Source:Physiotherapy, Volume 98, Issue 4
Helen Sharma, Cathy Bulley, Frederike M.J. van Wijck
Biyernes, Nobyembre 30, 2012
Experiences of an exercise referral scheme from the perspective of people with chronic stroke: a qualitative study
Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 4
Helen Sharma, Cathy Bulley, Frederike M.J. van Wijck
Objective To explore stroke survivors’ experiences of undertaking exercise in the context of an exercise referral scheme for people with chronic stroke. Design A qualitative design, using semi-structured interviews within a constructivist framework to explore the experiences of individual participants. Verbatim transcripts were thematically analysed. Rigour mechanisms included respondent validation, peer checking, and reflexivity. Setting An exercise referral scheme, based at a leisure centre in South London. Participants Nine community-dwelling stroke survivors took part; 5 male and 4 female, mean age 51 years (range 37–61 years); time post stroke 1–4 years, with mixed ethnic backgrounds. Findings Participants described greater physical and psychological well-being following participation in the exercise referral scheme. Categories that emerged were: improved exercise engagement and confidence, more internalised perceptions of control and enhanced lifestyle, work and social roles. Categories linked to form a master theme, labelled: ‘Exercise Referral Scheme as a catalyst for regaining independence.’ Conclusions This study supports the value of exercise referral schemes in enabling people with stroke to engage in exercise. For participants in this study, the scheme seemed influential in the process of regaining independence.
Source:Physiotherapy, Volume 98, Issue 4
Helen Sharma, Cathy Bulley, Frederike M.J. van Wijck
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.
Source:PM&R
Milad Alizadeh-Meghrazi, Kei Masani, Milos R. Popovic, Beverley Catharine Craven
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Contextualized perceptions of movement as a source of expanded insight: People with multiple sclerosis' experience with physiotherapy
Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-12, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.698717?ai=1mo2&mi=3s94u5&af=R
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Blowing the whistle to protect a patient: a comparison between physiotherapy students and physiotherapists
Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 4
Abraham Mansbach, Itzik Melzer, Yaacov G. Bachner
Objectives To answer three questions: Are physiotherapists and physiotherapy students willing to take action to prevent misconduct in order to protect a patient's interests? Are they willing to report the misconduct to authorities within an organisation and/or outside of it? Are they willing to report a colleague's wrongdoing as well as that of a manager? Design Observational questionnaire study. Participants Two hundred and twenty-seven participants divided into two groups: 126 undergraduate students at the Department of Physical Therapy at Ben Gurion University, and 101 certified physiotherapists working in hospitals and rehabilitation centres in south and central regions of Israel. Outcome measures Participants were presented with two vignettes – one describing a colleague's misconduct and the other describing a manager's misconduct – and asked to make a decision about whistleblowing. Results Both groups rated their own willingness to take action to change the harmful situations very highly. The physiotherapists perceived a colleague's misconduct as being more serious than the students, and were more willing to intervene internally. The students were more prepared than the physiotherapists to take such action externally. The students perceived the manager's misconduct as being more serious than the physiotherapists, and also reported a greater readiness to intervene externally. Conclusions Physiotherapists consider acts that are detrimental to a patient to be very serious, and are more willing to take action when the offending individual is a colleague. Students are more willing to blow the whistle externally. This article suggests tools for handling similar situations.
Source:Physiotherapy, Volume 98, Issue 4
Abraham Mansbach, Itzik Melzer, Yaacov G. Bachner
Benefits of Exercise During Pregnancy
Publication year: 2012
Source:PM&R, Volume 4, Issue 11
Heidi Prather, Tracy Spitznagle, Devyani Hunt
There is a direct link between healthy mothers and healthy infants. Exercise and appropriate nutrition are important contributors to maternal physical and psychological health. The benefits and potential risks of exercise during pregnancy have gained even more attention, with a number of studies having been published after the 2002 American College of Obstetrics and Gynecologists guidelines. A review of the literature was conducted by using PubMed, Scopus, and Embase to assess the literature regarding the benefits of exercise during pregnancy. The search revealed 219 publications, which the authors then narrowed to 125 publications. The purpose of this review is to briefly summarize the known benefits of exercise to the mother, fetus, and newborn.
Source:PM&R, Volume 4, Issue 11
Heidi Prather, Tracy Spitznagle, Devyani Hunt
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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Huwebes, Nobyembre 29, 2012
Continued recovery in an adult with cerebellar ataxia
Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-9, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.699605?ai=1mo2&mi=3s94u5&af=R
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The Six-Minute Walk Test in Chronic Pediatric Conditions: A Systematic Review of Measurement Properties
The six minute walk test (6MWT) is increasingly being used as a functional outcome measure for chronic pediatric conditions. Knowledge about its measurement properties is required to determine whether it is an appropriate test to use.
To systematically review all clinimetric studies on the 6MWT in chronic pediatric conditions
The databases MEDLINE, CINAHL, PEDro and Sportdiscus were searched up to February 2012
Study designed to evaluate measurement properties of the 6MWT in a chronic pediatric condition were included.
methodological quality of the included studies and the measurement properties of the 6MWT
A best evidence synthesis was performed of fifteen studies including nine different chronic pediatric conditions. Limited to strong evidence was found for reliability in various chronic conditions. Strong evidence was found for a positive criterion validity of the 6MWT with VO2peak in some populations but a negative criterion validity in other populations. Construct validity remained unclear in most patient groups because of methodological flaws. Little evidence was available for responsiveness and measurement error. Studies showed a large variability in test procedures despite existing guidelines for the performance of the 6MWT
Unavailability of a specific checklist to evaluate methodological quality of clinimetric studies on performance measures
Evidence for measurement properties of the 6MWT varies largely between chronic pediatric conditions. Further research is required in all patient groups to explore the ability of the 6MWT to measure significant and clinical important changes. Until then, changes measured with the 6MWT should be interpreted with caution. Future studies or consensus regarding modified test procedures in the pediatric population is recommended.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20120210v1?rss=1
Children with paralytic poliomyelitis: Utilization of physiotherapy services in Zamfara State, Nigeria
Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-9, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.703761?ai=1mo2&mi=3s94u5&af=R
Intensive Care Unit-Acquired Weakness: Implications for Physical Therapist Management
Patients admitted to the intensive care unit (ICU) can develop a condition referred to as "ICU-acquired weakness." This condition is characterized by profound weakness that is greater than might be expected to result from prolonged bed rest. Intensive care unit—acquired weakness often is accompanied by dysfunction of multiple organ systems. Individuals with ICU-acquired weakness typically have significant activity limitations, often requiring physical assistance for even the most basic activities associated with bed mobility. Many of these individuals have activity limitations months to years after hospitalization. The purpose of this article is to review evidence that guides physical rehabilitation of people with ICU-acquired weakness. Included are diagnostic criteria, medical management, and prognostic indicators, as well as criteria for beginning physical rehabilitation, with an emphasis on patient safety. Data are presented indicating that rehabilitation can be implemented with very few adverse effects. Evidence is provided for appropriate measurement approaches and for physical intervention strategies. Finally, some of the key issues are summarized that should be investigated to determine the best intervention guidelines for individuals with ICU-acquired weakness.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110117v2?rss=1
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Brain meningioma in a patient with complaints of low back pain and leg weakness
Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-6, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.734010?ai=1mo2&mi=3s94u5&af=R
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Physical Rehabilitation of Patients in Intensive Care Units Requiring Extracorporeal Membrane Oxygenation: A Small Case Series
Neuromuscular weakness and impaired physical function are common and long-lasting complications experienced by intensive care unit (ICU) survivors. There is growing evidence that implementing rehabilitation therapy, shortly after ICU admission, improves physical function and reduces healthcare utilization. Recently, there is increasing interest and utilization of Extracorporeal Membrane Oxygenation (ECMO) to support patients with severe respiratory failure. Patients receiving ECMO are at great risk for significant physical impairments and pose unique challenges for delivering rehabilitation therapy. Consequently, there is a need for innovative examples of safely and feasibly delivering active rehabilitation to these patients. We describe three patients with respiratory failure requiring ECMO who received physical rehabilitation to illustrate and discuss relevant feasibility and safety issues.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20120336v1?rss=1
Basic Principles Regarding Strength, Flexibility, and Stability Exercises
Publication year: 2012
Source:PM&R, Volume 4, Issue 11
William Micheo, Luis Baerga, Gerardo Miranda
Strength, flexibility, and stability are physiologic parameters associated with health-related physical fitness. Each of these domains affects health in general, the risk of injury, how an injury is treated, and performance in activities of daily living and sports. These domains are affected by individual phenotype, age, deconditioning, occupational activity, and formal exercise. Deficits or loss of strength, flexibility, and stability can be prevented or reduced with exercise programs. Normal muscle strength has been associated with general health benefits, increased life expectancy, psychological benefits, prevention of illness, and reduction of disability in older adults. Static flexibility programs have been shown to improve joint range of motion and tolerance to stretch but do not appear to reduce the risk of musculoskeletal injury and may impair muscle performance immediately after a static stretch. Dynamic flexibility, on the other hand, may enhance power and improve sports-specific performance. Stability training leads to improved balance and neuromuscular control, may prevent injury to the knee and ankle joints, and can be used for treatment of patients with low back pain.
Source:PM&R, Volume 4, Issue 11
William Micheo, Luis Baerga, Gerardo Miranda
Miyerkules, Nobyembre 28, 2012
Defining the Clinical Syndrome of Lumbar Spinal Stenosis: A Recursive Specialist Survey Process
Publication year: 2012
Source:PM&R
Danielle E. Sandella, Andrew J. Haig, Christy Tomkins-Lane, Karen S.J. Yamakawa
Background Lumbar spinal stenosis has evolved from an anatomic concept to a poorly defined clinical syndrome. Rules for such a syndrome need to be informed by the experience and beliefs of expert clinicians. The level of certainty is seldom considered in defining criteria for a syndrome. Objective To design an innovative online recursive survey technique to seek out information that is valued by specialists and to measure the impact of this evidence on their strength of conviction regarding the diagnosis of spinal stenosis. Design Prospective online survey. Setting Internet. University-based project. Participants American physiatrists recruited by online postings and postcards. Interventions A recursive process presented a scenario that allowed clinicians to choose 1 of 10 clinical factors and then asked their level of certainty about diagnosis when that factor is true. Subsequent questions build on that assumption by adding other factors. Main Outcome Measures Certainty regarding the diagnosis of clinical lumbar spinal stenosis. Results Of a total of 97 participants, 80 completed 3 or more iterations. “Leg pain while walking” (66%), “must sit down or bend” (66%), and “flex forward while walking” (49%) were the most commonly selected questions. “Normal foot pulses” (19%), “back pain” (16%), “leg pain” (15%), “relief with rest” (14%), and “sensory deficits” (12%) were of intermediate value, whereas “problems with balance,” “have fallen recently,” and “the sacroiliac joint is not the main pain generator” were all chosen less than 5% of the time. Statistically significant (P < .05) change in certainty ceased after 6 questions at 86.2% certainty. Conclusions A recursive approach to diagnostic certainty is valuable. Within 5 questions, clinicians become almost 90% certain that a person has clinical spinal stenosis. This question set provides one pragmatic clinical criterion for the syndrome of lumbar spinal stenosis.
Source:PM&R
Danielle E. Sandella, Andrew J. Haig, Christy Tomkins-Lane, Karen S.J. Yamakawa
Reliability and Responsiveness of the Gross Motor Function Measure-88 in Children With Cerebral Palsy
The "Gross Motor Function Measure" (GMFM-88) is a commonly used measure for evaluating gross motor function in children with cerebral palsy (CP). The relative reliability of GMFM-88 has been assessed in children with CP. However, little information is available about the absolute reliability or responsiveness of GMFM-88.
The objective of this research was to determine the absolute and relative reliability and responsiveness of the GMFM-88 in evaluating gross motor function in children with CP.
A clinical measurement design.
Ten raters scored GMFM-88 of 84 children from video records across all GMFCS levels to establish inter-rater reliability. Two raters participated to assess intra-rater reliability. Responsiveness was determined from three additional assessments after the baseline assessment. The inter- and intra-rater intraclass correlation coefficient (ICC) with 95% confidence intervals, standard error of measurement (SEM), smallest real difference (SRD), effect size (ES), and standardized response mean (SRM) were calculated.
The relative reliabilities of the GMFM were excellent (ICCs = 0.986-1.000). The SEM and SRD for total score of the GMFM were acceptable (1.60 and 3.14, respectively). Additionally, the goal total scores of the ES and SRM increased gradually in the three follow-up assessments (GMFCS level I–II: ES = 0.5, 0.6, and 0.8, SRM = 1.3, 1.8, and 2.0; GMFCS III–V: ES = 0.4, 0.7, and 0.9, SRM = 1.5, 1.7, and 2.0).
Children over 10 years of age with CP were not included in this study, so the results should not be generalized to all children with CP.
This study indicates that both reliability and responsiveness of the GMFM-88 are reasonable for measuring gross motor function in children with CP.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110374v1?rss=1
The Paralympic Movement: Using Sports to Promote Health, Disability Rights, and Social Integration for Athletes With Disabilities
Publication year: 2012
Source:PM&R, Volume 4, Issue 11
Cheri Blauwet, Stuart E. Willick
Competitive sports for people with disabilities has grown rapidly over the past several decades, and opportunities for participation are increasingly available throughout the spectrum from developmental to elite. The Paralympic Games, seen as the pinnacle sporting event that represents the broader Paralympic Movement, has provided a platform to showcase the abilities of people with disabilities while also serving as a catalyst for disability rights through ensuring integration, equality of opportunity, and accessibility of the built environment. Concurrently, media coverage of the Paralympic Games has led to an increased awareness of opportunities for sport participation for individuals with disabilities and, with it, the adjustment of norms regarding expectations for exercise as a component of preventive health. In addition, there is evidence of the power of sports to stimulate confidence, self-efficacy, and a self-perceived high quality of life for individuals with disabilities above and beyond the basic benefits to cardiometabolic fitness. When taken together, the promotion of health, disability rights, and social integration through sports has the power to transform the lives of those who participate and to further stimulate the expansion of opportunities available to the next generation of athletes with disabilities.
Source:PM&R, Volume 4, Issue 11
Cheri Blauwet, Stuart E. Willick
Dose–response effects of medical exercise therapy in patients with patellofemoral pain syndrome: a randomised controlled clinical trial
Publication year: 2012
Source:Physiotherapy
Berit Østerås, Håvard Østerås, Tom Arild Torstensen, Ottar Vasseljen
Objectives To evaluate two different therapeutic exercise regimens in patients with patellofemoral pain syndrome (PFPS). Design Multicentre, randomised controlled clinical trial. Setting Three primary healthcare physiotherapy clinics. Participants Forty-two patients with PFPS were assigned at random to an experimental group or a control group. Forty participants completed the study. Interventions Both groups received three treatments per week for 12 weeks. The experimental group received high-dose, high-repetition medical exercise therapy, and the control group received low-dose, low-repetition exercise therapy. The groups differed in terms of number of exercises, number of repetitions and sets, and time spent performing aerobic/global exercises. Main outcome measures Outcome parameters were pain (measured using a visual analogue scale) and function [measured using the step-down test and the modified Functional Index Questionnaire (FIQ)]. Results At baseline, there were no differences between the groups. After the interventions, there were statistically significant (P Conclusion The results indicate that exercise therapy has a dose–response effect on pain and functional outcomes in patients with PFPS. This indicates that high-dose, high-repetition medical exercise therapy is more efficacious than low-dose, low-repetition exercise therapy for this patient group. Registered on http://www.clinicaltrials.gov (identifier: NCT01290705 ).
Source:Physiotherapy
Berit Østerås, Håvard Østerås, Tom Arild Torstensen, Ottar Vasseljen
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).
Source:Physiotherapy
Annette Bishop, Jill Gamlin, Jeanette Hall, Cherida Hopper, Nadine E. Foster
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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
- Journal Physiotherapy Canada
- Online ISSN 1708-8313
- Print ISSN 0300-0508
- Journal Volume Volume 64
- Journal Issue Volume 64, Number 4 / 2012
Source: http://www.metapress.com/content/97n0813510p20151/
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A Combined Early Cognitive and Physical Rehabilitation Program for People Who Are Critically Ill: The Activity and Cognitive Therapy in the Intensive Care Unit (ACT-ICU) Trial
In the coming years, the number of survivors of critical illness is expected to increase. These survivors frequently develop newly acquired physical and cognitive impairments. Long-term cognitive impairment is common following critical illness and has dramatic effects on patients' abilities to function autonomously. Neuromuscular weakness affects similar proportions of patients and leads to equally profound life alterations. As knowledge of these short-term and long-term consequences of critical illness has come to light, interventions to prevent and rehabilitate these devastating consequences have been sought. Physical rehabilitation has been shown to improve functional outcomes in people who are critically ill, but subsequent studies of physical rehabilitation after hospital discharge have not. Post-hospital discharge cognitive rehabilitation is feasible in survivors of critical illness and is commonly used in people with other forms of acquired brain injury. The feasibility of early cognitive therapy in people who are critically ill remains unknown.
The purpose of this novel protocol trial will be to determine the feasibility of early and sustained cognitive rehabilitation paired with physical rehabilitation in patients who are critically ill from medical and surgical intensive care units.
This is a randomized controlled trial.
The setting for this trial will be medical and surgical intensive care units of a large tertiary care referral center.
The participants will be patients who are critically ill with respiratory failure or shock.
Patients will be randomized to groups receiving usual care, physical rehabilitation, or cognitive rehabilitation plus physical rehabilitation. Twice-daily cognitive rehabilitation sessions will be performed with patients who are noncomatose and will consist of orientation, memory, and attention exercises (eg, forward and reverse digit spans, matrix puzzles, letter-number sequences, pattern recognition). Daily physical rehabilitation sessions will advance patients from passive range of motion exercises through ambulation. Patients with cognitive or physical impairment at discharge will undergo a 12-week, in-home cognitive rehabilitation program.
A battery of neurocognitive and functional outcomes will be measured 3 and 12 months after hospital discharge.
If feasible, these interventions will lay the groundwork for a larger, multicenter trial to determine their efficacy.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110414v2?rss=1
Martes, Nobyembre 27, 2012
Oxford Grading Scale vs manometer for assessment of pelvic floor strength in nulliparous sports students
Publication year: 2012
Source:Physiotherapy
T. Da Roza, T. Mascarenhas, M. Araujo, V. Trindade, R. Natal Jorge
Objectives To compare pelvic floor muscle strength in nulliparous sports students measured using the modified Oxford Grading Scale and a Peritron manometer; and to compare the manometric measurements between continent and incontinent subjects. Design Cross-sectional study. All subjects were evaluated twice on the same day; first by vaginal digital examination and subsequently by vaginal pressure using a Peritron manometer. Participants Forty-three nulliparous female sports students [mean age 21 (standard deviation 4) years] from the Sports Faculty of the University of Porto. Results This study found a significant moderate correlation between the Oxford Grading Scale score and peak pressure on manometry (r P 2 O (range 21 to 1152 O). Out of 43 subjects, 37% (n Conclusions There was moderate correlation between peak pressure on manometry and the Oxford Grading Scale score. Peritron manometer measurements of pelvic floor muscle contractions showed no significant differences in vaginal resting pressure and peak pressure in continent and incontinent subjects.
Source:Physiotherapy
T. Da Roza, T. Mascarenhas, M. Araujo, V. Trindade, R. Natal Jorge
Driving and Post-Concussion Changes in Neuropsychological Performance
Publication year: 2012
Source:PM&R, Volume 4, Issue 10, Supplement
Maria T. Schultheis, Jocelyn Ang, Taylor Blake, Sandella J. Bradley, Gene Hong, Danielle Martin, Jocelyn C. Ricasa, Preeti Sunderaraman
Source:PM&R, Volume 4, Issue 10, Supplement
Maria T. Schultheis, Jocelyn Ang, Taylor Blake, Sandella J. Bradley, Gene Hong, Danielle Martin, Jocelyn C. Ricasa, Preeti Sunderaraman
Manuscript Reviewers
Physiotherapy Theory and Practice, Volume 28, Issue 8, Page 653-655, November 2012.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.736762?ai=1mo2&mi=3s94u5&af=R
Reading Performance After Vision Rehabilitation of Subjects With Homonymous Visual Field Defects
Publication year: 2012
Source:PM&R
Carolin Gall, Bernhard A. Sabel
Objective Subjects with homonymous visual field defects frequently experience reduced reading speed. The purpose of this study was to examine whether increased visual functioning after vision-restoration training (VRT) coincides with improved reading abilities. Design Prospective noncontrolled open-label trial. Setting Controlled laboratory setting for all diagnostic procedures that were conducted before and after 6 months of home-based VRT with telemedicine support. Patients Eleven subjects who had experienced a posterior-parietal stroke. Interventions Six months of VRT (1 hour daily repeated light stimulation in the partially damaged visual field). Main outcome measurements VRT outcome measures were the number of detected light stimuli in eye-tracker controlled high-resolution perimetry and the spared visual field within the affected hemifield up to the relative and absolute defect visual field border (square degrees). Enlargements of spared visual field within the affected hemifield were correlated with changes of reading speed after VRT. Results After VRT, the number of detected light stimuli increased by 5.02 ± 4.31% (mean ± SD; P = .03). The spared visual field up to the relative defect visual field border increased from 18.09 ± 32.35 square degrees before to 137.40 ± 53.32 after VRT (P = .006), as well as for the absolute defect visual field border from 36.95 ± 33.77 square degrees before VRT to 152.02 ± 49.70 after VRT (P = .005). Reading speed increased from 108.95 ± 33.95 words per minute before VRT to 122.26 ± 30.35 after VRT (P = .017), which significantly correlated with increased spared visual field up to the relative defect visual field border (r = 0.73, P = .016). Measures of eye movement variability did not correlate with VRT outcome. Conclusions VRT improved visual fields in parafoveal areas, which are most relevant for reading. This finding cannot be explained by changes in eye movement behavior. Because of a significant association between improvements of parafoveal vision and reading speed, we propose that patients with homonymous visual field defects who have reading deficits may benefit from visual stimulation by training.
Source:PM&R
Carolin Gall, Bernhard A. Sabel
Effectiveness of an Early Mobilization Protocol in a Trauma and Burns Intensive Care Unit: A Retrospective Cohort Study
Bed rest and immobility in patients on mechanical ventilation and/or in an intensive care unit (ICU) have detrimental effects. Studies in medical ICUs show that early mobilization is safe, does not increase cost, and can be associated with decreased ICU and hospital length of stay (LOS).
Assess the effects of an early mobilization protocol (EMP) on complication rates, ventilator days, and ICU and hospital LOS for patients admitted to a trauma and burn ICU (TBICU).
A retrospective cohort study of a interdisciplinary quality-improvement program.
Pre- and post-EMP patient data from the trauma registry for 2,176 patients admitted to the TBICU between May 2008 and April 2010 were compared.
No adverse events were reported related to the EMP. After adjusting for age and injury severity, there was a decrease in airway, pulmonary, and vascular complications (including pneumonia and DVT) post-EMP. Ventilator days, TBICU and hospital lengths of stay were not significantly decreased.
Using a historical control group, there was no way to account for other changes in patient care that may have occurred between the two periods that could have affected patient outcomes. The dose of physical activity both pre- and post-EMP were not specifically assessed.
Early mobilization of patients in a TBICU was safe and effective. Medical, nursing, and physical therapy staff, as well as hospital administration have embraced the new culture of "early mobilization" in the ICU.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110417v1?rss=1
Lunes, Nobyembre 26, 2012
Potential of the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy in a developing country: a pilot study
Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 3
C. Gordon, S. Roopchand-Martin, A. Gregg
Objectives To explore the possibility of using the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy (CP) in a developing country, and determine whether there is potential for an impact on their gross motor function. Design Pilot study with a pre–post-test design. Setting Sir John Golding Rehabilitation Center, Jamaica, West Indies. Participants Seven children, aged 6 to 12 Intervention Training with the Nintendo Wii was conducted twice weekly for 6 Main outcome measures Percentage attendance over the 6-week period, percentage of sessions for which the full duration of training was completed, and changes in gross motor function using the Gross Motor Function Measure (GMFM). Results All six participants who completed the study had 100% attendance, and all were able to complete the full 45 Conclusion The Nintendo Wii has the potential for use as a rehabilitation tool in the management of children with CP. Clinical trials should be conducted in this area to determine whether this could be an effective tool for improving gross motor function.
Source:Physiotherapy, Volume 98, Issue 3
C. Gordon, S. Roopchand-Martin, A. Gregg
Exercise to Enhance Mobility and Prevent Falls After Stroke: The Community Stroke Club Randomized Trial
Background. Exercise interventions can enhance mobility after stroke as well as prevent falls in elderly persons. Objective. Investigate whether an exercise intervention can enhance mobility, prevent falls, and increase physical activity among community-dwelling people after stroke. Method. A randomized trial with blinding of physical outcome assessment was conducted through local stroke clubs. Both groups, on average 5.9 years poststroke, received exercise classes, advice, and a home program for 12 months. The experimental group (EG) program (n = 76) aimed to improve walking, prevent falls and increase physical activity. The control group (CG) program (n = 75) aimed to improve upper-limb and cognitive functions. The primary outcomes were walking capacity, walking speed measured before and after the intervention, and fall rates monitored monthly. Results. At 12 months, the EG walked 34 m further in 6 minutes (95% confidence interval [CI] = 19-50; P < .001) and 0.07 m/s faster over 10 m (95% CI = 0.01-0.14; P = .03) than the CG. The EG had 129 falls, and the CG had 133. There were no differences in proportion of fallers (relative risk = 1.22; 95% CI = 0.91-1.62; P = .19) or the rate of falls between groups (incidence rate ratio = 0.96; 95% CI = 0.59-1.51; P = .88). Conclusion. The experimental intervention delivered through stroke clubs enhanced aspects of mobility but had no effect on falls.
Source: http://nnr.sagepub.com/cgi/content/abstract/26/9/1046?rss=1
Energy expended playing Xbox Kinect™ and Wii™ games: a preliminary study comparing single and multiplayer modes
Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 3
C. O’Donovan, E. Hirsch, E. Holohan, I. McBride, R. McManus, J. Hussey
Objectives It has been reported that a higher galvanic skin response is seen when playing video games against another human player than when playing alone, which suggests increased effort. The objectives of this study were to compare energy expenditure when playing two popular active video game consoles, and to compare energy expenditure when playing in single and multiplayer modes. Design Crossover trial with randomised playing order. Participants Fourteen healthy adults with a mean age of 21 [standard deviation (SD) 3] years. Methods and interventions Energy expenditure was measured using an indirect calorimeter at rest, during 10 Main outcome measures Metabolic equivalents (METs), heart rate, oxygen consumption and kilocalories expended. Results The energy expenditure during all gaming conditions was of a light intensity. Playing on the Xbox Kinect elicited greater energy expenditure than playing on the Wii [mean difference Conclusions No gaming condition required moderate-intensity activity in this group of young healthy adults. Potential explanations for the difference in energy expenditure seen between consoles and modes are discussed.
Source:Physiotherapy, Volume 98, Issue 3
C. O’Donovan, E. Hirsch, E. Holohan, I. McBride, R. McManus, J. Hussey
Potential of the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy in a developing country: a pilot study
Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 3
C. Gordon, S. Roopchand-Martin, A. Gregg
Objectives To explore the possibility of using the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy (CP) in a developing country, and determine whether there is potential for an impact on their gross motor function. Design Pilot study with a pre–post-test design. Setting Sir John Golding Rehabilitation Center, Jamaica, West Indies. Participants Seven children, aged 6 to 12 Intervention Training with the Nintendo Wii was conducted twice weekly for 6 Main outcome measures Percentage attendance over the 6-week period, percentage of sessions for which the full duration of training was completed, and changes in gross motor function using the Gross Motor Function Measure (GMFM). Results All six participants who completed the study had 100% attendance, and all were able to complete the full 45 Conclusion The Nintendo Wii has the potential for use as a rehabilitation tool in the management of children with CP. Clinical trials should be conducted in this area to determine whether this could be an effective tool for improving gross motor function.
Source:Physiotherapy, Volume 98, Issue 3
C. Gordon, S. Roopchand-Martin, A. Gregg
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Erratum: Erratum
Physical & Occupational Therapy in Pediatrics, Volume 0, Issue 0, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/01942638.2012.744577?ai=1ozx&mi=3s94u5&af=R
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Effect of Two Different Exercise Regimens on Trunk Muscle Morphometry and Endurance in Soldiers in Training
Limited evidence exists to inform how strength and endurance exercises commonly used to prevent low back pain affect muscle morphometry and endurance.
The purpose of this study was to analyze the effects of two exercise regimens on the morphometry and endurance of key trunk musculature in a healthy population.
Randomized Controlled Trial.
Military training setting.
A random subsample (n=340, 72% male, 21.9±4.2 years, 24.8±2.8 kg/m2) from the larger Prevention of Low Back Pain in the Military trial (n = 4,325) were included.
The core stabilization exercise program (CSEP) included low load/low repetition motor control exercises while the traditional exercise program (TEP) included exercises conducted fast using a high load/high repetition trunk strengthening exercises.
Baseline and follow-up examination included ultrasound imaging of the trunk muscles and endurance tests. Linear mixed models were fitted to study the group and time effect and their interactions, accounting for the clustering effect.
Symmetry generally improved in the rest and contracted states, but there were no differences suggestive of muscle hypertrophy or improved ability to contract the trunk muscles between Soldiers receiving CSEP or TEP. Total trunk endurance time decreased over the 12-week period; but endurance performance favored those Soldiers in the CSEP group (p≤0.05). Endurance time was not associated with future episodes of LBP.
The lack of morphological changes may not be detectable in an already active cohort or a more intensive dose was needed.
Although improved symmetry was noted, neither the CSEP or TEP resulted in muscle hypertrophy. Longer endurance times were noted in individuals who completed CSEP but were not strongly predictive of future low back pain episodes.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20120152v1?rss=1
Linggo, Nobyembre 25, 2012
Importance of correcting for individual differences in the clinical diagnosis of gait disorders
Publication year: 2012
Source:Physiotherapy, Volume 98, Issue 4
R. Senden, K. Meijer, I.C. Heyligers, H.H.C.M. Savelberg, B. Grimm
Objective To quantify the effects of subject characteristics on gait parameters using acceleration-based gait analysis. Design Cross-sectional study with a single group cohort. Setting Hospital setting. Participants One hundred and twenty healthy subjects (six age decade groups of 10 men and 10 women) performed a 20-m walking test. Methods Basic gait parameters (e.g. speed) and other clinically relevant parameters (e.g. step time asymmetry) were assessed during a 20-m walking test using a tri-axial accelerometer, attached at the level of the sacrum. Subject characteristics were recorded. Results Between 34% and 51% of the variability in gait parameters was explained by age, height and gender. Subject characteristics contributed less to the variance in step time asymmetry (R 2 R 2 R 2 Conclusions Age, height and gender are determinants of basic gait parameters, while their influence on gait irregularity and step time asymmetry is minimal. This indicates that gait is variable between subjects, showing the relevance of correcting gait for subject characteristics. This study describes preliminary work to build a database of gait parameters in healthy participants, describing the effects of age, gender and height. Further studies to extend this database with patients would provide further relevance to clinical practice.
Source:Physiotherapy, Volume 98, Issue 4
R. Senden, K. Meijer, I.C. Heyligers, H.H.C.M. Savelberg, B. Grimm
Validation of the Saskatoon Falls Prevention Consortium's Falls Screening and Referral Algorithm
Purpose: To investigate the concurrent validity of the Saskatoon Falls Prevention Consortium's Falls Screening and Referral Algorithm (FSRA). Method: A total of 29 older adults (mean [SD] age 77.7 [4.0] y) living in an independent-living senior's complex who met inclusion criteria completed a demographic questionnaire and the components of the FSRA and Berg Balance Scale (BBS). The FSRA consists of the Elderly Fall Screening Test (EFST) and the Multi-factor Falls Questionnaire (MFQ); it is designed to categorize individuals into low, moderate, or high fall-risk categories to determine appropriate management pathways. A predictive model for probability of fall risk, based on previous research, was used to determine concurrent validity of the FRSA. Results: The FSRA placed 79% of participants into the low-risk category, whereas the predictive model found the probability of fall risk to range from 0.04 to 0.74, with a mean (SD) of 0.35 (0.25). No statistically significant correlation was found between the FSRA and the predictive model for probability of fall risk (Spearman's ρ=0.35, p=0.06). Conclusion: The FSRA lacks concurrent validity relative to to a previously established model of fall risk and appears to over-categorize individuals into the low-risk group. Further research on the FSRA as an adequate tool to screen community-dwelling older adults for fall risk is recommended.
- Content Type Journal Article
- Category Advance Online Article
- Pages 1-10
- DOI 10.3138/ptc.2011-17
- Authors
- Sara Nicole Lawson, Shuya & Associates Integrative Sports Rehab and Wellness, Regina, Sask.
- Neal Zaluski, Craven SPORT Services
- Amanda Petrie, North 49 Balance & Dizziness Centre
- Cathy Arnold, School of Physical Therapy, University of Saskatchewan
- Jenny Basran, Geriatric Evaluation and Management Program, Saskatoon City Hospital, Saskatoon, Sask.
- Vanina Dal Bello-Haas, School of Rehabilitation Science, McMaster University Institute of Applied Health Sciences, Hamilton, Ont.
- Journal Physiotherapy Canada
- Online ISSN 1708-8313
- Print ISSN 0300-0508
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