Rehabilitation and Therapy Commons^™

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 …

Pressure Pain Threshold Testing Demonstrates Predictive Ability In People With Acute Whiplash., David Walton

David Walton

No abstract provided.

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 …

Load Carriage And The Female Soldier, Rob Marc Orr, Venerina Johnston, Julia Coyle, Rodney Pope

Rob Marc Orr

This paper reviews the physiological, biomechanical and health impacts of load carriage on the female soldier and extends to include issues acknowledged as impacting on the female athlete and hence the female soldier. Physiological factors such as fat mass, strength, aerobic endurance and biomechanical factors such as stride length and forward lean have the potential to increase the energy cost of load carriage and cause injury. The female athlete triad, iron deficiency, pelvic floor muscle dysfunction and military equipment issues can likewise reduce female soldier performance and increase injury risk. Research evidence is presented to inform the development and implementation …

Spinal Manipulation - Evidence For Physiotherapist Delivery Of Effective Procedures, D. Reid, T. Flynn, W. Hing, C. Mccarthy, P. Westerhuis

Wayne Hing

Extract:
Learning objectives: 1. Demonstrate an increased understanding of the evidence for the use of spinal manipulation in the management of musculoskeletal conditions. 2. Demonstrate an increased understanding of the required screening procedures to provide safe practice of spinal manipulation. 3. Demonstrate an increase understanding of different approaches to deliver HVT and undergraduate and post graduate level.

A Prospective Study Of Shoulder Pain In Primary Care: Prevalence Of Imaged Pathology And Response To Guided Diagnostic Blocks, Angela Cadogan, Mark Laslett, Wayne A. Hing, Peter J. Mcnair, Mark H. Coates

Wayne Hing

Background: The prevalence of imaged pathology in primary care has received little attention and the relevance of identified pathology to symptoms remains unclear. This paper reports the prevalence of imaged pathology and the association between pathology and response to diagnostic blocks into the subacromial bursa (SAB), acromioclavicular joint (ACJ) and glenohumeral joint (GHJ).

Methods: Consecutive patients with shoulder pain recruited from primary care underwent standardised x-ray, diagnostic ultrasound scan and diagnostic injections of local anaesthetic into the SAB and ACJ. Subjects who reported less than 80% reduction in pain following either of these injections were referred for a magnetic resonance …

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, …

Comparison Of Multimodal Physiotherapy And "R.I.C.E." Self-Treatment For Early Management Of Ankle Sprains, Wayne Hing, Justin Lopes, Patria A. Hume, Duncan A. Reid

Wayne Hing

Current guidelines advocate the use of R.I.C.E., the acronym for Rest, Ice, Compression and Elevation, for patient self-management of soft tissue injury. The purpose of this study was to investigate the efficacy of R.I.C.E. applied as part of patient self-management compared (R.I.C.E.) to R.I.C.E. incorporated with multimodal physiotherapy management (Physiotherapy). A randomised control trial was carried out in a Physiotherapy Clinic. Twenty eight participants with an acute ankle sprain were randomised into either R.I.C.E. (n=12) or Physiotherapy (n=16) groups. Pain, function and swelling for acute ankle sprain patients were recorded on Days 1, 3, 7, and 11 post injury. Medication …

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 …

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.

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.

Non-Invasive Brain Stimulation Techniques For Chronic Pain. A Cochrane Systematic Review And Meta-Analysis, Neil E. O'Connell, Louise Marston, Benedict M. Wand, Sally Spencer, Lorraine H. De Souza

Physiotherapy Conference Papers

Poster Presentation

Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronic pain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES) and transcranial direct current stimulation (tDCS). These approaches to pain treatment are relatively novel. It is important to assess the existing literature robustly to ascertain the current level of supporting evidence and to inform future research and potential clinical use.

Evaluation Of A Treatment-Based Classification Algorithm For Low Back Pain, Tasha R. Stanton, Julie Fritz, Mark J. Hancock, Jane Latimer, Chris G. Maher, Benedict M. Wand, Eric Parent

Physiotherapy Conference Papers

Poster Presentation

Theme: How can we better translate evidence into clinical practice?

Background: Several studies have investigated criteria for classifying patients with low back pain into treatment-based subgroups. A comprehensive algorithm was recently created to translate these criteria into a clinical decision-making guide. This study investigated the translation of the individual subgroup criteria into a comprehensive algorithm by studying the prevalence of patients meeting each treatment subgroup, more than one treatment subgroup, and none of the treatment subgroups. The reliability of the classification decision was also investigated.

Transcranial Direct Current Stimulation Of The Motor Cortex In The Treatment Of Chronic Non-Specific Low Back Pain. A Randomised, Double-Blind Exploratory Study, Neil E. O'Connell, John Cossar, Louise Marston, Benedict M. Wand, David Bunce, Lorraine H. De Souza, David W. Maskill, Andrew Sharp, G Lorimer Moseley

Physiotherapy Conference Papers

This exploratory study aimed to test the proof of principle that active anodal transcranial direct current stimulation (tDCS) applied to the motor cortex reduces pain significantly more than sham stimulation in a group of participants with chronic non-specific low back pain.

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

Physiotherapy Conference Papers

Patient satisfaction is an important patient-focussed indicator of the quality of physiotherapy care. We have completed an evaluation of patient satisfaction with musculoskeletal physiotherapy in Australia using the 20-item MedRisk Instrument for Measuring Patient Satisfaction With Physical Therapy Care (MRPS). In this paper we report on factors that influence patient satisfaction in this cultural context.

Treating Chronic Nonspecific Low Back Pain With A Sensorimotor Retraining Approach: An Exploratory Multiple-Baseline Study Of 3 Participants, Benedict M. Wand, Neil E. O'Connell, Flavia Di Pietro, Max Bulsara

Physiotherapy Conference Papers

Chronic nonspecific low back pain (CNSLBP) is a common healthcare problem for which current interventions are only moderately successful [1]. There is growing evidence of extensive cortical reorganisation and perceptual disturbances which may contribute to the condition [2]. The aim of this study was to test whether a graded sensorimotor retraining program, aimed at influencing cortical representation, would reduce pain intensity, interference of pain on daily life and self reported disability.

Factors Associated With Older Patients' Engagement In Exercise After Hospital Discharge, Anne-Marie Hill, Tammy Hoffmann, Steven Mcphail, Christopher Beer, Keith D. Hill, Sandra G. Brauer, Terrence P. Haines

Physiotherapy Papers and Journal Articles

Objectives: To identify factors that are associated with older patients' engagement in exercise in the 6 months after hospital discharge.

Design: A prospective observational study using qualitative and quantitative evaluation.

Setting: Follow-up of hospital patients in their home setting after discharge from a metropolitan general hospital.

Participants: Participants (N=343) were older patients (mean age ± SD, 79.4±8.5y) discharged from medical, surgical, and rehabilitation wards and followed up for 6 months after discharge.

Interventions: Not applicable.

Main Outcome Measures: Self-perceived awareness and risk of falls measured at discharge with a survey that addressed elements of the Health Belief Model. Engagement and …

Falls After Discharge From Hospital: Is There A Gap Between Older Peoples’ Knowledge About Falls Prevention Strategies And The Research Evidence?, Anne-Marie Hill, Tammy Hoffmann, Christopher Beer, Steven Mcphail, Keith D. Hill, David Oliver, Sandra G. Brauer, Terry P. Haines

Physiotherapy Papers and Journal Articles

Purpose: The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital.

Design and Methods: We used a semi-structured interview to survey older patients about to be discharged from hospital and examined their knowledge regarding falls prevention strategies to utilize in the post-discharge period. The study was part of a prospective cohort study, nested within a larger, randomized controlled trial. Participants (n = 333) were asked to suggest strategies to reduce their falls risk at home after discharge, and their responses were compared with current reported …

Implementing Routine Provider-Initiated Hiv Testing In Public Health Care Facilities In Kenya: A Qualitative Descriptive Study Of Nurses' Experiences, Catrin Evans, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Routine 'provider-initiated testing and counselling' (PITC) for HIV has been implemented amidst concern over how consent, confidentiality and counselling (the 3C’s) can be maintained in underresourced health care settings. In Kenya, PITC has been rolled out since 2005, HIV prevalence is 7.1% and over 86% of adults have not been tested. Kenyan nurses are the main cadre implementing PITC but little is known about their experiences of incorporating HIV testing into everyday practice and the challenges faced in maintaining the 3’Cs within their work environments. This study aimed to explore these issues and adopted a qualitative multi-method design using a …

Systematic Review Of Home Physiotherapy After Hip Fracture Surgery, Saurabh Mehta, Jean-Sébastien Roy

Physical Therapy Faculty Research

OBJECTIVE: To compare the benefits of home physiotherapy, institution-based physiotherapy and no physiotherapy following hip fracture surgery.

DESIGN: Systematic review and meta-analysis of randomized controlled trials.

METHODS: Two reviewers independently extracted data from 5 included studies. Standardized mean differences were pooled for health-related quality of life and performance-based outcomes. Review Manager Version 5 was used for data analysis.

RESULTS: Analysis of the 5 included studies indicated that home physiotherapy was better than no physiotherapy and similar to outpatient physiotherapy in improving patient-reported health-related quality of life. Performance-based outcomes were marginally better following outpatient physiotherapy compared with home physiotherapy 3 and …

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 …

Load Carriage And Its Force Impact, Robin Orr, Rodney Pope, Verenina Johnston, Julia Coyle

Rodney P Pope

Extract:
Just as history records that military personnel have been carrying heavy loads for over two millennia (Orr, 2010), so too does it show their impact on military force sustainment and combat effectiveness. Around 800BC, the heavy loads carried by Assyrian soldiers reduced their mobility and led them to experiment continually with their shields in order to lighten their loads (Gabriel, 2002). Around 400BC, the long marches of Cyrus’ ‘infamous 10,000’, an army of Greek mercenaries accompanied by Xenophon, would have resulted in numerous stress fractures, torn ligaments, muscle damage, blisters and abrasions. While some of these injuries can be …

Load Carriage And Its Force Impact, Robin Orr, Rodney Pope, Verenina Johnston, Julia Coyle

Rob Marc Orr

Extract:
Just as history records that military personnel have been carrying heavy loads for over two millennia (Orr, 2010), so too does it show their impact on military force sustainment and combat effectiveness. Around 800BC, the heavy loads carried by Assyrian soldiers reduced their mobility and led them to experiment continually with their shields in order to lighten their loads (Gabriel, 2002). Around 400BC, the long marches of Cyrus’ ‘infamous 10,000’, an army of Greek mercenaries accompanied by Xenophon, would have resulted in numerous stress fractures, torn ligaments, muscle damage, blisters and abrasions. While some of these injuries can be …