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Physical Therapy

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2011

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Full-Text Articles in Medicine and Health Sciences

Comprehensive Strength Training Program For A Recreational Senior Golfer 11-Months After A Rotator Cuff Repair, Jason Brumitt, Erik P. Meira, Hui En Gilpin, Meredith Brunette Dec 2011

Comprehensive Strength Training Program For A Recreational Senior Golfer 11-Months After A Rotator Cuff Repair, Jason Brumitt, Erik P. Meira, Hui En Gilpin, Meredith Brunette

Faculty Publications - College of Physical Therapy

Background and Purpose: Golf is a popular sport played by hundreds of thousands of individuals of all ages and of varying skill levels. An orthopedic or sports-related injury and/or surgery may limit an individual’s sport participation, require him/her to complete a course of rehabilitation, and initiate (or resume) a sportspecific training program. Unlike the availability of evidence to guide postsurgical rehabilitation and sportspecific training of athletes from sports other than golf, there have only been two reports describing outcomes after surgery and for golfers. The purpose of this case report is to present a post-rehabilitation return to sporttraining program for …


Clinical Care Plan: Interdisciplinary Course (Ccpic), Marcia Levinson, Pt, Phd, Mft, Amy M Egras, Pharm.D, Bcps, E. Adel Herge, Otd, Otr/L, Kathryn Shaffer, Rn, Msn Nov 2011

Clinical Care Plan: Interdisciplinary Course (Ccpic), Marcia Levinson, Pt, Phd, Mft, Amy M Egras, Pharm.D, Bcps, E. Adel Herge, Otd, Otr/L, Kathryn Shaffer, Rn, Msn

Department of Physical Therapy Faculty Papers

Background/Rationale:

Interprofessional collaborative practice significantly improves patient outcomes, reduces mortality and enhances quality-of-life.

Person-focused care demands collaboration among professions in a team approach to address multiple issues including illness, prevention, and health promotion activities.

Key elements of successful implementation of interprofessional education supported by Clinical Care Plan, Interprofessional Course (CCPIC):

-Increasing knowledge of the roles, responsibilities, and competencies of multiple health professions.

-Collaborating in teams

-Recognizing the patient as the expert

-Communicating effectively

Course Statistics:

-176 students from various disciplines completed course (2008-2011).

Disciplines include:

-Medicine, Nursing, Occupational Therapy, Physical Therapy, Pharmacy


Mechanisms Of The Contextual Interference Effect In Individuals Poststroke, Nicolas Schweughofer, Jeong-Yoon Lee, Hui-Ting Goh, Youggeun Choi, Sung Shin Kim, Jill Campbell Stewart Pt,Phd, Rebecca Lewthwaite, Carolee J. Winstein Nov 2011

Mechanisms Of The Contextual Interference Effect In Individuals Poststroke, Nicolas Schweughofer, Jeong-Yoon Lee, Hui-Ting Goh, Youggeun Choi, Sung Shin Kim, Jill Campbell Stewart Pt,Phd, Rebecca Lewthwaite, Carolee J. Winstein

Faculty Publications

Although intermixing different motor learning tasks via random schedules enhances long-term retention compared with “blocked” schedules, the mechanism underlying this contextual interference effect has been unclear. Furthermore, previous studies have reported inconclusive results in individuals poststroke. We instructed participants to learn to produce three grip force patterns in either random or blocked schedules and measured the contextual interference effect by long-term forgetting: the change in performance between immediate and 24-h posttests. Nondisabled participants exhibited the contextual interference effect: no forgetting in the random condition but forgetting in the blocked condition. Participants at least 3 mo poststroke exhibited no forgetting in …


Peak Triceps Surae Muscle Activity Is Not Specific To Knee Flexion Angles During Mvic, Kim Hébert-Losier, Anthony G. Schneiders, José A. García, S John Sullivan, Guy G. Simoneau Oct 2011

Peak Triceps Surae Muscle Activity Is Not Specific To Knee Flexion Angles During Mvic, Kim Hébert-Losier, Anthony G. Schneiders, José A. García, S John Sullivan, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

There is limited research on peak activity of the separate triceps surae muscles in select knee flexion (KF) positions during a maximum voluntary isometric contraction (MVIC) used to normalize EMG signals. The aim of this study was to determine how frequent peak activity occurred during an MVIC for soleus (SOL), gastrocnemius medialis (GM), and gastrocnemius lateralis (GL) in select KF positions, and if these peaks were recorded in similar KF positions. Forty-eight healthy individuals performed unilateral plantar-flexion MVIC in standing with 0°KF and 45°KF, and in sitting with 90°KF. Surface EMG of SOL, GM, and GL were collected and processed …


Biomechanical Effects Of Mobile Computer Location In A Vehicle Cab, Kyle Saginus, Richard W. Marklin, Patricia Seeley, Guy G. Simoneau, Stephen H. Freier Oct 2011

Biomechanical Effects Of Mobile Computer Location In A Vehicle Cab, Kyle Saginus, Richard W. Marklin, Patricia Seeley, Guy G. Simoneau, Stephen H. Freier

Physical Therapy Faculty Research and Publications

Objective: The objective of this research is to determine the best location to place a conventional mobile computer supported by a commercially available mount in a light truck cab.

Background: U.S. and Canadian electric utility companies are in the process of integrating mobile computers into their fleet vehicle cabs. There are no publications on the effect of mobile computer location in a vehicle cab on biomechanical loading, performance, and subjective assessment.

Method: The authors tested four locations of mobile computers in a light truck cab in a laboratory study to determine how location affected muscle activity of the lower back …


A Systematic Review Of The Health-Related Quality Of Life Measures Following Total Knee Arthroplasty, Saurabh Mehta, Mary Law, Jean-Sebastian Roy Oct 2011

A Systematic Review Of The Health-Related Quality Of Life Measures Following Total Knee Arthroplasty, Saurabh Mehta, Mary Law, Jean-Sebastian Roy

Physical Therapy Faculty Research

To perform systematic review and appraisal of common patient-reported outcomes (PROs) used in measuring aspects of health-related quality of life (HRQOL) following total knee arthroplasty (TKA). Especially, the study aimed to examine whether these common PROs assess the domains of HRQOL as described in the theoretical frameworks of the HRQOL.


Use Of The Term "Elderly", Dale Avers, Marybeth Brown, Kevin Chui, Rita A. Wong, Michelle M. Lusardi Oct 2011

Use Of The Term "Elderly", Dale Avers, Marybeth Brown, Kevin Chui, Rita A. Wong, Michelle M. Lusardi

All PTHMS Faculty Publications

Using the term elderly for a person who is robust and independent as well as for a person who is frail and dependent says little about the individual.


Analysis Of Vertical Ground Reaction Force Variables During A Sit To Stand Task In Participants Recovering From A Hip Fracture, Jeff R. Houck, Janet Kneiss, Susan V. Bukata, J. Edward Puzas Jun 2011

Analysis Of Vertical Ground Reaction Force Variables During A Sit To Stand Task In Participants Recovering From A Hip Fracture, Jeff R. Houck, Janet Kneiss, Susan V. Bukata, J. Edward Puzas

Faculty Publications - College of Physical Therapy

Background: A Sit to Stand task following a hip fracture may be achieved through compensations (e.g. bilateral arms and uninvolved lower extremity), not restoration of movement strategies of the involved lower extremity. The primary purpose was to compare upper and lower extremity movement strategies using the vertical ground reaction force during a Sit to Stand task in participants recovering from a hip fracture to control participants. The secondary purpose was to evaluate the correlation between vertical ground reaction force variables and validated functional measures.

Methods: Twenty eight community dwelling older adults, 14 who had a hip fracture and 14 control …


Exploring The Five Phases Of Physical Therapist Professional Development Advanced By The Clinical Doctorate Degree, Salome V. Brooks May 2011

Exploring The Five Phases Of Physical Therapist Professional Development Advanced By The Clinical Doctorate Degree, Salome V. Brooks

All PTHMS Faculty Publications

The American Physical Therapy Association (APTA) 2020 strategic plan mandated that the clinical doctor of physical therapy degree (DPT) will be the minimum practice standard. The APTA failed to articulate a functional practice description recognizing the varying levels of preparation. The current literature validates the existence of a stepwise pattern of professional development in similarly evolving disciplines. Applied nursing research by Benner (Benner model of professional development, 2001) identified five stages of professional development and characteristics that were useful in the discipline's advancement. The purpose of the study was to apply the structure of the Benner Model to physical therapy …


Incidence And Prevention Of Injury Of The Anterior Cruciate Ligament In Females, Arielle E. Gillie Apr 2011

Incidence And Prevention Of Injury Of The Anterior Cruciate Ligament In Females, Arielle E. Gillie

Senior Honors Theses

According to the American College of Sports Medicine, women are two to eight times more likely to sustain an anterior cruciate ligament injury than men at the same level of performance. This high incidence of women with an ACL injury is thought to be due to a number of gender differences. This study examines the research that has been conducted to determine the reason for the disproportionate incidence of anterior cruciate ligament in female population. The study encompasses anatomical structure of the knee joint, structural differences in the male and female knee, hormonal influences, biomechanical influences, neuromuscular influences, and strategies …


The College Of Health & Human Services [Annual Report], Western Kentucky University College Of Health And Human Services, Dr. John Bonaguro, Dean Apr 2011

The College Of Health & Human Services [Annual Report], Western Kentucky University College Of Health And Human Services, Dr. John Bonaguro, Dean

College of Health & Human Services Publications

No abstract provided.


Pedaling Alters The Excitability And Modulation Of Vastus Medialis H-Reflexes After Stroke, Dana P. Fuchs, Namita Sanghvi, Jon A. Wieser, Sheila Schindler-Ivens Apr 2011

Pedaling Alters The Excitability And Modulation Of Vastus Medialis H-Reflexes After Stroke, Dana P. Fuchs, Namita Sanghvi, Jon A. Wieser, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

Objective

Individuals post-stroke display abnormal Group Ia reflex excitability. Pedaling has been shown to reduce Group Ia reflexes and to normalize the relationship between EMG and reflex amplitude in the paretic soleus (SO). The purpose of this study was to determine whether these changes extend to the paretic quadriceps.

Methods

H-reflexes were used to examine Group Ia reflex excitability of the vastus medialis (VM). H-reflexes were elicited in paretic (n = 13) and neurologically intact (n = 13) individuals at 11 positions in the pedaling cycle and during static knee extension at comparable limb positions and levels of …


Validity And Reliability Of Two Abbreviated Versions Of The Gross Motor Function Measure., Laura K Brunton, Doreen J Bartlett Apr 2011

Validity And Reliability Of Two Abbreviated Versions Of The Gross Motor Function Measure., Laura K Brunton, Doreen J Bartlett

Physical Therapy Publications

Aim: The “gold standard” to measure gross motor functioning for children with cerebral palsy (CP) is the Gross Motor Function Measure (GMFM-66). The purpose of this study was to estimate the validity and reliability of two abbreviated versions (item set (GMFM-66 IS) and basal and ceiling (GMFM-66 B&C) approaches) of the GMFM-66.

Methods: Twenty-six children with CP aged 2 to 6 years across all GMFCS levels participated. At session one, both abbreviated versions were administered by two independent raters, followed by the full GMFM-66. In the subsequent session, only the abbreviated versions were administered, by the same raters. Concurrent validity, …


Are Scores On The Ppt Useful In Determination Of Risk Of Future Falls In Individuals With Dementia?, Mary K. Farrell, Richard A. Rutt, Michelle M. Lusardi, Ann K. Williams Apr 2011

Are Scores On The Ppt Useful In Determination Of Risk Of Future Falls In Individuals With Dementia?, Mary K. Farrell, Richard A. Rutt, Michelle M. Lusardi, Ann K. Williams

All PTHMS Faculty Publications

Individuals with dementia or Alzheimer’s disease (AD), exhibit both a progressive decline in cognitive function and accumulating difficulty with physical function.1 As cognitive impairment begins, individuals will initially demonstrate difficulties with short-term memory and with instrumental activities of daily living. As the dementia progresses, individuals will increasingly demonstrate difficulties with long-term memory, communication, and basic activities of daily living.


Aging Enhances Serum Cytokine Response But Not Task-Induced Grip Strength Declines In A Rat Model Of Work-Related Musculoskeletal Disorders., Dong L Xin, Michelle Y Harris, Christine K Wade, Mamta Amin, Ann E Barr, Mary F Barbe Mar 2011

Aging Enhances Serum Cytokine Response But Not Task-Induced Grip Strength Declines In A Rat Model Of Work-Related Musculoskeletal Disorders., Dong L Xin, Michelle Y Harris, Christine K Wade, Mamta Amin, Ann E Barr, Mary F Barbe

Department of Physical Therapy Faculty Papers

BACKGROUND: We previously reported early tissue injury, increased serum and tissue inflammatory cytokines and decreased grip in young rats performing a moderate demand repetitive task. The tissue cytokine response was transient, the serum response and decreased grip were still evident by 8 weeks. Thus, here, we examined their levels at 12 weeks in young rats. Since aging is known to enhance serum cytokine levels, we also examined aged rats.

METHODS: Aged and young rats, 14 mo and 2.5 mo of age at onset, respectfully, were trained 15 min/day for 4 weeks, and then performed a high repetition, low force (HRLF) …


Perspective Paper: Assessing Air Quality As Part Of A Physical Therapy Plan Of Care, Dennis Sobush, Monika Burrescia Mar 2011

Perspective Paper: Assessing Air Quality As Part Of A Physical Therapy Plan Of Care, Dennis Sobush, Monika Burrescia

Physical Therapy Faculty Research and Publications

Purpose: The purposes of this clinical perspective paper are (1) to expand physical therapists’ awareness to the topic of air quality as a health priority when providing professional services; and (2) to provide templates for screening the indoor clinical environments and patient profiles to avert respiratory exacerbations, especially in persons with asthma. Summary of Key Points: The location where a physical therapist practices determines the air quality indices to which a person is exposed. Poor indoor air quality can expose a person to even greater compromise of respiration (ie, Sick Building Syndrome) than outdoor air quality secondary to an array …


The Implications Of Chronic Pain Models For Rehabilitation Of Distal Radius Fracture, Saurabh Mehta, Joy Macdermid, Mary Tremblay Mar 2011

The Implications Of Chronic Pain Models For Rehabilitation Of Distal Radius Fracture, Saurabh Mehta, Joy Macdermid, Mary Tremblay

Physical Therapy Faculty Research

Distal radius fracture (DRF) is the most common fracture and usually occurs as a result of a fall. Most patients recover following DRF with minimal residual pain or disability; however, a small subset of patients continue to experience pain and disability even one year after the injury. Currently, there are no practice guidelines for early identification and treatment of patients who are potentially at greater risk of developing these adverse outcomes. As a result, hand therapy management of patients following DRF does not incorporate screening of these at-risk patients. The objective of this paper is to apply constructs from learned …


Pressure Distribution Over The Palm Region During Forward Falls On The Outstretched Hands, Woochol J. Choi, Stephen N. Robinovitch Feb 2011

Pressure Distribution Over The Palm Region During Forward Falls On The Outstretched Hands, Woochol J. Choi, Stephen N. Robinovitch

Physical Therapy Faculty Articles and Research

Falls on the outstretched hands are the cause of over 90% of wrist fractures, yet little is known about bone loading during this event. We tested how the magnitude and distribution of pressure over the palm region during a forward fall is affected by foam padding (simulating a glove) and arm configuration, and by the faller’s body mass index (BMI) and thickness of soft tissues over the palm region.

Thirteen young women with high (n=7) or low (n=6) BMI participated in a “torso release experiment” that simulated falling on both outstretched hands with the arm inclined either at 20° or …


The Effects Of Lesions In The Dorsolateral Pons On The Coordination Of Swallowing And Breathing In Awake Goats, Joshua M. Bonis, S. E. Neumueller, B. D. Marshall, K. L. Krause, B. Qian, Lawrence Pan, M. R. Hodges, Hubert V. Forster Feb 2011

The Effects Of Lesions In The Dorsolateral Pons On The Coordination Of Swallowing And Breathing In Awake Goats, Joshua M. Bonis, S. E. Neumueller, B. D. Marshall, K. L. Krause, B. Qian, Lawrence Pan, M. R. Hodges, Hubert V. Forster

Physical Therapy Faculty Research and Publications

The purpose of this retrospective study was to gain insight into the contribution of the dorsolateral pons to the coordination of swallowing and breathing in awake goats. In 4 goats, cannulas were chronically implanted bilaterally through the lateral (LPBN) and medial (MPBN) parabrachial nuclei just dorsal to the Kölliker–Fuse nucleus (KFN). After >2 weeks recovery from this surgery, the goats were studied for 5½ h on a control day, and on separate days after receiving 1 and 10 μl injections of ibotenic acid (IA) separated by 1 week. The frequency of swallows did not change during the control and 1 …


Analysis Of Knee Flexion Angles During 2 Clinical Versions Of The Heel Raise Test To Assess Soleus And Gastrocnemius Function, Kim Hébert-Losier, Anthony G. Schneiders, S John Sullivan, Richard J. Newsham-West, José A. García, Guy G. Simoneau Jan 2011

Analysis Of Knee Flexion Angles During 2 Clinical Versions Of The Heel Raise Test To Assess Soleus And Gastrocnemius Function, Kim Hébert-Losier, Anthony G. Schneiders, S John Sullivan, Richard J. Newsham-West, José A. García, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

STUDY DESIGN: Controlled laboratory study, using a repeated-measures, counterbalanced design. OBJECTIVES: To provide estimates on the average knee angle maintained, absolute knee angle error, and total repetitions performed during 2 versions of the heel raise test. BACKGROUND: The heel raise test is performed in knee extension (EHRT) to assess gastrocnemius and knee flexion (FHRT) for soleus. However, it has not yet been determined whether select knee angles are maintained or whether total repetitions differ between the clinical versions of the heel raise test. METHODS: Seventeen healthy males and females performed maximal heel raise repetitions in 0° (EHRT) and 30° (FHRT) …


Tactile Thresholds Are Preserved Yet Complex Sensory Function Is Impaired Over The Lumbar Spine Of Chronic Non-Specific Low Back Pain Patients: A Preliminary Investigation, Benedict M. Wand, Flavia Di Pietro, Pamela George, Neil E. O'Connell Jan 2011

Tactile Thresholds Are Preserved Yet Complex Sensory Function Is Impaired Over The Lumbar Spine Of Chronic Non-Specific Low Back Pain Patients: A Preliminary Investigation, Benedict M. Wand, Flavia Di Pietro, Pamela George, Neil E. O'Connell

Physiotherapy Conference Papers

Evidence indicates that chronic non-specific low back pain (CNSLBP) is associated with alteration in the brain’s cortical representation of the back, resulting in body perception disturbance and contributing to the condition [1,2]. This study investigated perception via ‘cortical’ sensory tests, in this case two-point discrimination and graphaesthesia—whose results partly depend on the integrity of cortical representation [2]. The hypothesis was dysfunction in these higher-order tasks, with simple tactile thresholds remaining unchanged. Furthermore a relationship between cortical sensation and severity of the condition was predicted.


The Relationship Between Dynamic Balance And Isokinetic Ankle Strength In Female College Athletes, Nika Evans Jan 2011

The Relationship Between Dynamic Balance And Isokinetic Ankle Strength In Female College Athletes, Nika Evans

Summer Research

Conflicting results have been found between dynamic balance and isokinetic ankle strength. PURPOSE: To investigate the relationships between ankle strength and dynamic balance. METHOD: 15 healthy female Division III varsity athletes (INSERT DEMOGRAPHIC DATA) were tested on a Cybex NORM isokinetic dynamometer performing maximal ankle plantar and dorsiflexion. Dynamic balance was assessed using the SEBT. Isokinetic strength was assessed through 8 maximal contractions of plantar and dorsiflexion at 60, 120, and 180º/s with a 60 second rest period between each velocity set. Pearson’s correlations were used to assess the relationship between the dynamic balance score and peak torque at each …


Comparação Das Habilidades Motoras Em Crianças Com Síndrome De Down E Crianças Sem Distúrbios De Desenvolvimento [Comparison Of Motor Skills In Children With Down Syndrome And Children Without Developmental Disorders], Laura De Moura Rodrigues, Edla Da Silva, Juliana Saccol Martins, Patricia Pereira Jan 2011

Comparação Das Habilidades Motoras Em Crianças Com Síndrome De Down E Crianças Sem Distúrbios De Desenvolvimento [Comparison Of Motor Skills In Children With Down Syndrome And Children Without Developmental Disorders], Laura De Moura Rodrigues, Edla Da Silva, Juliana Saccol Martins, Patricia Pereira

Other Topics

The aim of this study was to assess gross motor abilities, classifying them in stages, of children with Down syndrome and children without developmental disorders, and to compare them with each other. Twelve children with Down syndrome, from two special schools and twelve children without development disorders, from a regular school of Caxias do Sul city, in Brazil, were evaluated.

Six gross motor abilities were assessed: balance in one foot, walking on straight line, running, jumping on one foot, throwing and catching, through the tables of Gallahue and Ozmun (2001).

The children with Down syndrome could not keep up with …


Hand Grip Strength: Age And Gender Stratified Normative Data In A Population-Based Study, N. M. Massy-Westropp, T. K. Gill, A. W. Taylor, R. W. Bohannon, C. L. Hill Jan 2011

Hand Grip Strength: Age And Gender Stratified Normative Data In A Population-Based Study, N. M. Massy-Westropp, T. K. Gill, A. W. Taylor, R. W. Bohannon, C. L. Hill

Physical Therapy

No abstract provided.


Immunohistochemical Study Of Human Costotransverse Joints: A Preliminary Investigation, G. S. Dedrick, P. S. Sizer, B. G. Sawyer, J. M. Brismée, M. P. Smith Jan 2011

Immunohistochemical Study Of Human Costotransverse Joints: A Preliminary Investigation, G. S. Dedrick, P. S. Sizer, B. G. Sawyer, J. M. Brismée, M. P. Smith

Physical Therapy

No abstract provided.


Immediate Changes In Spinal Height And Pain After Aquatic Vertical Traction In Patients With Persistent Low Back Symptoms: A Crossover Clinical Trial, S. M. Simmerman, P. S. Sizer, G. S. Dedrick, G. G. Apte, J. M. Brismée Jan 2011

Immediate Changes In Spinal Height And Pain After Aquatic Vertical Traction In Patients With Persistent Low Back Symptoms: A Crossover Clinical Trial, S. M. Simmerman, P. S. Sizer, G. S. Dedrick, G. G. Apte, J. M. Brismée

Physical Therapy

No abstract provided.


The Deep Neck Flexor Endurance Test: Normative Data Scores In Healthy Adults, M. A. Domenech, P. S. Sizer, G. S. Dedrick, M. K. Mcgalliard, J. M. Brismée Jan 2011

The Deep Neck Flexor Endurance Test: Normative Data Scores In Healthy Adults, M. A. Domenech, P. S. Sizer, G. S. Dedrick, M. K. Mcgalliard, J. M. Brismée

Physical Therapy

No abstract provided.


Change In Spine Height Measurements Following Sustained Mid-Range And End-Range Flexion Of The Lumbar Spine, D. A. Gerke, J. M. Brismée, P. S. Sizer, G. S. Dedrick, C. R. James Jan 2011

Change In Spine Height Measurements Following Sustained Mid-Range And End-Range Flexion Of The Lumbar Spine, D. A. Gerke, J. M. Brismée, P. S. Sizer, G. S. Dedrick, C. R. James

Physical Therapy

No abstract provided.


Association Of Disturbances In The Thoracic Outlet In Subjects With Carpal Tunnel Syndrome: A Case-Control Study, M. S. Vaught, J. M. Brismée, G. S. Dedrick, P. S. Sizer, S. F. Sawyer Jan 2011

Association Of Disturbances In The Thoracic Outlet In Subjects With Carpal Tunnel Syndrome: A Case-Control Study, M. S. Vaught, J. M. Brismée, G. S. Dedrick, P. S. Sizer, S. F. Sawyer

Physical Therapy

No abstract provided.


Patient Satisfaction With Musculoskeletal Physiotherapy Care In Australia Is High, Vivian Yung, Martin Mackey, Benedict M. Wand, Roger Adams, Roger Nelson, Paul Beattie, Julia Hush Jan 2011

Patient Satisfaction With Musculoskeletal Physiotherapy Care In Australia Is High, Vivian Yung, Martin Mackey, Benedict M. Wand, Roger Adams, Roger Nelson, Paul Beattie, Julia Hush

Physiotherapy Conference Papers

Patient satisfaction is an important outcome of care and is intrinsically valuable to clinicians. The level of patient satisfaction with musculoskeletal physiotherapy care in Australia is unknown. Increased understanding of patient satisfaction will benefit patients by facilitating clinicians to optimise clinical service delivery.