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Introduction Physical therapy's mission to improve the health of society (1) operates against overwhelming evidence for poorer health outcomes for individuals from minoritized groups. (2-6) To meet the complex health [...], Objective. The demographic homogeneity of the physical therapist workforce and its educational pathway may undermine the profession's potential to improve the health of society. Building academic environments that support the development of all learners is fundamental to building a workforce to meet societal health care needs. The Benchmarking in Physical Therapy Education study uses the Physical Therapy Graduation Questionnaire to comprehensively assess learner perceptions of the physical therapist academic environment. The present report examined whether racial and ethnic minoritized (REM) physical therapist learners perceive their doctor of physical therapy education differently from their non-REM peers. Methods. Five thousand and eighty graduating doctor of physical therapy learners in 89 institutions provided demographic data and perceptions of a range of learning environment domains. Analyses included REM versus non-REM comparisons as well as comparisons among individual race and ethnicity groups. Results. Compared with their non-minoritized peers, REM respondents expressed less satisfaction with their education and lower confidence in their preparedness for entry-level practice. REM respondents observed more faculty professionalism disconnects and demonstrated less agreement that their program had fostered their overall psychological well-being. REM respondents experienced higher rates of mistreatment than their peers and reported higher rates of exhaustion and disengagement, the 2 axes of academic burnout. Black/African American and Hispanic/Latino/a/x (Hispanic, Latino, Latina, and/or Latinx) respondents incurred significantly more educational debt than Asian and White respondents. REM respondents reported greater empathy and greater interest in working in underserved communities. Conclusion. REM respondents perceived the physical therapist learning environment more negatively than their non-minoritized peers but expressed strong interest in serving people from underserved communities. These national benchmarks offer academic institutions the opportunity to self-assess their own environment and to work to improve the quality of the educational experience for all learners. Impact. In a nationwide benchmarking study, learners from minoritized race and ethnicity backgrounds reported more negative experiences and outcomes during physical therapist education than their non-minoritized peers. These same learners demonstrated high empathy and interest in serving people from underserved (under-resourced) communities. Learning environments that permit all individuals to thrive may be an essential avenue to improve the health of a rapidly diversifying society. Keywords: Educational, Environment, Learners, Minoritized, Racial and Ethnic Minoritized, Respondents

Introduction Leaders in physical therapist education recently highlighted the essential role of educational research to 'identify processes that promote learner development and outcomes to meet the needs of society.' (1) [...], Objective. The Benchmarking in Academic Physical Therapy study uses the Physical Therapist-Graduation Questionnaire (PT-GQ) survey to develop comprehensive performance benchmarks for physical therapist education. These benchmarks facilitate interprofessional comparisons and have application to accreditation self-study reporting. The purpose of this study is to report updated benchmarks from enrollment Wave 2 of the study, with an emphasis on curricular areas that align with accreditation standards. Methods. Seventy doctor of physical therapy (DPT) programs (26.5% national sample) administered the survey to graduates during 2020-2021. Where possible, respondent data were contextualized by statistical comparison with published medical student data (Welch t test, Hedges g). Results. There were 1894 respondents who participated in the study (response rate: 63.9%). The average survey duration was 32.9 minutes. White-only, non-Hispanic/Latino/a/x individuals (78.8%) exceeded the 2020 US Census prevalence (60.1%), and only one-half of respondents perceived a benefit to their training from the diversity present in their programs. Over 94% of respondents indicated that their curricula were characterized by "problem solving/critical thinking" and "clinical reasoning," but nearly one-half indicated "busywork" was prevalent. High curricular satisfaction ratings clustered in content areas relating to profession-specific technical skills and low ratings clustered in foundational sciences. DPT respondents reported significantly lower tolerance for ambiguity, significantly more exhaustion, and significantly less disengagement than medical students. Respondents endorsed higher levels of "adaptive" perfectionism (striving for high performance) than "maladaptive" perfectionism (concern over negative evaluations). Respondents with loans (27.7%) had debt exceeding $150,000, the benchmark above which the DPT degree loses economic power. Conclusion. PT-GQ benchmarks revealed strengths (eg, curricula emphasizing problem solving/critical thinking and clinical reasoning) and challenges (eg, low diversity, problematic student debt) in physical therapist education. Impact. Programs can use benchmarking for quality-improvement efforts and as a data source for accreditation self-study reports. The ongoing study will refine national benchmarks and pilot items to address new research questions. Keywords: Benchmarking, Doctor of Therapy, Physical, Respondents, Survey, Therapists

Introduction From its earliest days, physical therapy has endorsed a personalized, patient-centered approach. Astute clinicians have always understood that the patient's emotional state, family dynamics, work circumstances, genetic predisposition, and [...], Epigenetic processes enable environmental inputs such as diet, exercise, and health behaviors to reversibly tag DNA with chemical "marks" that increase or decrease the expression of an individual's genetic template. Over time, epigenetic adaptations enable the effects of healthy or unhealthy stresses to become stably expressed in the tissue of an organism, with important consequences for health and disease. New research indicates that seemingly non-biological factors such as social stress, poverty, and childhood hardship initiate epigenetic adaptations in gene pathways that govern inflammation and immunity, two of the greatest contributors to chronic diseases such as diabetes and obesity. Epigenetic processes therefore provide a biological bridge between the genome--an individual's genetic inheritance--and the Social Determinants of Health--the conditions in which they are born, grow, live, work, and age. This Perspective paper argues that physical therapy clinicians, researchers, and educators can use the theoretical framework provided by the International Classification of Functioning, Disability, and Health (ICF model) to harmonize new discoveries from both public health research and medically focused genomic research. The ICF model likewise captures the essential role played by physical activity and exercise, which initiate powerful and widespread epigenetic adaptations that promote health and functioning. In this proposed framework, epigenetic processes transduce the effects of the social determinants of health and behaviors such as exercise into stable biological adaptations that affect an individual's daily activities and their participation in social roles. By harmonizing "nature" and "nurture," physical therapists can approach patient care with a more integrated perspective, capitalizing on novel discoveries in precision medicine, rehabilitation science, and in population-level research. As the experts in physical activity and exercise, physical therapists are ideally positioned to drive progress in the new era of patient-centered population health care. Keywords: DNA, Genomics, Precision Medicine, Precision Rehabilitation, RNA, Social Determinants of Health

Introduction Optimal human movement begins with precise muscle contractions. Regular muscle activity is now recognized as a powerful intervention to restore movement, manage pain, recover from injury, and prevent or [...], Objective. Physical therapists develop patient-centered exercise prescriptions to help overcome the physical, emotional, psychosocial, and environmental stressors that undermine a person's health. Optimally prescribing muscle activity for people with disability, such as a spinal cord injury, is challenging because of their loss of volitional movement control and the deterioration of their underlying skeletal systems. This report summarizes spinal cord injury-specific factors that should be considered in patient-centered, precision prescription of muscle activity for people with spinal cord injury. This report also presents a muscle genomic and epigenomic analysis to examine the regulation of the proliferator-activated receptor [gamma] coactivator 1[alpha] (PGC-1[alpha]) (oxidative) and myostatin (hypertrophy) signaling pathways in skeletal muscle during low-frequency (lower-force) electrically induced exercise versus higher-frequency (higher-force) electrically induced exercise under constant muscle recruitment (intensity). Methods. Seventeen people with spinal cord injury participated in 1 or more unilateral electrically induced exercise sessions using a lower-force (1-, 3-, or 5-Hz) or higher-force (20-Hz) protocol. Three hours after the exercise session, percutaneous muscle biopsies were performed on exercised and nonexercised muscles for genomic and epigenomic analysis. Results. We found that low-frequency (low-force) electrically induced exercise significantly increased the expression of PGC-1[alpha] and decreased the expression of myostatin, consistent with the expression changes observed with high-frequency (higher-force) electrically induced exercise. Further, we found that low-frequency (lower-force) electrically induced exercise significantly demethylated, or epigenetically promoted, the PGC-1[alpha] signaling pathway. A global epigenetic analysis showed that >70 pathways were regulated with low-frequency (lower-force) electrically induced exercise. Conclusion. These novel results support the notion that low-frequency (low-force) electrically induced exercise may offer a more precise rehabilitation strategy for people with chronic paralysis and severe osteoporosis. Future clinical trials are warranted to explore whether low-frequency (lower-force) electrically induced exercise training affects the overall health of people with chronic spinal cord injury. Keywords: Disability, Hypertrophy, Molecular, Muscle, Plasticity, Rehabilitation

Introduction Physical therapist education is a complex endeavor that transforms students with strong academic and affective intelligence into entry-level health care providers who are ready for the complexities of clinical [...], Objective. Academic physical therapy has no universal metrics by which educational programs can measure outcomes, limiting their ability to benchmark to their own historical performance, to peer institutions, or to other health care professions. The PT-Graduation Questionnaire (GQ) survey, adapted from the Association of American Medical Colleges' GQ, addresses this gap by offering both inter-professional insight and fine-scale assessment of physical therapist education. This study reports the first wave of findings from an ongoing multi-site trial of the PT-GQ among diverse academic physical therapy programs, including (1) benchmarks for academic physical therapy, and (2) a comparison of the physical therapist student experience to medical education benchmarks. Methods. Thirty-four doctor of physical therapy (DPT) programs (13.2% nationwide sample) administered the online survey to DPT graduates during the 2019 to 2020 academic year. PT-GQ and Association of American Medical Colleges data were contrasted via Welch's unequal-variance t test and Hedges g (effect size). Results. A total of 1025 respondents participated in the study (response rate: 63.9%). The average survey duration was 31.8 minutes. Overall educational satisfaction was comparable with medicine, and respondents identified areas of curricular strength (eg, anatomy) and weakness (eg, pharmacology). DPT respondents provided higher ratings of faculty professionalism than medicine, lower rates of student mistreatment, and a lesser impact of within-program diversity on their training. One-third of respondents were less than "satisfied" with student mental health services. DPT respondents reported significantly higher exhaustion but lower disengagement than medical students, along with lower tolerance for ambiguity. Of DPT respondents who reported educational debt, one-third reported debt exceeding $150,000, the threshold above which the DPT degree loses economic power. Conclusions. These academic benchmarks, using the PT-GQ, provided insight into physical therapist education and identified differences between physical therapist and medical student perceptions. Impact. This ongoing trial will establish a comprehensive set of benchmarks to better understand academic physical therapy outcomes. Keywords: Academic Assessment, Tolerance for Ambiguity, Student Experience, Student Exhaustion, Student Empathy, Student Disengagement, Debt, Curriculum, CAPTE Accreditation

Physical therapists prescribe physical activity/exercise to improve cell, tissue, organ, and system function to advance the health and well-being of individuals. Our mechanistic understanding of the ways in which our [...], One of the newest frontiers of physical therapy is the field of epigenetics, which examines how pervasive environmental factors such as exercise regulate the expression of genes. The epigenome may be one of the most powerful systems through which exercise exerts its beneficial effects on health and longevity. Large epidemiology studies show that individuals who regularly exercise demonstrate a lower "epigenetic age," experience fewer metabolic diseases, and enjoy greater longevity. However, the dose, mode, intensity, and duration of exercise required to achieve a healthy epigenetic profile is unknown. As experts in exercise prescription, physical therapists are ideally suited to contribute to the discovery of this dose-response relationship. This perspective makes a case for the genesis of "precision physical therapy," which capitalizes on epigenetic discoveries to optimize exercise-based interventions. Summarized here is the emerging body of knowledge supporting epigenetic adaptations to exercise in humans, including the intriguing possibility that these environmentally modified traits could be passed down to offspring. In the future, it is likely that epigenetic data will enhance our understanding of individual disease risk and individual response to prescribed exercise. The profession of physical therapy must be alert to new epigenetic knowledge that can enhance the specificity and efficacy of movement-based treatments.

To meet requirements for accreditation, physical therapist academic programs conduct self-assessment analyses to gauge the quality of their educational environment. Each program tailors its quality-assessment strategies toward its own individual [...], Background. Identifying excellence in physical therapist academic environments is complicated by the lack of nationally available benchmarking data. Objective. The objective of this study was to compare a physical therapist academic environment to another health care profession (medicine) academic environment using the Association of American Medical Colleges Graduation Questionnaire (GQ) survey. Design. The design consisted of longitudinal benchmarking. Methods. Between 2009 and 2017, the GQ was administered to graduates of a physical therapist education program (Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, The University of Iowa [PTRS]). Their ratings of the educational environment were compared to nationwide data for a peer health care profession (medicine) educational environment. Benchmarking to the GQ capitalizes on a large, psychometrically validated database of academic domains that may be broadly applicable to health care education. The GQ captures critical information about the student experience (eg, faculty professionalism, burnout, student mistreatment) that can be used to characterize the educational environment. This study hypothesized that the ratings provided by 9 consecutive cohorts of PTRS students (n = 316) would reveal educational environment differences from academic medical education. Results. PTRS students reported significantly higher ratings of the educational emotional climate and student-faculty interactions than medical students. PTRS and medical students did not differ on ratings of empathy and tolerance for ambiguity. PTRS students reported significantly lower ratings of burnout than medical students. PTRS students descriptively reported observing greater faculty professionalism and experiencing less mistreatment than medical students. Limitations. The generalizability of these findings to other physical therapist education environments has not been established. Conclusions. Selected elements of the GQ survey revealed differences in the educational environments experienced by physical therapist students and medical students. All physical therapist academic programs should adopt a universal method to benchmark the educational environment to understand the student experience.

Richard K Shields, PT, PhD, has contributed to the physical therapy profession as a clinician, scientist, and academic leader (Fig. 1). Dr Shields is professor and department executive officer of [...]

Most rehabilitation specialists will be familiar with the term 'personalized medicine,' which was coined in the 1990s to capture the clinical promise of the Human Genome Project. (1) By sequencing [...]

The American Physical Therapy Association (APTA) provided funding for a series of meetings among a small group of leaders representing the research and clinical communities whose task was to plan [...]

In its recent history, the physical therapy profession embarked on at least 2 attempts to create a research agenda. The first attempt occurred in December 1993 when a panel of [...]

Background and Purpose The interpretation of the results of previous anti-osteoporosis interventions after spinal cord injury (SCI) is undermined by incomplete information about the intervention dose or patient adherence to [...]

Hemicorporectomy (HCP), also called 'translumbar amputation,' is a radical and disfiguring procedure in which the lower extremities, bony pelvis, external genitalia, rectum, and bladder are surgically removed. (1) This procedure [...], Background and Purpose. The long-term management following an hemicorporectomy (HCP) is not well documented in the scientific literature. The purpose of this case report is to describe the 25-year history of a man with a spinal cord injury who experienced severe musculoskeletal deterioration and hemicorporectomy. Case Description. The client sustained T10 complete paraplegia at age 18 years, developed severe decubitus ulcers, and required an HCP as a lifesaving measure 13 years later. The authors describe the chronology of several rehabilitation and prosthetic strategies and speculate on factors that may have contributed to their successes and failures. Outcomes. The client survived 12 years after the HCP and returned to independent mobility, self-care, and schooling despite complications with continued skin breakdown. Over the 12 years following discharge from the hospital after the spinal cord injury, he spent 749 days in the hospital. During the 12 years he lived after discharge from the hospital following the HCP, he was hospitalized 190 days. Discussion. The authors discuss factors contributing to the client's musculoskeletal deterioration including chronic wounds, postural deviations, and incomplete adherence to pressure-relief recommendations and raise considerations for physical therapists who treat patients after HCP. [Shields RK, Dudley-Javoroski S. Musculoskeletal deterioration and hemicorporectomy after spinal cord injury. Phys Ther. 2003;83:263-275.] Key Words: Decubitus ulcers, Hemicorporectomy, Secondary complications, Spinal cord injury.

Key Words: Chronic inflammatory demyelinating polyneuropathy; Chronic peripheral neuropathy; Exercise, strengthening and aerobic; Health-related quality of life; Impairments. Persons with chronic peripheral neuropathies often are given home exercise programs that [...], Background and Purpose. The effects of a home exercise program for persons with chronic peripheral neuropathies (CPN) have not been documented. We compared changes in impairment and health-related quality of life (HRQL) between exercise and control groups, investigated the relationship between HRQL and measures of impairment, and contrasted the HRQL of individuals with CPN to that previously described for the general population. Subjects. Twenty-eight subjects with CPN, aged 23 to 84 years (¦X=56.2, SD=14.9), completed the study. Methods. Impairment measures included average muscle score (AMS), handgrip force, walking time, and forced vital capacity. The HRQL instrument measured the eight scales of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the component scales. The exercise group (n=14) completed a 6-week home exercise program. The control group (n=14) did not participate in a home exercise program. Results. There was an increase in the AMS in the exercise group compared with the control group. No other between-group differences were found. The exercise group improved in scores on the role limitation scales of the SF-36. The AMS and walking time were moderately correlated with the physical function scale of the SF-36 (r=.55 and -.62, respectively). The SF-36 scores of individuals with CPN were lower than scores previously described for the general population. Conclusion and Discussion. The home exercise program appears to be an important component of the treatment of persons with CPN. Compared with the general population, patients with CPN appear to have a lower HRQL, but some areas appear to improve following a home exercise program. [Ruhland JL, Shields RK The effects of a home exercise program on impairment and health-related quality of life in persons with chronic peripheral neuropathies. Phys Ther. 1997:77:1026-1039.1

Key Words: Health-related quality of life, Outcome measures, Psychometric properties. Vestibular disease. Dizziness accounts for 8 million primary care visits to physicians in the United States annually.[1] Vestibular system disorders [...], Background and Purpose. The Dizziness Handicap Inventory (DHI) is a condition-specific health status measure for persons with vestibular disease, and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) is a generic health status assessment. The purposes of this study were (1) to describe the relationship between the DHI and the SF-36, (2) to examine the reliability and responsiveness of these measures for persons in a vestibular rehabilitation program, and (3) to compare health-related quality of life between individuals with vestibular disease and the general population. Subjects. Ninety-five patients, aged 25 to 88 years (¦ X=57.0, SD=14.9), were assessed. Methods. To determine reliability, 20 subjects completed both questionnaires twice, 24 to 48 hours apart. Thirty-one subjects completed both questionnaires before and after 6 to 8 weeks of vestibular rehabilitation to establish responsiveness. To establish the relationship between the two assessment tools, 95 subjects completed both questionnaires. Results. Each test was moderately to highly reliable (intraclass correlation coefficients [2,1]=.64-.95), but the tests were poorly to moderately correlated to each other (r =.11-.71). The DHI was more responsive to change than the SF-36. The SF-36 scores of individuals were lower than scores of the general population. Conclusion and Discussion. The DHI and the SF-36 provide reliable and responsive measurements, but they appear to provide different information about the health status of patients with vestibular disease. Compared with the general population, patients with vestibular disease had lower scores for health-related quality of life, but these scores improved after 6 to 8 weeks of treatment. Future studies should clarify whether this improved health status is due to vestibular rehabilitation. [Enloe LJ, Shields RK. Evaluation of health-related quality of life in individuals with vestibular disease using disease-specific and general outcome measures. Phys Ther. 1997;77:890-903.]

We developed a physical therapy computerized clinical practice database to study physical therapy outcomes. The information retrieved from any database, however, is only as good as the quality of the [...], Background and Purpose. High-quality measurements are needed to develop meaningful clinical practice databases to assess the effectiveness of physical therapy. This study determined the reliability, validity, and responsiveness of measurements obtained with five functional tests graded with the newly developed Iowa Level of Assistance Scale. Subjects and Methods. Eighty-six patients with total hip or knee replacements were tested at various time periods during their hospitalization. Patients were tested for five functional activities by four therapists to establih the reliability and test responsiveness. The Harris Hip Rating Scale was administered to assess the validity of the functional score. Results. The weighted Kappa statistic supported good intratester (K=. 79-.90) and moderate intertester (K=.48-.78) reliability. The correlation between the Harris Hip Rating Scale scores and the total functional scores was high (r= -.86). The total functional score was responsive to 4 days of therapy post-operatively. Conclusion and Discussion the assessment of function using the Iowa Level of Assistance Scale was shown to be highly reliable, valid, and responsive in patients following total hip or knee replacements.

The incidence of low back disorders is now such that the cost of this problem in the United States alone is estimated at between $20 and $50 billion annually.[1] Although [...], Background and Purpose. The purpose of this study was to determine the intertherapist reliability of judgments of stiffness and pain at L-1 to L-5 made using posteroantenor (PA) central pressure testing. Subjects. Three pairs of manipulative physical therapists with a minimum of 5 years of experience were asked to rate pain and stiffness in a total of 90 patients with low back pain. Methods. Each pair of therapists assessed 30 patients within their own clinic, using their preferred technique to perform an examination using the PA central pressure test at the five lumbar levels. Each pair of therapists recorded their ratings of pain and stiffness. Reliability of judgments was evaluated by intraclass correlation coefficients (ICC) and percentage of exact agreement scores. Results. The ICC values for pain judgments for the group as a whole ranged from .67 to .72, with agreement scores ranging from 31% to 43%. The ICC values for stiffness judgments ranged from .03 to .37, with agreement scores ranging from 21% to 26%. Conclusion and Discussion. Judgments of stiffness made by experienced manipulative physical therapists examining patients in their own clinics were found to have poor reliability, whereas pain judgments bad good reliability. Further investigation of this test is required in order to develop a more reliable method of assessing PA stiffness.

Key Words: Computers, Database management systems, Outcome and process assessment (health care), Physical disability. In December 1986, the Department of Physical Therapy at the University of Iowa Hospitals and Clinics [...], Clinical practice databases are frequently used to assess outcomes in various medical specialties. Formulating a computerized physical therapy medical record requires standardization of clinical assessments among the users. The purpose of this article is to describe an acute care physical therapy database system that emphasizes high-quality measures of function. The logic underlying the development of a physical therapy computerized medical record is described. Selected uses of the database are demonstrated by projects that assess data quality, generate clinical hypotheses, manage clinical data, develop clinical measures, and generate pilot data on patient variability. Patients seen in physical therapy for total joint replacement, pain, and decreased ambulation were studied to demonstrate some of the present capabilities of the database Clinical practice databases contribute to the overall research mission, provided the data are of high quality. The use of databases in conjunction with randomized clinical trials may serve an important role in determining effective physical therapy interventions to reduce disability. [Shields RK Leo KC, Miller B, et al. An acute care physical therapy clinical practice database for outcomes research. Phys Ther. 1994;74:463-470.]

Key Words: Buttocks, Lumbosacral region, Skin conditions, Spinal cord dysfunction, Spinal cord injuries, Ulcer. Pressure sores, one of the major complications facing individuals with spinal cord injury (SCI), occur over [...], We compared the effects of different lumbar support thicknesses on seated buttock pressure in individuals with and without spinal cord injury (SCI). Eighteen subjects with SCI (SCI group) and 18 subjects without SCI (control group) were seated on a pressure-sensing transducer incorporated into an adjustable chair The output was calibrated so that eight pressure intervals (colors) were displayed. The lumbar support thickness was adjusted to 0, 2.5, 5, and 7.5 cm, and the highest and lowest seated buttock pressures were analyzed. External measurements of the hip angle were taken for each lumbar support condition. High reliability of repeated seated test positions was found (intraclass correlation coefficient=.93). The 5- and 7.5-cm-thick lumbar supports caused a decrease in the highest pressure areas in the control group, but no change in the SCI group. The hip angle was increased with each increment in lumbar support thickness in both groups, but the SCI group's hip angle was consistently less than that of the control group for each lumbar support condition. The results of this study suggest that in individuals with chronic paralysis ([equal to or greater than] 3 years), the use of a wheelchair lumbar support bas a negligible effect on seated buttock pressure. [Shields RK, Cook TM Lumbar support thickness effect on seated buttock pressure in individuals with and without spinal cord injury Phys Ther 1992,72 218-2261

In 2002, the Sarbanes-Oxley Act (SOX) (Pub.L. 107-204, 116 Stat 745) was passed in direct response to a number of high-profile cases of accounting improprieties in major corporations. (1) Governing [...]

Key Words: Cross-training, Fatigue, Handgrip, Low-frequency, Muscle fatigue, Resistance training. Training specificity refers to improvements in a task that are a unique function of the variables chosen for an exercise [...], Background and Purpose. Exercise programs are more likely to be successful when they are based on research that predicts the outcomes of such training. This study determined the effect of submaximal rhythmic handgrip training on rhythmic handgrip endurance or work (RHW), isometric handgrip endurance time (IHE), and maximal voluntary isometric contraction for the handgrip force (MVIC) (in newtons). Subjects. Twenty-four male subjects (mean age = 26.2 years) with right-hand dominance were randomly assigned to a regular training group (n = 8), a low-level training group (n = 8), or a control group (n = 8). Methods. Rhythmic handgrip work, IHE, and MVIC were determined bilaterally before and after 6 weeks of a rhythmic right handgrip training program using 30% of MVIC. The low-level training group performed daily training with a near-zero load ([is less than] 0.005% of MVIC). Results. There was a 1,232% increase in RHW and an 8% decrease in IHE after the training program using 30% of MVIC for the right hand. The left hand showed a 43% increase in RHW after training, whereas the low-level training group showed a 35% increase in RHW. No differences were found between the change in the left-hand RHW of the regular training group and the change in the right-hand RHW of the low-level training group, but both measurements were greater than the change in the control group (6.4%). Conclusion and Discussion. Submaximal handgrip endurance training at 30% of MVIC had a minimal effect on submaximal IHE and MVIC of the handgrip, but it had a large effect on RHW of the trained extremity. The regular training group and the low-level training group showed similar increases in cross-education, suggesting that cross-education during endurance training is not intensity-dependent. [Shields RK, Leo KC, Messaros AJ, Somers VK. Effects of repetitive handgrip training on endurance, specificity, and cross-education. Phys Ther. 1999;79:467-475.]

Advancing rehabilitation research capacity involves understanding the plasticity of neuromuscular tissue, discovering the intervention and dose necessary to adapt the neuromuscular tissue, and verifying that the induced adaptation translates into [...]

I would like to compliment the multidisciplinary Program Committee and all those who took part in this Summit. The vision, organization, and written documentation are important first steps in developing [...]