. Mobilization and Manipulation techniques. Differential diagnosing.

Is it evidence-based? Yes. Many of the speakers had published several studies!
CDR Ramon Ector

COURSE TITLE: JODC (Joint Deployment Course for Physical Therapists)

COURSE DESCRIPTION: This course provides military PTs an opportunity to develop core-advanced competencies in orthopaedic triage and management of acute musculoskeletal and neurological injuries while deployed. These same evidence-based competencies are used to return injured soldiers "tactical athletes" to a high level of military technical and tactical readiness. This course also brings participants to an advanced level of understanding in general medicine topics (triage, differential diagnosis, and orthopedics) and methods of tracking procedures and patient outcomes.

COURSE LOCATION: Camp Bullis, San Antonio, TX

COURSE COST: Free tuition, lodging provided by hosting service. Food provided at a nominal cost.

COMMENTS FROM ATTENDEES: This was a good/solid course for military therapists planning to be deployed. In the past, there was a significant emphasis placed on manual therapy. However, the course is constantly changing. This time it was specifically geared toward military personnel and health screening. We spent two days discussing FMS testing that will soon be implemented for health screening at the brigade level. While this was interesting, it does not transfer over to USPHS/IHS.

We did spend an afternoon reviewing manual therapy techniques. This was excellent but brief.

We stayed on the River Walk and the total cost of the course was ~$1800. The accommodations were excellent.

If you have prior military service as a therapist, I would not recommend this course. If you are looking for a manual therapy course, the military has several other excellent courses that would be much more appropriate.

COURSE TITLE: COL Kersey Neuromusculoskeletal Evaluators Course

COURSE DESCRIPTION: This is a two-week continuing education course for physical therapy (PT) officers from the Army, Army Reserve, Navy, Navy Reserve, Air Force, Uniformed Public Health Service and Veterans Administration. The first week of the course focuses on instruction that will help you in your role as a primary care provider. Topics during the first week include screening for medical disease, differential diagnosis, pharmacology and radiology. The emphasis during the second week is on the diagnosis and management of disorders of the spine.

COURSE LOCATION: Fort Sam Houston, San Antonio, Texas

COURSE COST: Free to USPHS officers. Arrange with OPDIV to secure funding for transportation, lodging, and per diem.

COMMENTS FROM ATTENDEES: I thought the course was outstanding and everything presented was taught from an evidence based practice approach. Many of the leaders in physical therapy research were part of the clinical staff at the Army-Baylor program. The second week offered was mainly clinical time which provided invaluable hands-on experience. Various participants in the class also offered pearls of wisdom to contribute to the learning experience on a peer level. There was no part of the course that I did not enjoy or learn something. We were provided with CD's that contained contact information of our classmates and all the powerpoints including those shown in lab.

I enjoyed meeting the other physical therapists from the Army, Air Force, Navy, PHS, and VA Hospitals. We had lots of discussion regarding their rolls as PT's and some of the obstacles they face. It was a great opportunity to educate others about PHS.

The main downside is the expense of attending the course. Although the course itself is free, the living expense was costly. I would definately consider finding a roommate ahead of time to split the cost of the room especially if your agency provides limited funding. Be sure to inquire about a mini-refrigerator/microwave in your hotel room. There was a small expense but helpful toward saving money by dining in some days. LT Artresiah Rogers

COURSE TITLE: Integrated DOD Wound and Ostomy Coursey

COURSE DESCRIPTION: This is a 3.5 day course for all clinicians that work in wound management. All services participate and there were a great abundance of nursing officers from other branches of the military present. The first 2.5 days focus on classroom education including anatomy & physiology of the skin, wound healing physiology, assessment, documentation, debridement, topical therapy, trauma management in the field, ostomy & continence, wound research, amputee care and neonatal considerations. The following day of presentations are lead by product representatives but also include hands on demonstration of ABI and vacuum assisted therapy.

COURSE LOCATION: National Navy Medical Center, Bethesda, MD

COURSE COST: Tuition free to USPHS officers. There are costs associated with transportation, lodging, and per diem for those traveling.

COMMENTS FROM ATTENDEES: This is an outstanding course for any clinician that works with or manages wounds. We had a variety of participants including a couple podiatrists and a local physician. The primary clinicians who participated were nurses then therapists. The class was held in a auditorium with about 80 participants.

I enjoyed the case study presentations the most. Seeing the rationale of each clinician helped me solidify my clinical judgement with wound management issues here at Butner. I would advocate this course for beginners in wound management but would not steer an experienced clinician away from attending. There was cutting edge research and few other topics presented that all could benefit from.

Lastly the location is a very convenient. NNMC is a stop off the metro so commuting is preferred. Parking is really tight and just not the preferred mode of travel. NNMC has an underground shops and eateries right on site. There is also plenty to do in Washington DC! I highly recommend this course for all officers. LCDR Doug Henry.

Any comments or recommendations for any course that promotes Evidence Based Practices should be forwarded to CarlosEstevezPT@yahoo.com please include the above information and limit to 2-3 lines for comments.

If you are interested in attending a military-sponsored course, please contact LCDR Jessica Feda at jfeda@bop.gov. You may review current course offerings at the education subcommittee website.

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CAT EXPRESS: Critically Appraised Topics and summaries of peer-reviewed literature summarized by USPHS Therapists.

Aliitional contributions are welcome to keep this section current. Forward contributions to CarlosEstevezPT@yahoo.com. In constructing a new Critically Appraised Topic, please use the CATmaker link for guidance.

Orthopaedics

Spine

Cervical

Lumbar

Upper Extremity

Shoulder

Elbow

Lower Extremity

Hip

Knee

Foot/Ankle

Wound Care

Neurology

Pediatrics

Other

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EVIDENCE BASED MEDICINE LINKS - some sites may be blocked from government worksites. If so, please consider accessing from home.

Look for free full-text access to journal articles at these websites:

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CLINICAL CONSULTATION FORUMS/BLOGS

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PHYSICAL THERAPY PRESENTATION POSTINGS

Please provide presentations that have an impact on clinical practice. Submit presentation in power point or pdf format to CarlosEstevezPT@yahoo.com.

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USER NOTICE: If you note a discrepancy or non-operational link, please contact CarlosEstevezPT@yahoo.com.

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