Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.702854?ai=1mo2&mi=3s94u5&af=R
Miyerkules, Enero 16, 2013
Immediate and short-term effects of Mulligan's mobilization with movement on knee pain and disability associated with knee osteoarthritis – A prospective case series
Physiotherapy Theory and Practice, Volume 29, Issue 2, Page 87-95, February 2013.
Children with paralytic poliomyelitis: Utilization of physiotherapy services in Zamfara State, Nigeria
Physiotherapy Theory and Practice, Volume 29, Issue 2, Page 133-141, February 2013.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.703761?ai=1mo2&mi=3s94u5&af=R
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A brief interphase interval interposed within biphasic pulses enhances the contraction force of the quadriceps femoris muscle
Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-8, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.757405?ai=1mo2&mi=3s94u5&af=R
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Preventive Health Care Among Community-Dwelling Persons with Spinal Cord Injury
Available online 9 January 2013
Publication year: 2013
Source:PM&R
Objective To describe preventive health examinations/tests and behaviors of persons with traumatic spinal cord injury (SCI). Design Survey. Setting SCI clinic and telephone contact. Participants A total of 59 persons ≥18 years of age with traumatic SCI. Intervention None. Main Outcome Measures Preventive health examinations/tests and reason for not receiving an examination or test. Results Preventive health tests/examinations received within the past year: flu vaccination (40.7%); eye examination (50.8%); dental check-up (64.4%); physical examination (61.0%); vitamin D level (56.0%); cholesterol level (25.4%); and blood glucose level (39.0%). For men, 20.0% had a prostate examination and 20.0% had a colonoscopy. For women, 25.0% had a pelvic examination and 62.5% had a mammogram in the past 2 years. The most endorsed reasons for not getting an examination/test was “It was my choice” followed by “No one told me to have [examination/test].” The number of years injured had an inverse relationship with having vitamin D level checked (r = −334) and had a positive association with having serum cholesterol level checked (r = .474). Conclusion Preventive health tests and examinations in the SCI population are being obtained at about the same rate as in the U.S. population with some exceptions (ie, cholesterol level check, colonoscopy, and pelvic examination); however, the rates are far from the goals of Healthy People 2020. Primary care and SCI clinicians should be proactive in educating their patients about the importance of preventative health, especially those who have been injured for a long time.
Publication year: 2013
Source:PM&R
Correlation between the 8-repetition maximum test and isokinetic dynamometry in the measurement of muscle strength of the knee extensors: A concurrent validity study
Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-7, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.727529?ai=1mo2&mi=3s94u5&af=R
Kinesio tape management for superficial radial nerve entrapment: A case report
Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-10, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.717589?ai=1mo2&mi=3s94u5&af=R
Martes, Enero 15, 2013
Immediate and short-term effects of Mulligan's mobilization with movement on knee pain and disability associated with knee osteoarthritis – A prospective case series
Physiotherapy Theory and Practice, Volume 29, Issue 2, Page 87-95, February 2013.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.702854?ai=1mo2&mi=3s94u5&af=R
The Relationship Between Manual Ability and Ambulation in Adolescents with Cerebral Palsy
Physical & Occupational Therapy in Pediatrics, Volume 0, Issue 0, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/01942638.2012.754394?ai=1ozx&mi=3s94u5&af=R
Effect of Exercise and Weight Loss in People Who Have Hip Osteoarthritis and Are Overweight or Obese: A Prospective Cohort Study
Osteoarthritis (OA) is the most common joint disorder in the world and is recognized as a substantial source of disability. For people with OA of the knee, exercise in combination with weight loss is a proven effective conservative treatment option, yet evidence is lacking for people with hip OA.
The aim of this study was to obtain preliminary evidence of the effect of a program of exercise in combination with weight loss on physical function in people who have hip OA and are overweight or obese.
This investigation was a prospective cohort study.
Thirty-five people who were 25 years or older, had clinical and radiological evidence of hip OA, and were overweight or obese (body mass index of >25 kg/m2) were included. They participated in an 8-month program of exercise in combination with weight loss. A body mass index of 40 kg/m2 was used as the upper limit. The primary outcome was self-reported physical function, as measured with a subscale of the Western Ontario and McMaster Universities Osteoarthritis Index. Secondary outcome measures included pain and walking tests as quantitative measures of function.
Participation in the combination program resulted in a 32.6% improvement in self-reported physical function after 8 months, a finding that could be considered clinically relevant. Significant improvements also were seen in pain and on walking tests.
The lack of a control group was a limitation of this study.
This appears to be the first study investigating the effect of exercise and weight loss as a combination treatment in people with hip OA. The results provide preliminary evidence that this combination treatment is effective in people with hip OA.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110418v2?rss=1
Interrater Reliability of the Adapted Fresno Test across Multiple Raters
Purpose: The Adapted Fresno Test (AFT) is a seven-item instrument for assessing knowledge and skills in the major domains of evidence-based practice (EBP), including formulating clinical questions and searching for and critically appraising research evidence. This study examined the interrater reliability of the AFT using several raters with different levels of professional experience. Method: The AFT was completed by physiotherapists and occupational therapists, and a random sample of 12 tests was scored by four raters with different levels of professional experience. Interrater reliability was calculated using intra-class correlation coefficients (ICC [2, 1]) for the individual AFT items and the total AFT score. Results: Interrater reliability was moderate to excellent for items 1 and 7 (ICC=0.63–0.95). Questionable levels of reliability among raters were found for other items and for the total score. For these items, the raters were clustered into two groups—“experienced” and “inexperienced”—and then examined for reliability. The reliability estimates for rater 1 and rater 2 (“inexperienced”) increased slightly for items 2 and 5 and for the total score, but not for other items. For raters 3 and 4 (“experienced”), ICCs increased considerably, indicating excellent reliability for all items and for the total score (0.80–0.99), except for item 4, which showed a further decrease in ICC. Conclusion: Use of the AFT to assess knowledge and skills in EBP may be problematic unless raters are carefully selected and trained.
- Content Type Journal Article
- Category Advance Online Article
- Pages 1-6
- DOI 10.3138/ptc.2012-15
- Authors
- Lucylynn M. Lizarondo, International Centre for Allied Health Evidence
- Karen Grimmer, International Centre for Allied Health Evidence
- Saravana Kumar, International Centre for Allied Health Evidence
- Journal Physiotherapy Canada
- Online ISSN 1708-8313
- Print ISSN 0300-0508
Metabolic Changes in the Spinal Cord After Brachial Plexus Root Re-implantation
Objective. To investigate metabolic changes within the spinal cord using proton magnetic resonance spectroscopy (1H-MRS) and determine their relationship with clinical function in patients with complete brachial plexus avulsion who underwent reimplantation of the ventral roots. Methods. Single-voxel 1H-MRS of the cord between C1 and C3 was performed in 10 patients with normal spinal cord on MRI, who underwent reimplantation of C5 to T1 ventral roots on average 5.5 years earlier, and 19 healthy controls. The ratios of the concentrations of the following main metabolites, with respect to total creatine levels, were obtained: total N-acetyl-aspartate, choline-containing compounds, creatine and phosphocreatine (Cr), and myo-inositol (m-Ins). Patient disability was assessed using upper limb scales. Differences in metabolite concentration ratios and their correlations with disability were investigated. Results. Patients showed increased m-Ins/Cr ratio compared with controls, which was associated with the level of function of the affected arm and time from injury. Conclusions. The finding of increased m-Ins/Cr in patients suggests that reactive gliosis, perhaps in response to the degeneration of avulsed fibers, may occur in the spinal cord above the site of injury and be relevant to motor dysfunction. However, this pathological process appears to diminish with time. These insights underline the need to integrate metabolic imaging with structural and functional magnetic resonance imaging to obtain a complete view of spinal cord plasticity. Last, this study provides the first steps toward identifying markers to serve as outcome measures for trials comparing strategies of plexus repair following avulsion injury.
Source: http://nnr.sagepub.com/cgi/content/abstract/27/2/118?rss=1
Lunes, Enero 14, 2013
Comparison of Reliability, Validity, and Responsiveness of the Mini-BESTest and Berg Balance Scale in Patients With Balance Disorders
Recently, a new tool for assessing dynamic balance impairments has been presented: the 14-item Mini-BESTest.
The aim of this study was to compare the psychometric performance of Mini-BESTest and the Berg Balance Scale (BBS).
A prospective, single-group, observational design was used in the study.
Ninety-three participants (mean age=66.2 years, SD=13.2; 53 women, 40 men) with balance deficits were recruited. Interrater (3 raters) and test-retest (1–3 days) reliability were calculated using intraclass correlation coefficients (ICCs). Responsiveness and minimal important change were assessed (after 10 sessions of physical therapy) using both distribution-based and anchor-based methods (external criterion: the 15-point Global Rating of Change [GRC] scale).
At baseline, neither floor effects nor ceiling effects were found in either the Mini-BESTest or the BBS. After treatment, the maximum score was found in 12 participants (12.9%) with BBS and in 2 participants (2.1%) with Mini-BESTest. Test-retest reliability for total scores was significantly higher for the Mini-BESTest (ICC=.96) than for the BBS (ICC=.92), whereas interrater reliability was similar (ICC=.98 versus .97, respectively). The standard error of measurement (SEM) was 1.26 and the minimum detectable change at the 95% confidence level (MDC95) was 3.5 points for Mini-BESTest, whereas the SEM was 2.18 and the MDC95 was 6.2 points for the BBS. In receiver operating characteristic curves, the area under the curve was 0.92 for the Mini-BESTest and 0.91 for the BBS. The best minimal important change (MIC) was 4 points for the Mini-BESTest and 7 points for the BBS. After treatment, 38 participants evaluated with the Mini-BESTest and only 23 participants evaluated with the BBS (out of the 40 participants who had a GRC score of ≥3.5) showed a score change equal to or greater than the MIC values.
The consecutive sampling method drawn from a single rehabilitation facility and the intrinsic weakness of the GRC for calculating MIC values were limitations of the study.
The 2 scales behave similarly, but the Mini-BESTest appears to have a lower ceiling effect, slightly higher reliability levels, and greater accuracy in classifying individual patients who show significant improvement in balance function.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20120171v2?rss=1
The Therapeutic Alliance Between Clinicians and Patients Predicts Outcome in Chronic Low Back Pain
The impact of the relationship (therapeutic alliance) between patients and physical therapists on treatment outcome in the rehabilitation of chronic low back pain (LBP) has not been previously investigated.
To investigate whether the therapeutic alliance between physical therapists and chronic LBP patients predicts clinical outcomes.
Retrospective observational study nested within a randomized controlled trial.
182 patients with chronic LBP who volunteered for a randomized controlled trial that compared the efficacy of exercises and spinal manipulative therapy rated their alliance with physical therapists by completing the Working Alliance Inventory at the second treatment session. The primary outcomes of function, global perceived effect of treatment, pain, and disability were assessed before and after 8 weeks of treatment. Linear regression models were used to investigate if the alliance was a predictor of outcome or moderated the effect of treatment.
The therapeutic alliance was consistently a predictor of outcome for all the measures of treatment outcome. The therapeutic alliance moderated the effect of treatment on global perceived effect for two of three treatment contrasts (general exercise vs motor control exercise, spinal manipulative therapy vs motor control exercise). There was no treatment effect modification when outcome was measured with function, pain and disability measures.
Therapeutic alliance was measured at the second treatment session and it is likely to bias the interaction during initial stages of treatment. Data analysis was restricted to primary outcomes at 8 weeks.
Positive therapeutic alliance ratings between physical therapists and patients are associated with improvements of outcomes in LBP. Future research should investigate the factors explaining this relationship and the impact of training interventions aimed at optimizing the alliance.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20120137v1?rss=1
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Designing and Implementing a System for Tracking Functional Status After Stroke: A Feasibility Study
Available online 14 November 2012
Publication year: 2012
Source:PM&R
Objective To determine the feasibility of tracking stroke patients' functional outcomes in an integrated health system across a care continuum using the computer version of the Activity Measure of Post-Acute Care (AM-PAC). Setting A large integrated health care system in northern California. Participants A total of 222 stroke patients (aged ≥18 years) who were hospitalized after an acute cerebrovascular accident. Methods An AM-PAC assessment was made at discharge from sites of care, including acute hospital, inpatient rehabilitation hospital, skilled nursing facility, home during home care, and outpatient settings. Assessments also were completed in the patient's home at 6 months. Data from the AM-PAC program were integrated with the health care system's databases. Main Outcome Measurements (1) AM-PAC administration time at the various sites of care; (2) assessment of a floor or a ceiling effect; and (3) administrative burden of tracking participants. Results AM-PAC assessment sessions averaged 7.9 minutes for data acquisition in 3 domains: Basic Mobility, Activities of Daily Living, and Applied Cognition. Participants answered, on average, 27 AM-PAC questions per session. A small ceiling effect was observed at 6 months, and there was a larger ceiling effect when the instrument was administered in an institution, ie, when the AM-PAC institutional item bank was used rather than the community item bank. It was feasible to track patients and to assess their function using the AM-PAC instrument from institutional to community settings. Implementation of the AM-PAC in clinical environments, and the success of the project, were influenced by instrumental, technological, operational, resource, and cultural factors. Conclusions This study demonstrates the feasibility of implementing a single functional outcome instrument in clinical and community settings to measure rehabilitation functional outcomes of stroke patients. Integrating the AM-PAC measurement system into clinical workflows and the electronic medical record could provide assistance to clinicians for medical decision making, functional prognostication, and discharge planning.
Publication year: 2012
Source:PM&R
Children with paralytic poliomyelitis: Utilization of physiotherapy services in Zamfara State, Nigeria
Physiotherapy Theory and Practice, Volume 29, Issue 2, Page 133-141, February 2013.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.703761?ai=1mo2&mi=3s94u5&af=R
Perceived value of stroke outcome measures across the post-acute care continuum: A qualitative case study
Physiotherapy Theory and Practice, Volume 0, Issue 0, Page 1-9, Early Online.
Source: http://informahealthcare.com/doi/abs/10.3109/09593985.2012.727205?ai=1mo2&mi=3s94u5&af=R
Oral–Motor Function and Feeding Intervention
Physical & Occupational Therapy in Pediatrics, Volume 33, Issue 1, Page 111-138, February 2013.
Source: http://informahealthcare.com/doi/abs/10.3109/01942638.2012.750864?ai=1ozx&mi=3s94u5&af=R
Linggo, Enero 13, 2013
Exercise and Sport for Persons With Spinal Cord Injury
November 2012
Publication year: 2012
Source:PM&R, Volume 4, Issue 11
This review article provides an overview of the evidence that links exercise and sports participation to physical and psychological well-being among people with spinal cord injury. Two aspects of physical well-being are examined, including the prevention of chronic disease and the promotion of physical fitness. Multiple aspects of psychosocial well-being are discussed, including mental health, social participation, and life satisfaction. The review concludes with future research recommendations and a discussion of challenges and opportunities for using exercise and sports to promote health and well-being among people living with spinal cord injury.
Publication year: 2012
Source:PM&R, Volume 4, Issue 11
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