Feasibility of Direct-Access Physical Therapy for Concussion Management in the Pediatric Emergency Department: A Pilot Implementation Study
Bibliographic record
Abstract
OBJECTIVES: The objective of this study was to determine the feasibility of implementing an interdisciplinary approach to concussion assessment and management, including direct-access pediatric physical therapy in the pediatric emergency department (PED), with regard to parental satisfaction with early concussion management, documentation of clinical information for prognosis, and service organization metrics. METHODS: This was a single-center retrospective analysis of prospectively collected data. Patients <18 years old presenting to the PED with a suspected concussion were included and either received care using the interdisciplinary model of care (pediatric physical therapy + usual care) or usual care alone, depending on their time of presentation to the PED (12 hours/week of pediatric physical therapy coverage). Clinical and administrative data were collected from the participants' medical record. In addition, a random sample of participants received a quality improvement survey administered over the phone. RESULTS: Three hundred and forty-seven patients were included in the study population (mean [SD] age = 7.56 [5.62] years), and 81 were seen by the pediatric physical therapist. Those seen by the pediatric physical therapist had a significantly higher average satisfaction score for the Family domain (94.69 [11.60]) of the Pediatric Quality of Life Health care Satisfaction scale, than those who were not (89.02 [20.17]), as well as for Overall satisfaction (pediatric physical therapy = 95.45 [12.34] vs usual care = 89.21 [21.21]). Prognostic information was collected more systematically in patients seen by the pediatric physical therapist. CONCLUSIONS: The presence of a pediatric physical therapist in the PED could improve early management of children presenting for suspected concussions. Further research will help determine factors related to sustainability and prepare for broader implementation. IMPACT: Physical therapists, shown to be a positive addition in adult emergency departments, mostly for musculoskeletal conditions, were introduced in a PED in an interdisciplinary model of concussion care and were associated with improvements in satisfaction, clinical information documentation, and service organization. LAY SUMMARY: The study investigated whether direct access to pediatric physical therapy in the pediatric emergency department (PED) would enhance parental satisfaction, early concussion management, documentation, and service organization. Conducted at a single center, it analyzed data from patients under 18 years old with suspected concussions, comparing those who received care from a pediatric physical therapist plus usual care to those who received only usual care. Results showed that parents of children seen by the pediatric physical therapist reported higher satisfaction, and prognostic information was more systematically collected, suggesting that incorporating pediatric physical therapists into the PED could improve overall care and service organization.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".