A manuscript authored by a team from The Vert Mooney Research Foundation (DBA US Spine & Sport Foundation) and Spine & Sport Physical Therapy (www.spineandsport.com) was recently published in the APTA Physical Therapy Journal of Policy, Administration, and Leadership:

Katz R, Schwartz S, Phelps B, Faust S, Mortimer D, Verna JL, Mayer JM. Telehealth in physical therapy practice for musculoskeletal disorders: case series. The APTA Physical Therapy Journal of Policy, Administration, and Leadership, November 2022.

The manuscript reports on the development and implementation of a telehealth program during the COVID-19 pandemic. The novel aspects of being an early adopter of physical therapy telehealth in a private practice environment, along with research design and analysis via a non-profit foundation, are particularly noteworthy. An abstract of the published manuscript is shown below.

ABSTRACT

Study Design: Administrative case report.

Objectives: The objectives of this paper are to: 1. summarize the current regulatory considerations for physical therapy telehealth services for musculoskeletal disorders; 2. describe the implementation process of a telehealth program by an outpatient physical therapy organization across its 20 clinics during the SARS-CoV-2 (COVID-19) pandemic; and 3. provide recommendations for regulatory, organizational and research changes needed to support implementation of long-term telehealth services in musculoskeletal physical therapy practice.

Background: The COVID-19 pandemic has greatly disrupted the delivery of healthcare services. Telehealth provides a possible solution for improving delivery of services by enhancing access and fostering patient-centered approaches but has not been well-described in physical therapy practice.

Methods: The implementation processes of telehealth services by a large outpatient physical therapy center in California are described. Three patient cases are summarized for a more detailed description of the experience.

Analysis: Telehealth services were successfully implemented in a large outpatient physical therapy center in response to the COVID-19 pandemic. Initial responses from patients with musculoskeletal disorders and physical therapists about telehealth services were positive.

Conclusions: Telehealth has the potential to enhance physical therapy practice, though its specific structure and magnitude are unclear. Regulatory and organizational changes as well as research trials are needed to help clarify the role of telehealth.

A team from The Vert Mooney Research Foundation (DBA US Spine & Sport Foundation) recently presented findings of a 3-year FEMA Fire Prevention & Safety grant – Implementation of a Regional Firefighter Wellness Initiative – at two national conferences – American College of Sports Medicine (ACSM) in June 2022 and American Chiropractic College – Research Agenda Conference (ACC-RAC) in July 2022.

1. Lane CL, Mayer JM. Worksite exercise adherence in firefighters: findings during a global pandemic and record wildfire season. American College of Sports Medicine Annual Meeting, San Diego, CA, June 2022 (e-poster).
2. Mayer JM, Verna JL, Lane CL. Implementation of a firefighter wellness initiative during record wildfires and a global pandemic. Association Chiropractic Colleges – Research Agenda Conference, San Diego, CA, July 2022 (podium).

Abstracts of the presentations are shown below.

ACSM, June 2022

ABSTRACT: Occupational injury is prevalent in firefighters and exercise programming is beneficial to prevent injury and hasten recovery. Yet, implementation of worksite exercise programs has been intermittently successful. PURPOSE: The purpose of this study was to assess adherence factors in firefighters enrolled in a worksite fitness program during a global pandemic and record wildfire season. METHODS: A cross sectional study was conducted in career firefighters (n = 429) from 15 Southern California departments enrolled in a 9-18 month worksite fitness program. Exercise adherence, completed exercise sessions in the intervention period, was compared to baseline age, history of musculoskeletal (MSK) conditions, completion of wellness educational courses and physical fitness measures. ANOVA, T-Tests, or Chi-square were used to assess relationships between exercise adherence and baseline characteristics. RESULTS: Exercise adherence was poorer than anticipated and was attributed to the COVID-19 pandemic and record wildfire season. Significant weak correlations with exercise adherence were noted for age (r = 0.112, p = 0.035), BMI (r = -0.113, p = 0.033), back muscular endurance (r = 0.217, p < 0.000), core muscular endurance (r = 0.113, p = 0.035), and flexibility exercise frequency (r = 0.113, p = 0.035). Those with MSK history had a higher adherence rate than those without (History: 13.2 +/- 22.7%, No History: 4.7 +/- 7.4%, p = 0.021). Those who completed wellness education courses had a higher adherence rate than those who did not (Completed: 29.9 +/- 31.1%, Did Not Complete: 7.2 +/- 14.9%, p < 0.000). No significant relationships were noted between exercise adherence and waist circumference, bodyfat%, Functional Movement Screen, or cardiovascular and resistance exercise frequencies. CONCLUSION: These findings suggest that the most adherent participants were more fit, older, and had a MSK history. However, the poor adherers were less fit, suggesting that firefighters who need exercise programming the most were not adherent. While more research is needed, future iimplementation efforts should minimize delivery barriers, consider a hybrid approach of face-to-face and virtual sessions, and focus on delivering to firefighters who are most vulnerable to MSK conditions.

ACC-RAC, July 2022

ABSTRACT: Objective: Firefighters have elevated rates of cardiovascular, musculoskeletal, and sleep disorders. However, specific guidance on implementing interventions to address these conditions is largely unavailable. The purpose of this project was to implement a firefighter wellness initiative targeting obesity, musculoskeletal injuries, and sleep disorders. Methods: An observational cohort project was conducted in 429 career firefighters from 15 California departments. Assessments included anthropometric, fitness, and patient-reported outcomes that are known health risk indicators. Physical fitness, injury prevention, and educational interventions were customized and triaged according to needs, goals, and risk levels. Interventions were delivered over 9-18 months in one-on-one and group settings, via face-to-face and telehealth sessions. The initiative was implemented during record wildfires and the COVID-19 pandemic, which disrupted delivery. Results: 127 firefighters completed 9-month follow-up assessments. For those at highest risk at baseline, significant improvements (p < 0.05) were observed in waist circumference, muscular endurance, functional movement, exercise frequency, dietary intake, and sleep quality. Conclusion: Improvements in key health risk indicators were observed in firefighters who participated in a wellness initiative. While the relatively low adherence may limit generalizability, the unprecedented environment provided an opportunity to inform future implementation of occupational wellness program

Leonard N. Matheson, PhD recently received the 2021 Health Advocate Award from the American Occupational Therapy Association (AOTA). The Health Advocate Award expresses appreciation for extraordinary contributions of national significance that led to the advancement of health promotion and/or health care. AOTA – a leading body of the Occupational Therapy profession in the world – recognized Dr. Matheson’s contributions as a “Work-Oriented Neurorehabilitation Pioneer, Educator, and Policy Advocate.”

Dr. Matheson is a founding Board Member of The Vert Mooney Research Foundation and President of EPIC Neurorehabilitation & Psychology Services. As a Clinical Psychologist and researcher, his contributions to the field of occupational rehabilitation across many domains are unparalleled. More importantly, he is an outstanding mentor, great friend, and has touched the lives of many people around the world.

Congratulations, Dr. Matheson!

USSSF Director of Program Development and Board Member, Charity Lane, was recently published in the first 2021 edition of the NSCA TSAC Report (#60) on the topic of Sleep programs in the fire service.

Lane CL, Melton B. Sleep improvement programs in firefighters – a critically appraised topic. National Strength & Conditioning Association (NSCA) Tactical Strength and Conditioning (TSAC) Report, 2021, 60.

Abstract / page 1: click here

Full text available here – NSCA member access only: https://lnkd.in/g4WSfW3

Found here: https://pubmed.ncbi.nlm.nih.gov/32796259/

Objective: This study assessed worksite exercise delivered by on-site supervision (supervised) or telehealth to reduce lost work time (LWT) related to low back pain (LBP) in firefighters. Methods: A cluster randomized controlled trial assigned 264 career firefighters to supervised (n = 86) or telehealth (n = 95) back and core exercises 2X/week for 12 months, or control (n = 83). Results: 58.0% (153/264) of participants reported LBP and 7.6% (20/264) reported LWT related to LBP (control n = 10, supervised n = 5, telehealth n = 5). Participants in the control group experienced 1.15 times as many hours of LWT as the supervised group, and 5.51 times as many hours of LWT as the telehealth group. Conclusions: Worksite exercise, delivered by on-site supervision or telehealth, can reduce LWT related to LBP in career firefighters.