Physiotherapy Commons^™

A Fine Balance And A Shared Learning Journey: Exploring Healthcare Engagement Through The Experiences Of Youth With Neuromuscular Disorders, V Travlos, C Bulsara, S Patman, J Downs

Physiotherapy Papers and Journal Articles

BACKGROUND: Youth with Neuromuscular Disorders (NMD) who are wheelchair users can now survive well into adulthood if their multisystem comorbidities are prudently managed. Uptake of health behaviors may optimize their health outcomes.

OBJECTIVE: To explore youths’ perceptions of health, health behaviors and healthcare engagement.

METHODS: This qualitative study purposefully recruited 11 youth with NMD from a concurrent, population-based study for variability of age, gender, type of NMD and their ratings of motivation and engagement. Interview data were analyzed and synthesized by thematic content.

RESULTS: Participants perceived healthcare engagement as being given tools (knowledge and responsibility) and using them to maintain …

A Binational Multicenter Pilot Feasibility Randomized Controlled Trial Of Early Goal-Directed Mobilization In The Icu, C Hodgson, M Bailey, R Bellomo, S Berney, H Buhr, L Denehy, B Gabbe, M Harrold, A Higgins, T Iwashyna, R Papworth, R Parke, S Patman, J Presneill, M Saxena, E Skinner, C Tipping, P Young, S Webb

Physiotherapy Papers and Journal Articles

Objectives: The primary objective was to determine if the early goal-directed mobilization (EGDM) intervention could be delivered to patients receiving mechanical ventilation with increased maximal levels of activity compared to standard care.

Design: A pilot, randomized controlled trial

Setting: Five intensive care units (ICUs) in Australia and New Zealand

Participants: Fifty critically ill adults, mechanically ventilated for greater than 24 hours.

Intervention: Patients were randomly assigned to either EGDM (intervention) or to standard care (control). EGDM comprised functional rehabilitation treatment conducted at the highest level of activity possible for that patient assessed by the ICU mobility scale …

Assessing Knowledge, Motivation And Perceptions About Falls Prevention Among Care Staff In A Residential Aged Care Setting, Jo-Aine Hang, Jacqueline Francis-Coad, Bianca Burro, Debbie Nobre, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Falls are a serious problem in residential aged care settings. The aims of the study were to determine the feasibility of surveying care staff regarding falls prevention, and describe care staff levels of knowledge and awareness of residents' risk of falls, knowledge about falls prevention, motivation and confidence to implement falls prevention strategies. A custom designed questionnaire was administered to care staff at one site of a large residential aged care organization in Australia. The survey response was 58.8%. Feedback from staff was used to inform the administration of the survey to the wider organization. Seven (29.2%) care staff reported …

Surviving Critical Illness: What Is Next? An Expert Consensus Statement On Physical Rehabilitation After Hospital Discharge, M Major, R Kwakman, M Kho, B Connolly, D Mcwilliams, L Denehy, S Hanekom, S Patman, R Gosselink, C Jones, F Nollett, D Needham, R Engelbert, M Van Der Schaaf

Physiotherapy Papers and Journal Articles

Background: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness?

Methods: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record. A literature review determined five themes, forming the basis for Delphi round one, which was aimed at generating ideas. Statements were drafted and ranked on a 5-point Likert scale in two …

Evaluating The Impact Of A Falls Prevention Community Of Practice In A Residential Aged Care Organisation, Jacqueline Francis-Coad

Theses

Falls in the residential aged care (RAC) sector are a global concern with humanitarian and economic consequences. Reducing falls using a multifactorial approach involving multidisciplinary staff is recommended, but it is not clear how RAC organisations in Australia can achieve this in a resource constrained environment. One potential solution is to develop a sustainable means of addressing falls prevention from within an organisation, creating a forum for staff to share ideas, expertise and achieve goals in a community of practice (CoP). The purpose of this research was to evaluate the impact of a falls prevention CoP on falls outcomes in …

The Impact Of Peer-Led Falls Prevention Education On Community-Dwelling Older Adults: A Mixed Methods Evaluation, Linda Khong

Theses

Older adults are not optimally engaged in falls prevention strategies. Peer education may be an approach to improving engagement and uptake of falls prevention strategies by community-dwelling older adults. However, empirical research regarding this approach has been inconclusive. Accordingly, the primary aim of this research was to design a peer-led falls prevention education program and evaluate its impact on community-dwelling older adults’ beliefs, knowledge, motivation, and intention to engage in falls prevention strategies. This research was a mixed methods study conducted in two phases. Phase 1 comprised three concurrent studies. These aimed to elucidate the issues regarding falls prevention education …

A Cochrane Systematic Review Of Physiotherapy For Pain And Disability In Adults With Complex Regional Pain Syndrome (Crps), Keith M. Smart, Benedict Wand, Neil E. O'Connell

Physiotherapy Conference Papers

No abstract provided.

Transcutaneous Electrical Nerve Stimulation (Tens) For Neuropathic Pain In Adults (Protocol), William Gibson, Benedict Wand, Neil 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:

To determine the analgesic effectiveness of TENS versus placebo (sham) TENS, TENS versus usual care, TENS versus no treatment and TENS in addition to usual care versus usual care alone in the management of neuropathic pain in adults.

Eccentric Loading Of Triceps Surae Modulates Stretch Shortening Cycle Behaviour - A Possible Therapeutic Mechanism, J Debenham, W Gibson, M Travers, A Campbell, G Allison

Physiotherapy Papers and Journal Articles

Context: Eccentric exercises are increasingly being used to treat lower limb musculoskeletal conditions such as Achilles tendinopathy. Despite widespread clinical application and documented efficacy, mechanisms underpinning clinical benefit remain unclear. Positive adaptations in motor performance are one potential mechanism.

Objective: To investigate how an eccentric loading intervention influences measures of stretch-shortening cycle (SSC) behaviour during a hopping task.

Design: Within subjects repeated measures observational study.

Setting: University motion analysis laboratory.

Participants: Healthy adults. Interventions: A single intervention of 5 sets of 10 eccentric plantarflexion contractions at 6 RM using a commercial seated calf raise machine.

Main outcome measures: Lower limb …

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.

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 …

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 …

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 …

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 …

The Prevalence, Characteristics, Impact And Management Of Headache In People With Schizophrenia And Schizoaffective Disorder: A Cross Sectional Cohort Study, Joanne Connaughton

Theses

Headache is the most common pain problem reported by people with schizophrenia, with 12 month prevalence rates of around 50%. Despite this little research has been conducted into the characteristics, impact and management of headaches in this population. There is evidence to support the efficacy of physiotherapy treatment of cervicogenic headache and tension type headache and determining the prevalence, impact and current management of these types of headache was of particular interest.

A pilot study was first undertaken to identify and refine an appropriate headache questionnaire, develop an algorithm to use for classification of headache and test the repeatability and …

Evaluating Web-Based Pelvic Floor Muscle Education For Pregnant Women, Judith Wilson

Theses

Background: Guidelines recommend that when pregnant women attend antenatal education they gain adequate knowledge about pregnancy-related topics, including the function of pelvic floor muscles and how to undertake a pelvic floor muscle exercise programme. Evidence is limited about how this information can be optimally delivered to pregnant women such that they gain knowledge, confidence and motivation to engage in a pelvic floor muscle exercise programme during the antenatal period. The primary objectives of the research were to evaluate the effect of delivering a web-based pelvic floor muscle education intervention in addition to usual antenatal care on primiparae women’s awareness; knowledge; …

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 …

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 …

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 …

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. …

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 …

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 …

Assessing Tactile Acuity In Musculoskeletal Medicine: How Good Are Two Point Discrimination Tests At The Neck, Hand, Back And Foot?, M Catley, A Tabor, Benedict Wand, G L. Moseley

Physiotherapy Conference Papers

No abstract provided.

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 …