Rehabilitation and Therapy Commons^™

Eccentric Loading Increases Peak Torque Angle Of The Ankle Plantar Flexors In Healthy Volunteers, Matthew Willisch, Peter Hamer, Luke Hopper, Max Bulsara, James R. Debenham

Physiotherapy Papers and Journal Articles

Eccentric loading of the ankle plantar Flexor’s (PF) has demonstrated clinical efficacy in the conservative treatment of Achilles tendinopathy, however, its mechanism of therapeutic benefit remains unclear. The purpose of this study was to examine the effects of PF eccentric loading on PF angle to peak torque (AtPT), peak torque (PT) and lower limb vertical stiffness. Thirty healthy volunteers were randomised to an eccentric (n=15) or concentric (n=13) exercise group. A 10-week loading programme of the ankle plantar flexors was completed. AtPT, PT and vertical stiffness were compared within and between groups before and after the interventions. AtPT increased in …

Top 10 Research Questions To Promote Physical Activity Research In People With Binge Eating Disorder, Davy Vancampfort, Simon Rosenbaum, Michel Probst, Joanne Connaughton, Christy Du Plessis, Taisei Yamamoto, Jolien Diedens, Brendon Stubbs

Physiotherapy Papers and Journal Articles

Despite emerging evidence illustrating the benefits of physical activity for people with binge eating disorder, engaging this population in physical activity is challenging. The International Organization of Physical Therapists in Mental Health (IOPTMH) set out to summarize, appraise and strengthen the direction of physical activity endeavors. This process led to the identification of 10 important research questions which are discussed. Addressing these 10 research questions is critical for developing evidence-based approaches for promoting and sustaining an active lifestyle in people with binge eating disorder.

Employment Patterns Of Notre Dame Graduate Physiotherapists 2006–12: Targeting Areas Of Workforce Need, Eleni Bacopanos, Susan Edgar

Physiotherapy Papers and Journal Articles

Background: The Australian physiotherapy workforce is changing both in demographics and service needs. Physiotherapy curriculum and clinical education focus is ideally based on up-to-date knowledge of this changing workforce.

Aim: The aim of this study was to determine the employment patterns of Physiotherapy graduates from The University of Notre Dame Australia (Notre Dame).

Method: An online survey was conducted of Notre Dame Physiotherapy graduates (2006-2012) with a 50% response rate (n=157).

Results: Survey results established the employment location, employment status, healthcare sector, area of practice, salary and employment history of Notre Dame graduates. The results highlighted links between curriculum, clinical …

Transcutaneous Electrical Nerve Stimulation (Tens) For Chronic Pain - An Overview Of Cochrane Reviews (Protocol), M J. Catley, W Gibson, B M. Wand, C Meads, N. E. O'Connell

Physiotherapy Papers and Journal Articles

This is the protocol for a review and there is no abstract. The objectives are as follows:

1. To provide an overview of evidence from Cochrane systematic reviews of the effectiveness of TENS to reduce pain in adults with chronic pain (excluding headache or migraine).
2. To provide an overview of evidence from Cochrane systematic reviews of the safety of TENS to reduce pain in adults with chronic pain (excluding headache or migraine).
3. To identify possible sources of inconsistency in the approaches taken to evaluating the evidence related to TENS for chronic pain (excluding headache or migraine) in the Cochrane Library with …

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

Physiotherapy Papers and Journal Articles

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 …

Educators' Perspectives About How Older Hospital Patients Can Engage In A Falls Prevention Education Programme: A Qualitative Process Evaluation, Anne-Marie Hill, Steven M. Mcphail, Jacqueline Francis-Coad, Nicholas Waldron, Christopher Etherton-Beer, Leon Flicker, Katharine Ingram, Terry P. Haines

Physiotherapy Papers and Journal Articles

Objectives: Falls are the most frequent adverse event reported in hospitals. Patient and staff education delivered by trained educators significantly reduced falls and injurious falls in an older rehabilitation population. The purpose of the study was to explore the educators’ perspectives of delivering the education and to conceptualise how the programme worked to prevent falls among older patients who received the education.

Design: A qualitative exploratory study.

Methods: Data were gathered from three sources: conducting a focus group and an interview (n=10 educators), written educator notes and reflective researcher field notes based on interactions with the educators during …

Exploring The Role And Skill Set Of Physiotherapy Clinical Educators In Work Integrated Learning, Susan Edgar, Joanne Connaughton

Physiotherapy Papers and Journal Articles

Clinical educators are under increasing pressures in the workplace to provide quality education of healthcare students within varying supervision frameworks. Along with facilitating the teaching of clinical skills, clinical educators play a support role for students and so require more than expert clinical abilities in their vital position linking institutions and the healthcare environment. Twelve physiotherapy clinical educators attended one of two focus groups exploring their opinions on the role and skill set of clinical educators in work-integrated learning (WIL).Clinical educators described their role, their skills, challenges they faced supporting the needs of students, as well as future training requirements. …

A Stepped-Wedge Cluster Randomised Controlled Trial For Evaluating Rates Of Falls Among Inpatients In Aged Care Rehabilitation Units Receiving Tailored Multimedia Education In Addition To Usual Care: A Trial Protocol, Anne-Marie Hill, Nicholas Waldron, Christopher Etherton-Beer, Steven Mcphail, Katharine Ingram, Leon Flicker, Terry P. Haines

Physiotherapy Papers and Journal Articles

INTRODUCTION:

Falls are the most frequent adverse event reported in hospitals. Approximately 30% of in-hospital falls lead to an injury and up to 2% result in a fracture. A large randomised trial found that a trained health professional providing individualised falls prevention education to older inpatients reduced falls in a cognitively intact subgroup. This study aims to investigate whether this efficacious intervention can reduce falls and be clinically useful and cost-effective when delivered in the real-life clinical environment.

METHODS:

A stepped-wedge cluster randomised trial will be used across eight subacute units (clusters) which will be randomised to one of four …

Illusory Touch Temporarily Improves Sensation In Areas Of Chronic Numbness: A Brief Communication, Benedict Martin Wand, Samantha Eve Stephens, Effie Ida Marquita Mangharam, Pamela Jane George, Max Bulsara, Neil Edward O'Connell, G Lorimer Moseley

Physiotherapy Papers and Journal Articles

Background. Creating the visual illusion of touch can improve tactile perception in healthy subjects. Objective. We were interested in seeing if creating the illusion of touch in an insensate area could improve sensation in that area. Methods. Fourteen people with chronic numbness participated in a randomized crossover experiment. The 4 conditions were the following: (a) stimulation over the unaffected limb with mirror visual feedback (experimental condition), (b) stimulation over the affected limb with mirror visual feedback, (c) stimulation over the unaffected limb without mirror visual feedback, and (d) stimulation …

Moving In An Environment Of Induced Sensorimotor Incongruence Does Not Influence Pain Sensitivity In Healthy Volunteers: A Randomised Within-Subject Experiment, Benedict Wand, Lareina Szpak, Pamela J. George, Max Bulsara, Neil Edward O'Connell, G. Lorimer Moseley

Physiotherapy Papers and Journal Articles

Objectives: It has been proposed that in the same way that conflict between vestibular and visual inputs leads to motion sickness, conflict between motor commands and sensory information associated with these commands may contribute to some chronic pain states. Attempts to test this hypothesis by artificially inducing a state of sensorimotor incongruence and assessing self-reported pain have yielded equivocal results. To help clarify the effect sensorimotor incongruence has on pain we investigated the effect of moving in an environment of induced incongruence on pressure pain thresholds (PPT) and the pain experienced immediately on completion of PPT testing.

Methods: Thirty-five healthy …

An Audit Of Antenatal Education Facilitated By Physiotherapists In Western Australian Public Hospitals, Judy Wilson, Richard G. Berlach, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

This paper reports on the delivery of antenatal education by physiotherapists in Western Australia in 2012, including the location of antenatal education providers, number of mothers attending, qualifications of physiotherapists involved, allocation of physiotherapy hours, the content of the education, and strategies used to enhance learning in the classes. A survey was emailed to the physiotherapists in 31 hospitals with maternity services that were funded by the Department of Health Western Australia. Antenatal education facilitated by a physiotherapist was provided at 25/30 (83.3%) hospitals. Four physiotherapists had postgraduate women’s health qualifications and all the antenatal education classes provided information about …

Movement Restriction Does Not Modulate Sensory And Perceptual Effects Of Exercise-Induced Arm Pain, Markus Hubscher, Simon Tu, Tasha Stanton, G Lorimer Moseley, Benedict M. Wand, John Booth, James H. Mcauley

Physiotherapy Papers and Journal Articles

BACKGROUND:

Movement restriction has been proposed as an important modulator of changes in sensory and perceptual function and motor imagery performance that are observed in musculoskeletal pain syndromes. There are no empirical data to support this view.

PURPOSE:

The primary objective of this experiment was to determine the effects of movement restriction on local and widespread sensory, perceptual and motor imagery changes after exercise-induced muscular pain. Further objectives were to investigate whether changes in sensory perception are correlated with pain intensity and tactile acuity or motor imagery performance.

METHODS:

In forty healthy volunteers, delayed onset muscle soreness (DOMS) of the …

Achilles Tendinopathy Alters Stretch Shortening Cycle Behaviour During A Sub-Maximal Hopping Task, James R. Debenham, Mervyn J. Travers, William Gibson, Amity Campbell, Garry T. Allison

Physiotherapy Papers and Journal Articles

Objectives

To describe stretch shortening cycle behaviour of the ankle and lower limb in patients with Achilles tendinopathy (AT) and establish differences with healthy volunteers.

Design

Between-subjects case-controlled.

Methods

Fifteen patients with AT (mean age 41.2 ± 12.7 years) and 11 healthy volunteers (CON) (mean age 23.2 ± 6.7 years) performed sub-maximal single-limb hopping on a custom built sledge-jump system. Using 3D motion analysis and surface EMG, temporal kinematic (lower limb stiffness, ankle angle at 80 ms pre-contact, ankle angle at contact, peak ankle angle, ankle stretch amplitude) and EMG measures (onset, offset and peak times relative to contact) were …

Psychometric Properties Of The Compulsive Exercise Test In An Adolescent Eating Disorder Population, Pam Formby, Hunna J. Watson, Anna Hilyard, Kate Martin, Sarah J. Egan

Physiotherapy Papers and Journal Articles

The objective of this study was to evaluate the factor structure, validity, and reliability of the Compulsive Exercise Test (CET) in an adolescent clinical eating disorder population. The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project, a prospective ongoing registry study comprising consecutive paediatric tertiary eating disorder referrals. Adolescents (N = 104; 12-17 years) with eating disorders completed the CET and other measures. Factor structure, convergent validity, and internal consistency were evaluated. Despite failing to identify a factor structure, the study provided clear evidence of the multidimensionality of the measure. The total score correlated significantly …

Expert Consensus And Recommendations On Safety Criteria For Active Mobilization Of Mechanically Ventilated Critically Ill Adults, Carol L. Hodgson, Kathy Stiller, Dale M. Needham, Claire J. Tipping, Megan Harrold, Claire E. Baldwin, Scott Bradley, Sue Berney, Lawrence R. Caruana, Doug Elliott, Margot Green, Kimberley Haines, Alisa Higgins, Kirsi-Maija Kaukonen, Isabel A. Leditschke, Marc R. Nicols, Jennifer Paratz, Shane Patman, Elizabeth Skinner, Paul J. Young, Jennifer M. Zanni, Linda Denehy, Steven A. Webb

Physiotherapy Papers and Journal Articles

Introduction:

The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients.

Methods:

A systematic literature review was followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilization of mechanically ventilated patients.

Results:

Safety considerations were summarized in four categories: respiratory, cardiovascular, neurological and other. Consensus was achieved on all criteria for safe mobilization, with the exception being levels of vasoactive agents. Intubation via an endotracheal tube was not a contraindication to early mobilization and a fraction of inspired oxygen less than …

Tailored Education For Older Patients To Facilitate Engagement In Falls Prevention Strategies After Hospital Discharge—A Pilot Randomized Controlled Trial, Anne-Marie Hill, Christopher Etherton-Beer, Terry P. Haines

Physiotherapy Papers and Journal Articles

Background

The aims of the study were to evaluate the effect of providing tailored falls prevention education in hospital on: i) engagement in targeted falls prevention behaviors in the month after discharge: ii) patients’ self-perceived risk and knowledge about falls and falls prevention strategies after receiving the education.

Methods

A pilot randomized controlled trial (n = 50): baseline and outcome assessments conducted by blinded researchers. Participants: hospital inpatients 60 years or older, discharged to the community. Participants were randomized into two groups. The intervention was a tailored education package consisting of multimedia falls prevention information with trained health professional follow-up, …

Measurement Of Localized Tissue Water - Clinical Application Of Bioimpedance Spectroscopy In Wound Management, L C. Ward, K Sharpe, Dale Edgar, V Finlay, F Wood

Physiotherapy Papers and Journal Articles

Wound healing is a complex process which can be impeded by the presence of accumulated cell fluid or oedema. A simple and convenient method for the assessment of wound oedema would aid improvement in patient care. In this proof of concept study we investigated whether bioelectrical impedance spectroscopy has the potential to provide such a tool. A number of important observations were made. Firstly, the method was highly reproducible and data can be obtained from electrodes located at different positions around the region of interest; important given the highly variable topography of surface wounds, e.g. burns. Secondly, the method was …

Physiotherapists Have Accurate Expectations Of Their Patients’ Future Health-Related Quality Of Life After First Assessment In A Subacute Rehabilitation Setting, Steven M. Mcphail, Emily Nalder, Anne-Marie Hill, Terry P. Haines

Physiotherapy Papers and Journal Articles

Background.

Expectations held by health professionals and their patients are likely to affect treatment choices in subacute inpatient rehabilitation settings for older adults. There is a scarcity of empirical evidence evaluating whether health professionals expectations of the quality of their patients’ future health states are accurate.

Methods.

A prospective longitudinal cohort investigation was implemented to examine agreement (kappa coefficients, exact agreement, limits-of-agreement, and intraclass-correlation coefficients) between physiotherapists’ (n=23) prediction of patients’ discharge health-related quality of life (reported on the EQ-5D-3L) and the actual health-related quality of life self-reported by patients (n=272) at their discharge assessment (using the EQ-5D-3L). The mini-mental …

Cost Effectiveness Of Patient Education For The Prevention Of Falls In Hospital: Economic Evaluation From A Randomized Controlled Trial, Terry P. Haines, Anne-Marie Hill, Keith D. Hill, Sandra G. Brauer, Tammy Hoffmann, Christopher Etherton-Beer, Steven M. Mcphail

Physiotherapy Papers and Journal Articles

Background

Falls are one of the most frequently occurring adverse events that impact upon the recovery of older hospital inpatients. Falls can threaten both immediate and longer-term health and independence. There is need to identify cost-effective means for preventing falls in hospitals. Hospital-based falls prevention interventions tested in randomized trials have not yet been subjected to economic evaluation.

Methods

Incremental cost-effectiveness analysis was undertaken from the health service provider perspective, over the period of hospitalization (time horizon) using the Australian Dollar (A$) at 2008 values. Analyses were based on data from a randomized trial among n = 1,206 acute and …

Circumstances Of Falls And Falls-Related Injuries In A Cohort Of Older Patients Following Hospital Discharge, Anne-Marie Hill, Tammy Hoffman, Terry P. Haines

Physiotherapy Papers and Journal Articles

Background:

Older people are at increased risk of falls after hospital discharge. This study aimed to describe the circumstances of falls in the six months after hospital discharge and to identify factors associated with the time and location of these falls.

Methods:

Participants in this randomized controlled study comprised fallers (n = 138) who were part of a prospective observational cohort (n = 343) nested within a randomized controlled trial (n = 1206). The study tested patient education on falls prevention in hospital compared with usual care in older patients who were discharged from hospital and followed for six months …

Low Dose Ct Vs Plain Abdominal Radiography For The Investigation Of The Acute Abdomen, Long K. Nguyen, Daniel D. Wong, Daniel M. Fatovich, Justin M. Yeung, Jennifer Persaud, Christopher J. Wood, David De Vos, Richard M. Mendelson

Physiotherapy Papers and Journal Articles

Background: To compare low-dose abdominal computed tomography (LDCT) with plain abdominal radiography (AR) in the primary investigation of acute abdominal pain to determine if there is a difference in diagnostic yield, the number of additional investigations required and hospital length of stay (LOS).

Methods: This randomized controlled trial was approved by the institutional review board, and informed consent was obtained. Patients presenting to the emergency department with an acute abdomen and who would normally be investigated with AR were randomized to either AR or LDCT. The estimated radiation dose of the LDCT protocol was 2–3 mSv compared to 1.1 mSv …

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 …

A Randomized Trial Comparing Digital Video Disc With Written Delivery Of Falls Prevention Education For Older Patients In Hospital, Anne-Marie Hill, Steven Mcphail, Tammy Hoffman, Keith Hill, David Oliver, Christopher Beer, Sandra Brauer, Terry P. Haines

Physiotherapy Papers and Journal Articles

Objectives: To compare the effectiveness of a digital video disc (DVD) with that of a written workbook delivering falls prevention education to older hospital patients on self-perceived risk of falls, perception of falls epidemiology, knowledge of prevention strategies, and motivation and confidence to engage in self-protective strategies. To compare the effect of receiving either education approach versus no education on patients' perception of falls epidemiology.

Design: Randomized trial (DVD vs workbook) with additional quasi-experimental control group.

Settings: Geriatric, medical, and orthopedic wards in Perth and Brisbane, Australia.

Participants: One hundred (n=51 DVD, n=49 workbook) hospital inpatients aged 60 and older …