C harles M. Magistro, PT, DPT(Hon), DrSci(Hon), FAPTA, died on April 21 at the grand age of 91 ye... more C harles M. Magistro, PT, DPT(Hon), DrSci(Hon), FAPTA, died on April 21 at the grand age of 91 years. His career spanned more than 6 decades, and his leadership, vision, and passion for practice excellence had a direct impact on the patients he treated and on all of us, whether we are clinicians, researchers, or faculty members. Let me start with the bare facts, which are impressive enough. Charles and Noël Magistro were married for 68 years and raised 5 children; their son died at the age of 26 of a brain tumor in 1985. Their 4 daughters have added 10 grandchildren and one great-grandchild to this remarkable family. In 1946, Charles was discharged from the US Navy as a First Class Pharmacist's Mate. He went to undergraduate school at Pomona College in California and received a certificate in physical therapy from Columbia University in 1950 (along with 400 other physical therapist students across the country). More than 60 years ago, Charles led the effort to establish Pomona Valley Hospital Medical Center's physical therapy and rehabilitation department. The first of its kind in Southern California, today this service is one of the largest outpatient rehabilitation programs in the tri-county area. It was named the Charles M. Magistro Physical Therapy & Rehabilitation Center in 2015.
BackgroundThe impact of frailty on walking recovery after hip fracture has not been reported. We ... more BackgroundThe impact of frailty on walking recovery after hip fracture has not been reported. We describe the prevalence of frailty approximately 3 months after hip fracture, and identify the impact of baseline frailty on ambulation recovery.MethodsData from the Community Ambulation Project, that examined the effects of 2 multicomponent home exercise programs on 6-minute walk test in participants post hip fracture, were used to reconstruct the 5-item frailty phenotype. We detailed the prevalence of frailty by subgroup and assessed the comparability between frailty groups for the categorical variable of achieving 300 m in 6-minute walk test (community ambulation threshold), and the continuous variable of total distance in 6-minute walk test before and after 16 weeks of intervention.ResultsOf the 210 participants, 9% were nonfrail, 59% were prefrail, and 32% were frail. The odds of a nonfrail participant achieving the 300-m threshold were 14.4 (95% CI: 2.4–87.6) times the odds of a frail participant, while a prefrail participant’s odds were 6.1 (95% CI: 1.3–28.4) times after controlling for treatment group and baseline walking distance. The nonfrail participants had an increase of 92.1 m from baseline to 16 weeks, the prefrail had a 50.8 m increase, and the frail group had the smallest increase of 36.6 m (p < .001 for all).ConclusionsPrefrailty and frailty were highly prevalent in this sample of community-dwelling survivors of a recent hip fracture. Gains in walking distance and attaining a level of community ambulation were affected significantly by the level of baseline frailty.
e all are buried in paperwork and red tape, but we also live in an environment where trust is low... more e all are buried in paperwork and red tape, but we also live in an environment where trust is low and suspicion is high. To ensure even greater transparency in our published work, PTJ is presenting a new and improved confl ictof-interest (COI) policy. We are adopting the COI policy and form developed by the International Journal of Medical Journal Editors (http://www.icmje.org/). 1 Four types of disclosures are included in this policy: (1) Authors' associations with commercial entities that provided support for the work reported in the submitted manuscript. (2) Authors' associations with commercial entities that have an interest in the general area of the submitted manuscript. (3) Any fi nancial associations involving the author or author's spouse and children younger than 18 years of age.
T his is my last editorial as editor in chief (EIC). I had a wonderful 10 years. I learned so muc... more T his is my last editorial as editor in chief (EIC). I had a wonderful 10 years. I learned so much and will sorely miss the opportunity to preview emerging science, highlight new clinical issues, and push "hot topics." I worked with an outstanding interprofessional and global team of experts devoted to PTJ's mission: to engage and inspire an international readership on topics related to physical therapy, to publish innovative and highly relevant content for both clinicians and scientists, and to use "a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care." My vocabulary is insufficient to describe the qualities of the team with whom I have worked. During my tenure, PTJ was served by 52 Editorial Board members. We evolved from an Editorial Board consisting of US-based physical therapists (and one Canadian) to a board comprising international leaders in physical therapy, medicine, biomechanics, and nursing. Dr. Daniel Riddle is the only Editorial Board member who was with me since the beginning. As deputy editor, he was invaluable in helping to ensure that the journal's content is innovative and rigorous. PTJ's Editorial Board members have extraordinary expertise, wisdom, and passion for physical therapy and rehabilitation. We worked well together to improve scientific rigor and attract established and emerging scientists and clinicians to contribute to an exploding body of evidence. Supporting our efforts are hundreds of manuscript reviewers who have volunteered countless hours poring over manuscripts to provide reviews that are timely, constructive, and kind.
Objectives. Physical therapist intervention studies can be deemed ineffective when, in fact, they... more Objectives. Physical therapist intervention studies can be deemed ineffective when, in fact, they may not have been delivered as intended. Measurement of treatment fidelity (TF) can address this issue. The purpose of this study was to describe TF of a home-based intervention, identify factors associated with TF, and examine whether components of TF were associated with the outcome of change in 6-minute walk distance (6MWD). Methods. This is a secondary analysis of community-dwelling hip fracture participants who completed standard therapy and were randomly assigned to the active intervention (Push). Push was 16 weeks of lower extremity strengthening, function, and endurance training. TF was defined as delivery (attendance rate, exercise duration) and receipt (progression in training load, heart rate reserve [HRR] during endurance training, and exercise position [exercise on floor]). The outcome was 6MWD. Independent variables included baseline (demographic and clinical) measures. Descriptive statistics were calculated; linear and logistic regressions were performed. Results. Eighty-nine participants were included in this analysis; 59 (66%) had attendance of 75% or greater. Participants walked for 20 minutes or more for 78% of sessions. The average training load increased by 22%; the mean HRR was 35%; and 61 (69%) participants exercised on the floor for at least 75% of sessions. Regression analyses showed that a higher body mass index and greater baseline 6MWD were related to components of TF; 4 out of 5 components of TF were significantly related to 6MWD. The strongest TF relationship showed that those who exercised on the floor improved by 62 m (95% CI = 31-93 m) more than those who did not get on the floor. Conclusions. Measures of TF should extend beyond attendance rate. This analysis demonstrates how measures of TF, including program attendance, progression in training load, endurance duration, and exercising on the floor were significantly related to improvement in 6MWD in participants post hip fracture. Impact. This careful analysis of treatment fidelity assured that the intervention was delivered and received as intended. Analysis of data from a large trial with participants after hip fracture showed that regular attendance, frequent endurance training for 20 minutes, increases in lower extremity training loads, and exercising on the floor were associated with improvements in the outcome of 6-minute-walk distance. The strongest association with improvement was exercising on the floor.
C harles M. Magistro, PT, DPT(Hon), DrSci(Hon), FAPTA, died on April 21 at the grand age of 91 ye... more C harles M. Magistro, PT, DPT(Hon), DrSci(Hon), FAPTA, died on April 21 at the grand age of 91 years. His career spanned more than 6 decades, and his leadership, vision, and passion for practice excellence had a direct impact on the patients he treated and on all of us, whether we are clinicians, researchers, or faculty members. Let me start with the bare facts, which are impressive enough. Charles and Noël Magistro were married for 68 years and raised 5 children; their son died at the age of 26 of a brain tumor in 1985. Their 4 daughters have added 10 grandchildren and one great-grandchild to this remarkable family. In 1946, Charles was discharged from the US Navy as a First Class Pharmacist's Mate. He went to undergraduate school at Pomona College in California and received a certificate in physical therapy from Columbia University in 1950 (along with 400 other physical therapist students across the country). More than 60 years ago, Charles led the effort to establish Pomona Valley Hospital Medical Center's physical therapy and rehabilitation department. The first of its kind in Southern California, today this service is one of the largest outpatient rehabilitation programs in the tri-county area. It was named the Charles M. Magistro Physical Therapy & Rehabilitation Center in 2015.
BackgroundThe impact of frailty on walking recovery after hip fracture has not been reported. We ... more BackgroundThe impact of frailty on walking recovery after hip fracture has not been reported. We describe the prevalence of frailty approximately 3 months after hip fracture, and identify the impact of baseline frailty on ambulation recovery.MethodsData from the Community Ambulation Project, that examined the effects of 2 multicomponent home exercise programs on 6-minute walk test in participants post hip fracture, were used to reconstruct the 5-item frailty phenotype. We detailed the prevalence of frailty by subgroup and assessed the comparability between frailty groups for the categorical variable of achieving 300 m in 6-minute walk test (community ambulation threshold), and the continuous variable of total distance in 6-minute walk test before and after 16 weeks of intervention.ResultsOf the 210 participants, 9% were nonfrail, 59% were prefrail, and 32% were frail. The odds of a nonfrail participant achieving the 300-m threshold were 14.4 (95% CI: 2.4–87.6) times the odds of a frail participant, while a prefrail participant’s odds were 6.1 (95% CI: 1.3–28.4) times after controlling for treatment group and baseline walking distance. The nonfrail participants had an increase of 92.1 m from baseline to 16 weeks, the prefrail had a 50.8 m increase, and the frail group had the smallest increase of 36.6 m (p < .001 for all).ConclusionsPrefrailty and frailty were highly prevalent in this sample of community-dwelling survivors of a recent hip fracture. Gains in walking distance and attaining a level of community ambulation were affected significantly by the level of baseline frailty.
e all are buried in paperwork and red tape, but we also live in an environment where trust is low... more e all are buried in paperwork and red tape, but we also live in an environment where trust is low and suspicion is high. To ensure even greater transparency in our published work, PTJ is presenting a new and improved confl ictof-interest (COI) policy. We are adopting the COI policy and form developed by the International Journal of Medical Journal Editors (http://www.icmje.org/). 1 Four types of disclosures are included in this policy: (1) Authors' associations with commercial entities that provided support for the work reported in the submitted manuscript. (2) Authors' associations with commercial entities that have an interest in the general area of the submitted manuscript. (3) Any fi nancial associations involving the author or author's spouse and children younger than 18 years of age.
T his is my last editorial as editor in chief (EIC). I had a wonderful 10 years. I learned so muc... more T his is my last editorial as editor in chief (EIC). I had a wonderful 10 years. I learned so much and will sorely miss the opportunity to preview emerging science, highlight new clinical issues, and push "hot topics." I worked with an outstanding interprofessional and global team of experts devoted to PTJ's mission: to engage and inspire an international readership on topics related to physical therapy, to publish innovative and highly relevant content for both clinicians and scientists, and to use "a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care." My vocabulary is insufficient to describe the qualities of the team with whom I have worked. During my tenure, PTJ was served by 52 Editorial Board members. We evolved from an Editorial Board consisting of US-based physical therapists (and one Canadian) to a board comprising international leaders in physical therapy, medicine, biomechanics, and nursing. Dr. Daniel Riddle is the only Editorial Board member who was with me since the beginning. As deputy editor, he was invaluable in helping to ensure that the journal's content is innovative and rigorous. PTJ's Editorial Board members have extraordinary expertise, wisdom, and passion for physical therapy and rehabilitation. We worked well together to improve scientific rigor and attract established and emerging scientists and clinicians to contribute to an exploding body of evidence. Supporting our efforts are hundreds of manuscript reviewers who have volunteered countless hours poring over manuscripts to provide reviews that are timely, constructive, and kind.
Objectives. Physical therapist intervention studies can be deemed ineffective when, in fact, they... more Objectives. Physical therapist intervention studies can be deemed ineffective when, in fact, they may not have been delivered as intended. Measurement of treatment fidelity (TF) can address this issue. The purpose of this study was to describe TF of a home-based intervention, identify factors associated with TF, and examine whether components of TF were associated with the outcome of change in 6-minute walk distance (6MWD). Methods. This is a secondary analysis of community-dwelling hip fracture participants who completed standard therapy and were randomly assigned to the active intervention (Push). Push was 16 weeks of lower extremity strengthening, function, and endurance training. TF was defined as delivery (attendance rate, exercise duration) and receipt (progression in training load, heart rate reserve [HRR] during endurance training, and exercise position [exercise on floor]). The outcome was 6MWD. Independent variables included baseline (demographic and clinical) measures. Descriptive statistics were calculated; linear and logistic regressions were performed. Results. Eighty-nine participants were included in this analysis; 59 (66%) had attendance of 75% or greater. Participants walked for 20 minutes or more for 78% of sessions. The average training load increased by 22%; the mean HRR was 35%; and 61 (69%) participants exercised on the floor for at least 75% of sessions. Regression analyses showed that a higher body mass index and greater baseline 6MWD were related to components of TF; 4 out of 5 components of TF were significantly related to 6MWD. The strongest TF relationship showed that those who exercised on the floor improved by 62 m (95% CI = 31-93 m) more than those who did not get on the floor. Conclusions. Measures of TF should extend beyond attendance rate. This analysis demonstrates how measures of TF, including program attendance, progression in training load, endurance duration, and exercising on the floor were significantly related to improvement in 6MWD in participants post hip fracture. Impact. This careful analysis of treatment fidelity assured that the intervention was delivered and received as intended. Analysis of data from a large trial with participants after hip fracture showed that regular attendance, frequent endurance training for 20 minutes, increases in lower extremity training loads, and exercising on the floor were associated with improvements in the outcome of 6-minute-walk distance. The strongest association with improvement was exercising on the floor.
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