Listening Time — 17:56

Editor-in-Chief Alan Jette, PT, PhD, FAPTA, talks with Kathleen Mangione, PT, PhD, FAPTA, about something critically important to physical therapists but rarely top of mind: treatment fidelity. Was the treatment given in a trial actually delivered as intended? Did the patients perform the techniques correctly? Did the patients get winded or fatigued, which would suggest they understood intensity? And how well did the patients do the exercises in real-life settings, indicating that they applied what they learned in sessions?

"The fidelity piece for physical therapists, especially when it's an exercise intervention, is extraordinarily compelling," says Mangione. But, she continues, "the collecting and analyzing of fidelity data is really labor intensive and resource intensive, especially for complex interventions like the ones that most physical therapists do." She explains that most physical therapist interventions "are biobehavioral programs."

Mangione shares results and insights from the Community Ambulation Project, including the pros and cons of measures used. One take-home message for clinicians: Men and women should be approached similarly when it comes to exercise—they both can perform exercises as designed, and those who do the exercises as designed achieve better outcomes. Mangione is coauthor of "Using Treatment Fidelity Measures to Understand Walking Recovery: A Secondary Analysis From the Community Ambulation Project." https://academic.oup.com/ptj/advance-article-abstract/doi/10.1093/ptj/pzab109/6210027