Rehabilitation and Therapy Commons^™

The Incidence Of Falls In Intensive Care Survivors, Shane M. Patman, Diane Dennis, Kylie Hill

Shane Patman

Background: Falling among adults in acute care is an important problem with falls rates in tertiary hospitals ranging from 2% to 5%. Factors that increase the risk of falling, such as advanced age, altered mental status, medications that act on the central nervous system and poor mobility, often characterise individuals who survive a prolonged intensive care unit (ICU) admission.

Purpose: To measure the incidence of falls and describe the characteristics of fallers among intensive care survivors.

Methods: A comprehensive retrospective chart review was undertaken of 190 adults who were intubated and ventilated for ≥168 h and survived their acute care …

Intensive Care Unit Mobility Practices In Australia And New Zealand: A Point Prevalence Study, Susan C. Berney, Megan Harrold, Steven A. Webb, Ian Seppelt, Shane Patman, Peter J. Thomas, Linda Denehy

Shane Patman

Objectives:

To develop a comprehensive set of items describing physiotherapy mobilisation practices for critically ill patients, and to document current practices in intensive care units in Australia and New Zealand, focusing on patients having > 48 hours of mechanical ventilation.

Design:

Prospective, observational, multicentre, single-day, point prevalence study.

Participants and Setting:

All patients in 38 Australian and New Zealand ICUs at 10 am on one of three designated days in 2009 and 2010.

Main Outcome Measures:

Demographic data, admission diagnosis and mobilisation practices that had occurred in the previous 24 hours.

Results:

514 patients were enrolled, with 498 complete datasets. Mean …

Seeing It Helps: Movement-Related Back Pain Is Reduced By Visualization Of The Back During Movement, Benedict M. Wand, Verity M. Tulloch, Pamela J. George, Anne J. Smith, Roger Goucke, Neil E. O'Connell, G Lorimer Moseley

Pamela George

Objectives: The aim of this study was to determine whether visualization of the back influenced parameters of movement-related pain in people with chronic nonspecific low back pain. Methods: We used a randomized cross-over experiment in which 25 participants performed repeated lumbar spine movements under 2 conditions. In the visual feedback condition, patients were able to visualize their back as it moved by the use of mirrors. In the control condition, the mirror was covered so no visualization of the back was possible. Results: The average postmovement pain intensity after participants had moved with visual feedback was less (35.5+/-22.8 mm) than …

Eccentric Fatigue Modulates Stretch-Shortening Cycle Effectiveness - A Possible Role In Lower Limb Overuse Injuries, James R. Debenham, M Travers, William Gibson, A Campbell, G Allison

William Gibson

The role of fatigue in injury development is an important consideration for clinicians. In particular, the role of eccentric fatigue in stretch shortening cycle (SSC) activities may be linked to lower limb overuse conditions. The purpose of this study was to explore the influence of ankle plantarflexor eccentric fatigue on SSC effectiveness during a hopping task in healthy volunteers. 11 healthy volunteers (23.2 ± 6.7 years) performed a sub-maximal hopping task on a custom- built sledge system. 3D motion capture and surface EMG were utilised to measure lower limb stiffness, temporal kinematic measures and muscle timing measures at baseline and …

Chronic Mid Portion Achilles Tendinopathy Is Not Associated With Central Sensitisation, Ian W. Skinner, James R. Debenham, Sarah Krumenachera, Max K. Bulsara, Benedict M. Wand

James Debenham

Achilles tendinopathy (AT) is a common painful and disabling condition and current understanding of its pathophysiology is incomplete. Widespread hyperalgesia as a clinical manifestation of central sensitisation has emerged as a possible contributor to the pain state in chronic musculoskeletal injuries. Eight AT participants and eight healthy, gender, age and activity matched participants were recruited to participate in a case-controlled repeated measures study. Pressure pain threshold (PPT) was measured with a manual electronic algometer at four sites bilaterally; tibialis anterior (TA), patella tendon (PT), common wrist extensor tendon (CWET), and first dorsal interosseous (1DI). We hypothesised a reduction in PPT …

Are There Associations Among Physical Activity, Fatigue, Sleep Quality And Pain In People With Mental Illness? A Pilot Study, Joanne Connaughton, Shane Patman, C Pardoe

Joanne Connaughton

Accessible summary

• Many people with mental health disorders experience fatigue, pain and poor sleep. In other patient groups, physical exercise has been shown to have positive effects on these symptoms.

• It is unknown whether day-to-day physical activity (not necessarily exercise) affects sleep quality or severity of pain or fatigue in those with mental illness.

• This study observed physical activity, sleep quality, pain and fatigue in four people hospitalized with severe mental illness.

• Significant associations were found between pain and fatigue severity in the morning, but not in the evening. A significant association was found between physical activity and morning and …

Top 10 Research Questions To Promote Physical Activity In Bipolar Disorders: A Consensus Statement From The International Organization Of Physical Therapists In Mental Health, Davy Vancampfort, Simon Rosenbaum, Michel Probst, Joanne Connaughton, Christy Du Plessis, Taisei Yamamoto

Joanne Connaughton

A New Measure Of Toddler Parenting Practices And Associations With Attachment And Mothers' Sensitivity, Competence, And Enjoyment Of Parenting, Melanie Zimmer-Gembeck, Haley Webb, Rae Thomas, Stefanie Klag

Rae Thomas

Self-determination theorists argue that parents can support or thwart their children’s psychological needs for relatedness, autonomy, and competence. The first aim of this study was to develop a measure to assess six dimensions of parenting theoretically linked to meeting toddlers’ needs. The second aim was to examine the associations of these dimensions with mothers’ sensitivity, attachment, and parenting attitudes. Participants were 61 mothers who expressed having parenting difficulties. Mothers completed questionnaires to assess their warmth, autonomy support, structure, rejection, coercion, and chaos, and self-reported their parenting competence and enjoyment. Mother–toddler interactions were observed to assess mothers’ sensitivity, and attachment was …

Soldier Occupational Load Carriage – A Narrative Review Of Associated Injuries, Robin Orr, Rodney Pope, Venerina Johnston, Julia Coyle

Rodney P Pope

This narrative review examines injuries sustained by soldiers undertaking occupational load carriage tasks. Military soldiers are required to carry increasingly heavier occupational loads. These loads have been found to increase the physiological cost to the soldier and alter their gait mechanics. Aggregated research findings suggest that the lower limbs are the most frequent anatomical site of injury associated with load carriage. While foot blisters are common, other prevalent lower limb injuries include stress fractures, knee and foot pain, and neuropathies, like digitalgia and meralgia. Shoulder neuropathies (brachial plexus palsy) and lower back injuries are not uncommon. Soldier occupational load carriage …

The Effect Of Low-Volume, High-Intensity Interval Training On Blood Glucose Markers, Anthropometric Measurements, And Cardiorespiratory Fitness In Patients With Type Ii Diabetes., Sujoy Bose

Sujoy Bose

The profound biologic, & societal burden of the syndrome of Diabetes Mellitus (DM) is subject of numerous ongoing research. There is significant interest in non-pharmacologic glycemic control, principally by exercise. While beneficial effects of generic exercise on glucose metabolism have been well established in literature, there is a paucity of research on the volume, intensity, & type of the most optimal forms of exercise that affect glycemic physiology in those with type II DM. The goal of this study was to perform a systematic review of the impact of high intensity interval training (HIIT) on glycemic control in people with …

Endurance And Fatigue Characteristics Of The Neck Muscles In Patients With Cervical Radiculopathy, Marie Halvorsen, Allan Abbott, Anneli Peolsson, Asa Dedering

Allan D. Abbott

Purpose: The aim of the study was to compare myoelectric manifestation in neck muscle endurance and fatigue characteristics during sub-maximal isometric endurance test in patients with cervical radiculopathy and asymptomatic subjects. An additional aim was to explore associations between primary neck muscle endurance, myoelectric fatigability, and self-rated levels of fatigue, pain and subjective health measurements in patients with cervical radiculopathy.

Methods: Muscle fatigue in the ventral and dorsal neck muscles was assessed in patients with cervical radiculopathy and in an asymptomatic group during an isometric neck muscle endurance test in prone and supine. 46 patients and 34 asymptomatic subjects participated. …

Comparison Of A Novel Direct Measure Of Rapid Pain Intensity Change To Traditional Serial 100 Mm Vas Measurement Of Pain Intensity, Mark Laslett, Peter Mcnair, Angela Cadogan, Wayne Hing

Wayne Hing

Objectives: Key diagnostic decisions often turn on measurement of change in pain intensity after diagnostic anesthetic blocks. This study aimed to introduce a new direct measure pain intensity change and compare it with percent change as calculated from the traditional preprocedure and postprocedure pain visual analog scales. Methods: Shoulder pain patients enrolled in a diagnostic accuracy study comparing clinical variables with image-guided local anesthetic injections were assessed with both the traditional preprocedure and postprocedure visual analog scales and the new direct method. Percent change in pain intensity was calculated with both instruments and were compared using statistical methods. The percentage …

Soldier Self-Reported Reductions In Task Performance Associated With Operational Load Carriage, Rob Orr, Rodney Pope, Venerina Johnston, Julia Coyle

Rodney P Pope

Australian Army soldiers are required to carry heavy loads of around 48kg while deployed on military operations. Research has associated decrements in soldiers’ ability to perform key tasks with carriage of these loads. To determine whether soldiers are aware of the negative impact of load carriage on their performance of operational tasks, soldier responses relating to perceptions of load carriage impacts on performance of five key tasks while on operations were collected. Data, captured via an online survey tool, were analysed to determine relationships between soldier perceptions and loads carried. In addition, responses were drawn from a 5-point Likert Scale …

Is There A Need For Cervical Collar Usage Post Anterior Cervical Decompression And Fusion Using Interbody Cages? A Randomized Controlled Pilot Trial, Allan Abbott, Marie Halvorsen, Asa Dedering

Allan D. Abbott

Anterior cervical discectomy and fusion (ACDF) is a common surgical intervention for radiculopathy resulting from degenerative cervical spine conditions. Post-surgical cervical collar use is believed to reduce post-operative pain, provide the patient with a sense of security during activities of daily living and even reduce rates of non-fusion. This prospective randomized controlled pilot trial investigates trial design feasibility in relation to prospective physical, functional, and quality of life-related outcomes of patients undergoing ACDF with interbody cage, with (n = 17) and without (n = 16) post-operative cervical collar usage. Results show that the sample provides sufficient statistical power to show …

Physiotherapist Agreement When Visually Rating Movement Quality During Lower Extremity Functional Screening Tests, Chris Whatman, Wayne Hing, Patricia Hume

Wayne Hing

Objectives: To investigate physiotherapist agreement in rating movement quality during lower extremity functional tests using two visual rating methods and physiotherapists with differing clinical experience.

Design: Clinical measurement.

Participants: Six healthy individuals were rated by 44 physiotherapists. These raters were in three groups (inexperienced, novice, experienced).

Main measures: Video recordings of all six individuals performing four lower extremity functional tests were visually rated (dichotomous or ordinal scale) using two rating methods (overall or segment) on two occasions separated by 3e4 weeks. Intra and inter-rater agreement for physiotherapists was determined using overall percentage agreement (OPA) and the first order agreement coefficient …

The Effectiveness Of Post-Operative Rehabiliation Following Partial Meniscectomy Of The Knee, Duncan Reid, Jana Rydwanski, Wayne Hing, Steve White

Wayne Hing

Background: Injuries to the menisci of the knee are a common cause of impairment and functional disability. The prevalence of meniscal injury ranges from 19 to 56% depending on the population studied. Arthroscopic surgery to the meniscus may be required if conservative care has failed. There is still controversy as to the need for routine post-operative rehabilitation to improve function and reduce impairments.

Objectives: The purpose of this paper was to systematically review the literature that evaluated the effectiveness of post-operative exercise programmes to improve function and reduce impairments following partial meniscectomy of the knee.

Methods: A computerized electronic search …

Effect Of Tissue Mechanical Properties On Cuff-Based Blood Pressure Measurements, H. Lan, A. M. Al-Jumaily, A. Lowe, W. Hing

Wayne Hing

This paper presents a 3D finite element upper arm model, validated by experiments as well as clinical data, used to study the error introduced in blood pressure measurements due to variability of arm tissue mechanical properties. The model consists of three separate cylindrical parts: soft tissue, bone and brachial artery. The artery volume changes under the cuff are used to represent the cuff pressure oscillations for analyzing blood pressure measurements. These oscillation trends are identical to observed clinical data. Also an upper arm simulator is designed and built for model validation. The model shows that the variation of soft tissue …

Leg Pain And Psychological Variables Predict Outcome 2-3 Years After Lumbar Fusion Surgery, Allan Abbott, Raija Tyni-Lenne´, Rune Hedlund

Allan D. Abbott

Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2–3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2–3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping …

The Effects Of Spinal Posture And Pelvic Fixation On Trunk Rotation Range Of Motion, Trevor Montgomery, Mark Boocock, Wayne Hing

Wayne Hing

Background: Axial rotation of the trunk is important to many vocational tasks and activities of daily living, and may be associated with back injuries. The influence of spinal postures on trunk rotation appears conflicting. This study investigated the influence of forward trunk inclination, spinal posture and pelvic fixation on maximum trunk rotation.

Methods: Twenty male participants were assessed using an optoelectronic motion-analysis system to track trunk movement during maximal trunk rotations in different spinal positions within the sagittal plane. A repeated-measures multivariate analysis of variance investigated the effects of forward trunk inclination, spinal posture and pelvic fixation on trunk and …

Interexaminer Reliability Of Orthopaedic Special Tests Used In The Assessment Of Shoulder Pain, Angela Cadogan, Mark Laslett, Wayne Hing, Peter Mcnair, Maynard Williams

Wayne Hing

Orthopaedic special tests (OST) are commonly used in the assessment of the painful shoulder to assist to rule-in or rule-out specific pathology. A small number of tests with high levels of diagnostic accuracy have been identified but interexaminer reliability data is variable or lacking. The aim of this study was to determine the interexaminer reliability of a group of OST with demonstrated diagnostic accuracy at primary care level. Forty consecutive subjects with shoulder pain were recruited. Six tests were performed by two examiners (physiotherapists) on the same day. Tests included the active compression test, Hawkins–Kennedy test, drop-arm test, crank test, …

Reliability Of A New Hand-Held Dynamometer In Measuring Shoulder Range Of Motion And Strength, Angela Cadogan, Mark Laslett, Wayne Hing, Peter Mcnair, Maynard Williams

Wayne Hing

Acceptable reliability is a prerequisite for inclusion of physical examination tests in clinical examinations of the painful shoulder. The aim of this study was to establish the intraexaminer and interexaminer reliability of measures of shoulder range of motion (ROM) and muscle force using a new hand-held dynamometer with the ability to standardize overpressure force during passive ROM tests. Forty consecutive subjects with shoulder pain were recruited, and tests were performed by two physiotherapists. Tests included active ROM elevation, passive ROM glenohumeral abduction and external rotation and resisted abduction and external rotation. All tests demonstrated high levels of intraexaminer reliability (ICC …

Kinematics During Lower Extremity Functional Screening Tests - Are They Reliable And Related To Jogging?, Chris Whatman, Wayne Hing, Patria Hume

Wayne Hing

Purpose: To investigate the within-day and between-day reliability of 3D lower extremity kinematics during five lower extremity functional screening tests and to assess the association between these kinematics and those recorded during jogging.

Methods: Peak three-dimensional lower extremity kinematics were quantified in 25 uninjured participants during five lower extremity functional tests and jogging. A nine camera motion analysis system (Qualysis Medical AB, Sweden) was used to capture three trials of all tests. All functional tests were repeated by 10 participants one to two days later. Visual 3D (C-Motion Inc, USA) and Labview were used to process all data. Intraclass correlation …

Patients' Experience Post-Lumbar Fusion Regarding Back Problems, Recovery And Expectations In Terms Of The International Classification Of Functioning, Disability And Health, Allan Abbott, Rune Hedland, Raija Tyni-Lenné

Allan D. Abbott

Purpose - To describe within the context of the International Classification of Functioning, Disability and Health ((ICF)), patient's experiences post-lumber fusion regarding back problems, recovery and expectations of rehabilitation and to contrast with the content of outcome measures and the ICF low back pain ((LBP)) core sets.

Methods - The study has a cross-sectional and retrospective design and involves 20 lumbar fusion patients. Using the ICF, qualitative content analysis of semi-structured interviews 3–6 months post-surgery was performed. This was compared with the ICF related content of the Oswestry Disability Index ((ODI)), Medical Outcome Study Short Form 36 ((SF-36)), European Quality …

Postoperative Rehabiliation Of Lumbar Disc Herniation, Maria Kyhlbäck, Gunilla Kjellby-Wendt, Allan Abbott, Monica Millisdotter, Per Grönlund, Mia Johansson, Ann-Christin Johansson

Allan D. Abbott

No abstract provided.

Mobilisation With Movement: The Art And The Science, Bill Vincenzino, Wayne Hing, Darren Rivett, Toby Hall

Wayne Hing

An authoritative text and accompanying DVD presenting the growing evidence base for Mobilisation with Movement techniques.

Developed over the past 26 years, Mobilisation with Movement (MWM) remains a relatively new form of manual therapy. It is, however, becoming one of the most popular approaches for the management of musculoskeletal disorders.

Mobilisation with Movement: The art and the science introduces the concept of Mobilisation with Movement, describes basic Mobilisation with Movement techniques and outlines its principles of application.

The book summarises the emergent evidence base underpinning Mobilisation with Movement techniques, including randomised controlled trials, and shows how far the technique has …

The Influence Of Psychological Factors On Pre-Operative Levels Of Pain Intensity, Disability And Health-Related Quality Of Life In Lumbar Spinal Fusion Surgery Patients, Allan Abbott, Raija Tyni-Lenné, Rune Hedland

Allan D. Abbott

Objectives - To assess the extent to which perceived pain and psychological factors explain levels of disability and health-related quality of life (HRQOL) in patients scheduled for lumbar fusion surgery, and to test the hypothesis that relationships between pain intensity, mental health, fear of movement/(re)injury, disability and HRQOL are mediated by cognitive beliefs and appraisals.

Design - Cross-sectional, correlation study.

Setting - Orthopaedic outpatient setting in a tertiary hospital.

Participants - One hundred and seven chronic back pain patients scheduled for lumbar fusion surgery.

Measures - Visual analogue scale for pain intensity, Short Form 36 mental health subscale, Tampa Scale …

Variation And Reliability Of Ultrasonographic Quantification Of The Architecture Of The Medial Gastrocnemius Muscle In Young Children, Kirsten Legerlotz, Heather Smith, Wayne Hing

Wayne Hing

The aim of this study was to evaluate the suitability of ultrasonography for the quantification of gastrocnemius muscle architecture in healthy young children. The variation and reliability of measurement of muscle thickness, pennation angle and fibre length of the medial gastrocnemius were determined, using stationary and portable ultrasound machines, in 13 boys and eight girls aged 4–10. Ultrasound images were obtained from each leg, in duplicate, with the ankle at 90°, then at maximal plantar flexion, with the two machines within the same session. The same set of 16 scans was repeated in four children 4–6 weeks later. The mean …

Early Rehabilitation Targeting Cognition, Behavior, And Motor Function After Lumbar Fusion. A Randomized Controlled Trial, Allan Abbott, Raija Tyni-Lenne´, Rune Hedlund

Allan D. Abbott

Study Design - Open label randomized controlled trial with 3-, 6-, 12-month, and 2- to 3-year follow-up.

Objective - To investigate the effectiveness of a psychomotor therapy focusing on cognition, behavior, and motor relearning compared with exercise therapy applied during the first 3 months after lumbar fusion.

Summary of Background Data - Postoperative management after lumbar fusion commonly focuses on analgesic pain control and activities of daily living. After 3 months, exercise therapy is often implemented. No randomized controlled trial has investigated early rehabilitation techniques conducted during the first 3 months after surgery.

Methods - The study recruited 107 patients, …

Spinal Manipulation For Dysmenorrhoea (Review), Michelle Proctor, Wayne Hing, Trina Johnson, Patricia Murphy, Julie Brown

Wayne Hing

Background: Dysmenorrhoea (occurrence of painful menstrual cramps of uterine origin) is a common gynaecological condition. The character of pain from musculoskeletal dysfunction can be very similar to gynaecological pain by presenting cyclicly and being altered by hormonal changes associated with menstruation. Medical treatment for dysmenorrhoea usually comprises anti-inflammatory drugs, oral contraceptives, or surgical intervention. Spinal manipulation is a non-medical intervention. It has been suggested that manipulation of the vertebrae may increase spinal mobility thus improving pelvic blood supply and facilitating pain relief.

Objectives: To determine the safety and efficacy of spinal manipulative interventions for the treatment of dysmenorrhoea when compared …

The Use Of Contrast Therapy Recovery Within The New Zealand Elite Sports Setting, Wayne Hing

Wayne Hing

Background: Contrast therapy is a recovery modality that is widely used by many athletes despite the lack of scientific evidence for its use.

Aim: The purpose of this paper is to firstly survey and analyse the current utilisation of contrast therapy within the elite sports of New Zealand (NZ) and secondly, to compare the findings with current scientific research.

Method: A questionnaire was developed to survey elite NZ sports teams on their use of contrast therapy. The majority of respondents (79%) utilised contrast therapy as a recovery modality.

Results: The results indicated that contrast therapy is used immediately post exercise, …