Physiotherapy Commons^™

Cardiac Conditions, Ana Paula Coelho Figueira Freire, Mark R. Elkins

All Faculty Scholarship for the College of Education and Professional Studies

This Editorial introduces another of Journal of Physiotherapy’s article collections.These are collections of papers on a particular topic, published in the Journal of Physiotherapy within the past decade and compiled to: facilitate access to important recent findings on the topic; highlight trends in research designs, methods, populations and interventions; and suggest avenues for further research. The studies in this article collection relate to physiotherapy management of cardiac conditions.

Sickle Cell Disease Chronic Joint Pain: Clinical Assessment Based On Maladaptive Central Nervous System Plasticity, Tiago Da Silva Lopes, Samir K. Ballas, Jamille Evelyn Rodrigues Souza Santana, Pedro De Melo-Carneiro, Lilian Becerra De Oliveira, Katia Nunes Sá, Larissa Conceição Dias Lopes, Wellington Dos Santos Silva, Rita Lucena, Abrahão Fontes Baptista

Department of Medicine Faculty Papers

Chronic joint pain (CJP) is among the significant musculoskeletal comorbidities in sickle cell disease (SCD) individuals. However, many healthcare professionals have difficulties in understanding and evaluating it. In addition, most musculoskeletal evaluation procedures do not consider central nervous system (CNS) plasticity associated with CJP, which is frequently maladaptive. This review study highlights the potential mechanisms of CNS maladaptive plasticity related to CJP in SCD and proposes reliable instruments and methods for musculoskeletal assessment adapted to those patients. A review was carried out in the PubMed and SciELO databases, searching for information that could help in the understanding of the mechanisms …

Early Mobilization Following Elbow Dislocation And Immobilization, Grant Pheil

Graduate Research Showcase

Early Mobilization following Elbow Dislocation and Immobilization; Pheil G, Georgia College & State University: Milledgeville, GA.

Background: This case presents a 16-year-old male junior high school soccer athlete. His injury occurred during a homecoming kickball game in which he hyperextended his elbow. The hyperextension resulted in an audible popping sound. Differential Diagnosis: There was an obvious deformity and swelling seen at the athlete’s olecranon process and cubital fossa. The athletic trainer identified a dislocation and reduced the humeroulnar joint on the first attempt. The athletes’ parents were immediately contacted, and he was transported to the orthopedist in town. Neurovascular assessments …

Effectiveness Of Home-Based Rehabilitation Program In Minimizing Disability And Secondary Falls After A Hip Fracture: Protocol For A Randomized Controlled Trial, Anum Sadruddin Pidani, Saniya Sabzwari, Khabir Ahmad, Ata Khan, Shahryar Noordin

Department of Surgery

Introduction: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population.
Methods and analysis: …

Patient Experiences Of A Physiotherapy-Led Multidisciplinary Rehabilitative Intervention After Successful Treatment For Oesophago-Gastric Cancer, Annemarie Bennett, L. O'Neill, D. Connolly, E. M. Guinan, L. Boland, Suzanne Doyle, J. O'Sullivan, J. V. Reynolds, J. Hussey

Articles

Purpose To qualitatively explore the perceived impact of a 12-week rehabilitative intervention for oesophago-gastric cancer survivors on their physical, mental and social wellbeing. Methods Of the 21 participants who completed the intervention, 19 took part in a semi-structured focus group interview. Four audio-taped focus groups were held, ranging in size from two to eight participants. Focus groups were transcribed and analysed using a descriptive qualitative approach. Results At recruitment, participants were 23.5 ± 15.2 months post-surgery and all had suboptimal fitness levels. Participants reported improvements in their physical capacity and ability to carry out activities of daily living during the …

Virtual Reality As A Training Tool To Treat Physical Inactivity In Children, Adam W. Kiefer, David Pincus, Michael J. Richardson, Gregory D. Myer

Psychology Faculty Articles and Research

Lack of adequate physical activity in children is an epidemic that can result in obesity and other poor health outcomes across the lifespan. Physical activity interventions focused on motor skill competence continue to be developed, but some interventions, such as neuromuscular training (NMT), may be limited in how early they can be implemented due to dependence on the child’s level of cognitive and perceptual-motor development. Early implementation of motor-rich activities that support motor skill development in children is critical for the development of healthy levels of physical activity that carry through into adulthood. Virtual reality (VR) training may be beneficial …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

A Comparison Of The Scapular Flip Test Between Women With Breast Cancer And Healthy Controls, Mary Insana Fisher, Lucinda Pfalzer, Ellen W. Levy, Shana Harrington, Lynn H. Gerber, Nicole L. Stout

Physical Therapy Faculty Publications

Presentation at the World Confederation for Physical Therapy Congress, held May 1-4, 2015, in Singapore.

Background: The Scapular Flip test was designed to screen for spinal accessory nerve palsy. The spinal accessory nerve can be damaged in breast cancer surgery and treatment, resulting in scapular dyskinesis and upper limb (UL) impairment in women with breast cancer (BC). This test could be useful to screen for UL impairment in BC.

Purpose: The purpose of this study was to describe shoulder impairments as defined by a positive Flip Test in a group of women with BC at baseline, 1-3 months, and 12+ …

Innovative Evaluation Of Dexterity In Pediatrics, Susan V. Duff, Dorit H. Aaron, Gloria R. Gogola, Francisco J. Valero-Cuevas

Physical Therapy Faculty Articles and Research

Introduction

Hand dexterity is multifaceted and essential to the performance of daily tasks. Timed performance and precision demands are the most common features of quantitative dexterity testing. Measurement concepts such as rate of completion, in-hand manipulation and dynamic force control of instabilities are being integrated into assessment tools for the pediatric population.

Purpose

To review measurement concepts inherent in pediatric dexterity testing and introduce concepts that are infrequently measured or novel as exemplified with two assessment tools.

Methods

Measurement concepts included in common assessment tools are introduced first. We then describe seldom measured and novel concepts embedded in two instruments; …

Clinical Assessment Of The Infant And Child Following Perinatal Brachial Plexus Injury, Susan V. Duff, Carol Dematteo

Physical Therapy Faculty Articles and Research

Introduction

After perinatal brachial plexus injury (PBPI), clinicians play an important role in injury classification as well as the assessment of recovery and secondary conditions. Early assessment guides the initial plan of care and influences follow-up and long-term outcome.

Purpose

To review methods used to assess, classify and monitor the extent and influence of PBPI with an emphasis on guidelines for clinicians.

Methods

We use The International Classification of Functioning, Disability, and Health (ICF) model to provide a guide to assessment after PBPI for rehabilitation clinicians.

Discussion

With information gained from targeted assessments, clinicians can design interventions to increase the …

Cardiac Rehabilitation Programmes For Low-Risk Patients And Leisure Athletes: A Potential Paradox, Wendy Bjerke, Stu Steinman, Vincent Cotto

All PTHMS Faculty Publications

Background: Athletes are enrolled in cardiac rehabilitation (CR) programmes in small numbers and require unique diagnostic testing and training considerations. Additionally, many physiotherapists, exercise physiologists, athletic trainers and physicians lack experience treating athletes in CR due to their limited exposure to these types of patients. Content: This analysis distinguishes athletes from typical CR patients within the context of diagnostic testing, assessment, exercise prescription, and management. Several case studies present unique challenges and approaches to the rehabilitation of athletes in a CR setting. Conclusions: Athletes enrolled in CR should be treated and trained according to their abilities and goals. Combining traditional …

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 …