Bibliometric Analysis of Articles Published in Physical Therapy, 1980 –2009

eAppendix.
Domain Codes and Definitions

Type of Article
Research reports: articles that collected or analyzed primary data, such as clinical and laboratory trials, as well as
systematic reviews.

Topical reviews: articles that describe general or specific topics and do not involve collection of primary data.
Examples include nonsystematic literature reviews and clinical or professional perspectives.

Case reports: articles that describe clinical practice, such as case studies and case series.

Type of Participants
Human–symptomatic adults: humans aged 18 years or older with current symptomatic clinical condition.

Human–asymptomatic adults: “normal” or asymptomatic humans aged 18 years or older.

Human–combined adults: both symptomatic and asymptomatic adults.

Human–health care practitioners: medical or health-related practitioners, including students, assessed in a profes-
sional capacity.

Human–symptomatic children: humans aged 17 years or younger with current symptomatic clinical condition.

Human–asymptomatic children: “normal” or asymptomatic humans aged 17 years or younger.

Human–combined children: both symptomatic and asymptomatic children.

Animals: awake or anesthetized nonhuman animals.

Tissue: removed tissue or fluid, such as biopsies, blood, cadavers, synovium, urine.

None: participants were not enrolled in study.

Physical Therapy Focus Area*

Cardiopulmonary: articles focused on the area of cardiopulmonary specialty practice.

Education: articles focused on the area of preprofessional and postprofessional educational development, including
curriculum concepts, teaching and learning styles, and professional behaviors.

Integumentary: articles focused on the area of integumentary specialty practice.

Musculoskeletal: articles focused on the area of musculoskeletal specialty practice.

Neurological: articles focused on the area of neurological specialty practice.

Physical therapist practice and policy: articles focused on the area of physical therapy standards of practice,
including legal/ethical considerations, workplace safety, administration, policy/procedures, health promotion, fiscal
management, and documentation.

Research: articles focused on the instruction of obtaining, utilizing, conducting, or interpreting rehabilitation
research, study methods, research design, and statistical analysis.

* To assist with coding of this domain, 3 questions were asked regarding each article:
Question 1: Is it clear from brief review of title or abstract what is the area of focus? If not, go to question 2.
Question 2: Is a clinical population involved or described in study? If so, code the article based on the clinical population. If not, go to question 3.
Question 3: Is a clinical or therapeutic technique utilized or described? If so, code the article based on the primary technique/intervention.
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Research Design
Research Design Algorithm

Question 1. Was the study a review?

1. If yes3question 2

2. If no3question 3

Question 2. Was a systematic search conducted and reported?

1. If yes3code as systematic review OR meta-analysis

2. If no3code as nonsystematic review

Question 3. If non-review, what was the aim of the study?

1. To simply describe a population3code as descriptive (choose best option)

2. To quantify the relationship among factors3code as analytical. If participants were randomly assigned to groups or order of testing of multiple
conditions, choose experimental (randomized controlled OR within-subject). If nonexperimental, go to question 4.

For observational, analytical studies, the main types will depend on the timing of the measurement of outcome.

Question 4. When were the outcomes determined?

1. Sometime after the exposure or intervention3prospective

2. At the same time as the exposure or intervention3cross-sectional

3. Before the exposure was determined3retrospective

Research Design Tree

All Studies

Review Non-review

Systematic Non-
systematic Descriptive Analytical

Systematic Meta-analysis Case Experimental Observational

series

Case Randomized- Cross- Prospective Retrospective

report controlled sectional

Qualitative Within-subjects

Survey

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Purpose of Article
Anatomy/physiology: articles informing or examining new or existing information on foundational and theoretical
information, such as basic anatomy, pathoanatomy, kinesiology, motor behavior/learning, and physical, emotional,
psychological, physiological, or pathophysiological processes and responses. Includes studies examining aspects of
interventions utilizing asymptomatic participants in nonclinical or laboratory settings.

Etiology: articles informing or examining the incidence, prevalence, risk factors, and impact of a particular disease
or disorder (ie, determining an association between an exposure and a disease or condition).
Prognosis: articles informing or examining factors related to the prediction of the clinical course or natural history
of a disease or condition. Prognosis studies must use or discuss a valid outcome measure at a follow-up session.

Diagnosis: articles informing or examining data on the diagnostic process or specific aspects of diagnosis, including
screening for disease, characterization of the disease or condition, specific features or symptoms, and classification.
Diagnosis studies must use or discuss a reference standard for diagnosis.

Treatment: articles informing or examining the potential mechanisms, utilization, or effects of a given physical
therapy, rehabilitative, or medical intervention. Includes studies performed in clinical settings with symptomatic
participants. Treatment studies must discuss both a clinical population and active treatment.

Prevention: articles informing or examining potential mechanisms, utilization, or effects of preventative measures.

Metric: articles informing or examining the development, utilization, reliability, validity, or responsiveness of a
measurement or therapeutic tool, scale, questionnaire, or technique.

Quality Improvement: articles informing or examining quality improvement of physical therapy services through
the description or investigation of factors such as continuing medical education, acquisition of evidence, prepro-
fessional or postprofessional education, mentorship, professional behaviors, problem solving, and critical thinking.

Economics: articles informing or examining the economics of a health care disease, condition, or problem or of
physical therapist practice. Includes issues related to health care costs, direct access, interdisciplinary relations, and
local, state, or federal topics.

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Clinical Condition*
Examples:

Anterior cruciate ligament (ACL) injury Guillain-Barré syndrome

Adhesive capsulitis Head injury
Alzheimer disease Heart disease
Amputation Hip pain
Amyotrophic lateral sclerosis (ALS) Hypertension
Ankylosing spondylitis (AS) Incontinence
Arthritis Knee pain
Cancer Low back pain
Carpal tunnel syndrome (CTS) Multiple sclerosis
Cerebral palsy (CP) Neck pain
Chronic fatigue syndrome (CFS) Parkinson disease (PD)
Chronic obstructive pulmonary disease (COPD) Peripheral neuropathy
Cystic fibrosis (CF) Rheumatoid arthritis (RA)
Deep vein thrombosis (DVT) Scoliosis
Developmental delay Spina bifida
Diabetes Spinal cord injury (SCI)
Down syndrome Stroke
Elbow pain Temporomandibular disorder (TMD)
Fibromyalgia Vestibular disorder
Foot pain

* To assist with coding of this domain, 2 questions were asked regarding each article:
Question 1: Is a clinical condition listed as a key word? If not, go to question 2.
Question 2: Has a similar term been designated or selected for use to describe population?

Type of Intervention
Acupuncture: intervention includes use of either acupuncture or dry needling procedure.

Education: intervention includes education of patient regarding physical therapy process, diagnosis, classification,
treatment, prognosis, and activity modification. Examples include back school, brochures, caregiver education,
classroom instruction, early intervention education, home exercise instruction, home modifications, instructional
set, patient education, shoe wear education, and videotape instruction.

Electrotherapies, heat and cold: intervention includes use of modalities that provide a therapeutic benefit via
electrical, thermal, radiant, or acoustic stimuli. Examples include biofeedback, burst-modulated alternated current,
contrast bath, cryotherapy, diathermy, electrical stimulation, electromyographic biofeedback, high-intensity laser,
high-voltage pulsed galvanic stimulation, hyperthermia therapy, interferential current, iontophoresis, microamper-
age stimulation, microwave diathermy, moist heat, neuromuscular electrical stimulation, non-contact ultrasound,
paraffin bath, phonophoresis, pulsed current, pulsed electromagnetic therapy, Russian current, sensory amplitude
electrical stimulation, shock-wave therapy, tap water galvanism, thermotherapy, transcutaneous electrical stimula-
tion, ultrasound, ultraviolet light, and vapocoolant spray.

Fitness training: intervention includes instruction or performance of general aerobic or basic total body condition-
ing exercises. Examples include cycling, dancing, endurance training, ergometer, graded exercise, HealthRider,a
indoor walking, interval training, jogging, outdoor walking, plyometric exercise, stair climbing, stationary bicycling,
treadmill walking, and water running.
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Gait and locomotor training: intervention includes patient-performed and clinician-assisted gait activity overground
or on treadmill with goal other than for general cardiovascular benefit. Examples include electromechanical gait
trainer, 4-point gait, overground gait training, robotic-assisted body-weight–supported training, task-oriented gait
training, therapist-assisted body-weight–supported training, 3-point gait, and visual cued gait.

Health promotion: intervention includes public instruction on matters pertaining to health promotion, such as that
seen in public health fairs. Examples include blood pressure or cholesterol screening and general exercise advice.

Hydrotherapy: intervention includes partial or total body immersion in water for a therapeutic benefit. Examples
include balneotherapy, aquatic fitness exercise, Hubbard tank, and standard tank.

Manual therapy: intervention includes clinician-delivered soft tissue, joint, or nerve-based stretching; mobilization
or manipulation aimed at improving range of motion, relaxation, or tissue extensibility and reducing pain or swelling.
Examples include anterior-to-posterior glides, connective tissue massage, inferior glides, ischemic trigger point
compression, lateral distraction, long-axis distraction, manipulation, manual traction, mobilization, myofascial
release, neural mobilization, retrograde massage, Rolfing, transverse friction, and trigger point therapy.

Mechanotherapy: intervention includes instruction or use of mechanical devices aimed at reducing pain, improving
range of motion, or improving circulation. Examples include autorange cradle, continuous passive motion, inter-
mittent vasopneumatic compression, inversion traction, mechanical traction, and tilt table.

Neurodevelopmental treatment (NDT), neurofacilitation: intervention includes neurodevelopmental and neuro-

motor facilitation/inhibition techniques. Examples include asymmetric tonic neck reflex, Bobath method, combi-
nation of isotonics, constraint-induced movement therapy, proprioceptive neuromuscular facilitation, rhythmic
stabilization, vestibular techniques, and vibration stimulation.

Orthosis, taping, splinting: intervention includes instruction or use of implements or equipment to offer body or
limb support, protection, correction, or replacement to improve mobility or performance. Examples include
adaptive sitting, assistive device, Boston brace, Buzzer vest, cast, cervical collar, cervicothoracic brace, crutches,
DESEMO customized seat support, Dynasplint device,b foot orthosis, halo device, heel lift, hosiery, inserts, lumbar
roll, Milwaukee brace, Minerva body jacket, parapodium, pelvic belt, Philadelphia collar, prosthesis, splint, shoulder
roll, shrinker sling, sock, spine cushion, taping, wheelchair, and wrap.

Other: intervention to address disease or condition that is not considered within the scope of physical therapist
practice. Examples include heart surgery, implantable nerve stimulator, injections, mechanical ventilation, medica-
tion, nerve block, nutritional supplementation, photochemical therapy, speech therapy, and surgery.

Psychosocial, behavioral: intervention includes use of behavioral or psychosocial strategies. Examples include
behavior modification, cognitive-behavioral therapy, general relaxation, graded activity, and progressive goal
attainment.

Respiratory therapy: intervention includes instruction or performance of exercises or activities aimed at improving
respiration or airway clearance. Examples include assisted coughing, breathing exercise, diaphragmatic breathing,
drainage positioning, forced expiratory techniques, glossopharyngeal breathing, inspiratory muscle training, manual
chest vibration, manual lung inflation, percussion, postural drainage, pursed-lip breathing, suctioning, and vibration.

Skill or task training: intervention includes instruction or performance of specific functional task training. Examples
include activities of daily living, balance exercise, core stabilization, dance therapy, dynamic balance, game-based
exercise, grasping, head positioning exercise, hippotherapy, jump training, mental practice, motor control exercise,
perturbation training, play therapy, posture, reaching, rolling, sensorimotor training, sit-to-stand, specific spine
stabilization, stabilometer, stair training, tai chi, and task practice.

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Stretching and range of motion (ROM): intervention includes instruction or performance of general or specific
self-stretching or ROM exercises aimed at restoring or improving mobility or flexibility. Examples include active
ROM, Codman exercise, high-load brief stretching, low-load prolonged stretching, McKenzie exercises, passive
ROM, Pilates, slump stretching, static stretching, Williams exercises, and yoga.

Strength training: intervention includes implementation of a part or complete progressive resistive program aimed
at restoring or improving muscle strength, speed, or power.

Work hardening: intervention includes participation or enrollment in a structured, goal-oriented work hardening
program.

Wound therapy: intervention includes instruction or use of procedures for improving wound healing, scar man-
agement, and removing nonviable tissue or exudates. Examples include bandaging, dressings, hyperbaric chamber,
Jobst pump,c pressure therapy, Tubigrip gloves,d vacuum-compression, wound cleaning, and wound irrigation.

a
ICON Health and Fitness Inc, 1500 South 1000 West, Logan, UT 84321.
b
Dynasplint Systems Inc, River Reach, Suite W21, 770 Ritchie Hwy, Severna Park, MD 21146.
c
BSN Medical Inc, 5825 Carnegie Blvd, Charlotte, NC 28209.
d
Alimed Inc, 297 High St, Dedham, MA 02026.

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