Miyerkules, Oktubre 31, 2012

Reliability of Six Physical Performance Tests in Older People With Dementia

Background

Physical performance tests are important to assess the effect of physical activity interventions in older people with dementia, but their psychometric properties have not been systematically established within this specific population.

Objective

To determine the relative and absolute test-retest reliability of the 6-meter walk test, the figure-of-eight (FoE), the Timed-up-and-Go (TUG), the FICSIT-4, the Chair-Rise test (CRT), and the Jamar dynamometer. These tests are used to assess gait speed, dynamic balance, functional mobility, static balance, lower-limb strength, and grip strength, respectively.

Design

A prospective, nonexperimental study.

Methods

Older people with dementia (n=58; age range 70–92 years) performed each test at baseline and again after one week. Intraclass correlation (ICC), standard error of measurement (SEM), minimal detectable change (MDC) and (log transferred) limits of agreement of Bland-Altman plots were calculated.

Results

The relative reliabilities of the FoE, TUG, and Jamar dynamometer were excellent (ICC .90–.95) and good for the 6-meter walk test, FICSIT-4, and CRT (ICC .79–.86). SEMs and MDCs were large for all tests. The absolute reliability of the TUG and CRT was significantly influenced by the level of cognitive functioning (as assessed with the MMSE).

Limitations

The specific etiology of dementia was not obtained.

Conclusions

The results show that when used in older people with mild to moderate dementia the physical performance tests evaluated are useful to detect differences in performance between individuals and therefore suitable for cross-sectional or controlled intervention studies. They appear less suitable to monitor clinically relevant intra-individual performance changes. Future studies should focus on the development of more sensitive tests and the identification of criteria for clinically relevant changes in this rapidly growing population.

Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110164v1?rss=1

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Evaluation of an Advanced-Practice Physical Therapist in a Specialty Shoulder Clinic: Diagnostic Agreement and Effect on Wait Times

Purpose: To examine the role of an advanced-practice physiotherapist (APP) with respect to (1) agreement with an orthopaedic surgeon on diagnosis and management of patients with shoulder problems; (2) wait times; and (3) satisfaction with care. Methods: This prospective study involved patients with shoulder complaints who were referred to a shoulder specialist in a tertiary care centre. Agreement was examined on seven major diagnostic categories, need for further examination and surgery, and type of surgical procedure. Wait times were compared between the APP- and surgeon-led clinics from referral date to date of initial consultation, date of final diagnostic test, and date of confirmed diagnosis and planned treatment. A modified and validated version of the Visit-Specific Satisfaction Instrument assessed satisfaction in seven domains. Kappa (κ) coefficients and bias- and prevalence-adjusted kappa (PABAK) values were calculated, and strength of agreement was categorized. Wait time and satisfaction data were examined using non-parametric statistics. Results: Agreement on major diagnostic categories varied from 0.68 (good) to 0.96 (excellent). Agreement with respect to indication for surgery was κ=0.75, p<0.001; 95% CI, 0.62–0.88 (good). Wait time for APP assessment was significantly shorter than wait time for surgeon consultation at all time points (p<0.001); the surgeon's wait time was significantly reduced over 3 years. High satisfaction was reported in all components of care received from both health care providers. Conclusions: Using experienced physiotherapists in an extended role reduces wait times without compromising patient clinical management and overall satisfaction.

  • Content Type Journal Article
  • Category Advance Online Article
  • Pages 1-10
  • DOI 10.3138/ptc.2011-56
  • Authors
    • Helen Razmjou, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto
    • Susan Robarts, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto
    • Deborah Kennedy, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto
    • Cheryl McKnight, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto
    • Anne Marie MacLeod, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto
    • Richard Holtby, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto

Source: http://www.metapress.com/content/y784n5v333n5tr72/

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Peer Reviewers and Book Reviewers for 2012

Peer Reviewers and Book Reviewers for 2012

  • Content Type Journal Article
  • Category Peer Reviewers and Book Reviewers
  • Pages 429-429
  • DOI 10.3138/ptc.64.4.429

Source: http://www.metapress.com/content/97n0813510p20151/

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Personal Health Behaviors and Role-Modeling Attitudes of Physical Therapists and Physical Therapist Students: A Cross-Sectional Study

Background

Physical therapists have been encouraged to engage in health promotion practice. Health professionals who engage in healthy behaviors themselves are more apt to recommend those behaviors, and patients are more motivated to change their behaviors when their health care provider is a credible role model.

Objective.

The purpose of this study was to describe the health behaviors and role-modeling attitudes of physical therapists and physical therapist students.

Design.

This study was a descriptive cross-sectional survey.

Methods.

A national sample of 405 physical therapists and 329 physical therapist students participated in the survey. Participants' attitudes toward role modeling and behaviors related to physical activity, fruit and vegetable consumption, abstention from smoking, and maintenance of a healthy weight were measured. Wilcoxon rank sum tests were used to examine differences in attitudes and behaviors between physical therapists and physical therapist students.

Results.

A majority of the participants reported that they engage in regular physical activity (80.8%), eat fruits and vegetables (60.3%), do not smoke (99.4%), and maintain a healthy weight (78.7%). Although there were no differences in behaviors, physical therapist students were more likely to believe that role modeling is a powerful teaching tool, physical therapist professionals should "practice what they preach," physical activity is a desirable behavior, and physical therapist professionals should be role models for nonsmoking and maintaining a healthy weight.

Limitations.

Limitations of this study include the potential for response bias and social desirability bias.

Conclusions.

Physical therapists and physical therapist students engage in health-promoting behaviors at similarly high rates but differ in role-modeling attitudes.

Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110037v2?rss=1

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Profiling physiotherapy student preferred learning styles within a clinical education context

Publication year: 2012
Source:Physiotherapy

Steve Milanese, Susan Gordon, Aya Pellatt

Objectives This study investigated the preferred learning styles, related to clinical education of a cohort of final year physiotherapy students. Design A cross sectional observation study using a questionnaire survey. Setting Undergraduate physiotherapy program at James Cook University, Townsville, Queensland. Participants 48 final year physiotherapy students representing 89% of the total cohort (48/54). Interventions Survey questionnaire using Kolb's Learning Style Inventory (Version 3.1). Results The preferred learning styles were spread uniformly across the three learning styles of Converging, Assimilating and Accommodating, with the least preferred method of learning style the Diverging style. This suggests that in the clinical environment this student cohort are least likely to prefer to develop their learning from actually experiencing the scenario i.e. in front of a real life patient (concrete experience), and were more likely prefer this learning to come from a theoretical perspective, allowing them to consider the problem/scenario before experiencing it. When transforming this experience into knowledge, they prefer to use it on a ‘real life’ patient (active experimentation). Conclusion Whilst understanding learning styles have been promoted as a means of improving the learning process, there remains a lack of high level evidence. The findings of this study reinforce those of other studies into the learning styles of physiotherapy students suggesting that physiotherapy students share common learning style profiles.




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Using digital photography to document rectus femoris flexibility: A reliability study of the modified Thomas test

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-9, Early Online.

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Martes, Oktubre 30, 2012

Low impact weight-bearing exercise in an upright posture increases the activation of two key local muscles of the lumbo-pelvic region

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-10, Early Online.

Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.698718?ai=1mo2&mi=3s94u5&af=R

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Comparison of post-treatment effects of conventional and acupuncture-like transcutaneous electrical nerve stimulation (TENS): A randomised placebo-controlled study using cold-induced pain and healthy human participants

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-8, Early Online.

Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2011.551803?ai=1mo2&mi=3s94u5&af=R

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Whole-Body Vibration During Passive Standing in Individuals With Spinal Cord Injury: Effects of Plate Choice, Frequency, Amplitude, and Subject's Posture on Vibration Propagation

Publication year: 2012
Source:PM&R

Milad Alizadeh-Meghrazi, Kei Masani, Milos R. Popovic, Beverley Catharine Craven

Background To date, few pharmacologic or rehabilitation interventions for sublesional osteoporosis (SLOP) or low bone mass of the hip and knee regions after spinal cord injury (SCI) have produced significant or sustained increases in lower extremity bone mineral density. Whole body vibration (WBV) is a potential intervention for the prevention and/or treatment of SLOP. Objective The objective of this study was to identify the optimal WBV conditions (ie, plate, frequency, amplitude, and subject posture) among men with chronic SCI during passive standing. A priori, the “optimal WBV condition” was defined as the combination of WBV parameters that facilitates lower extremity vibration absorption while minimizing vibration propagation to the head. Design This phase 0 device development study assessed the lower extremity propagation characteristics of WBV in men with and without SCI by using a variety of a priori specified plates, frequencies, amplitudes, and postures. The study's aim was to facilitate the implementation and future evaluation of the efficacy of WBV and passive standing for prevention and treatment of men with SCI and SLOP. Setting A tertiary SCI rehabilitation center in Toronto, Canada. Participants Healthy men with chronic paraplegia (n = 5) and those without SCI (n = 7), ages 20-50 years, weighing 68-113 kg, and having a height of 168-188 cm. Interventions An EasyStand standing frame was fitted onto 2 commercially available vibration platforms: WAVE and Juvent. Accelerometers were attached to the participants' forehead, hip, knee, and ankle to measure vibration propagation. Vibration parameters evaluated were posture (knee angles of 140°, 160°, and 180° [180° for Juvent only]), vibration frequency (25 Hz, 35 Hz, and 45 Hz), and vibration amplitude (0.6 mm and 1.2 mm [WAVE only]). The subjects were exposed to all combinations of posture, frequencies, and amplitudes during the experiments (total parameter combinations: 12 WAVE and 9 Juvent). Main Outcome Measurements Peak-to-peak vibration and transmissibility of vibration were recorded and computed for each accelerometer at the tested locations. Results Variations in frequency generated the most noticeable changes in propagation characteristics, followed by variations in knee angle and amplitude. Conclusions WBV therapy delivered with use of the WAVE platform with a knee angle of 140°, plate frequency of 45 Hz, and amplitude of 1.2 mm met our a priori criteria for the “optimal WBV condition.” Future studies should evaluate the therapeutic efficacy of the WAVE platform by using these parameters to maintain or augment bone mass among persons with SCI and SLOP.




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Resistance Training Reduces Subclinical Inflammation in Obese, Postmenopausal Women.

Author: PHILLIPS, MELODY D. 1; PATRIZI, ROBERT M. 1; CHEEK, DENNIS J. 2; WOOTEN, JOSHUA S. 3; BARBEE, JAMES J. 4; MITCHELL, JOEL B. 1
Page: 2099-2110

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Poster 9 Loss of Femoral Neck “Waistline” in Pistol Grip Hip Deformity Predisposing to Hip Arthroplasty in the Young Population: A Case Report

Publication year: 2012
Source:PM&R, Volume 4, Issue 10, Supplement

Harjasleen Walia, John J. Michalisin, Barry C. Root






Source: http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=IRSSSEARCH&_method=citationSearch&_piikey=S1934148212011069&_version=1&md5=b7b267e2985d7c75d796b82196077bc7

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Surgeons Discuss Joint Preservation.

Author:
Page: 114-115

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An exploration of the professional identity embedded within UK cardiorespiratory physiotherapy curricula

Publication year: 2012
Source:Physiotherapy

Carolyn Roskell

Objectives To explore whether consensus exists about content and professional identity represented within pre-registration cardiorespiratory physiotherapy (CPT) curricula, and to establish whether the curricula feature contemporary themes evident in policy and professional guidance in order to test whether CPT education is demonstrating responsiveness and relevance to practice. Design An exploratory qualitative case study design employing documentary analysis of curricula materials related to CPT. Participants Fourteen UK higher education institutions offering undergraduate physiotherapy qualifying programmes agreed to participate. Intervention Relevant curriculum documentation was requested, such as student module guides, programme handbooks and institutional module descriptors, encompassing information including indicative content, teaching and learning methods, and modes of assessment. Document analysis combined deduction (through content analysis) and induction (through thematic analysis). Results Consensus was observed on core content, underpinning philosophy and professional identity across institutions. The projected identity appeared to be strongly biomedical in focus, and was less well influenced by some of the contemporary aspects promoted by the Chartered Society of Physiotherapy, such as promotion of a patient-centred model of practice and acknowledgement of the emotional challenges existing within this area of work. Conclusion Continuing critical review of the content and approach promoted within curricula is needed to ensure that learning remains relevant and responsive to current agendas. This study supports the need for course teams to reconsider the emphasis within individual curricula to ensure that responsiveness and relevance to the practice setting are made explicit.




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Lunes, Oktubre 29, 2012

Bone and Joint in Brief.

Author:
Page: 120

Source: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&LSLINK=80&D=ovft&AN=01300517-201211000-00008&SOURCE=rss.ctoc&SYNTAX=N

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Chartered Society of Physiotherapy's identification of national research priorities for physiotherapy using a modified Delphi technique

Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 3

Gabrielle Rankin, Alison Rushton, Pat Olver, Ann Moore

Objective To define research priorities to strategically inform the evidence base for physiotherapy practice. Design A modified Delphi method using SurveyMonkey software identified priorities for physiotherapy research through national consensus. An iterative process of three rounds provided feedback. Round 1 requested five priorities using pre-defined prioritisation criteria. Content analysis identified research themes and topics. Round 2 requested rating of the importance of the research topics using a 1–5 Likert scale. Round 3 requested a further process of rating. Quantitative and qualitative data informed decision-making. Level of consensus was established as mean rating ≥3.5, coefficient of variation ≤30%, and ≥55% agreement. Consensus across participants was evaluated using Kendall's W. Participants Four expert panels (n =40–61) encompassing a range of stakeholders and reflecting four core areas of physiotherapy practice were established by steering groups (n =204 participants overall). Findings Response rates of 53–78% across three rounds were good. The identification of 24/185 topics for musculoskeletal, 43/174 for neurology, 30/120 for cardiorespiratory and medical rehabilitation, and 30/113 for mental and physical health and wellbeing as priorities demonstrated discrimination of the process. Consensus between participants was good for most topics. Measurement validity of the research topics was good. The involvement of multiple stakeholders as participants ensured the current context of the intended use of the priorities. Conclusions From a process of national consensus involving key stakeholders, including service users, physiotherapy research topics have been identified and prioritised. Setting priorities provides a vision of how research can contribute to the developing research base in physiotherapy to maximise focus.




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Validity of measuring humeral torsion using palpation of bicipital tuberosities

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-8, Early Online.

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User perceptions of gaming interventions for improving upper extremity motor function in persons with chronic stroke

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-7, Early Online.

Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.717591?ai=1mo2&mi=3s94u5&af=R

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Using digital photography to document rectus femoris flexibility: A reliability study of the modified Thomas test

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-9, Early Online.

Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.731140?ai=1mo2&mi=3s94u5&af=R

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Disclaimer Page

Publication year: 2012
Source:PM&R, Volume 4, Issue 10, Supplement








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Oncology Rehabilitation Provision and Practice Patterns across Canada

Purpose: Rehabilitation is increasingly recognized as an important therapeutic intervention for people with cancer. The main objective of this study was to explore the current practice pattern and provision of oncology rehabilitation in Canada. Methods: A descriptive cross-sectional online survey was administered to Canadian facilities offering cancer treatment and/or listed as offering rehabilitation services during or after cancer treatment (cancer centres, rehabilitation hospitals, community centres, and private clinics). Results: Of the 116 sites contacted, 62 completed the questionnaire, 20 of which reported having an oncology rehabilitation programme. The majority of respondents indicated that they are not meeting their clients' rehabilitation needs. Rehabilitation programmes were provided by multidisciplinary health care teams, the majority of which included a physiotherapist. Funding and availability of resources were identified as the main barriers to the development of oncology rehabilitation programmes. Conclusions: Formal oncology rehabilitation programmes appear to be scarce, despite growing evidence that rehabilitation offers benefits across the cancer survivorship continuum.

  • Content Type Journal Article
  • Category Advance Online Article
  • Pages 1-13
  • DOI 10.3138/ptc.2011-53
  • Authors
    • Alyssa Canestraro, Department of Physical Therapy, University of Toronto
    • Anthony Nakhle, Department of Physical Therapy, University of Toronto
    • Malissa Stack, Department of Physical Therapy, University of Toronto
    • Kelly Strong, Department of Physical Therapy, University of Toronto
    • Ashley Wright, Department of Physical Therapy, University of Toronto
    • Marla Beauchamp, Department of Physical Therapy, University of Toronto
    • Katherine Berg, Department of Physical Therapy, University of Toronto
    • Dina Brooks, Department of Physical Therapy, University of Toronto

Source: http://www.metapress.com/content/yxt5gl3l551m64l5/

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Linggo, Oktubre 28, 2012

Movement Kinematics During a Drinking Task Are Associated With the Activity Capacity Level After Stroke

Background. Kinematic analysis is a powerful method for an objective assessment of movements and is increasingly used as an outcome measure after stroke. Little is known about how the actual movement performance measured with kinematics is related to the common traditional assessment scales. The aim of this study was to determine the relationships between movement kinematics from a drinking task and the impairment or activity limitation level after stroke. Methods. Kinematic analysis of movement performance in a drinking task was used to measure movement time, smoothness, and angular velocity of elbow and trunk displacement (TD) in 30 individuals with stroke. Sensorimotor impairment was assessed with the Fugl-Meyer Assessment (FMA), activity capacity limitation with the Action Research Arm Test (ARAT), and self-perceived activity difficulties with the ABILHAND questionnaire. Results. Backward multiple regression revealed that the movement smoothness (similarly to movement time) and TD together explain 67% of the total variance in ARAT. Both variables uniquely contributed 37% and 11%, respectively. The TD alone explained 20% of the variance in the FMA, and movement smoothness explained 6% of the variance in the ABILHAND. Conclusions. The kinematic movement performance measures obtained during a drinking task are more strongly associated with activity capacity than with impairment. The movement smoothness and time, possibly together with compensatory movement of the trunk, are valid measures of activity capacity and can be considered as key variables in the evaluation of upper-extremity function after stroke. This increased knowledge is of great value for better interpretation and application of kinematic data in clinical studies.

Source: http://nnr.sagepub.com/cgi/content/abstract/26/9/1106?rss=1

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Diagnosing and Managing Osteoporosis in Younger Adults.

Author: Hoffmeister, Ellen
Page: 109-111

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Flow-Mediated Dilation Is Acutely Improved after High-Intensity Interval Exercise.

Author: CURRIE, KATHARINE DIANNE 1; MCKELVIE, ROBERT S. 1,2,3; MACDONALD, MAUREEN J. 1
Page: 2057-2064

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Insights from a physiotherapist's lived experience of osteoarthritis

Physiotherapy Theory and Practice, Volume 28, Issue 8, Page 604-616, November 2012.

Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2011.654320?ai=1mo2&mi=3s94u5&af=R

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Rating Scale Analysis and Psychometric Properties of the Caregiver Self-Efficacy Scale for Transfers

Physical & Occupational Therapy in Pediatrics, Volume 32, Issue 4, Page 404-415, October 2012.

Source: http://informahealthcare.com/doi/abs/10.3109/01942638.2012.694993?ai=1ozx&mi=3s94u5&af=R

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Sabado, Oktubre 27, 2012

Academy News

Publication year: 2012
Source:PM&R, Volume 4, Issue 10








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Why Do People Delay Accessing Health Care for Knee Osteoarthritis? Exploring Beliefs of Health Professionals and Lay People

Purpose: In knee osteoarthritis (OA), opportunity for non-surgical intervention is reduced by time lost between symptom onset and diagnosis. The study's purpose was to understand, from the perspective of various stakeholders, the reasons for delay and useful strategies to enhance early awareness of knee OA. Method: In this qualitative study, focus groups of health professionals (n=6) and community-dwelling individuals (n=7) discussed questions relating to knowledge, attitudes, and beliefs about OA; experiences with people with OA; health care seeking behaviour; and access to services, and suggested strategies to enhance public awareness. Qualitative analyses identified dominant themes. Results: Reasons for delay from the layperson's perspective included lack of knowledge about risk factors and prevention and a belief that knee pain is expected with age. Reasons related to the health care system included long wait times and frustration getting appointments. Health professionals were unclear on which discipline should discuss prevention and risk factors. Suggested strategies included advocating a healthy lifestyle, developing prevention programs, and using celebrities to inform the public. Conclusions: Participants identified multiple reasons for delays and strategies to counter them. Knowledge about gaps in the OA care process can facilitate physiotherapists' participation in developing strategies for early intervention.

  • Content Type Journal Article
  • Category Advance Online Article
  • Pages 1-8
  • DOI 10.3138/ptc.2011-50
  • Authors
    • Shreya S. Prasanna, School of Physical and Occupational Therapy, McGill University, Montreal
    • Nicol Korner-Bitensky, School of Physical and Occupational Therapy, McGill University, Montreal
    • Sara Ahmed, School of Physical and Occupational Therapy, McGill University, Montreal

Source: http://www.metapress.com/content/42q11g4n3565v374/

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Validity of measuring humeral torsion using palpation of bicipital tuberosities

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-8, Early Online.

Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.675416?ai=1mo2&mi=3s94u5&af=R

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Poster 202 Progressive Enhanced Eccentric or Concentric Resistance Exercise Training for Knee Osteoarthritis: Initial Results on Pain and Function

Publication year: 2012
Source:PM&R, Volume 4, Issue 10, Supplement

Kevin R. Vincent, Alan S. Hamilton, Clarissa Lomonaco, Matthew Martenson, Cindy Montero, Quang Nguyen, Heather K. Vincent, Joseph G. Wasser






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More Than One in Five Short-Term Nursing-Facility Patients Fall During Stay.

Author:
Page: 118

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Biyernes, Oktubre 26, 2012

Editorial Board

Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 2








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The clinical effects of Kinesio® Tex taping: A systematic review

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-12, Early Online.

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Poster 1 Quality Improvement on a PMR Consult Service

Publication year: 2012
Source:PM&R, Volume 4, Issue 10, Supplement

Adrian Cristian, Frederick Aziz, Laurentiu I. Dinescu, Ethan Egan, Vishal P. Rekhala, Marc K. Ross, Travis R. von Tobel






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Walking during body-weight-supported treadmill training and acute responses to varying walking speed and body-weight support in ambulatory patients post-stroke

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-12, Early Online.

Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.727526?ai=1mo2&mi=3s94u5&af=R

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Validity of measuring humeral torsion using palpation of bicipital tuberosities

Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-8, Early Online.

Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.675416?ai=1mo2&mi=3s94u5&af=R

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Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain

Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 2

Ah Young Song, Hang Jin Jo, Paul S. Sung, Yoon Hyuk Kim

Objective To investigate three-dimensional angular changes of the pelvis and lower extremities during trunk axial rotation in subjects with and without chronic low back pain (LBP). Design Repeated-measures design. Participants Thirty volunteers participated in the study (15 with LBP, 15 without LBP). The mean age of the subjects was 44 (standard deviation 15.8) years (range 27 to 63 years). Main outcome measures All participants were asked to perform five sets of axial trunk rotation activities with a bar in a standing position. The outcome measures included three-dimensional rotational angles of the pelvis and lower extremities (foot, calf and thigh). Results The angular change of the pelvis in the sagittal plane differed between subjects with and without LBP (P =0.03). There were no significant differences in angular changes of the lower extremities in the frontal and transverse planes between groups. Conclusions The angular change of the pelvis in the sagittal plane differed significantly between groups. Further research is needed to investigate the three-dimensional characteristics of biomechanical and neuromuscular aspects in subjects with LBP.




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Huwebes, Oktubre 25, 2012

Validity of Two Wearable Monitors to Estimate Breaks from Sedentary Time.

Author: LYDEN, KATE 1; KOZEY KEADLE, SARAH L. 1; STAUDENMAYER, JOHN W. 2; FREEDSON, PATTY S. 1
Page: 2243-2252

Source: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&LSLINK=80&D=ovft&AN=00005768-201211000-00026&SOURCE=rss.ctoc&SYNTAX=N

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Computerised lung sound monitoring to assess effectiveness of chest physiotherapy and secretion removal: a feasibility study

Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 3

G. Ntoumenopoulos, Y. Glickman

Objectives To explore the feasibility of computerised lung sound monitoring to evaluate secretion removal in intubated and mechanically ventilated adult patients. Design Before and after observational investigation. Setting Intensive care unit. Participants Fifteen intubated and mechanically ventilated adult patients receiving chest physiotherapy. Interventions Chest physiotherapy included combinations of standard closed airway suctioning, saline lavage, postural drainage, chest wall vibrations, manual-assisted cough and/or lung hyperinflation, dependent upon clinical indications. Main outcome measures Lung sound amplitude at peak inspiration was assessed using computerised lung sound monitoring. Measurements were performed immediately before and after chest physiotherapy. Data are reported as mean [standard deviation (SD)], mean difference and 95% confidence intervals (CI). Significance testing was not performed due to the small sample size and the exploratory nature of the study. Results Fifteen patients were included in the study [11 males, four females, mean age 65 (SD 14) years]. The mean total lung sound amplitude at peak inspiration decreased two-fold from 38 (SD 59) units before treatment to 17 (SD 19) units after treatment (mean difference 22, 95% CI of difference −3 to 46). The mean total lung sound amplitude from the lungs of patients with a large amount of secretions (n =9) was over four times ‘louder’ than the lungs of patients with a moderate or small amount of secretions (n =6) [56 (SD 72) units vs 12 (13) units, respectively; mean difference −44, 95% CI of difference −100 to 11]. The mean total lung sound amplitude decreased in the group of ‘loud’ right and left lungs (n =15) from 37 (SD 36) units before treatment to 15 (SD 13) units after treatment (mean difference 22, 95% CI of difference 6 to 38). Conclusion Computerised lung sound monitoring in this small group of patients demonstrated a two-fold decrease in lung sound amplitude following chest physiotherapy. Subgroup analysis also demonstrated decreasing trends in lung sound amplitude in the group of ‘loud’ lungs following chest physiotherapy. Due to the small sample size and large SDs with high variability in the lung sound amplitude measurements, significance testing was not reported. Further investigation is needed in a larger sample of patients with more accurate measurement of sputum wet weight in order to distinguish between secretion-related effects and changes due to other factors such as airflow rate and pattern.




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Moderate-Intensity Running Causes Intervertebral Disc Compression in Young Adults.

Author: KINGSLEY, MICHAEL IAN 1,2; D'SILVA, LINDSAY ANTONIO 2; JENNINGS, CAMERON 3; HUMPHRIES, BRENDAN 3; DALBO, VINCENT JAMES 3; SCANLAN, AARON TERRANCE 3
Page: 2199-2204

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Poster 43 Repeated Blasts Induce Deterioration of Rats Cognitive and Locomotor Function

Publication year: 2012
Source:PM&R, Volume 4, Issue 10, Supplement

Oscar U. Scremin, Mulugeta Million, Keith M. Norman, Margareth Roch, James J. Schultz, A.M. Erika Scremin






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Commentary on "Pain, Balance, Activity, and Participation in Children With Hypermobility Syndrome".

Author: Selby-Silverstein, Lisa PT, PhD, NCS; Atkins, Tiffeny PT, DPT, PCS
Page: 344

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Evidence to Practice Commentary: Is More Therapy Better?

Physical & Occupational Therapy in Pediatrics, Volume 32, Issue 4, Page 383-387, October 2012.

Source: http://informahealthcare.com/doi/abs/10.3109/01942638.2012.726894?ai=1ozx&mi=3s94u5&af=R

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Poster 4 An Interactive Format for Improving Medical Student Exposure to Physical Medicine & Rehabilitation

Publication year: 2012
Source:PM&R, Volume 4, Issue 10, Supplement

Kimberly Ross, Seema R. Khurana, Gabriel H. Sunn






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Calcaneal Quantitative Ultrasound Compared With Hip and Femoral Neck Dual-Energy X-Ray Absorptiometry in People With A Spinal Cord Injury

Publication year: 2012
Source:PM&R, Volume 4, Issue 10

Thomas J. Schnitzer, Nicole Wysocki, Danielle Barkema, James Griffith, Victoria Lent, Meghan Romba, Rachel Welbel, Sheena Bhuva, Bindu Manyam, Sarah Linn

Objective To evaluate the sensitivity and specificity of calcaneal quantitative ultrasound (QUS) measurements for identifying osteoporosis determined by dual-energy x-ray absorptiometry (DXA) at the hip in a spinal cord injury (SCI) population. Design Cross-sectional retrospective review of data collected in the bone health registry of persons with a disability. Setting Inpatients and outpatients at a single acute rehabilitation hospital. Participants A convenience sample of 66 participants, both inpatients and outpatients, with a spinal cord injury. Methods Calcaneal T scores were determined by ultrasound, and bone density of the lumbar spine, total hip, and femoral neck were determined by DXA. Main Outcome Measurements Right and left calcaneal QUS T scores and right and left hip and femoral neck DXA T scores. Results Right and left hip DXA T scores were strongly associated with corresponding right and left calcaneal QUS T scores (right: r = .72, P < .001; left: r = .70, P < .001). Similar associations were found when we evaluated femoral neck T scores and calcaneal QUS T scores. Receiver operating characteristic analysis for evaluating QUS to identify DXA-defined osteoporosis demonstrated an area under the curve of 0.81 for all participants (acute and chronic injury) and 0.68 for those with a chronic SCI. Conclusions A strong association exists between calcaneal QUS T scores and bone density T scores at the hip measured by DXA. QUS may have a place in the screening of people with SCI 1 year or more after their injury to evaluate their bone status.




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Miyerkules, Oktubre 24, 2012

Extended Exercise Rehabilitation After Hip Fracture Improves Patients' Physical Function: A Systematic Review and Meta-Analysis

Background

Although the principal goal of hip fracture management is a return to the pre-event functional level, most survivors fail to regain their former levels of autonomy. One of the most effective strategies to mitigate the fracture's consequences is therapeutic exercise.

Purpose

The purpose of this study was to review and quantify the reported effects of an extended exercise rehabilitation program offered beyond the regular rehabilitation period on improving physical functioning for patients with hip fractures.

Sources

The Cochrane libraries, PubMed, CINAHL, PEDro, and EMBASE were searched to April 2012.

Study Selection

All randomized controlled trials comparing extended exercise programs with usual care for community-dwelling people after hip fracture were included in the review.

Data Extraction and Synthesis

Two reviewers conducted each step independently. The data from the included studies were summarized, and pooled estimates were calculated for 11 functional outcomes.

Results

Thirteen trials were included in the review and 11 in the meta-analysis. The extended exercise program showed modest effect sizes (ESs), which reached significance, under random theory, for knee extension strength for the affected and nonaffected sides (ES=0.47, 95% confidence interval [CI]=0.27–0.66, and ES=0.45, 95% CI=0.16–0.74, respectively), balance (ES=0.32, 95% CI=0.15–0.49), physical performance-based tests (ES=0.53, 95% CI=0.27–0.78), Timed "Up & Go" Test (ES=0.83, 95% CI=0.28–1.4), and fast gait speed (ES=0.42, 95% CI=0.11–0.73). Effects on normal gait speed, Six-Minute Walk Test, activities of daily living and instrumental activities of daily living, and physical function subscale of the 36-Item Short-Form Health Survey (SF-36-PF) did not reach significance. Community-based programs had larger ESs compared with home-based programs.

Conclusions

To the authors' knowledge, this is the first meta-analysis to provide evidence that an extended exercise rehabilitation program for patients with hip fractures has a significant impact on various functional abilities. The focus of future research should go beyond just effectiveness and study the cost-effectiveness of extended programs.

Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110274v2?rss=1

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Which Prognostic Factors for Low Back Pain Are Generic Predictors of Outcome Across a Range of Recovery Domains?

Background.

Recovery from low back pain (LBP) is multidimensional and requires the use of multiple-response (outcome) measures to fully reflect these many dimensions. Predictive prognostic variables that are present or stable in all or most predictive models that use different outcome measures could be considered "universal" prognostic variables.

Objective.

The aim of this study was to explore the potential of universal prognostic variables in predictive models for 4 different outcome measures in patients with mechanical LBP.

Design.

Predictive modeling was performed using data extracted from a randomized controlled trial. Four prognostic models were created using backward stepwise deletion logistic, Poisson, and linear regression.

Methods.

Data were collected from 16 outpatient physical therapy facilities in 10 states. All 149 patients with LBP were treated with manual therapy and spine strengthening exercises until discharge. Four different measures of response were used: Oswestry Disability Index and Numeric Pain Rating Scale change scores, total visits, and report of rate of recovery.

Results.

The set of statistically significant predictors was dependent on the definition of response. All regression models were significant. Within both forms of the 4 models, meeting the clinical prediction rule for manipulation at baseline was present in all 4 models, whereas no irritability at baseline and diagnosis of sprains and strains were present in 2 of 4 of the predictive models.

Limitations.

The primary limitation is that this study evaluated only 4 of the multiple outcome measures that are pertinent for patients with LBP.

Conclusions.

Meeting the clinical prediction rule was prognostic for all outcome measures and should be considered a universal prognostic predictor. Other predictive variables were dependent on the outcomes measure used in the predictive model.

Source: http://ptjournal.apta.org/cgi/content/short/ptj.20120216v2?rss=1

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Is supervised exercise training safe in patients with anorexia nervosa? A meta-analysis

Publication year: 2012
Source:Physiotherapy

L.W.C. Ng, D.P. Ng, W.P. Wong

Background Anorexia nervosa is an eating disorder that is often preceded by excessive physical activity. As such, exercise is not often prescribed in the clinical management of individuals with anorexia nervosa. Objective To examine the effects of supervised exercise training in patients with anorexia nervosa. Data sources Five databases were searched from their inception to Week 14 of 2011 using the subject headings ‘anorexia’ and ‘exercise’ to identify relevant studies. Eligibility criteria PRISMA guidelines were followed. Studies that investigated the effects of inclusion of supervised exercise training in clinical management with usual management in patients diagnosed with anorexia nervosa were included in this review. Case reports were excluded. Data extraction and synthesis Two reviewers independently extracted data using a standardised assessment form. Quality assessment was rated for the controlled trials and single-group studies using the PEDro scale and Downs and Black scale, respectively. Fixed or random effect approaches were used to determine effect size, depending on the heterogeneity of the studies. Results Pooled randomised controlled trials and quasi-randomised studies showed no significant effect of supervised exercise training on selected anthropometric measurements, while the single-group studies showed significant improvement in weight and body fat. Although Short Form-36 revealed no training effect, distorted feelings about food and exercise were reduced. Cardiovascular fitness also improved with no decrease in weight. Limitations Heterogeneity of exercise training programmes, small sample size (n 20) for 67% of the trials, and inability to exclude publication bias. Conclusions Inclusion of supervised exercise training in the comprehensive management of patients with anorexia nervosa appears to be safe, as no detrimental effect was observed in anthropometry. Strength and cardiovascular fitness were also shown to improve.




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Chartered Society of Physiotherapy's identification of national research priorities for physiotherapy using a modified Delphi technique

Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 3

Gabrielle Rankin, Alison Rushton, Pat Olver, Ann Moore

Objective To define research priorities to strategically inform the evidence base for physiotherapy practice. Design A modified Delphi method using SurveyMonkey software identified priorities for physiotherapy research through national consensus. An iterative process of three rounds provided feedback. Round 1 requested five priorities using pre-defined prioritisation criteria. Content analysis identified research themes and topics. Round 2 requested rating of the importance of the research topics using a 1–5 Likert scale. Round 3 requested a further process of rating. Quantitative and qualitative data informed decision-making. Level of consensus was established as mean rating ≥3.5, coefficient of variation ≤30%, and ≥55% agreement. Consensus across participants was evaluated using Kendall's W. Participants Four expert panels (n =40–61) encompassing a range of stakeholders and reflecting four core areas of physiotherapy practice were established by steering groups (n =204 participants overall). Findings Response rates of 53–78% across three rounds were good. The identification of 24/185 topics for musculoskeletal, 43/174 for neurology, 30/120 for cardiorespiratory and medical rehabilitation, and 30/113 for mental and physical health and wellbeing as priorities demonstrated discrimination of the process. Consensus between participants was good for most topics. Measurement validity of the research topics was good. The involvement of multiple stakeholders as participants ensured the current context of the intended use of the priorities. Conclusions From a process of national consensus involving key stakeholders, including service users, physiotherapy research topics have been identified and prioritised. Setting priorities provides a vision of how research can contribute to the developing research base in physiotherapy to maximise focus.




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PhysioDirect: Supporting physiotherapists to deliver telephone assessment and advice services within the context of a randomised trial

Publication year: 2012
Source:Physiotherapy

Annette Bishop, Jill Gamlin, Jeanette Hall, Cherida Hopper, Nadine E. Foster

Physiotherapy-led telephone assessment and advice services for patients with musculoskeletal problems have been developed in many services in the UK, but high quality trial data on clinical and cost effectiveness has been lacking. In order to address this ‘The PhysioDirect trial’ (ISRCTN55666618), was a pragmatic randomised trial of a PhysioDirect telephone assessment and advice service. This paper describes the PhysioDirect system used in the trial and how physiotherapists were trained and supported to use the system and deliver the PhysioDirect service. The PhysioDirect system used in the trial was developed in Huntingdon and now serves a population of 350,000 people. When initiating or providing physiotherapy-led telephone assessment and advice services training and support for physiotherapists delivering care in this way is essential. An enhanced skill set is required for telephone assessment and advice particularly in listening and communication skills. In addition to an initial training programme, even experienced physiotherapists benefit from a period of skill consolidation to become proficient and confident in assessing patients and delivering care using the telephone. A computer-based system assists the delivery of a physiotherapy-led musculoskeletal assessment and advice service. Clinical Trials Registration Number (ISRCTN55666618).




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Individualized Behavioral Assessments and Maternal Ratings of Mastery Motivation in Mental Age-Matched Toddlers With and Without Motor Delay

Background

Mastery motivation is a precursor of later developmental outcomes. Evidence about whether toddlers with motor delay have lower mastery motivation is inconclusive.

Objective

To examine differences between mental age matched toddlers with and without motor delay on various mastery motivation indicators.

Design

A mental age and gender matched case-control study.

Methods

Twenty-two children with motor delay, aged 23 – 47 months, and 22 children developing typically, aged 15 – 29 months were recruited. Persistence and mastery pleasure were measured with behavioral tasks that were moderately challenging for each child and with maternal ratings using the Dimensions of Mastery Questionnaire (DMQ). The DMQ was rated by the mother based on her perception of her child's motivation. Two types of structured tasks (a puzzle and a cause-effect toy selected to be moderately challenging for each individual child) were administered in a laboratory setting and recorded on videos. Paired t tests or Wilcoxon signed rank tests were used to examine group differences in persistence and mastery pleasure (α=.007; two tailed).

Results

Children with motor delay were rated lower on DMQ persistence than the typically developing group, but they did not show significantly lower persistence on the structured tasks. There were no significant differences in mastery pleasure between the two groups on either measure.

Limitations

Large within sample variability on the tasks and small sample size makes subgroup analysis (e.g., different severities) difficult.

Conclusions

Toddlers with motor delays did not show lower persistence and pleasure when given tasks that were moderately challenging; however, mothers tended to view their delayed toddlers as having lower motivation. Clinicians and parents should provide appropriately challenging tasks to increase children's success and motivation.

Source: http://ptjournal.apta.org/cgi/content/short/ptj.20120068v1?rss=1

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