Scholars@Duke
Joshua Kurt Johnson

Joshua Kurt Johnson

Assistant Professor in Orthopaedic Surgery
Orthopaedic Surgery, Physical Therapy
joshua.johnson@duke.edu
311 Trent Drive, Durham, NC 27710

Selected Publications

Unveiling the Impact of Occupational Therapy on Acute Care Outcomes: A Machine Learning Approach.

Journal Article Arch Phys Med Rehabil · November 24, 2025 OBJECTIVE: To examine the effects of occupational therapy (OT) services on patient discharge outcomes. DESIGN: This is a retrospective cohort study. We developed decision tree algorithms to investigate how 3 measures of OT service delivery-(1) the total nu ... Full text Link to item Cite

Use of the iPRISM webtool in a learning community to assess implementation context and fit of a novel clinical decision support tool for physical therapy triage in acute care hospitals.

Journal Article PM R · November 2025 BACKGROUND: The iPRISM webtool is an interactive tool designed to aid the process of applying the Practical, Robust Implementation and Sustainability Model (PRISM) for the assessment of and fit with context. A learning community (LC) is a multidisciplinary ... Full text Link to item Cite

Disparities in Physical Function and Rehabilitation Utilization: A Cross-sectional Study of Patients Hospitalized for Acute Medical Illness.

Journal Article J Gen Intern Med · September 18, 2025 BACKGROUND: Black patients have poorer physical function and mobility compared to White patients but utilize physical rehabilitation services less. OBJECTIVE: To determine whether racial differences exist in physical function and post-acute care facility u ... Full text Link to item Cite

Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic.

Journal Article Arch Rehabil Res Clin Transl · September 2025 OBJECTIVE: To examine the occurrence of physical and cognitive impairments among survivors of critical coronavirus disease of 2019 (COVID-19) who attend an intensive care unit (ICU) recovery clinic and describe their utilization of community-based rehabili ... Full text Link to item Cite

Development and Validation of PT-PENCIL: The Physical Therapy Frequency Clinical Decision Support Tool to Increase Hospital Discharge to Home.

Journal Article Phys Ther · August 5, 2025 IMPORTANCE: Identifying patients most likely to benefit from physical therapy in the hospital could aid physical therapists in optimizing treatment allocation for the purpose of increasing discharge to home. OBJECTIVE: The aims of this study were to develo ... Full text Link to item Cite

Interrater Reliability of the AM-PAC 6-Clicks Basic Mobility Short Form Between Nurses and Physical Therapists.

Journal Article Arch Phys Med Rehabil · July 2025 OBJECTIVE: To examine the interrater reliability between nurse- and physical therapist (PT)-recorded scores from the Activity Measure for Post-Acute Care 6-Clicks Basic Mobility short form across hospitals, services, and categories of assessment timing. DE ... Full text Link to item Cite

The Case for Aggregated Rehabilitation-Relevant Data Across Health Care Systems and Settings.

Journal Article Phys Ther · April 2, 2025 Health care value, quantified as outcome per unit cost, requires knowing which outcomes are influenced by which intervention at what cost. The value of rehabilitation is still largely unknown. Much of the reason for this limited evidence is historically po ... Full text Link to item Cite

Skilled Nursing and Home Health Policy: A Primer for the Hospital Clinician.

Journal Article Arch Phys Med Rehabil · February 2025 This paper addresses the increasing challenges faced by hospital clinicians in coordinating and recommending postacute care for patients, focusing on issues related to access to the most common postacute services: skilled nursing facilities (SNFs) and home ... Full text Link to item Cite

High-intensity home-based rehabilitation in a Medicare accountable care organization.

Journal Article Am J Manag Care · January 2025 OBJECTIVES: Patients are often discharged to a skilled nursing facility (SNF) for postacute rehabilitation. Functional outcomes achieved in SNFs are variable, and costs are high. Especially for accountable care organizations (ACOs), home-based postacute re ... Full text Link to item Cite

Medicare's Post-Acute Care Reimbursement Models as of 2023: Past, Present, and Future.

Journal Article J Bone Joint Surg Am · August 21, 2024 The Centers for Medicare & Medicaid Services is continually working to mitigate unnecessary expenditures, particularly in post-acute care (PAC). Medicare reimburses for orthopaedic surgeon services in varied models, including fee-for-service, bundled payme ... Full text Link to item Cite

The Use of Telerehabilitation to Improve Movement-Related Outcomes and Quality of Life for Individuals With Parkinson Disease: Pilot Randomized Controlled Trial.

Journal Article JMIR Form Res · July 31, 2024 BACKGROUND: Individuals with Parkinson disease (PD) can improve their overall mobility and participation in daily activities as they engage in frequent exercise. Despite the need for individually tailored exercises, persons with PD often face barriers to a ... Full text Link to item Cite

Early physical rehabilitation dosage in the intensive care unit associates with hospital outcomes after critical COVID-19.

Journal Article Crit Care · July 18, 2024 OBJECTIVE: To examine the relationship between physical rehabilitation parameters including an approach to quantifying dosage with hospital outcomes for patients with critical COVID-19. DESIGN: Retrospective practice analysis from March 5, 2020, to April 1 ... Full text Open Access Link to item Cite

High Risk of Readmission After THA Regardless of Functional Status in Patients Discharged to Skilled Nursing Facility.

Journal Article Clin Orthop Relat Res · July 1, 2024 BACKGROUND: The postoperative period and subsequent discharge planning are critical in our continued efforts to decrease the risk of complications after THA. Patients discharged to skilled nursing facilities (SNFs) have consistently exhibited higher readmi ... Full text Link to item Cite

Early physical rehabilitation dosage in the IntensiveCare Unit predicts hospital outcomes after criticalCOVID-19.

Journal Article Res Sq · May 15, 2024 OBJECTIVE: to examine the relationship between physical rehabilitation parameters including a novel approach to quantifying dosage with hospital outcomes for patients with critical COVID-19. DESIGN: Retrospective practice analysis from March 5, 2020, to Ap ... Full text Link to item Cite

Considering Mobility Status and Home Environment in Readmission Risk After Total Knee Arthroplasty.

Journal Article J Bone Joint Surg Am · December 20, 2023 BACKGROUND: Discharge disposition following total knee arthroplasty (TKA) offers varying levels of post-acute care monitoring depending on the medical status of the patient and his or her ability to function independently. Discharge disposition following T ... Full text Link to item Cite

Physical therapy provision for patients with pneumonia in US hospitals.

Journal Article J Hosp Med · September 2023 BACKGROUND: Physical therapy (PT) appears beneficial for hospitalized patients. Little is known about PT practice patterns and costs across hospitals. OBJECTIVE: To examine whether receiving PT is associated with specific patient and hospital characteristi ... Full text Link to item Cite

Association between physical therapy frequency and postacute care for a national cohort of patients hospitalized with pneumonia.

Journal Article J Hosp Med · September 2023 BACKGROUND: Annually more than 300,000 patients hospitalized for pneumonia need postacute care. Patients and systems prefer home discharge, but physical limitations often necessitate postacute care. It is unknown whether frequency of physical therapy in th ... Full text Link to item Cite

Comparison of stratification techniques for optimal management of patients with chronic low back pain in spine clinics.

Journal Article Spine J · September 2023 BACKGROUND CONTEXT: Identifying optimal stratification techniques for subgrouping patients with low back pain (LBP) into treatment groups for the purpose of identifying optimal management and improving clinical outcomes is an important area for further res ... Full text Link to item Cite

Assisted ambulation to improve health outcomes for older medical inpatients (AMBULATE): study protocol for a randomized controlled trial.

Journal Article Trials · July 24, 2023 BACKGROUND: Hospitalized older adults spend as much as 95% of their time in bed, which can result in adverse events and delay recovery while increasing costs. Observational studies have shown that general mobility interventions (e.g., ambulation) can mitig ... Full text Open Access Link to item Cite

Stratification of spine patients based on self-reported clinical symptom classes: Evaluation of long-term outcomes and subsequent interventions.

Journal Article N Am Spine Soc J · June 2023 BACKGROUND: Prior work by our group developed a stratification tool based on four PROMIS domains for patients with low back pain (LBP). Our study aimed to evaluate the ability of our previously developed symptom classes to predict long-term outcomes, and d ... Full text Link to item Cite

Effects of an electronic health record‐based mobility assessment and automated referral for inpatient physical therapy on patient outcomes: A quasi‐experimental study

Journal Article Health Services Research · February 2023 AbstractObjectiveTo assess the effectiveness of a hospital physical therapy (PT) referral triggered by scores on a mobility assessment embedded in the electronic health record (EHR) and co ... Full text Cite

Stratification of spine patients based on self-reported clinical symptom classes.

Journal Article Spine J · July 2022 BACKGROUND CONTEXT: Improving prognostic stratification for patients with low back pain (LBP) outside of a primary care setting has been identified as an important area for further research. PURPOSE: Our study aimed to identify clinical symptom classes of ... Full text Link to item Cite

Patient Versus Clinician Proxy Reliability of the AM-PAC "6-Clicks" Basic Mobility and Daily Activity Short Forms.

Journal Article Phys Ther · June 3, 2022 OBJECTIVE: The purpose of this study was to test the reliability of the Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" mobility and activity short forms between patients and therapist proxies. As a secondary aim, reliability was examined when pat ... Full text Link to item Cite

Association of Physical Therapy Treatment Frequency in the Acute Care Hospital With Improving Functional Status and Discharging Home

Journal Article Medical Care · June 2022 Background:Physical therapists (PTs) are consulted to address functional deficits during hospitalization, but the effect of PT visit frequency on patients’ outcomes is not clear. ... Full text Cite

Key Data Elements for Longitudinal Tracking of Physical Function: A Modified Delphi Consensus Study.

Journal Article Phys Ther · April 1, 2022 OBJECTIVE: Physical function is associated with important outcomes, yet there is often a lack of continuity in routine assessment. The purpose of this study was to determine data elements and instruments for longitudinal measurement of physical function in ... Full text Link to item Cite

PLAN and AM-PAC "6-Clicks" Scores to Predict Discharge Disposition After Primary Total Hip and Knee Arthroplasty.

Journal Article J Bone Joint Surg Am · February 16, 2022 BACKGROUND: Determination of the appropriate post-discharge disposition after total hip (THA) and knee (TKA) arthroplasty is a challenging multidisciplinary decision. Algorithms used to guide this decision have been administered both preoperatively and pos ... Full text Link to item Cite

An Explanatory Model for the Relationship Between Physical Therapists' Self-perceptions of Value and Care Prioritization Decisions in the Acute Hospital

Journal Article Journal of Acute Care Physical Therapy · October 2021 Purpose:The aim of the study was to understand how acute care physical therapists' perceptions of the value of physical therapy inform their decisions regarding which patients to treat. Full text Open Access Cite

Functional Recovery Rate: A Feasible Method for Evaluating and Comparing Rehabilitation Outcomes Between Skilled Nursing Facilities.

Journal Article J Am Med Dir Assoc · August 2021 OBJECTIVES: The recovery of patients' physical function and the rate at which this occurs are important parameters for evaluating value in post-acute care (PAC). However, no metrics are presently used to compare skilled nursing facilities (SNFs) based on t ... Full text Link to item Cite

High-Intensity Postacute Care at Home

Journal Article NEJM Catalyst · May 20, 2021 Full text Cite

Frequency of Physical Therapist Intervention Is Associated With Mobility Status and Disposition at Hospital Discharge for Patients With COVID-19.

Journal Article Phys Ther · January 4, 2021 OBJECTIVE: For patients diagnosed with the novel coronavirus, COVID-19, evidence is needed to understand the effect of treatment by physical therapists in the acute hospital on patient outcomes. The primary aims of this study were to examine the relationsh ... Full text Open Access Link to item Cite

Use of the Activity Measure for Post-Acute Care "6 Clicks" Basic Mobility Inpatient Short Form and National Institutes of Health Stroke Scale to Predict Hospital Discharge Disposition After Stroke.

Journal Article Phys Ther · August 31, 2020 OBJECTIVE: Therapists in the hospital are charged with making timely discharge recommendations to improve access to rehabilitation after stroke. The objective of this study was to identify the predictive ability of the Activity Measure for Post-Acute Care ... Full text Link to item Cite

Physical Function in the Hospital Is Associated With Patient-Centered Outcomes in an Inpatient Rehabilitation Facility.

Journal Article Phys Ther · August 12, 2020 OBJECTIVE: Poor knowledge of the relationships between physical function (PF) in the hospital and patient outcomes in an inpatient rehabilitation facility (IRF) limits the identification of patients most appropriate for discharge to an IRF. This study aime ... Full text Link to item Cite

The Association between Patients’ Physical Function in the Hospital and Their Outcomes in Skilled Nursing Facilities

Journal Article Phys Ther Policy Admin Leadership · November 1, 2019 Study Design. Retrospective observational study. Background. Shifting policies incentivize the appropriate use of skilled nursing facilities (SNFs) by linking reimbursement to patient outcomes. An appropriate recommendation for SNF care following hospitali ... Open Access Cite

Short-Term Clinical and Quality Outcomes Have Inconsistent Changes From a Quality Improvement Initiative to Increase Access to Physical Therapy in the Cardiovascular and Surgical ICU

Journal Article Critical Care Explorations · October 2019 Objectives:Studies of mobility during critical illness have mostly examined transitions from immobility (passive activities) or limited mobility to active “early mobility.” ... Full text Cite

Characteristics of Usual Physical Therapy Post‐Total Knee Replacement and Their Associations With Functional Outcomes

Journal Article Arthritis Care & Research · September 2019 ObjectiveAlthough total knee replacement (TKR) surgery is highly prevalent and generally successful, functional outcomes post‐ Full text Cite

Short-term functional recovery after total joint arthroplasty is unaffected by bundled payment participation.

Journal Article Arthroplast Today · March 2019 BACKGROUND: Bundled payment models for lower extremity total joint arthroplasty (TJA) aim to improve value by decreasing costs via efficient care pathways. It is unclear how such models affect patient-centered outcomes such as functional recovery. We aimed ... Full text Link to item Cite

Improving Outcomes for Critically Ill Cardiovascular Patients Through Increased Physical Therapy Staffing.

Journal Article Arch Phys Med Rehabil · February 2019 OBJECTIVE: To examine the effect of increasing physical therapy (PT) staff in a cardiovascular intensive care unit (CVICU) on temporal measures of PT interventions and on outcomes important to patients and hospitals. DESIGN: Retrospective pre/post subgroup ... Full text Link to item Cite

Glenohumeral Internal Rotation Deficit and Injuries: A Systematic Review and Meta-analysis

Journal Article Orthopaedic Journal of Sports Medicine · May 1, 2018 Background: There is an association between throwing activity and glenohumeral internal rotation deficit (GIRD). An 18° to 20° deficit has been adopted as the standard definition of pathological GIRD, but specific ... Full text Cite