Poster Hall: Abstracts & Authors

The following posters were selected for inclusion in this year’s poster hall and you may earn CE credit by reviewing the information presented and answering the questions that follow each poster. You may also ask additional questions of the poster authors by email, using the address provided.

EARN CE: Posters are presented as PDFs. You must complete at least 4 poster quizzes successfully in order to earn 1 hour of CE credit. A maximum of 3.75 hours of CE may be awarded by successfully completing all 15 poster quizzes. These hours count as self-study for PT or PTA license renewal.

To submit your quiz answers for CE, follow this link ( and transfer your poster quiz answers to the submission form, where it will be scored and the CE credit will be awarded in your personal profile. Please note that you will be asked to sign in to the IPTA website in order to complete the poster quiz and be awarded CE. You may skip any set of poster questions by selecting the “X. Skip this Question” answer for each question for that poster.

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The deadline for Poster hall quiz submissions is March 31st. After March 31st, no more quiz submissions will be accepted. Don’t miss out on this opportunity to learn about these awesome research projects and earn CE!


1. Unmasking Gait Impairments in Individuals with Neurological Conditions

 Andrew J Strubhar, PT, PhD, Noah Gould, SPT, Lauren Getz, SPT, Devin Thomas, SPT 

Purpose and Background: The purpose of this study was to explore if backward walking and tandem walking on a beam can assist in unmasking gait impairments in individuals with neurological conditions. As patients recover from neurological conditions, improvements are often seen in forward gait. Some of the common outcome measures used in the clinical setting to assess forward gait include the 10-meter walk test (10MWT), and the Timed Up and Go (TUG). However, although these tests look at forward walking, walking in everyday life does not always strictly consist of walking in a straight line. To maneuver and manage daily environments, individuals must step in multiple directions. Lack of dynamic control is a key impairment associated with neurological disorders such as PD, MS, and stroke. The literature indicates that dynamic activities like tandem gait and backward walking are more likely to bring to light impairments that simple static activities wouldn’t find. As an example, individuals following a stroke demonstrated decreased cadence and gait speed as well as an increased need for upper extremity support with backward walking compared to forward walking. As a premise, we understand that individuals with neurological impairments will have differences in their scores on gait measures when compared to aged-matched unimpaired individuals and that difference can be expressed in a percent difference. We anticipated that the percent difference between impaired and unimpaired individuals would be greater when performing the backward and tandem gait tasks compared to the percent difference in forward gait tasks.

Participants: Five subjects between the ages of 34 and 65 with neurological impairments were recruited for this study. Three of these individuals have had a cerebral vascular accident, one had a brain tumor, and one has Multiple Sclerosis. All these individuals have had gait impairments for more than a year at the time of this study.

Methods: Before and after 10 weeks of physical therapy in a pro bono clinic, data was collected on their ability to perform the TUG (Timed up and Go test) and 10 MWT (Meter Walk Test). Data was then collected on each participant on their ability to walk tandem (TAN) forward on a beam as well as backwards walking (BKW) overground. For the tandem walking portion of the study, the beam measured 1.91 cm (3/4 inches) tall x 8.89 cm (3.5 inches) wide and was a total of 3 meters long. None of the participants utilized an assistive device (AD) during the trials. Time taken to complete each trial across three attempts for both tandem and backwards walking were averaged. Age-matched individuals with no gait impairments did the same tests. Data was then compared with the results from three age-matched controls. A percent difference was calculated between the timed measures (TUG, 10MWT, TAN and BKW) of the individuals with impairments and their age-matched control (age-matched individuals were within 3 years of the target subject’s age). Data from the post physical therapy group was used to compare with the aged-match controls. Since the individuals were undergoing physical therapy, it was felt that if the pre-therapy measures were used, they could demonstrate inflated impairments.

Results: The percent difference between the impaired group post-clinic vs. age-matched controls were used to equilibrate the impact of the measures and compare results for 10MWT and TUG trials and the TAN and BKW trials. The percent difference was calculated by taking the absolute value of the difference in scores between two groups and dividing that number by the average score of the two values. Across the 5 subjects, the average percent difference for 10MWT and TUG were 67% and 84%, respectively. Average percent difference for TAN and BKW were 117% and 101%, respectively.

Conclusion: The larger percentage difference in average tandem and backward walking indicate that these tasks demonstrate a greater impairment in gait function compared to traditional forward walking tasks. Tandem and backward walking represent functional stepping with a narrow base of support and stepping in directions other than forward which are part of normal bipedal locomotion. The percentage difference scores in these individuals indicated that these skills were deficient compared to their forward walking skills. These results may have occurred because much of their therapy and or daily practice may have emphasized normal forward locomotion. These results add to our understanding the need for high-intensity gait training in multiple locomotor tasks when providing physical therapy to individuals with neurological impairments. The method of calculating percentage difference provided a useful way to equilibrate the impact of different measures. Future studies of this nature would benefit from the usage of a larger sample size, a 6-month follow up with all subjects, as well as closer age-matched controls to each subject. 


  1. All of the following measures or stepping patterns were looked at in individuals with neurological impairments in this study EXCEPT:
    1. Timed Up and Go
    2. Four Square step test
    3. 10 Meter Walk Test
    4. Tandem walking
    5. Backward walking
  2. Which two measures in this study were the most difficult for individuals with neurological impairments as compared to aged-matched unimpaired individuals?
    1. Timed Up and Go and Four Square step test
    2. 10 Meter Walk Test and Timed Up and Go
    3. Tandem walking and Backward walking
    4. Tandem walking and Timed Up and Go
  3. What is one practical conclusion of this case series study on gait?
    1. Gait speed is the most important variable of gait in our patients
    2. Patients may need more practice in multidirectional and narrow-based gait
    3. It is not practical to have patients practice walking in different directions, especially since it is typically harder than a forward gait
    4. Beam walking is nearly impossible for those with neurological impairments

Ask a question about this study: [email protected] 

2. Leadership Styles of Doctor of Physical Therapy Program Directors

Dawn S. Brown, PT, DPT, EdD, OCS 

Background/Purpose: The Commission on Accreditation of Physical Therapy Education requires Doctor of Physical Therapy (DPT) program directors to have academic and professional qualifications to lead their programs, but many directors lack awareness of their leadership styles. The purpose of this quantitative descriptive correlational study was to examine the leadership styles of current DPT program directors, analyze the relationship between DPT program directors’ self-perceptions of their leadership style and effectiveness, and understand a relationship between leadership styles and race and ethnicity.

Methods: Data were collected using the 45-item Multifactor Leadership Questionnaire 5X Short which measures transformational, transactional, and laissez-faire leadership styles and the leadership outcomes of extra effort, effectiveness, and satisfaction, and a demographic profile questionnaire. The surveys were distributed to 247 DPT program directors. Data were analyzed using descriptive statistics and Pearson correlations.

Results: Eighty-three DPT program directors responded to the survey. The results suggest a positive correlation that DPT program directors perceive themselves as having a transformational leadership style and to a lesser extent laissez-faire leadership style. There was a statistically significant positive correlation (p < 0.01) between the transformational leadership factors of inspirational motivation and the leadership outcome of effectiveness. There was a statistically significant positive correlation (p < 0.01) among the transformational leadership factors of idealized influence attributed, inspirational motivation, individual consideration; the transactional factor of contingent reward; and the leadership outcome of satisfaction. There was no correlation between the remaining leadership factors (management by-exception active, management-by-exception passive, and laissez-faire) and leadership outcomes. A relationship between leadership style and race and ethnicity was not established.

Discussion: The results of this study suggest that current DPT program directors perceive themselves as consistently implementing a transformational leadership style. DPT program directors exhibited some characteristics of the transactional leadership style factor contingent reward, but laissez-faire leadership was not exhibited. A relationship between leadership style and race and ethnicity could not be determined due to nonresponse bias.

Conclusion: This study is known to be among the first to explore the leadership styles of DPT program directors. Further development of the transformational leadership style should be a priority for DPT program directors. 


  1. The purpose of this study included which of the following research questions?
    1. What are the leadership styles utilized by DPT program faculty?
    2. Is there a relationship between the DPT program directors’ leadership styles and each of the three outcome scores (extra effort, effectiveness, and satisfaction) as measured by the MLQ 5X Short?
    3. Is there a relationship between DPT program directors’ leadership styles as measured by the MLQ 5X Short with gender?
    1. Is there a relationship between DPT program directors’ leadership styles as measured by the MLQ 5X Short with years of experience?
  2. Overall, the mean scores reported for the leadership styles of DPT program directors corresponded positively with which of the following leadership styles?
    1. Transactional
    2. Tranformational
    3. Laissez-faire
    4. Servant
  3. Which of the following was one of the recommendations based upon the results of this study?
    1. Create explicit leadership standards and development
    2. Increasing the number of historically marginalized faculty based on gender and sexual orientation
    3. Revamp the demographic profile questionnaire to be inclusive of racial and ethnic diversity leadership styles
    4. Standardize the mean number of years of physical therapy program directors

Ask a question about this study: [email protected] 

3. DPT students’ perceptions regarding their confidence in knowledge, skills, and collaboration in the first year of study during the Covid-19 pandemic: a survey study 

Kavork E. Hagopian, PT, DPT, MBA, FAAOMPT;  Tricia Gatia, SPT; Hayley Johnson, SPT;  Madeline Meier, SPT;  Azi Riahi, SPT;  Jeff Steuck, SPT; Andrea Swanson, SPT

Background and Purpose: During the COVID-19 pandemic, universities were forced to abruptly shut down and transition to remote learning. Limited information exists regarding the impact of remote learning, caused by the shut down, on students’ views and opinions. The purpose of this study is to explore DPT students’ perceptions throughout their first-year didactic portion of an entry-level program during the pandemic, regarding the following constructs: confidence in learned clinical skills and knowledge of anatomy, quality of classmate collaboration, and how remote and hybrid learning has impacted their experience.

Methods: A survey was sent to forty-eight DPT students in the Class of 2022.5 at Rosalind Franklin University (via Qualtrics). Out of forty-eight, twenty-three students responded to the survey and nineteen fully completed it. Survey questions pertained to students’ first didactic year in the program, their attitudes toward education methods, and confidence in different aspects of their experiences.

Results: Based on Mann-Whitney U data analyses, no statistically significant differences were seen in the confidence in anatomy, clinical skills and classmate collaboration of the following groups: students who were affected by COVID-19 vs. those who were not, those who lived closer vs. further from campus, those who would defer starting the program for a year vs. those who would not, those who lived with others vs. those who lived alone, and those who had vs. did not have a reliable internet connection.

Conclusions: Students who contracted, or lived with someone who contracted COVID-19, did not report any differences in their experiences compared to those that were not directly impacted by COVID-19; however, 63% reported they would have deferred their education rather than experience it as they did. These results are not likely to be generalizable due to limited participants, recall bias, attrition, control for extraneous variables, and ordinal measurement issues. 


  1. In the study, statistical significance was see in in the confidence in anatomy, clinical skills and classmate collaboration of the following groups in the study:
    1. Students who were affected by Covid-19
    2. Students who lived closer to campus
    3. Those who had reliable internet.
    1. None of the above.
  2. The clinical implications of this study included:
    1. The need to determine if hybrid learning and curriculum changes during Covid-19 impacted confidence in abilities for future professionals.
    2. Determining the potential factors behind students’ reasoning for wanting to defer their first year of PT school for a year.
    3. Identifying the ways in which the Civid-19 pandemic did impact students’ educational experience.
    1. All of the above.
  3.  True/False: This study proved that students with Covid-19 reported a very different experience in their first year PT School curriculum compared to others in their cohort.

Ask a question about this study: [email protected] 

4. Rehabilitation for Patients with Bone Metastases 

Mary Jesse, PT, DHS, Board Certified Clinical Specialist in Oncologic Physical Therapy, Board Certified Physical Therapist in Orthopedic Physical Therapy 

Background: Rehabilitation clinicians will treat cancer survivors. In the United States, 16.9 million people with a history of cancer were alive in 2019.1 This number is expected to increase to 22.1 million by the year 2030.1 This is related to two phenomena: 1) improvement in cancer survival rates due to early detection and improvement in cancer treatment, and, 2) the aging population.2 Survivors will be seen in the clinic for both and related and non-related physical issues.
One complication of cancer is bone metastasis. Different cancer types have different patterns of metastasis with prostate, lung, renal, and breast having the highest incidence of metastasis to the bone.3 Although bone metastasis can be asymptomatic, it can also result in pain limiting quality of life or skeletal-related events such as bone fractures, hypercalcemia, and spinal cord compression.4

Purpose: The purpose of this poster is to address the differential diagnosis of bone involvement in the oncology population when they present to the clinic with musculoskeletal complaints when metastasis has not been diagnosed. Also, this poster will also describe the precautions to be considered and the recommendations for activity and exercise for patients who are presenting with known bone metastases and/or related skeletal event.

Method: Current literature was reviewed to determine the physical therapist’s role in differential diagnosis and treatment of patients with bone metastasis in the oncology population. Only data in the last 10 years was considered to insure relevancy and accuracy.

Results: Rehabilitation of this patient population has been noted to be appropriate and helpful5,6,7 Clinical assessment is important to differentiate if the signs and symptoms that a patient presents demonstrate “red flags” or indicators for further imaging or consults before treating. Both treatment of pain related to metastasis to the bone and rehabilitation to address mobility and strength issues while recovering from a skeletal event are plans that can safely be developed by the physical therapist to improve this group’s quality of life.8,9,10

Conclusion: Awareness of physical therapist professionals of common patterns of specific cancers as well as “red flags” that a patient may present will help with differential diagnosis of skeletal related events that occur with bone metastasis. Knowledge of the differences in bony changes related to metastasis would be helpful in making a safe and effective plan for activity as well to help decrease pain and improve quality of life. Awareness of best treatment practices for this population is important as the number and age of survivors increases. 


  1. T/F Primary bone cancer is more common than secondary bone metastasis.
  2. T/F Exercise should be avoided if someone is diagnosed with bone metastasis.
  3. T/F Patients with a bone metastasis should always be considered as non-weightbearing on the affected limb.

Ask a question about this study: [email protected] 

5. The Prevalence and Knowledge of Electromyography as a Diagnostic Tool Used by Physical Therapists in Clinical Settings: An Exploratory Survey in Illinois. 

Naglaa Elskendidy, PT, MS, DSc;  Amanda Arendt, SPT; Tristan Bugos, SPT; Sarah Gandhi-Besbes, SPT; Benjamin Howlett, SPT; Andrey Simeonovski, SPTKelsy Turskey, SPT 

Background and Purpose: Electrodiagnostic testing consists of electromyography (EMG) that measures muscle electrical activity, and a nerve conduction velocity study. Although EMG testing is not explicitly mentioned in the Illinois state practice act, physical therapists (PTs) are not prohibited from administering it. This study intended to determine the level of knowledge and prevalence of needle EMG use among PTs in Illinois. It was hypothesized that 1) there would be limited knowledge of EMG among licensed PTs, and 2) respondents would report a low frequency of diagnostic EMG use in their clinical setting.

This cohort single-point survey was collected over 15 weeks, distributed to Illinois licensed PTs in 42 clinics and a DPT program, and posted on the IPTA website. Fifty-three respondents completed the survey. Exclusion criterion was PTs not licensed in Illinois. The survey had 25 questions distributed throughout 7 pathways. The number of questions per pathway was dictated by the participants’ familiarity with EMG, ability to perform it, usage within their clinic, and referral received. Descriptive statistics were used to analyze the majority of responses. Chi-square test was used to analyze the association between several outcome variables.

Fifty-five responses were collected and 2 were omitted for not meeting the inclusion criteria. Seven of 53 respondents (13%) reported EMG being used in the clinic. While the association between clinical knowledge and prevalence of EMG was not statistically significant, the impact on clinical decision-making for those not familiar with EMG was (p <0.001).

Results showed a low prevalence of EMG use and a lack of perceived familiarity with it among the respondents. However, the majority of PTs acknowledged the potential benefit of EMG use. Due to the small sample size but wide geographical distribution throughout the state, these results may be cautiously generalizable to PTs practicing in Illinois. 


  1. T/F EMG testing is not explicitly mentioned in the Illinois Physical Therapy Practice Act; therefore, physical therapists are prohibited from administering it in this state.
  2. Where did the survey respondents acquire most of their knowledge of EMG? 
    1. Advanced Post-Professional Degree
    2. Continuing EducationElectrophysiology Board Certification (ABPTS Specialization)Electrophysiology
    3. Fellowship / Residency
    4. Entry-level Physical Therapy Education 
  3. Among physical therapists in Illinois who reported using EMG, what effects did EMG findings have on their patients’ plan of care?
    1. No effect on plan of care
    2. Useful information for intervention but no alterations to plan of care
    3. Typically altered the plan of care

Ask a question about this study: [email protected] 

6. Acute Care Physical Therapy Treatment for a Patient with Pleural Effusion: A Case Report 

Morgan Powell, SPT; Christian Evans, PT, Ph.D., Professor 

Intro: Pleural effusion (PE) is an accumulation of fluid in the pleural space leading to symptoms of dyspnea, cough, and pleuritic back or chest pain. Physical therapy (PT) may be useful to mobilize these patients, but the role of PT in managing patients with PE has not been well studied.

Purpose: The purpose of this case report was to describe the PT management of a patient with a complicated medical history and PE.

Case description: This study was approved by the Midwestern University IRB and the patient provided written, informed consent. The patient was a 68-year-old female, seen in acute care, with a diagnosis of large PE on the left side and symptoms of progressing shortness of breath. Her comorbidities included heart failure, end stage renal disease, diabetes, and chronic obstructive pulmonary disease. Therapy focused on mobility, gait, and diaphragmatic breathing due to the patients’ loss of functional mobility and reduced safety at home. The Activity Measure for Post-Acute Care 6-Clicks (AMPAC-6Clicks) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used to assess the patient’s progress. The patient scored 14 (representing 50% impairment) on the AMPAC-6 Clicks and 79 on MLHFQ prior to PT.

Methods: The patient’s strength, range of motion, and functional mobility were evaluated. Based on findings of reduced mobility and strength, a treatment plan consisting of mobility and strength training was indicated to allow the patient to safely return home.

Outcome: The patient received 9 PT sessions over 3 weeks and demonstrated improvements in independence, functional mobility, and endurance. She demonstrated a 3-point increase in AMPAC 6-Clicks (< minimally clinical important difference score) and was discharged home with assistance from her fiancé.

Discussion: Pleural effusion is often a secondary diagnosis and doesn’t typically limit a patient’s function. However, this case report demonstrates how a PE can have significant impact on functional mobility and limit a patient’s household ambulation. With the incorporation of PT, this patient was able to increase mobility and decrease shortness of breath, allowing a safe return home. Higher quality research is needed to assess the role of PT in managing patients with PE. 


  1.  The most common etiology of pleural effusion is:
    1. Pneumonia
    2. End stage renal disease
    3. Heart failure
    4. Malignancy
  2. What type of breathing technique was utilized during physical therapy treatment sessions?
    1. Diaphragmatic breathing
    2. Pursed lip breathing
    3. Chest breathing
    4. Mouth breathing
  3. Was the change in the AMPAC 6 Clicks score clinically significant?
    1. Yes
    2. No

Ask a question about this study: [email protected] 

7. Exploring the Lived Experiences of Transgender Students in Health Professions Programs, A Phenomenological Study 

Karson Barrett, PT, DPT; Matthew Nuciforo, PT, DPT, PhD

Background / Purpose: The transgender and gender diverse population faces significant institutional discrimination and marginalization in higher education. Within physical therapy and other health professional education programs, transgender and gender non-conforming people are underrepresented and face unique challenges. The purpose of this study was to explore the lived experiences of transgender students in health professions programs in the U.S. Understanding their experiences could contribute to creating more inclusive health professional education programs.

Method: Using a qualitative phenomenological research design, semi-structured interviews were conducted with each participant via video conference. Participants included four transgender students from differing health professions programs including healthcare administration, allopathic medicine, psychology, and social work. Thematic analysis and inductive coding techniques were used to assess the lived experience of participants and identify sub-themes and primary themes.

Results: Five primary themes were identified from the data: identities, the academic environment, navigating heteronormative health professions, forming relationships, and family and financial challenges. The participants described the complexities of identity and intersectionality within their education. Within the academic environment, participants encountered non-inclusive curricula and a lack of academic support. Student advocacy efforts addressing LGBTQ+ medical mistreatment, employer bias, and lack of inclusion in research stemmed from the experience of navigating heteronormative health professions. Despite complicated social interactions with peers, participants often found community with other LGBTQ+ students and through collaborations with faculty on advocacy work. Varying levels of financial and family struggles also contributed to the lived experience of participants.

Conclusions: This study identified various challenges faced by transgender students in health professions programs, highlighting the importance of inclusive health education and fostering a sense of belonging in educational and professional environments. These findings have potential implications for institutional program design within health professions programs including physical therapy education programs. 


  1. This study sampled which population?
    1. LGBTQ+ students
    2. Transgender graduate students
    3. Underrepresented high school students
    4. Undergraduate students
  2. T/F This is a qualitative research study.
  3. The results discussed which aspects of the students’ experiences?
    1. Forming relationships in graduate school
    2. On campus vs. off campus living
    3. The application process
    4. Facility improvements

Ask a question about this study: [email protected] 

8. Self-perceived factors contributing to prenatal and postpartum exercise levels: A survey study 

Natalie Turrentine, PT, DPT, OCS, MSHA; Emma Dimalanta, SPT; Aamna Javed, SPT; Sam Kage, SPT; Kim Kamman, SPT; Aubrie Krause, SPT; Wilore Piguing, SPT 

Purpose: The primary purpose of this survey study was to evaluate perceptions of individuals who gave birth in the past five years on their quantity, intensity, and type of exercise habits before, during, and after pregnancy. A secondary purpose analyzed participation in physical therapy (PT) and perceived barriers to exercise.

Methods: A Qualtrics survey recruited participants via email, social media, and flyers. 285 participants met inclusion criteria. Quantitative data were numerically coded, then analyzed utilizing Intellectus. Friedman’s ANOVA assessed exercise intensity and minutes. McNemar’s Chi Square test for independence assessed differences in exercise type for the time periods of before vs during and before vs after pregnancy. Frequency statistics assessed referral to PT.

Results: Freidman’s ANOVA for exercise intensity (alpha level 0.05) was χ2(2) = 473.92, p < .001, indicated differences between median Rate of Perceived Exertion (RPE) before, during, and after pregnancy. Median RPE was 6.3 before pregnancy, 4.0 during, and 4.9 after. Freidman’s ANOVA for exercise quantity (alpha level 0.05) was χ2(2) = 162.48, p < .001 indicated significant differences, between before vs during and before vs after, in time spent exercising. Prepartum, walking (70%) and running (54%) were the most preferred exercise types, but walking was the most preferred during (85%) and postpartum (83%). 14% of participants were referred to PT during pregnancy, of which 39% were self-referrals and 43% from healthcare professionals. Barriers to exercise during pregnancy were discomfort (47%) and time (41%).

Conclusions: Survey results showed exercise quantity, intensity, and type differed before, during, and after pregnancy. Time and intensity of exercise were highest before pregnancy, decreased during, and did not return to prepregnancy levels. Walking and running were the most preferred exercise type pre-pregnancy, however, only walking remained the most preferred type of exercise during and after pregnancy. Pain and discomfort were the most selected hesitations with exercise during pregnancy, yet there was a lack of participation and referral to PT. 


  1. Which of the following options were identified as being the biggest hesitation about exercise during pregnancy?
    1. Finding exercises for pregnant individuals
    2. Safety of my baby
    3. Safety of myself
    4. Pain and discomfort
  2. According to our survey, what was the most preferred exercise type of respondents during pregnancy?
    1. Fitness Classes
    2. Running
    3. Walking
    4. Weightlifting
  3. T/F Participants reported that they returned to similar intensity of exercise postpartum as compared to before pregnancy. 

Ask a question about this study: [email protected]

9. The Effect of Mindfulness on Musculoskeletal Pain and Function: A Case RepMapping Sources of Cross-Contamination in a Mock Acute Care Hospital Setting 

Christian Evans, PT, PhD, Professor, Physical Therapy, CHS, Midwestern University; Taemin Jeon, SPT; Ashley N. Klopstein, SPT; Elin M. Ream, SPT; Kelly A Lempicki, PharmD, BCPS, Assistant Director, Clinical Skills and Simulation Center, Associate Professor, Pharmacy Practice, Midwestern University

Background: Healthcare associated infections in acute care (AC) hospital environments often result from contact by staff and patients, but few studies have examined how surface contact by Physical Therapist (PTs) and patients contribute to cross-contamination.

Purpose: To examine patterns of hand-contact contamination in a mock AC environment by PTs and patients.

Methods: IRB approval was obtained and all subjects provided informed consent. The design was a prospective observational study in a mock AC hospital. In the first experiment, only PTs (12 pairs of student PTs, 12 encounters) used a hand sanitizer containing the fluorescent dye CETEARETH-20 and were instructed to go about their normal duties evaluating and treating patients. In the second experiment, only patients (4 mock patients, 10 encounters) used CETEARETH-20 hand sanitizer. After each experiment, 32 pre-determined surfaces were swiped for residual CETEARETH-20 and samples were read in a fluorimeter. Degree of surface contact (DOC) was determined based on a standard curve for CETEARETH-20. The PT sessions were also videotaped and analyzed for frequency of contacts (FOC) of surfaces.

Results: For PTs, FOC showed that the laptops, patients, bed railings, gait belts and IV poles were the most frequently contacted surfaces; however, DOC based on fluorescent demonstrated doorknobs, bed rails, gait belts, walkers and canes were most contaminated. For patients, DOC demonstrated the tray tables, wheelchairs, walkers, doorknobs, and the pulse ox were most contaminated. When cross-referencing DOC between patients and PTs, walkers and gait belts were both among the most contacted, representing potential for cross-contamination.

Discussion: Degree of contact for both patients and PTs was high for equipment such as walkers and gait belts. This equipment may represent common points for cross contamination in an AC setting. Results highlight the importance of using dedicated equipment in patients rooms to limit pathogenic exposure; however, this is not always feasible. Therefore, PTs should take additional disinfection precautions in the AC setting to limit contamination of these surfaces. Limitations included a mock AC setting and the use of a surrogate to measure microbial contamination. Additional studies examining pathogenic transmission patterns in clinical AC settings are needed to confirm these findings. 


  1.  What percentage of all hospital admissions result in a healthcare associated infections?
    1. 5%
    2. 10%
    3. 40%
    4. 50%
  2. Which hospital room surface was most contaminated in this study based on fluorescence measurements (i.e. highest RFUs)?
    1. Chest tube collection box
    2. Call light button
    3. Pulse oximeter
    4. Doorknob
  3. Which surfaces had the highest risk for CROSS-CONTAMINATION based on being both frequently contacted by PTs and also highly contaminated? 
    1. Call light, spirometer and PT laptop
    2. Bed rails, gait belts and Oxygen tube and regulator
    3. Doorknob, sliding board and catheter

Ask a question about this study: [email protected] 

10. A Systematic Review: Promoting Professional Behaviors and Attitudes in Healthcare Students

Seth J. Kress, PT, DPT, OCS; Kent E. Irwin, PT, DHS, MS; Elizabeth Campione, PT, DPT, CLT-LANA; Kathy D. Hall, PT, EdD 

Purpose/Hypothesis: The development of professional behaviors and attitudes among healthcare students can be challenging because these skills are abstract and complex concepts rather than technical skills. Healthcare professions have called for increased teaching of professionalism to students in the past 20 years. The purpose of this study was to conduct a systematic review (SR) across six healthcare disciplines to investigate the most effective teaching and educational methods for developing students’ professional behaviors and attitudes.

Materials/Methods: Healthcare and educational databases were electronically searched. Of 4,370 articles identified, 54 met the inclusion criteria. Studies included were experimental, qualitative, cohort studies, case reports, and descriptive studies published in the English language between 2005 and 2021. The variables of interest included teaching methods, educational interventions, and outcomes in healthcare curricula of professionalism in physical therapy, medicine, occupational therapy, nursing, dentistry, and pharmacy education. Each title, abstract, and full-text article was independently screened by two reviewers to determine if inclusion and exclusion criteria were met. Study quality was appraised using the Mixed Methods Appraisal Tool.

Results: The mixed methods quality appraisal resulted in 87% of studies being judged as high quality Thirteen teaching methods were identified to foster the development of professional behaviors. The most used teaching methods were self-assessment/reflection, group discussion, lecture, service-based learning, case studies, and role modeling. Each of these teaching methods was rarely used in isolation but frequently used in combination. Study outcomes were assessed to determine the effectiveness of the teaching methods on developing student professional behaviors and/or attitudes. 89% of the studies reviewed resulted in positive changes in professional behaviors or attitudes.

Conclusions: The majority of the identified teaching methods resulted in positive changes in professional behaviors and attitudes. Effective teaching methods promoting the development of professional behaviors and attitudes in healthcare students commonly use a combination of methods. Reflection was the most used teaching method and was used in conjunction with another teaching method in 24 of 28 studies. The results of this SR offer healthcare educators evidence-based options for facilitating growth of professional behaviors and attitudes in students. 


  1. What are the MOST common teaching methods found in the SR that are used to foster the development of professionalism in healthcare students?
    1. Cases, lecture, and simulation
    2. Reflection, group discussion, and lecture
    3. Role playing, group discussion, and team-based teaching
    4. Service-based learning, reflection, and peer-based teaching
  2. What percentage of the studies resulted in positive changes in professional behavior or attitude?
    1. 35%
    2. 53%
    3. 72%
    4. 89%
  3. Which teaching method resulted in the HIGHEST percentage of positive change in professional behavior or attitude when used in isolation or in combination?
    1. Group Discussion
    2. Lectures
    3. Role Playing
    4. Simulation

Ask a question about this study: [email protected] 

11. Single Training Session for Reactive Stepping in Individuals with Chronic Stroke: A Case Series 

Mikaela Arredondo, SPT; Maren Wisniewski, SPT; Daria Wilson, SPT; Nicole Gilbert, SPT; Elizabeth B. Grobbel, SPT; Austin Hemenway, SPT; Sarah Lipscomb, SPT; Pooja Patel, SPT; Claire Reynolds, SPT; Haiting Shui, SPT; Lois Deming Hedman, PT, DScPT, MS; Heather K. Henderson, PT, DPT; Heidi Rebecca Roth, PT, DHS; Katherine Masa Martinez, PT, PhD 

Background and Purpose: Stroke survivors tend to execute reactive steps slower compared to controls and show a preference for initiating reactive steps with their non-paretic limb (NPL). Unweighting the paretic limb (PL) can foster reactive step initiation with the PL in stroke survivors. The purpose of this case series is to evaluate the effect of a single training session on the incidence of initiating perturbation-induced reactive stepping (PIRS) with the PL in two stroke survivors with different levels of lower extremity (LE) impairment. We hypothesize that after a training session, participants will increase initiating a reactive step with their PL.

Case Description: Participant A1 is a 57 year old male s/p stroke 14 years ago. Participant B1 is a 73 year old female s/p stroke 18 years ago. Both have right-sided hemiparesis, live independently, and are community ambulators. A1 does not use an assistive device; B1 uses an AFO and straight cane. A1 had no abnormal LE synergies present; B1 demonstrated abnormal LE synergies and distal weakness (LE Fugl-Meyer). A1 demonstrated faster walking velocity than B1, however, both were community ambulators based on gait speed (10 meter walk test). A1 reported higher balance confidence using the Activities-Specific Balance Confidence scale (100%) than B1 (66.25%).

Pre and post-tests included PIRS in equal weight-bearing (WB) and the MiniBEST reactive postural control sub-test (lean test). Reactive step training was performed using an anterior waist pull perturbation at 10% of the participant’s body weight (BW). Participants stood on force plates while secured in a harness and received perturbations once they achieved a predetermined LE weight distribution. Training consisted of over 90 trials with gradual increase of WB on the PL starting at 20% BW, while being instructed to initiate a reactive step with the PL. During training, A1 achieved 75% PL WB and B1 achieved 52% PL WB.

Outcomes: In PIRS testing, A1 progressed from initiating stepping with their PL in 4% of trials in the pre-test to 100% of trials in the post-test, while B1 progressed from 0% to 32%. Although there was no improvement on lean test scores for either participant, during the post-test, A1 stepped with their PL during the forward and paretic lateral lean. B1 was apprehensive for all directions of the lean test, always stepped with NPL leg first, and was unable to independently recover in the paretic lateral lean direction.

Discussion: Reactive step training may be an effective method to encourage people to reactively step with their PL. People with more LE impairment post-stroke may need additional training sessions to achieve greater WB on the PL to build a motor plan for unweighting the PL to execute PL reactive stepping. COVID restrictions affected our ability to provide in-person training over multiple sessions and winter weather affected participant recruitment. A larger sample size may increase the external validity of our case series. Further investigation is needed to determine the optimal dose of perturbation training for reactive stepping given individual participant characteristics. 


  1. Persons post stroke tend to take a reactive step to a perturbation with their:
  1. Either leg
  2. Non-paretic leg
  3. Paretic leg

2. A single training session of 90 anterior waist-pull perturbation showed what change in the percentage of times the participants initiated a reactive step with their paretic leg immediately after training.  

  1. Five percent increase
  2. Decrease
  3. Increase
  4. No change

3. T/F This case series adds to previous work that showed reactive step training may be effective in facilitating person post stroke to initiate a reactive step with their paretic leg.

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12. DPT Student Attitudes and Confidence Towards Working with Older Adults: Impact of Exposures  

Elizabeth Viveros, SPT; Katie Davis, SPT; Jessica Boblak, SPT; Anna Wypych, SPT; Beata Stopka, SPT; Andres Garcia, SPT; Maryleen (Mary) K. Jones, PT, DHS, MPT, NCS, CSRS, CLT; Heidi Moyer, PT, DPT, GCS, CEEAA 

Background/Purpose: With the growing complexities of care management skills required for successful treatment of older adult populations, early career physical therapists may be unprepared to manage the needs of this population. The cumulative effects of social attitudes paired with limited consistent exposure to older populations may negatively impact the profession’s ability to manage the unique needs of the older adult population. The aim of this study is to determine the impact of dedicated geriatric didactic coursework and clinical education exposure on the perspectives and motivation of second-year doctor of physical therapy students on the prospect of pursuing a career working with older adults in the future.

Methods: Students in the second year of a DPT program participated in two mixed methods online surveys following 2 weeks of geriatric-specific content and again after their first clinical rotation.

Results: Twenty-one students completed the survey after receiving dedicated older adult content and 14 students completed the survey after their clinical experience. Survey analysis found that 57.9% of older adult exposures occurred within the academic and outpatient clinical settings. Student confidence and interest levels with older adults significantly improved post clinical experiences. Areas of concern for students centered around complexity and frailty, however, post-exposure increased awareness of the complex needs of the older adult population was noted. Additional areas of interest noted by students were promotion of quality of life for older adults post clinical exposure. However, post didactic content, an interest in advocacy for older adults was noted with a decrease in interest post clinical experience. Increased awareness of bias towards older adults was noted post clinical experiences.

Discussion/Conclusion: To improve DPT students’ attitudes towards working with older adult populations, both didactic coursework and clinical exposure should be implemented throughout the curriculum to address attitudes, comfort level, and ageist biases early in a student’s physical therapy career. Further research should examine the frequency and duration required for maximizing student confidence and attitudes toward working with geriatric populations as well as quantifying what constitutes a meaningful or impactful experience that could lead to a change of perception. 


  1. Which of the following was the number one ranked concern of DPT students related to working with older adults after their first full-time clinical practicum? 
    1. complexity of care required for older adults 
    2. lack of experience with the older adult population
    3. not finding the population interesting 
    4. potential for harming older adults with interventions 
  2. Which of the following led to the highest improvement in reducing student physical therapist bias against older adults? 
    1. didactic-based geriatric-focused content
    2. full-time clinical practicum experience
    3. improv comedy classes
    4. None of the above 
  3. T/F DPT students require sufficient exposure to a patient population prior to making informed decisions about their desire to treat that patient population. 

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13. Improvisation in Doctor of Physical Therapy Student Education 

Justin Drogos, PT, DPT; William Healey, Pt, EdD; Jonathan Webb, MBA; Eleanor Hoag, SPT; Paolo Jimenez, SPT; Delany Liter, SPT; Hannah Meyer, SPT; Mark J. Strudas, SPT; Sandra Seitz, MSE, SPT 

Purpose: This study investigated the effectiveness of an improvisation program with Doctor of Physical Therapy (DPT) students enrolled in the Northwestern University Feinberg School of Medicine Department of Physical Therapy and Human Movement Sciences (PTHMS). The purpose was to measure student 1) resilience, 2) coping self-efficacy, 3) self-esteem, and 4) communication skills pre and post four 45-minute improvisation sessions within a 10-week timeframe.
Subjects: Experimental participants in this study included 9 currently enrolled 1st-year PTHMS DPT students who completed all 4 sessions as well as all pre and post surveys. Control group participants included 9 currently enrolled 1st-year PTHMS DPT students who did not participate in sessions and completed all pre and post surveys. Exclusion criteria included non-PTHMS DPT students.
Methods: A REDCap online survey was composed of 1) scales that measure resilience (Connor-Davidson Resilience Scale 25), coping self-efficacy (Coping Self-Efficacy Scale), self-esteem (Rosenberg’s Self-Esteem Scale); 2) PTHMS Improv Program evaluation; and 3) participant demographics. The survey was completed after participant consent was obtained at the start of the program and after the last module or end of the program. A PTHMS program evaluation was collected after the final session. Nonparametric tests were used to calculate outcome measure differences from pre to post both within and across groups. A 5-point Likert scale was used for program evaluation with 2 open-ended questions.
Results: This study compared self-esteem, resiliency, and coping in students that completed (n=9) and did not complete (control, n=9) the improv program. Non-parametric tests were used to calculate differences as results were not normally distributed. A Mann-Whitney U test revealed no significant differences in self-esteem (U= 30, p= 0.39), resiliency (U= 31.5, p= 0.44), or coping (U= 35, p= 0.67) between the two groups before or after the intervention. A Wilcoxon Signed-Rank test revealed no significant differences in self-esteem (z= -0.07, p= 0.94), resiliency (z= -0.43, p= 0.67), or coping (z= -0.49, p= 0.62) from pre to post intervention within the intervention group. There were also no significant differences for any outcome measure within the control group. All program evaluation items assessing participant satisfaction scored ≥ 4/5 and open-ended questions assessing participant feedback were positive.
Conclusion: Although outcome measures did not yield significant differences between and within groups, the program evaluations clearly reported high satisfaction, enjoyment and suggests meaningful growth as a DPT student as well as providing social support during a rigorous DPT program. Next steps for future studies include increasing total intervention time, embedding sessions into existing course work, reducing evaluation burden, and increasing participation size.
Clinical Relevance: The unscripted and spontaneous nature of improvisation fosters essential skills (adaptability, active listening, and thinking on one’s feet) physical therapists need to provide exceptional patient care and seamless teamwork. 


  1. Medical improv applies the techniques utilized in improvisation to facilitate the development of medical professionals’
    1. Adaptability
    2. Confidence
    3. Empathy
  2. T/F All participants in the improv programs felt more confident, resilient, effective as a communicator, and able to think on their feet.
  3. The validated outcomes measures used to measure participants’ resilience, self-esteem, and coping may not be best for this intervention because they are highly sensitive to the immediate time frame they are administered. For DPT students, these confounding factors include:
    1. Exams
    2. Schedule changes
    3. Bonding with classmates

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14.Reliability of Handheld Ultrasound Unit Measuring the Deep Core Musculature: Student vs. Experienced User 

Thomas Dillon, PT, DPT, OCS; Teresa Elliott-Burke, PT, DPT, MHS; Jason VanDyck, SPT; Leo Guzman, SPT; Odell Miller, SPT 

Background/Purpose: To determine the inter-rater reliability between a student physical therapist (PT) and an experienced PT using recently developed handheld ultrasound imaging (UI) to measure the thickness of lumbar multifidus (LM) and the transverse abdominis (TrA) muscles, two muscles frequently measured and observed when using UI as biofeedback for treatment of low back pain. The researchers hypothesize the student user will show no differences in imagining measurements when compared to an experienced user. Established UI units may not be utilized in PT clinics or PT education due to excessive cost and space restrictions. There is limited research on the reliability of less expensive, handheld UI equipment when measuring musculature.

Method: 33 healthy participants, 19 females and 14 males, 23-88 yrs. old, with no current back pain or dysfunction and being capable of lying prone for at least 10 minutes. LM was observed in the prone and the TrA in supine. The student obtained images at rest and with three muscle contractions of each muscle utilizing the Butterfly iQ handheld ultrasound device. Contractions were held for 10 seconds. The on-device calipers were used to measure the muscle thickness. Both users were blinded to the thickness measurement. The experienced user performed the same measurements. Each user measured the thickness of the musculature at rest and with three contractions totaling 16 data points per participant. The sequencing of users alternated with each subject.

Results: Inter-rater reliability of LM at rest between the student and experienced users was good (ICC=0.856, 95% CI) and the inter-rater reliability of TrA at rest was excellent (ICC=0.930, 95% CI [.858,.965]). The inter-rater reliability of the average of three contraction trials was good for LM (ICC=0.833, 95% CI) and TrA (ICC=0.67, 95% CI). The intra-rater reliability of the novice rater was excellent when measuring LM (ICC=.981, 95% CI and TrA thickness (ICC=.925, 95% CI). The intra-rater reliability of the experienced rater was also excellent for the LM (ICC=.975, CI) and TrA (ICC=.969, CI). 


  1. What are the author’s proposed benefits of handheld ultrasound devices compared to established units?
    1. Reduced cost
    1. Improved portability
    2. Reduced size of unit
    3. All of the above
  2. What is the inter-rater reliability of handheld ultrasound imaging between an experienced and novice user when measuring the thickness of the lumbar multifidus and transverse abdominis muscles during contraction?
    1. Good (ICC = 0.76-0.9)
    2. Poor (ICC = 0-0.49)
    3. Moderate (ICC = 0.5-0.75)
    4. Excellent (ICC = > 0.91)
  3. How many hours of ultrasound imaging training did the novice user have?
    1. None
    2. 4 hours, informal
    3. 10 hours, formal
    4. 15+ hours, informal

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15. Physical and Occupational Therapy Student Collaboration for a Patient Post Pontine Stroke 

Kelsey Thompson, SPT; Abigail Maas, OTS; Jeanne O’Neil McCoy, PT, DPT, MS, NCS; Joseph Williamson-Link, MOT, OTR/L 

BACKGROUND/PURPOSE: Interprofessional collaboration among rehabilitation professionals is paramount to optimal patient outcomes. The purposes of this case report are to illustrate the results of physical/occupational therapy student (SPT/OTS) collaboration when paired with partnered occupational/physical therapy (OT/PT) clinical instructors (CIs) and to discuss rehabilitation collaboration opportunities/outcomes for a patient s/p pontine stroke.

CASE DESCRIPTION: The OTS and SPT were both completing full-time internships at an inpatient rehabilitation facility and were paired with partnering OT/PT CIs. The patient was a previously independent, middle-aged male with significant cardiac history s/p median posterior pontine stroke. Throughout the patient’s 14-day inpatient rehabilitation stay, PT interventions focused on functional mobility training including gait with and without rolling walker (RW), standing balance, body weight support training, and aquatic therapy. OT interventions focused on oculomotor exercises (with guidance from optometrist following OT vision screen), vestibular and somatosensory balance exercises, Activities of Daily Living (ADLs), and functional mobility.

OUTCOMES: The SPT and OTS collaborated informally throughout the patient’s stay and more formally sharing an in-service presentation with the inpatient team. The patient’s Berg Balance Scale score increased from 10/56 to 37/56; Postural Assessment Scale for Stroke (PASS) increased from 26/36 to 32/36; and 10 Meter Walk Test improved with RW from 0.73 m/sec to 0.84 m/sec. Action Research Arm Test (ARAT) (57/57) and 9 Hole Peg Test (39 seconds right, 36 seconds left) were not long-term goal areas. Vision impairments significantly improved with the patient continuing to wear optometrist supplied prism glasses. CARE Tool change scores were significant with ADL scores improving from overall partial/moderate assist to independent at RW level; gait improved from total assist to supervision with RW and minimal assistance without assistive device; and stairs improved from substantial/maximal assistance to supervision. The patient was discharged home with his significant other, who completed a student-lead family education visit, with recommendations for intermittent supervision/assistance as needed RW level and day rehabilitation.

DISCUSSION/CONCLUSIONS: The OTS/SPT benefited from collaboration throughout the patient’s stay to promote skill development and practice reflection. The patient benefited from interdisciplinary collaboration to optimize functional abilities post pontine stroke in an inpatient rehabilitation setting. 


  1. All but which one of the following would be considered a typical symptom following pontine stroke?
    1. Double Vision
    2. Memory Loss
    3. Dizziness
    1. Loss of Coordination
  2. T/F Stroke is a leading cause of death and disability in the United States.
  3. A patient’s baseline 10MWT following an acute stroke is 0.23 m/sec (household ambulation). Which of the following discharge scores would be considered a minimal detectable change?
    1. 0.28 m/sec\
    2. 0.30 m/sec
    3. 0.34 m/sec
    4. 0.42 m/sec

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