Rehabilitation and Therapy Commons^™

Perceived Body Distortion Rather Than Actual Body Distortion Is Associated With Chronic Low Back Pain In Adults With Cerebral Palsy: A Preliminary Investigation, Hirofumi Yamashita, Tomohiko Nishigami, Akira Mibu, Katsuyoshi Tanaka, Masahiro Manfuku, Hikaru Fukuhara, Koichi Yoshino, Yoichi Seto, Benedict Wand

Physiotherapy Papers and Journal Articles

Objectives: The aim of the present study was to investigate whether distorted body perception is a feature of the low back pain experience in people with Cerebral Palsy (CP) and whether any distortions noted are confounded by the presence of motor and postural impairments commonly seen in CP.

Methods: Forty‐five individuals participated in this study: fifteen adults with CP with LBP (CP_Pain group), fifteen adults with CP without LBP (CP_noPain group), and fifteen age‐matched adults with LBP but no CP (Pain group). Body perception was evaluated using the Fremantle Back Awareness Questionnaire (FreBAQ) and by assessing two‐point discrimination (TPD) thresholds …

Reviews May Overestimate The Effectiveness Of Medicines For Back Pain: Systematic Review And Meta-Analysis, Matthew K. Bagg, Edel O'Hagan, Pauline Zahara, Benedict Wand, Markus Hubscher, G. Lorimer Moseley, James H. Mcauley

Physiotherapy Papers and Journal Articles

Objective: Systematic-reviews of analgesics for low back pain generally include published data only. Obtaining data from unpublished trials is potentially important because they may impact effect sizes in meta-analyses. We determined whether including unpublished data from trial registries changes the effect sizes in meta-analyses of analgesics for low back pain.

Study Design and Setting: Trial registries were searched for unpublished data that conformed to the inclusion criteria of n=5 individual source systematic-reviews. We reproduced the meta-analyses using data available from the original reviews then re-ran the same analyses with the addition of new unpublished data.

Results: Sixteen completed, unpublished, trials …

Evaluating The Impact Of A Falls Prevention Community Of Practice In A Residential Aged Care Setting: A Realist Approach, J Francis-Coad, C Etherton-Beer, C Bulsara, N Blackburn, P Chivers, A Hill

Physiotherapy Papers and Journal Articles

Background: Falls are a major socio-economic problem among residential aged care (RAC) populations resulting in high rates of injury including hip fracture. Guidelines recommend that multifactorial prevention strategies are implemented but these require translation into clinical practice. A community of practice (CoP) was selected as a suitable model to support translation of the best available evidence into practice, as it could bring together likeminded people with falls expertise and local clinical knowledge providing a social learning opportunity in the pursuit of a common goal; falls prevention. The aims of this study were to evaluate the impact of a falls prevention …

Evaluating The Impact Of Operating A Falls Prevention Community Of Practice On Falls In A Residential Aged Care Setting, Jacqueline Francis-Coad, Terry Haines, Christopher Etherton-Beer, Debbie Nobre, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background/Purpose: Falls are a leading adverse event in residential aged care (RAC) settings with prevention a global aim. The purpose of this study was to determine whether operating a falls prevention community of practice (CoP) delivering evidence-based prevention interventions could change the rate of falls and injurious falls in a RAC setting.

Methods: A prospective quasi-experimental pre/post design was conducted. Participants were 13 RAC sites (779 beds) of a single RAC organization, with 20 multidisciplinary staff volunteering as CoP members.

Results: Falls rates pre CoP were 10.1/1,000 occupied bed days (OBD) compared with 10.9 /1,000 OBD post CoP operation [coefficient …

Evaluation Of Older People's Knowledge, Awareness, Motivation And Perceptions About Falls And Falls Prevention In Residential Aged Care Homes: A Tale Of Two Cities, Jacqueline Francis-Coad, Tessa Watts, Christopher Etherton-Beer, Gerwyn Panes, Howard Griffiths, Michelle Anderson, Tracy Williams, Beth Griffiths, Debbie Nobre, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Falls prevention strategies can only be effective in reducing falls amongst older people if they are adopted and enacted in their daily lives. There is limited evidence identifying what older people in residential aged care (RAC) homes understand about falls and falls prevention, or what may limit or enable their adoption of strategies. This study was conducted in two countries and explored older people’s knowledge and awareness of falls and their preferences, opportunities and motivation to undertake falls prevention strategies. A cross-sectional survey was administered to participants (N = 70) aged 65 years and over, living in six RAC homes …

Impact Of Tailored Falls Prevention Education For Older Adults At Hospital Discharge On Engagement In Falls Prevention Strategies Postdischarge: Protocol For A Process Evaluation, Chiara Naseri, Steven M. Mcphail, Julie Netto, Terrence P. Haines, Meg E. Morris, Christopher Etherton-Beer, Leon Flicker, Den-Ching A. Lee, Jacqueline Francis-Coad, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Introduction: Older adults recently discharged from hospital have greater incidence of adverse events, functional decline, falls and subsequent readmission. Providing education to hospitalised patients on how to prevent falls at home could reduce postdischarge falls. There has been limited research investigating how older adults respond to tailored falls prevention education provided at hospital discharge. The aim of this study is to evaluate how providing tailored falls prevention education to older patients at the point of, and immediately after hospital discharge in addition to usual care, affects engagement in falls prevention strategies in the 6-months postdischarge period, including their capability and …

Critically Appraised Paper: Preoperative Physiotherapy Education Halved Postoperative Pulmonary Complications In Patients After Upper Abdominal Surgery [Commentary], Shane Patman

Physiotherapy Papers and Journal Articles

No abstract available for this paper.

Investigating Falls In Adults With Intellectual Disability Living In Community Settings And Their Experiences Of Post-Fall Care Services: Protocol For A Prospective Observational Cohort Study, Portia Ho, Caroline Bulsara, Shane Patman, Max Bulsara, Jenny Downs, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background: Falls among older adults with intellectual disability (ID) are recognised as a serious health problem potentially resulting in reduced health-related quality of life and premature placement in residential care. However there are limited studies that have investigated this problem and thus falls rates among older adults with ID remain uncertain. Furthermore, people with ID rely heavily on familial and professional care support to address health problems, such as after having a fall. No studies have explored the post-fall care that people with ID receive.

Method: This research will be carried out in two phases using a convergent mixed methods …

Embodying The Illusion Of A Strong, Fit Back In People With Chronic Low Back Pain. A Pilot Proof-Of-Concept Study, Tomohiko Nishigami, Benedict Wand, Roger Newport, Natasha Ratcliffe, Kristy Themelis, David Moen, Cat Jones, G Lorimer Moseley, Tasha R. Stanton

Physiotherapy Papers and Journal Articles

Objective: This proof-of-concept pilot study aimed to investigate if a visual illusion that altered the size and muscularity of the back could be embodied and alter perception of the back.

Methods: The back visual illusions were created using the MIRAGE multisensory illusion system. Participants watched real-time footage of a modified version of their own back from behind. Participants undertook one experimental condition, in which the image portrayed a muscled, fit-looking back (Strong), and two control conditions (Reshaped and Normal) during a lifting task. Embodiment, back perception as well as pain intensity and beliefs about the back during lifting were assessed. …

Grip And Muscle Strength Dynamometry In Acute Burn Injury: Evaluation Of An Updated Assessment Protocol, Paul M. Gittings, Dana A. Hince, Benedict M. Wand, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry.

Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum …

Trunk Muscle Activity During Drop Jump Performance In Adolescent Athletes With Back Pain, T. Palsson, J. Caneiro, R. Hirata, D. Griffin, William Gibson, Mervyn Travers

Physiotherapy Papers and Journal Articles

It was with great interest we read the recently published article “Trunk Muscle Activity during Drop Jump Performance in Adolescent Athletes with Back Pain.” Investigating back pain (BP) in adolescents is commendable as there is growing evidence that for many, an experience of BP as early as 14 years of age may relate to ongoing pain in adulthood (Coenen et al., 2017). Indeed, the conventional narrative is changing as individual physical factors such as posture, use of schoolbags, and hypermobility are only weakly associated with adolescent BP. Rather, factors which predict BP at a young age are considered to …

Visually-Induced Analgesia In A Deep Tissue Experimental Pain Model: A Randomised Cross-Over Experiment, Megan Van Selm, William Gibson, Mervyn Travers, Lorimer Moseley, Dana A. Hince, Benedict Wand

Physiotherapy Papers and Journal Articles

Background: Visualizing one’s own painful body part appears to have an effect on reported pain intensity. Furthermore, it seems that manipulating the size of the viewed image can determine the direction and extent of this phenomenon. When visual distortion has been applied to clinical populations the analgesic effects have been in opposition to those observed in some experimental pain models. To help resolve this problem we explored the effect of visualisation and magnification of the visual image on reported pain using a delayed onset muscle soreness (DOMS) pain model.

Methods: We induced DOMS in the quadriceps of 20 healthy volunteers. …

An Objective Measure For The Assessment And Management Of Fluid Shifts In Acute Major Burns, Pippa Kenworthy, Michael Phillips, Tiffany L. Grisbrook, William Gibson, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

Background: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability of BIS across different dressing conditions and electrode positions, establish the influence of Acticoat™ on BIS variable measures and determine the validity of whole-body BIS to assess net fluid shift in the presence of moderate to major burns.

Methods: An observational longitudinal cohort study was conducted from December 2014 …

Paracetamol, Nsaids And Opioid Analgesics For Chronic Low Back Pain: A Network Meta-Analysis (Protocol), Matthew K. Bagg, Andrew J. Mclachlan, Christopher G. Maher, Steven J. Kamper, Christopher M. Williams, Nicholas Henschke, Benedict M. Wand, G L. Moseley, Markus Hubscher, Neil E. O'Connell, Maurits W. Van Tulder, Adriani Nikolakopoulou, James H. Mcauley

Physiotherapy Papers and Journal Articles

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:

To answer the clinical question: ‘what analgesic medicine shall I prescribe this patient with chronic low back pain to reduce their pain?’.

The objectives are to determine the analgesic effects, safety, effect on function, and relative rank according to analgesic effect, safety and effect on function of a single course of opioid analgesics, NSAIDs or paracetamol or combinations of these medicines.

Expert Consensus For Respiratory Physiotherapy Management Of Mechanically Ventilated Adults With Community-Acquired Pneumonia: A Delphi Study, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Rationale and aims: Patients with community‐acquired pneumonia (CAP) are frequently admitted to an intensive care unit. Physiotherapy may be provided to optimize respiratory function; however, there is significant variability in clinical practice and limited research directing best practice for this cohort. This study aimed to determine expert consensus for best physiotherapy practice for invasively ventilated adults with CAP.

Method: A modified Delphi technique involved an international expert panel completing three rounds of an online questionnaire. The initial 35‐statement questionnaire, based on a systematic literature review and survey of current clinical practice, covered physiotherapy assessment and treatment of intubated patients with …

Recent Data From Radiofrequency Denervation Trials Further Emphasise That Treating Nociception Is Not The Same As Treating Pain, Matthew K. Bagg, James H. Mcauley, G Lorimer Moseley, Benedict M. Wand

Physiotherapy Papers and Journal Articles

Chronic low back pain is a condition that current health care provision is failing and we suggest that recent evidence from the interventional pain medicine field points to what these failings are. Radiofrequency denervation is performed on the presumption that denervation of a peripheral structure will eradicate or significantly reduce pain and improve function. The results of six moderately sized and well conducted clinical trials that demonstrate no efficacy and no real-world effectiveness for denervation procedures are a stark illustration of how flawed this approach is. We suggest that these results represent a line-in-the-sand for back pain research and management. …

Non-Invasive Brain Stimulation Techniques For Chronic Pain, Neil E. O'Connell, Louise Marston, Sally Spencer, Lorraine H. Desouza, Benedict M. Wand

Physiotherapy Papers and Journal Articles

Stimulating the brain without surgery in the management of chronic pain in adults

Bottom line: There is a lack of high-quality evidence to support or refute the effectiveness of non-invasive brain stimulation techniques for chronic pain.

Background: Electrical stimulation of the brain has been used to address a variety of painful conditions. Various devices are available that can electrically stimulate the brain without the need for surgery or any invasive treatment. There are five main treatment types: repetitive transcranial magnetic stimulation (rTMS) in which the brain is stimulated by a coil applied to the scalp, cranial electrotherapy stimulation (CES) in …

Is Heavy Eccentric Calf Training Superior To Wait-And-See, Sham Rehabilitation, Traditional Physiotherapy And Other Exercise Interventions For Pain And Function In Mid-Portion Achilles Tendinopathy?, Myles Murphy, Mervyn Travers, William Gibson

Physiotherapy Papers and Journal Articles

Background: Mid-portion Achilles tendinopathy (AT) is prevalent amongst athletic and non-athletic populations with pain, stiffness and impaired function typically reported. While different management options exist, loading protocols remain the best available intervention and have been shown to be effective in the management of AT. Trials investigating loading in AT have used a variety of different protocols, and recent narrative reviews suggest that no protocol is superior to another when comparing outcomes in pain and function. However, there has been no systematic review or meta-analysis completed to determine this. Furthermore, the narrative review did not consider wait-and-see or sham interventions, thus …

Reducing Falls In Older Adults Recently Discharged From Hospital: A Systematic Review And Meta-Analysis, Chiara Naseri, Terry P. Haines, Christopher Etherton-Beer, Steven Mcphail, Meg E. Morris, Leon Flicker, Julie Netto, Jacqueline Francis-Coad, Den-Ching A. Lee, Ronald Shorr, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background: Older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital.

Methods: Literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager®

Results: Sixteen studies (total sample size N= 3,290, from …

The Translation, Validity And Reliability Of The German Version Of The Fremantle Back Awareness Questionnaire, Katja Ehrenbrusthoff, Cormac G. Ryan, Christian Gruneberg, Benedict Wand, Denis J. Martin

Physiotherapy Papers and Journal Articles

Background: The Fremantle Back Awareness Questionnaire (FreBAQ) claims to assess disrupted self-perception of the back. The aim of this study was to develop a German version of the Fre-BAQ (FreBAQ-G) and assess its test-retest reliability, its known-groups validity and its convergent validity with another purported measure of back perception.

Methods: The FreBaQ-G was translated following international guidelines for the transcultural adaptation of questionnaires. Thirty-five patients with non-specific CLBP and 48 healthy participants were recruited. Assessor one administered the FreBAQ-G to each patient with CLBP on two separate days to quantify intra-observer reliability. Assessor two administered the FreBaQ-G to each patient …

Mental Wellbeing In Non-Ambulant Youth With Neuromuscular Disorders: What Makes The Difference?, Vivienne Travlos, Jenny Downs, Andrew Wilson, Dana Hince, Shane Patman

Physiotherapy Papers and Journal Articles

The physical and social challenges associated with neuromuscular disorders may impact mental wellbeing in non-ambulant youth during the more vulnerable period of adolescence. This cross-sectional survey investigated non-ambulant youths’ mental wellbeing and relationships with physical health, participation and social factors. The conceptual model was the International Classification of Functioning, Disability and Health (ICF). Thirty-seven youth aged 13 – 22 years old (mean age 17.4 years; n = 30 male; n = 24 Duchenne Muscular Dystrophy) and their parents provided biopsychosocial data through a comprehensive self-report questionnaire. The primary outcome measure was the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS). Relationships between …

Safety And Feasibility Of Transcranial Direct Current Stimulation (Tdcs) Combined With Sensorimotor Retraining In Chronic Low Back Pain: A Protocol For A Pilot Randomised Controlled Trial, A Ouellette, M Liston, W Chang, D Walton, B Wand, S Schabrun

Physiotherapy Papers and Journal Articles

Introduction Chronic low back pain (LBP) is a common and costly health problem yet current treatments demonstrate at best, small effects. The concurrent application of treatments with synergistic clinical and mechanistic effects may improve outcomes in chronic LBP. This pilot trial aims to (1) determine the feasibility, safety and perceived patient response to a combined transcranial direct current stimulation (tDCS) and sensorimotor retraining intervention in chronic LBP and (2) provide data to support a sample size calculation for a fully powered trial should trends of effectiveness be present.

Methods and analysis A pilot randomised, assessor and participant-blind, sham-controlled trial will …

Transcutaneous Electrical Nerve Stimulation (Tens) For Neuropathic Pain In Adults, W Gibson, B Wand, N O'Connell

Physiotherapy Papers and Journal Articles

Background: Neuropathic pain, which is due to nerve disease or damage, represents a significant burden on people and society. It can be particularly unpleasant and achieving adequate symptom control can be difficult. Non-pharmacological methods of treatment are often employed by people with neuropathic pain and may include transcutaneous electrical nerve stimulation (TENS). This review supersedes one Cochrane Review ’Transcutaneous electrical nerve stimulation (TENS) for chronic pain’ (Nnoaham 2014) and one withdrawn protocol ’Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults’ (Claydon 2014). This review replaces the original protocol for neuropathic pain that was withdrawn.

Objectives: To determine the …

The Development Of The Dutch Version Of The Fremantle Back Awareness Questionnaire, Lotte Janssens, Nina Goossens, Benedict M. Wand, Madelon Pijnenburg, Tinne Thys, Simon Brumagne

Physiotherapy Papers and Journal Articles

Background: Disturbed body perception may play a role in the aetiology of chronic low back pain (LBP). The Fremantle Back Awareness Questionnaire (FreBAQ) is currently the only self-report questionnaire to assess back-specific body perception in individuals with LBP.

Objectives: To perform a cross-cultural adaptation of the FreBAQ into Dutch.

Design: Psychometric study.

Methods: A Dutch version of the FreBAQ was generated through forward-backward translation, and was completed by 73 patients with LBP and 73 controls to assess discriminant validity. Structural validity was assessed by principal component analysis. Internal consistency was assessed by the Cronbach's alpha coefficient. Construct validity was assessed …

Development And Psychometric Properties Of Knee-Specific Body-Perception Questionnaire In People With Knee Osteoarthritis: The Fremantle Knee Awareness Questionnaire, T Nishigami, A Mibu, K Tanaka, Y Yamashita, E Yamada, B Wand, M Catley, T Stanton, G Moseley

Physiotherapy Papers and Journal Articles

Background: Recent systematic reviews have demonstrated that pain associated with knee osteoarthritis (OA) is a complex phenomenon that involves various contributors. People with knee OA exhibit symptoms of impaired body-perception, including reduced tactile acuity, impairments in limb laterality recognition, and degraded proprioceptive acuity. The Fremantle Back Awareness Questionnaire (FreBAQ) was developed to assess body-perception specific to the back in people with chronic low back pain. The aim of this study was to develop and assess the psychometric properties of a knee-specific version of the FreBAQ-J (FreKAQ-J), determine whether people with knee pain experience perceptual impairments and investigate the relationship between …

Resistance Training For Rehabilitation After Burn Injury: A Systematic Literature Review And Meta-Analysis, P Gittings, T Grisbrook, Dale Edgar, F Wood, B Wand, N O'Connell

Physiotherapy Papers and Journal Articles

Background/aim: Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury.

Methods: Medline & EMBASE, PubMed, CINAHL and CENTRAL were searched from inception to October 2016. Studies were identified that implemented resistance training in rehabilitation. Data were combined and included in meta-analyses for muscle strength and lean mass. Otherwise, narrative analysis was completed. The quality of evidence for each outcome was summarised and …

The Effect Of Complex Falls Prevention Interventions On Falls In Residential Aged Care Settings: A Systematic Review Protocol, Jacqueline Francis-Coad, Christopher Etherton-Beer, Debbie Nobre, Chiara Naseri, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

The objective of this review is to synthesize the best available evidence on the effectiveness of complex falls prevention interventions on fall reductions in the residential aged care population, implemented at two or more of the following levels: organization, facility or resident.

Specifically the review question is: What is the effect of complex falls prevention interventions on falls in residential aged care settings?

Anatomical Knowledge Retention In Physiotherapy Students: A Preliminary Assessment, M Dayal, J Owens, W Gibson, G Strkalj

Physiotherapy Papers and Journal Articles

Introduction: Anatomical knowledge and understanding are key components of physiotherapy education and practice. Traditionally, anatomy has been taught as a foundation stream within the first year(s) of physiotherapy education. This curricular model is based on the assumption that further learning in subsequent years builds upon the knowledge gained in the early stages of the program. However, the retention rate in all basic sciences has often been called into question. In anatomy, several studies suggest that anatomy knowledge endures considerable attrition, highlighting the need for the evaluation of retention rates. This paper aimed at making a preliminary assessment of the knowledge …

Clinical Guidelines For Low Back Pain: A Critical Review Of Consensus And Inconsistencies Across Three Major Guidelines, N O'Connell, C Cook, B Wand, S Ward

Physiotherapy Papers and Journal Articles

Given the scale and cost of the low back pain problem, it is imperative that healthcare professionals involved in the care of people with low back pain have access to up-to-date, evidence-based information to assist them in treatment decision-making. Clinical guidelines exist to promote the consistent best practice, to reduce unwarranted variation and to reduce the use of low-value interventions in patient care. Recent decades have witnessed the publication of a number of such guidelines. In this narrative review, we consider three selected international interdisciplinary guidelines for the management of low back pain. Guideline development methods, consistent recommendations and inconsistencies …

A Survey Of Clinicians Regarding Respiratory Physiotherapy Intervention For Intubated And Mechanically Ventilated Patients With Community‐Acquired Pneumonia. What Is Current Practice In Australian Icus?, L Van Der Lee, A Hill, S Patman

Physiotherapy Papers and Journal Articles

Rationale, aims, and objectives: Community-acquired pneumonia (CAP) is a common cause for intensive care unit (ICU) admission resulting in high morbidity and mortality. There is a paucity of evidence regarding respiratory physiotherapy for intubated and mechanically ventilated patients with CAP, and anecdotally clinical practice is variable in this cohort. The aims of this study were to identify the degree of variability in physiotherapy practice for intubated adult patients with CAP and to explore ICU physiotherapist perceptions of current practice for this cohort and factors that influence physiotherapy treatment mode, duration, and frequency.

Method: A survey was developed based on common …