Physical Therapy Commons^™

The Tailoring Of National Guidelines For Upper Extremity Post-Stroke Rehabilitation: A Concept In Use., Salem F. Alatawi

Internet Journal of Allied Health Sciences and Practice

Background: In Saudi Arabia, national evidence-based clinical guidelines (NCG) were created based for healthcare interventions. However, clinicians appear to be slow to incorporate the evidence into practice. As a result, there exists a time-gap between the gathering and presentation of evidence for best practice and the use of that evidence by clinicians. It becomes, therefore, imperative to investigate the gap between the research evidence and clinical practice. The knowledge to action (KTA) framework is available to facilitate the implementation of research evidence. This framework incorporates the theory of tailoring, a concept that is intended to create a fit between …

Reviewing The Diagnostic Classifications Used For Low Back Pain In Physiotherapy-Related Research., Steve Milanese, David Worth

Internet Journal of Allied Health Sciences and Practice

Background: The evidence-to-practice gap, where clinical practice does not reflect the findings from research evidence, has been identified as a concern in allied health disciplines such as physiotherapy. Failure to provide care according to current (research) evidence raises the potential that patients are receiving care that is either not needed, is ineffective, less effective than current research indicates, or potentially harmful. For research evidence to be translatable to clinical practice, the research should be seen to be applicable, i.e. the clinician should be able to recognise that the research study sample reflects their patient population. Method: This study presents …

Encouraging Students To Draw On Work Experiences When Articulating Achievements And Capabilities To Enhance Employability, Denise A. Jackson, Susan Edgar

Physiotherapy Papers and Journal Articles

Employability drives higher education policy yet despite the investment in developing ‘rounded’ graduates, students experience difficulties in articulating their achievements and capabilities during graduate recruitment. The purpose of this research was to trial and evaluate a career development intervention aimed at drawing on work experiences when applying for graduate roles. Students (N = 136) from two contrasting disciplines, Business and Physiotherapy, and two institutions participated in a two-staged intervention. A focus group was also conducted with career advisors (N = 9) to examine student engagement with career development learning. Findings indicated that students were confident in their ability …

Managing Achilles Pain (The Map Study) - A Process Evaluation Of Data Collection Methods, Adrian Mallows, Chris Littlewood, Jo Jackson, James Debenham

Physiotherapy Papers and Journal Articles

Background: Process evaluations explore the way in which a study was conducted. The Managing Achilles Pain study (MAP study) had the primary aim of assessing the feasibility of the protocol for a future large longitudinal cohort study that would investigate the association and predictive relationship of self-efficacy, working alliance and expectations with outcome in the management of Achilles tendinopathy.

Objectives: This study aimed to evaluate the processes conducted in the MAP study by exploring the acceptability of the study procedures from the participants' and physiotherapists' perspectives.

Design: A qualitative evaluation using semi-structured telephone interviews.

Method: All physiotherapists and participants who …

Changing The Narrative In Diagnosis And Management Of Pain In The Sacroiliac Joint Area, Thorvaldur S. Palsson, William Gibson, Ben Darlow, Samantha Bunzli, Gregory Lehman, Martin Rabey, Niamh Moloney, Henrik B. Vaegter, Matthew K. Bagg, Mervyn Travers

Physiotherapy Papers and Journal Articles

The sacroiliac joint (SIJ) is often considered to be involved when people present for care with low back pain where the sacroiliac joint (SIJ) is located. However, determining why the pain has arisen can be challenging, especially in the absence of a specific cause such as pregnancy, disease, or trauma, where the SIJ may be identified as a source of symptoms with the help of manual clinical tests. Nonspecific SIJ-related pain is commonly suggested to be causally associated with movement problems in the sacroiliac joint(s); a diagnosis traditionally derived from manual assessment of movements of the SIJ complex. Management choices …

A Brain-Computer Interface For Closed-Loop Sensory Stimulation During Motor Training In Patients With Tetraplegia, Sarah Helen Thomas

Theses and Dissertations--Biomedical Engineering

Normal movement execution requires proper coupling of motor and sensory activation. An increasing body of literature supports the idea that incorporation of sensory stimulation into motor rehabilitation practices increases its effectiveness. Paired associative stimulation (PAS) studies, in which afferent and efferent pathways are activated in tandem, have brought attention to the importance of well-timed stimulation rather than non-associative (i.e., open-loop) activation. In patients with tetraplegia resulting from spinal cord injury (SCI), varying degrees of upper limb function may remain and could be harnessed for rehabilitation. Incorporating associative sensory stimulation coupled with self-paced motor training would be a means for supplementing …

Changes In Muscle Size, Quality And Power Are Related To Physical Function In Patients With Critical Illness, Kirby Mayer

Theses and Dissertations--Rehabilitation Sciences

Patients admitted to intensive care unit (ICU) are known to develop significant impairments in physical function. Patients with critical illness suffer up to 30% reductions in muscle size within the first ten days of admission to the ICU. Muscle strength testing, Medical Research Council-sum score, is current gold-standard to diagnosis ICU-acquired weakness and predicts risk of mortality and long-term physical function. Muscle power different from muscle strength in that it accounts for velocity of movement, is potentially a better independent predictor of function that has not been studied in this population. In addition, we hypothesize that muscle size and quality …

Åstrand-Rhyming And Ymca: A Compare And Contrast Literature Review Of Two Submaximal Cycle Ergometer Tests, Sean Roberts

Williams Honors College, Honors Research Projects

In the world of exercise prescription there are two major protocols that are used to test an individual’s aerobic capacity at a submaximal intensity using a stationary bicycle. These protocols require participants to exercise at a constant work rate until a specified hear rate is reached. Data can then be analyzed to determine the participant’s aerobic capacity. The objective of this literature review is to look at these two tests – the Åstrand-Rhyming cycle ergometer test (ARCET) and the YMCA cycle ergometer test – and determine if one is better than the other for different populations and which one an …

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 …

Transcutaneous Electrical Nerve Stimulation (Tens) For Chronic Pain - An Overview Of Cochrane Reviews (Review), William Gibson, Benedict M. Wand, Catherine Meads, Mark J. Catley, Neil E. O'Connell

Physiotherapy Papers and Journal Articles

Background: Chronic pain, considered to be pain lasting more than three months, is a common and often difficult to treat condition that can significantly impact upon function and quality of life. Treatment typically includes pharmacological and non-pharmacological approaches. Transcutaneous electrical nerve stimulation (TENS) is an adjunct non-pharmacological treatment commonly recommended by clinicians and often used by people with pain.

Objectives: To provide an overview of evidence from Cochrane Reviews of the effectiveness of TENS to reduce pain in adults with chronic pain (excluding headache or migraine). To provide an overview of evidence from Cochrane Reviews of the safety of …

Effect Of Case Presentation On Physical Therapy Students’ Clinical Reasoning, Nicholas Larosa

UNF Graduate Theses and Dissertations

This mixed-methods study investigated the effects of case method presentation on the clinical reasoning hypotheses generated, strategies implemented, and errors made by physical therapy students working through a musculoskeletal clinical problem. The study was framed by Marton and Säljö’s levels of processing, McCrudden’s et al. goal-focusing model, Cognitive Load Theory, and the Model of Domain Learning. Verbatim transcriptions for each problem-solving session was created and coded. Cohen’s kappa was κ = .75 indicating substantial inter-rater reliability for the finalized coding schemes. Quantitative analysis included mean and standard deviation calculations followed by Mann Whitney-U comparisons which detected several significant differences …

Effects Of Pain Neuroscience Education On Physician Assistant Students Understanding Of Pain And Attitudes And Beliefs About Pain., Kory Zimney, Adriaan Louw, Julie Johnson, Suzanne Peppers, Kevin Farrell

Faculty Publications

PURPOSE: Evaluate the effectiveness and efficiency of two different pain neuroscience education (PNE) lectures provided to physician assistant (PA) students. Primary outcomes explored were knowledge of pain and shift in attitudes and beliefs about chronic pain after the lecture.

METHODS: A PNE lecture was provided at two separate university PA programs. One program received a two-hour PNE lecture with a case-based example. The other program received a one-hour PNE lecture without the casebased example. Measurement of change for pre and post-test pain knowledge and attitudes and beliefs about chronic pain were recorded.

RESULTS: Students at both universities showed medium effect …

Tips For Allied Health Professionals To Successfully Engage With Research: A Commentary, Siti Nurliyana Abdullah, Saravana Kumar

Internet Journal of Allied Health Sciences and Practice

While allied health professionals are encouraged to engage with research, there are numerous challenges to do so in practice. In this commentary, we reflect on some of these challenges and provide some simple tips on strategies that can be used by allied health professionals to overcome these challenges. These tips may provide a starting point for allied health professionals to successfully engage with research.

Supplemental Training And Injury Prevention In The Sport Of Ultra-Running, Jessica M. Heidebrink

Senior Honors Theses

By definition, ultra-marathon running is a sport that covers any distance above the 26.2-mile marathon distance in a single race. The mountains of Virginia host many ultra-marathon races that attract endurance runners from all over the nation to participate. Training is an essential component of running an ultra. Although there is not one specific way to train for an ultra, there is research that correlates the success of the top ultra-runners and their training preferences regarding supplemental training and injury prevention. To gain a more complete understanding of how to prepare for a successful ultra-marathon, an online survey was created …

Chronic Ankle Instability And Hip Muscle Function: A Systematic Review, Lindsay Carroll

Graduate Student Research Symposium

Purpose/background

The connection between hip strength and knee function is widely accepted in rehabilitation. The beginnings of evidence supporting a connection between the hip and ankle in people with chronic ankle instability (CAI) causes clinicians to question how the hip and the ankle may interact in this population. The purpose of this review is to provide a cohesive summary of the current available evidence examining hip muscle function in people with chronic ankle instability so that clinicians are better able to treat these patients.

Methods

An electronic search of PubMed was performed to locate studies published in peer-reviewed journals that …

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 …

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. …

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.

Changes In Reach To Eat Movement Control After Intensive Training For Children With Unilateral Cerebral Palsy, Yaching Hung, Aryeh D. Spingarn

Publications and Research

Ya Ching Hung EdD. and Aryeh Spingarn EP-C, CSCS, EIM-Level 2 Queens College, City University of New York Department of Family, Nutrition, and Exercise Sciences, Changes in Reach to Eat Movement Control After Intensive Training for Children with Unilateral Cerebral Palsy. Purpose: The current study compares the effects of an intervention on children with Congenital Hemiplegia during a simple eating task using kinematic analyses. Previous studies looked at simple bimanual tasks such as opening a drawer; no studies examined the effects of intensive training on unimanual reach, grasp, and eat movement control. Methods: 20 children with Unilateral Spastic Cerebral Palsy …

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 …

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. …

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.

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 …

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 …

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 …

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 …

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 …

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 …