Clinical Research Directory

ATI Evidence-based Guide Investigating Clinical Services

The goal of this study is to evaluate how standard-of-care outpatient rehabilitation is delivered and how variation in care delivery mechanisms relates to clinical outcomes, service utilization, and value in patients receiving physical or occupational therapy. The study will focus on patients with musculoskeletal (MSK) conditions receiving physical or occupational therapy. The focus is to use existing standard-of-care documentation in a physical therapy (PT) electronic medical record (EMR) to evaluate patient characteristics, interventions delivered, utilization management, and clinical outcomes in routine outpatient PT care, in order to generate evidence to improve clinical effectiveness and quality of care. Researchers will compare different care delivery mechanisms to see if variations lead to significant differences in outcomes. Participants will have their standard-of-care documentation analyzed, including routine clinical measures, objective/functional measures, and patient-reported outcomes. They will not be directly involved in research interventions or randomization. This study does not involve a research intervention, randomization, or alteration of clinical care. It is a retrospective cohort study analyzing existing standard-of-care documentation from ATI's physical therapy EMR. Data are collected via the investigators proprietary electronic medical record system and are synthetic to the clinical process that is, the data are collected in real-time with patients and the scores are immediately provided to the treating therapist as well as archived for later Registry and scientific use.

Multidirectional Isometric Assessment of the Hip

With the exception of the shoulder, the hip is among the most frequently injured areas in swimmers. Despite this, hip injuries are often overlooked in training and prevention programmes. Such neglect can cause significant damage to muscles, particularly the adductors, and the joint itself, potentially requiring arthroscopic surgery or even leading to secondary injuries in related structures such as the knee. Furthermore, hip strength and range of motion directly affect swimmers' underwater kicking speed. Although hip assessments are common in other sports, like football, for injury prevention and performance analysis-both dynamically and isometrically-isometric testing is particularly recommended due to its higher reproducibility. Therefore, this study aims to validate a multidirectional isometric hip test in swimmers and examine agonist-antagonist muscle ratios in young advanced swimmers. A comparative analysis will be conducted on 30 elite swimmers. This will include a descriptive analysis of the group and comparative analyses between breaststroke/non-breaststroke swimmers and between genders. Maximum isometric contractions of both lower limbs will be measured using a Chronojump force sensor (Boscosystem, Barcelona, Spain). Athletes will stand on a step positioned centrally within a rack or cage, either laterally or frontally depending on the movement assessed (ABD-ADD or flexion-extension, respectively). They will grip the appropriate supports with their hands and perform three maximal efforts of each movement lasting 3 seconds, without compensatory actions (any attempt with compensations will be discounted). There will be a 20-second rest between attempts. All three attempts will be recorded. To assess measurement reliability, tests will be repeated after 48 hours for subsequent comparison.

The Fast-track Centre for Hip and Knee Replacement Database

This is a prospective study-registry on preoperative patient characteristics and postoperative complications in patients having fast-track hip and knee replacement surgery in 8 Danish dedicated arthroplasty departments from all five health regions in Denmark. The registry consists of detailed patient and physician reported preoperative characteristics and including prescribed medication and lab results. Follow-up is based on electronical medical records by dedicated nurses with physician backup and includes Clavien-Dindo and Comprehensive Complication Index scoring. All patients having day-surgery also completes a patient reported questionaire on health-care utilization and return to work by day 30. Finally, a machine-learning algorithm for identification of "high-risk" patients based on he preoperative data is included.