Background and Purpose: The increasing complexity of medical care in the United States calls for providers to become leaders in various aspects of health care. Combining clinical skills with knowledge of public health and the business/administrative side of health care allows health care providers, including physical therapists, to effectively manage and navigate the changing health care environment and become leaders in their field. The purpose of this paper is to describe the method and process of successfully establishing dual degree programs in business and public health and in the physical therapist education program at Emory University. Method/Model Description and Evaluation: The process for institutional level agreements, curricular structure, admissions process, and graduation requirements for dual degree program students in the Doctor of Physical Therapy (DPT) and Master of Business Administration (MBA) or Master of Public Health (MPH) at Emory University is described in this paper. Additionally, 2 surveys were conducted: 1 survey of all students in 3 DPT classes (n = 201) and the other survey of dual degree program graduates as of 2013 (n = 8). The surveys evaluated student awareness of the dual degree programs during the DPT program application process and characteristics and perceptions related to the dual degree programs. Outcomes: Eighty-three percent of all students indicted that they were aware of the dual degree programs while applying to our DPT program and 6% indicated it was a key deciding factor in their decision to apply to our program. The graduating grade-point average (GPA) and first time pass rate on the National Physical Therapy Exam (NPTE) licensure of the dual degree students in the DPT program is at least equal to that of the overall DPT class graduating the same year. Moreover, 86% of dual degree program graduates indicated that it made them a more competitive job candidate. Discussion and Conclusion: In addition to fostering interprofessional education, the dual degree programs at Emory show positive outcomes, as all graduates indicated that their dual degree positively impacted their careers, and the majority reported specifically using their dual degree in their career. Also, the graduating GPA and first time pass rate on the NPTE of the dual degree students in the DPT program is at least equal to that of the overall DPT class graduating the same year, suggesting that the burden of an additional course of study was not adversely impacting their performance in the DPT program. At Emory University, the dual DPT/MBA and DPT/MPH programs have been designed to provide students with the necessary clinical, business, administrative, policy analysis, and public health perspectives required to excel as leaders in the future health care system.

Context: Heel lifts are often prescribed as part of the treatment program for patients with overuse injuries associated with limited ankle dorsiflexion. However, little is known about how joint kinematics and temporal variables are affected by heel lifts. Objective: To determine the effects of heel lifts on selected lower extremity kinematic and temporal variables during the stance phase of gait in subjects with limited ankle dorsiflexion. Design: Two-way, fully repeated-measures design. The 2 factors were side (right or left) and walking condition (shoes alone, 6-mm heel lifts in shoes, 9-mm heel lifts in shoes). Setting: University biomechanics laboratory. Patients or Other Participants: Twenty-six volunteers (21 females, 5 males) with no more than 5° of ankle joint dorsiflexion. Intervention(s): Subjects were tested in shoes alone and in shoes with 6-mm and 9-mm heel lifts. Main Outcome Measure(s): We used the Qualisys Motion Analysis System to measure ankle dorsiflexion excursion, maximal knee extension, and time to heel off during the stance phase of gait under the 3 walking conditions. Results: On the right side, ankle dorsiflexion excursion increased significantly with the 6-mm and 9-mm heel lifts compared with shoes alone ( P < .05). On the left side, ankle dorsiflexion increased significantly with the 9-mm heels lifts over shoes alone and with the 9-mm heel lifts compared with the 6-mm heel lifts ( P < .05). Time to heel off increased significantly for walking with the 9-mm heel lifts compared with shoes alone ( P < .05). No differences were noted for maximal knee extension ( P > .05). Conclusions: Clinicians may consider prescribing heel lifts for patients with limited dorsiflexion range of motion if increasing ankle dorsiflexion excursion and time to heel off during the stance phase of gait may be beneficial.

Context: Gastrocnemius stretching exercises often are prescribed as part of the treatment program for patients with overuse injuries associated with limited ankle dorsiflexion. However, little is known about how the position of the subtalar joint during gastrocnemius stretching affects ankle dorsiflexion range of motion (ROM). Objective: To determine the effect of subtalar joint position during gastrocnemius stretching on ankle dorsiflexion ROM. Design: This study was a 3-way mixed-model design. The 3 factors were subtalar joint position (supinated, pronated), lower extremity (experimental, control), and time (pretest, posttest). Lower extremity and time were the repeated measures. Setting: University research laboratory. Patients or Other Participants: Thirty-three healthy volunteers (29 women, 4 men). Intervention(s): Participants performed a gastrocnemius stretching exercise 2 times daily for 3 weeks with the subtalar joint of the randomly assigned experimental side (dominant or nondominant) in the randomly assigned position (supination or pronation). The contralateral lower extremity served as the control. Main Outcome Measure(s): Before and after the 3-week gastrocnemius stretching program, we used goniometers to measure ankle dorsiflexion ROM in weight-bearing and non–weight-bearing positions with the subtalar joint positioned in anatomic 0°. Results: Ankle dorsiflexion ROM measured in weight-bearing and non–weight-bearing positions increased after the gastrocnemius stretching program (P  =  .034 and .003, respectively), but the increase in ROM did not differ based on subtalar joint position (P  =  .775 and .831, respectively). Conclusions: Subtalar joint position did not appear to influence gains in ankle dorsiflexion ROM after a gastrocnemius stretching program in healthy volunteers.