Objective
The Commission on Accreditation in Physical Therapy Education has introduced a requirement that 50% of core faculty members in a physical therapist education program have an academic doctoral degree, which many programs are not currently meeting. Competition between programs for prestige and resources may explain the discrepancy of academic achievement among faculty despite accreditation standards. The purpose of this study was to identify faculty and program characteristics that are predictive of programs having a higher percentage of faculty with academic doctoral degrees.
Methods
Yearly accreditation data from 231 programs for a 10-year period were used in a fixed-effects panel analysis.
Results
For a 1 percentage point increase in the number of core faculty members, a program can expect a decline in academic doctoral degrees by 14% with all other variables held constant. For a 1% increase in either reported total cost or expenses per student, a program could expect a 7% decline in academic doctoral degrees with all other variables held constant. Programs that have been accredited for a longer period of time could expect to have proportionately more faculty members with academic doctoral degrees.
Conclusions
Programs may be increasing their core faculty size to allow faculty with academic doctoral degrees to focus on scholarly productivity. The percentage of faculty with academic doctoral degrees declines as programs increase tuition and expenditures, but this may be due to programs’ tendency to stratify individuals (including part-time core faculty) into teaching- and research-focused efforts to maximize their research prowess and status.
Impact
This study illuminates existing relationships between physical therapist faculty staffing, time spent in research versus teaching, and program finances. The results of this study should be used to inform higher education policy initiatives aimed to lower competitive pressures and the costs of professional education.
Central sensitization (CS) is characterized by adaptations to the central nervous system resulting in decreased sensory thresholds and widespread hypersensitivity. CS is often difficult to manage, with current treatment strategies primarily consisting of medication, pain science education, cognitive behavioral therapy, and graded exercise intervention. Spinal manipulation represents a potential alternative treatment for CS because of its centrally acting neurophysiological mechanisms. However, experimental trials utilizing spinal manipulation in persons with CS often lack the controls or methodology required to determine the technique's effect on meaningful clinical outcomes. This paper summarizes the mechanistic and experimental evidence on spinal manipulation for centrally mediated pain and hypersensitivity, and offers recommendations for future study considerations in this topic area.
Patients with cervical radiculopathy (CR) may present with accompanying symptoms of hyperalgesia, allodynia, heaviness in the arm, and non-segmental pain that do not appear to be related to a peripheral spinal nerve. These findings may suggest the presence of central or autonomic nervous system involvement, requiring a modified management approach. The purpose of this case report is to describe the treatment of a patient with signs of CR and upper extremity (UE) hyperalgesia who had a significant decrease in her UE pain and hypersensitivity after a single thoracic spine manipulation (TSM). A 48-year-old female presented to physical therapy with acute neck pain radiating into her left UE that significantly limited her ability to sleep and work. After a single TSM, the patient demonstrated immediate and lasting reduction in hyperalgesia, hypersensitivity to touch, elimination of perceived heaviness and coldness in her left UE, and improved strength in the C6-8 myotome, allowing for improved functional activity capacity and tolerance to a multi-modal PT program. Based on these results, clinicians should consider the early application of TSM in patients with CR who have atypical, widespread, or severe neurological symptoms that limit early mobilization and tolerance to treatment at the painful region.
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