The following PTJ podcast is the PTJ Symposium: Rehabilitation of Patients With Critical Illness. The symposium took place at APTA's Combined Sections Meeting on January 24, 2013, in San Diego, California. The participants are Michelle Kho, PT, PhD, Diane Clark, PT, DScPT, Darin Trees, PT, DPT, CWS, and Amy Pawlik, PT, DPT, CCS. The moderator is Patricia Ohtake, PT, PhD, editor of the Special Series on Critical Illness. Introducing the symposium is James Smith, PT, DPT, MA, President of the Acute Care Section of APTA.

The Early Prediction of Functional Outcome After Stroke (EPOS) study assessed the accuracy of physical therapists and a computational prediction model in predicting the outcomes in upper limb function in people with acute stroke. In this podcast, Erwin van Wegen, PhD, one of the authors of an article on the EPOS Study published in the April 2013 issue of PTJ, is joined by Dorian Rose, PT, PhD, and moderator James Carey, PT, PhD, to discuss the methods, results, and implications of the EPOS Study. How might amount of treatment influence the prediction? What factors do clinicians consider when making their predictions? What role does the clinician’s experience and intuition play in the accuracy of the prediction of outcome? What are the ethical implications of predicting stroke outcomes?

In an article published in the March 2013 issue of PTJ, Daniel Martins and colleagues found that ankle joint mobilization (AJM) decreased postoperative mechanical hyperalgesia in mice and that this effect was prevented by treatment of the mice with caffeine. In this podcast, 3 of the authors of the study--Daniel Martins, Leidiane Mazzardo-Martins, and Adair Santos--join moderator Kathleen Sluka and Joel Bialosky to discuss the study findings as well as the benefits and pitfalls of using animal models of pain. The group also discusses how the outcomes of studies of animal models can be translated into human studies.

In her December 2012 editorial introducing the Special Series on Rehabilitation for People With Critical Illness, Editor in Chief Rebecca Craik reminded readers that, as recently as 5 years ago, there was debate about whether physical therapists should even be practicing in acute care settings. In fact, that was the topic of the 2007 Rothstein Debate--"Should Physical Therapists Practice in Acute Care Settings?"--at PT 2007: The Annual Conference and Exposition of the American Physical Therapy Association, on June 29, 2007, in Denver, Colorado. The participants were Anthony Delitto, PT, PhD, FAPTA, and Charles M. Magistro, PT, FAPTA. The moderator was Dianne V. Jewell, PT, PhD, CCS, FAACVCPR. Listen to this podcast, and consider the remarkable developments that have taken place in acute care physical therapy since this debate took place. The Rothstein Debate is named in honor of PTJ's Editor in Chief Emeritus Jules M. Rothstein, PT, PhD, FAPTA (1947–2005).

The January 2013 Perspective article "Grounding Early Intervention: Physical Therapy Cannot Just Be About Motor Skills Anymore" by Lobo et al focuses on the early-intervention application of grounded cognition theory (cognitive development is created, shaped, and maintained by everyday perceptual-motor experiences within social and cultural contexts). According to this theory, motor development and cognitive development do not occur separately from each other or in isolation from the child's real-world environment. In this podcast, authors Michele Lobo and Regina Harbourne are joined by Lisa Chiarello and Moderator Jan Willem Gorter to discuss the implications of grounded cognition for early intervention and the ramifications of this theory beyond pediatric practice. Says Chiarello of the article by Lobo et al, "Every single physical therapist should read this."

Total hip arthroplasty (THA) is a common procedure for osteoarthritis, complications due to hip fractures, rheumatoid arthritis, and congential dislocation of the hip. Are there variables that can identify patients at risk for unsuccessful outcomes after this surgery? In "Prediction of Functional Outcome at Six Months Following Total Hip Arthroplasty" (November 2012), Dr Emily Slaven concluded that such variables as body mass index, age, and sex could be used to identify patients at risk for less favorable outcomes after THA. In this podcast, Slaven is joined by orthopedic surgeon and researcher Dr Robert Wagenmakers and moderator Dr Rebecca Craik to discuss her study and other current research on the topic. They also discuss the influence of different surgical approaches on outcomes and compare postoperative rehabilitation approaches in the United States and the Netherlands.

On November 6, 2012, the United States holds presidential and congressional elections. How does health care fit into the choices facing voters? What is likely to happen after the election? And how does it affect the physical therapy profession? PTJ Editor in Chief Rebecca Craik leads a discussion of the issues and candidates with Justin Moore, Vice President, Government and Payment Advocacy at APTA, and Roger Herr, a member of APTA's Board of Directors and APTA's Public Policy and Advocacy Committee. The American Physical Therapy Association and PTJ do not endorse or take a position on presidential candidates but seek to empower members to be active participants in the electoral process.

The step count, particularly total steps per day, is most common measure of walking activity in people poststroke--but does the step account accurately reflect "real world" walking activity in this population? In "The Structure of Walking Activity in People After Stroke Compared With Older Adults Without Disability: A Cross-Sectional Study" (September 2012), lead author Darcy Reisman, PT, PhD, and colleagues discovered that the reduced number of steps per day after stroke is the result of a reduced number of bouts of walking--a finding that would not come to light if only total steps were analyzed. In this PTJ podcast, Reisman is joined by Bruce Dobkin, MD, FRCP, an investigator with the LEAPS trial, and Moderator Janice Eng, PT/OT, PhD, to discuss walking activity in people poststroke. What measures of walking activity are most meaningful for patients poststroke? Are there new technologies on the horizon that may increase the ability to measure "real world" activity and adjust interventions accordingly?

Listen to the 43rd Mary McMillan Lecture--"Face Into the Storm"--delivered by Dr Alan Jette at the opening ceremonies of PT 2012 the Annual Conference and Exposition of the American Physical Therapy Association on June 7, 2012, in Tampa, Florida. Introducing Dr Jette is APTA President Dr Paul Rockar Jr.

A number of psychological factors--including pain catastrophizing, depression, general anxiety, fear, self-efficacy--appear to have an effect on rehabilitation outcomes. The size of this effect and the amount of influence of particular factors, however, are still unclear. The August 2012 PTJ article "Influence of Fear-Avoidance Beliefs on Functional Status Outcomes for People With Musculoskeletal Conditions of the Shoulder" reported that elevated fear-avoidance beliefs were associated with poorer outcomes in only 2 of 8 shoulder disease categories, and the effect was small. In this discussion podcast, 2 of the authors, Bhagwant Sindhu, PhD, OTR, and Mark Bishop, PT, PhD, join Julie Fritz, PT, PhD, ATC, and moderator Chris Main, PhD, FBPsS, to discuss the implications of their study and the direction of future research on the influence of psychological factors on patient outcomes.