Page: 10
Miyerkules, Disyembre 26, 2012
Exercise in Cardiovascular Diseases
November 2012
Publication year: 2012
Source:PM&R, Volume 4, Issue 11
Abstract Analysis of extensive data has shown that exercise training provides significant impact on prevention and modification of cardiovascular diseases and mortality. In general, exercise recommendations for patients with cardiovascular diseases are based on individual aerobic capacity and comorbidities. Patients with acute syndromes benefit from participating in a cardiac rehabilitation program, whereas patients with chronic syndromes benefit from a life-long home-based program. In general, exercise prescription should involve aerobic activities in combination with resistance, flexibility, and balance exercises. This review will discuss an exercise prescription for patients with coronary artery disease, heart failure, and after heart transplantation. Detailed precautions for particular groups of patients will be discussed.
Publication year: 2012
Source:PM&R, Volume 4, Issue 11
Martes, Disyembre 25, 2012
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
Reliability of Six Physical Performance Tests in Older People With Dementia
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.
The purpose of this study was to determine the relative and absolute test-retest reliability of the 6-m walk test, the Figure-of-Eight Walk Test (F8W), the Timed "Up & Go" Test (TUG), the Frailty and Injuries: Cooperative Studies of Intervention Techniques–4 (FICSIT–4) Balance Test, 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.
This investigation was a prospective, nonexperimental study.
Older people with dementia (n=58, age range=70–92 years) performed each test at baseline and again after 1 week. Intraclass correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable change (MDC), and log-transferred limits of agreement of Bland-Altman plots were calculated.
The relative reliability of the F8W, TUG, and Jamar dynamometer was excellent (ICC=.90–.95) and good for the 6-m walk test, FICSIT–4, and CRT (ICC=.79–.86). The 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 Mini-Mental State Examination [MMSE]).
The specific etiology of dementia was not obtained.
The physical performance tests evaluated are useful to detect differences in performance between older people with mild to moderate dementia and, therefore, are 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.20110164v2?rss=1
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
- Journal Physiotherapy Canada
- Online ISSN 1708-8313
- Print ISSN 0300-0508
Source: http://www.metapress.com/content/42q11g4n3565v374/
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What Characterizes People Who Have an Unclear Classification Using a Treatment-Based Classification Algorithm for Low Back Pain? A Cross-Sectional Study
A treatment-based classification algorithm for low back pain (LBP) was created to help clinicians select treatments that a patient is most likely to respond to. To allow the algorithm to classify all people with LBP, additional criteria are provided to assist therapists' decisions for patients who do not clearly fit a subgroup (ie, unclear classifications). Recent studies have found that ~34% of LBP patients have unclear classifications.
To guide improvements to the algorithm, it is imperative to determine if these patients are different from those with clear classifications.
Secondary analysis of data from three previous studies investigating the algorithm.
Baseline data from 529 consecutively-recruited LBP patients were used (3 discrete cohorts). The primary outcome was the type of classification: ‘clear’ or ‘unclear’. Univariate logistic regression was used to determine which participant variables were related to having an unclear classification.
People who received an unclear classification had greater odds of being older (OR=1.01; 95%CI=1.003-1.033), having a longer duration of LBP(OR=1.001; 95%CI=1.000-1.001), having had previous LBP (OR=1.61; 95%CI=1.04-2.49), having less fear avoidance beliefs related to both work (OR=0.98; 95%CI=0.96-0.99) and physical activity (OR=0.98; 95%CI=0.96-0.996), and having less LBP-related disability (OR=0.98; 95%CI=0.96-0.99) than people with clear classifications.
The studies from which patient data were drawn had different inclusion criteria and clinical settings.
People receiving unclear classifications appear to be less affected by their LBP (lower disability and fear avoidance beliefs), despite typically having a longer duration of LBP. Future studies should investigate if modifying the algorithm to possibly exclude these people or provide them with a different intervention improves outcomes.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20120263v1?rss=1
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