Thomas Gus Almonroeder

Importance: Physical therapists routinely make discharge recommendations for patients in the hospital, yet the reasoning that drives these decisions is poorly characterized. Objective: The objective was to describe contemporary acute care physical therapists’ discharge reasoning and examine associations between reasoning constructs and recommended discharge intensity. Design: This study used a cross-sectional clinical vignette-based survey. Therapists provided a discharge recommendation and supporting rationale. Free-text rationales were analyzed using directed content analysis, and quantitative associations between coded reasoning constructs and discharge recommendation intensity were examined using regression modeling. Setting: The survey was conducted electronically with United States physical therapists practicing in hospitals. Participants: Participants were eighty-nine acute care physical therapists who completed discharge recommendations and free-text rationales for 10 vignettes. Interventions: none Main outcomes: The three main outcomes for this study included: (1) Frequency and co-occurrence of coded reasoning constructs; (2) therapist-level reasoning profiles; and (3) associations between constructs and discharge intensity. Results: Across 1604 construct code applications, 3 constructs dominated discharge reasoning: therapist prior experience (29.6%), patient functioning and disability (26.3%), and patient life context (25.3%). The majority (69.7%) of therapists demonstrated mixed reasoning patterns while less than one-third demonstrated a dominant reasoning profile. Patient functioning and disability was the only construct statistically associated with recommending more intensive post-acute care in ordered (OR = 1.70; 95% CI = 1.22–2.39) and binary (OR = 2.21; 95% CI = 1.30–3.74) models. Conclusions: Acute care discharge reasoning concentrates on functional status, professional experience, and patient life context, with other domains functioning mainly as situational amplifiers. Relevance: A refined framework for discharge reasoning may support clearer interdisciplinary communication, inform targeted education, and guide efforts to optimize post-acute care utilization.

Knapp, ZR, Minger, AJ, Trent, RA, Sandvik, JE, Mihalik, JD, Dobbs, WC, McBride, SP, and Almonroeder, TG. Relationships between countermovement jump metrics and skating speed among male and female collegiate hockey athletes. J Strength Cond Res XX(X): 000–000, 2026—The purpose of this exploratory study was to examine the extent to which lower-body power, propulsive force, velocity, jump height, and reactive strength during a countermovement jump (CMJ) are related to skating speed among male and female collegiate ice hockey athletes. Twenty-six male and 22 female collegiate hockey athletes participated in this cross-sectional study. Athletes completed CMJ testing on a force platform and an on-ice skating speed test. CMJ-derived variables included peak power, mean power, peak force, mean force, peak velocity, jump height, and the modified reactive strength index. Pearson product-moment correlation analyses were conducted separately for men and women to examine relationships between CMJ metrics and average skating speed. Faster skating speed was associated with greater peak/mean power, peak velocity, jump height, and reactive strength for both men and women ( r ≥ 0.43). By contrast, the relationships between skating speed and peak force ( r ≤ 0.13) and mean force ( r ≤ 0.30) were weak, with 95% confidence intervals spanning 0. Greater lower-body power was associated with faster skating speed in both male and female collegiate hockey athletes; this relationship seemed to be driven primarily by movement velocity rather than propulsive force magnitude. These findings suggest that the ability to rapidly generate force may be more relevant to skating speed than force production alone. In addition, jump height may serve as a practical off-ice metric for monitoring neuromuscular qualities related to skating speed when on-ice testing is not feasible.

The primary aim of this study was to examine pitching performance metrics before and after ulnar collateral ligament reconstruction (UCLR) among Major League Baseball (MLB) starting and relief pitchers. The following information was extracted from the “Tommy John Surgery List” database regarding UCLR surgeries among MLB pitchers: UCLR date, pitcher type (starting pitcher, relief pitcher), and age at time of UCLR. Pitching performance metrics were extracted from the Baseball Savant online platform for the two seasons immediately prior to UCLR (pre) and the two seasons immediately following returning to pitching after UCLR (post). Fifty-nine pitchers were included in this study (29 starting pitchers, 30 relief pitchers). The outcome measures included the number of pitches thrown, earned run average (ERA), walks plus hits per inning pitched (WHIP), strikeout percentage, whiff percentage, walk percentage, batting average against, ground ball percentage, and fastball velocity. There was a pitcher type-by-time interaction effect for ERA (p = 0.01; η² = 0.12) and WHIP (p = 0.01; η² = 0.12). Starting pitcher ERA increased from 3.68 to 4.40 from pre- to post-surgery, while relief pitcher ERA decreased from 4.47 to 3.90. In addition, starting pitcher WHIP increased from 1.22 to 1.29 from pre- to post-surgery, while relief pitcher WHIP decreased from 1.38 to 1.28. There was a main effect of time for pitches thrown (p = 0.04; η² = 0.07). Significant differences between starting and relief pitchers were observed for changes in ERA and WHIP following UCLR, whereas no pitcher type-by-time interactions were observed for the remaining performance metrics. Both starting and relief pitchers threw fewer pitches following UCLR, while fastball velocity and other key pitching performance metrics remained largely unchanged.

Purpose: The objectives of this study were to develop a 2-item abbreviated version of the Program Sense of Belonging questionnaire (ProSBq) and to evaluate its ability to identify student physical therapists with relatively low valued competence and social acceptance.Methods: A cross-sectional study was conducted using survey data from 634 students enrolled in physical therapist education programs across the United States. The 10-item ProSBq was used to assess 2 dimensions of belonging: valued competence and social acceptance. Principal component analysis was performed to identify representative items for each subscale, with 1 item selected per subscale. Pearson product-moment correlations were used to examine relationships between the single items and their corresponding subscale scores. Classification performance was evaluated by assessing how accurately the single-item responses classified students reporting a relatively low sense of valued competence and social acceptance, based on their full ProSBq subscale scores. Multiple single-item response thresholds were examined to assess classification accuracy.Results: The single items demonstrated strong relationships with their corresponding subscale scores (r=0.63–0.80, with part-whole correction). For valued competence, sensitivity increased from 53.6% to 92.9%, whereas specificity decreased from 96.3% to 73.5% when a more inclusive threshold was used. A similar sensitivity-specificity tradeoff was observed for social acceptance. Receiver operating characteristic curve analyses demonstrated excellent discrimination (area under the curve ≥0.90).Conclusion: Single ProSBq items demonstrated strong relationships with full valued competence and social acceptance subscale scores and acceptable classification performance. The abbreviated 2-item ProSBq may provide a practical and efficient method for identifying students experiencing low valued competence or social acceptance.

Introduction.: A strong sense of belonging has been shown to play a critical role in students' academic success and mental well-being. Developing tools to assess belongingness among student physical therapists may help to identify those who are at risk for academic struggles and mental health challenges, as well as to evaluate the impact of interventions designed to foster belongingness. Review of Literature.: The Program Sense of Belonging (ProSB) questionnaire was developed to assess student physical therapists' sense of belonging within their educational program. A preliminary analysis of the ProSB questionnaire identified a two-factor structure, with dimensions of “social acceptance” and “valued competence.” The purpose of this study was to further evaluate the factor structure and construct validity of the ProSB questionnaire using exploratory (EFA) and confirmatory (CFA) factor analysis. Subjects.: A total of 634 student physical therapists completed the ProSB questionnaire as part of an anonymous online survey. Methods.: Half of the responses were used for EFA (n = 317) and the other half for CFA (n = 317). Exploratory factor analysis was first conducted to evaluate the factor structure of the ProSB questionnaire. Confirmatory factor analysis was then performed to determine whether the factor structure identified through EFA was supported in an independent subsample of students. Results.: Exploratory factor analysis yielded a 2-factor structure, with dimensions of social acceptance and valued competence. Confirmatory factor analysis model fit indices suggested acceptable model fit (comparative fit index = 0.96 and standardized root mean square residual = 0.04), with all items loading significantly ( P < .001) on their respective factors. Discussion.: Our findings support the construct validity of the ProSB questionnaire as a multidimensional measure of program-level belongingness among student physical therapists. Conclusion.: The ProSB questionnaire appears to be a psychometrically sound tool for assessing program-level sense of belonging among student physical therapists, with potential applications in research, program evaluation, and student support initiatives.

The lack of normative data for single-leg vertical jump testing makes it challenging to determine when an injured athlete has achieved a level of interlimb symmetry that is within normal limits. The purpose of this study was to establish normative values for single-leg vertical jump height interlimb symmetry based on data from uninjured adolescent athletes. One hundred seventy three uninjured adolescent athletes completed single-leg vertical jump testing with both limbs. Descriptive statistics were generated to summarize the percent differences in jump heights between the limbs (interlimb symmetry) for the male and female athletes. Having normative data available will help clinicians assess injured athletes’ recovery.

Background: Meniscus injuries often accompany anterior cruciate ligament (ACL) tears. However, little is known about how different surgical approaches to treat concomitant meniscus injuries impact hop performance after ACL reconstruction. Purpose: The purpose of this study was to compare hop test inter-limb symmetry for patients who had undergone ACL reconstruction without an associated meniscal surgery, patients who had undergone ACL reconstruction with a meniscus repair, and patients who had undergone ACL reconstruction with a partial meniscectomy. Study Design: Cross-sectional study Methods: Hop test data collected at the time of return-to-sport testing (average of 6.4 ± 1.4 months after surgery) was extracted from electronic medical records for 192 patients who had undergone ACL reconstruction. Of these patients, 102 had undergone an isolated ACL reconstruction, 60 had undergone an ACL reconstruction along with a meniscus repair, and 30 had undergone an ACL reconstruction along with a partial meniscectomy. Analysis of variance was used to compare limb symmetry indices for the single- and triple-hop tests. These limb symmetry indices reflected the ratio of the hop distance for the involved limb relative to the uninvolved limb, expressed as a percentage. Results: The sample was comprised of 100 males and 92 females. Their average age was 20.6 ± 8.2 years. There were significant differences among the groups for the single-hop test (p = 0.031) and triple-hop test (p = 0.024) limb symmetry indices. For both tests, the patients who had undergone ACL reconstruction with a partial meniscectomy tended to exhibit greater deficits in hop performance for their involved limb (relative to their uninvolved limb), compared to those without a meniscal injury and those who had undergone meniscus repair. Conclusions: The results of this study suggest that patients who undergo ACL reconstruction along with a partial meniscectomy tend to experience less complete and/or delayed recovery of involved-limb hop performance, which could reflect more persistent deficits in lower body power. Level of Evidence: 3

Introduction.: National Physical Therapy Examination (NPTE) first-time pass rates are trending downward in recent years. As a result, there is a need for programs to identify ways to promote improved NPTE performance among their graduates. Review of Literature.: Previous studies have identified factors that can be used to predict an individual's chances of passing the NPTE. However, to our knowledge, there are no published studies describing interventions designed to improve NPTE performance. The purpose of this study was to examine the impact of a novel intervention, which involved providing students with an individualized predicted NPTE score combined with faculty advising to support their NPTE preparation. Subjects.: This study included members of 6 consecutive cohorts (190 total graduates) from an entry-level doctoral physical therapist education program. Methods.: The members of the first 3 cohorts served as historical controls, while the final 3 cohorts received the intervention (experimental cohorts). The intervention involved using a regression model to predict students’ NPTE scores based on their prior academic performance. Faculty then shared these predicted scores with students and provided individualized advising to support their NPTE preparation. Regression analyses were conducted to compare NPTE performance for the control and experimental cohorts, while accounting for between-group differences in academic performance. Results.: On average, the experimental cohorts performed 25.9 points higher on the NPTE and had over 5 times greater odds of passing the NPTE, compared to those in the control cohorts, after accounting for the covariates within the regression models. Discussion and Conclusion.: Our intervention, which combined providing students with their predicted NPTE scores and faculty advising to support students’ NPTE preparation, was feasible to implement without requiring extensive additional resources. It appears that our novel intervention is a viable approach for promoting improved first-time NPTE performance.