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Physical therapy [journal]
- Effectiveness of Passive Physical Modalities for Shoulder Pain: A Systematic Review by the Ontario Protocol for Traffic Injury Management Collaboration. [JOURNAL ARTICLE]
- Phys Ther 2014 Nov 13.
Shoulder pain is a common musculoskeletal condition in the general population. Passive physical modalities are commonly used to treat shoulder pain. However, previous systematic reviews report conflicting results.To evaluate the effectiveness of passive physical modalities for the management of soft tissue injuries of the shoulder.MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from January 1(st), 1990 to April 18(th), 2013.Randomized controlled trials (RCTs), cohort and case-control studies were eligible. Random pairs of independent reviewers screened 1470 of 1760 retrieved articles after removing 290 duplicates. Twenty-two articles were eligible for critical appraisal. We critically appraised the eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Of those, 11 studies had a low risk of bias.The lead author extracted data from low risk of bias studies and built evidence tables. A second reviewer independently checked the extracted data.We synthesized the findings of low risk of bias studies according to principles of best evidence synthesis. We found that pre-tensioned tape, ultrasound and interferential current are not effective to manage shoulder pain. However, diathermy and corticosteroid injections lead to similar outcomes. Low-level laser therapy provides short-term pain reduction for subacromial impingement syndrome. Extracorporeal shock-wave therapy is not effective for subacromial impingement syndrome but it provides benefits for persistent shoulder calcific tendonitis.Non-English studies excluded.Most passive physical modalities do not benefit patients with subacromial impingement syndrome. However, low-level laser therapy is more effective than placebo or ultrasound for subacromial impingement syndrome. Similarly, shock-wave therapy is more effective than sham for persistent shoulder calcific tendinitis.
- Physical therapy information: could it reduce hospital 30-day readmissions? [Letter]
- Phys Ther 2014 Nov; 94(11):1680-2.
- On "Effectiveness of trigger point dry needling…" Cotchett MP, Munteanu SE, Landorf KB. Phys Ther. 2014;94:1083-1094. [Letter]
- Phys Ther 2014 Nov; 94(11):1677-80.
- On "The human movement system: our professional identity…" Sahrmann SA. Phys Ther. 2014;94:1034-1042. [Letter]
- Phys Ther 2014 Nov; 94(11):1676.
- Effectiveness of the Godelieve Denys-Struyf (GDS) Method in Patients With Low Back Pain: A Cluster Randomized Controlled Trial. [JOURNAL ARTICLE]
- Phys Ther 2014 Oct 30.
The Godelieve Denys-Struyf method (GDS) is a motor learning intervention which may be applied in group or individualized sessions.To compare the effectiveness of: a) routine physiotherapy, b) group GDS (GDS-G) sessions, c) group and individualized GDS (GDS-I) sessions.Cluster randomized controlled trial.21 Primary Care Physical Therapy Units ("clusters") of the Spanish National Health Service (SNHS).461patients with sub-acute and chronic low back pain (LBP).Clusters were randomized into three groups. All received medical treatment and a 15 min group education session on active management. Additional interventions were; "Control", fifteen 40 min. sessions of transcutaneous electrical nerve stimulation, microwave and standardized exercises; "GDS-G", eleven 50 min group GDS sessions; "GDS-I", the same 11 sessions plus four 50-min individualized GDS sessions.Primary outcomes: LBP, pain referred down to the leg (RP) (separate Pain Intenstiy-Numeric Rating Scales), and disability (Roland-Morris Questionnaire -RMQ-), at baseline and 2, 6 and 12 months later. Secondary outcomes: Use of medication and self-reported health (mental [MCS] and physical [PCS] component summaries of SF-12). Separate linear mixed models for LBP, RP and disability were developed to adjust for potential confounders. Randomization, outcome assessment and data analyses were blinded.At 12 months, disability improved 0.7 (95% CI: -0.4;1.8) RMQ points in the Control group, 1.5 (0.4;2.7) in the GDS-I group (p=0.252) and 2.2 (1.2;3.2) in the GDS-G group (p=0.024). There were no differences in pain.The amount of exercise was smaller in the Control group. GDS-I sessions were provided by junior physiotherapists.Disability improvement was slightly higher with Group GDS sessions than with the program routinely used in PT Units within the SNHS. Adding individualized GDS sessions eliminates this advantage. Further studies should compare GDS with other types of exercise.
- Effectiveness of Preoperative Physical Therapy for Elective Cardiac Surgery. [JOURNAL ARTICLE]
- Phys Ther 2014 Oct 24.
<LEAP> highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions-medications, surgery, education, nutrition, exercise-and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature. Each article in this PTJ series summarizes a Cochrane review or other scientific evidence resource on a single topic and will present clinical scenarios based on real patients to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on the effectiveness of pre-operative physical therapy for elective cardiac surgery. More specifically, does pre-operative physical therapy prevent postoperative pulmonary complications in patients undergoing elective cardiac surgery, and if so, what types of interventions are most effective and are there patients with certain characteristics that benefit from therapy?
- Considerations in the Efficacy and Effectiveness of VR Interventions for Stroke Rehabilitation: Moving the Field Forward. [JOURNAL ARTICLE]
- Phys Ther 2014 Oct 24.
In the past 2 decades, researchers have demonstrated the potential for virtual reality (VR) technologies to provide engaging and motivating environments for stroke rehabilitation interventions.(1) Much of the research has been focused on the Exploratory Phase and jumps to Intervention Efficacy trials and Scale Up Evaluation have been made with limited understanding of the active ingredients in a VR intervention for stroke.(2,3) The rapid pace of technology development is an additional challenge for this emerging field, providing a moving target for researchers developing and evaluating potential VR technologies. Recent advances in customized games and cutting-edge technology used for VR are beginning to allow for researchers to understand and control aspects of the intervention related to motivation, engagement and motor control and learning. In this paper, we argue for researchers to take a progressive, step-wise approach through the stages of intervention development using evidence-based principles, take advantage of the data that can be obtained, and utilize measurement tools in order to design effective VR interventions for stroke rehabilitation that can be assessed through carefully designed efficacy and effectiveness trials. This paper is motivated by the recent calls in the field of rehabilitation clinical trials research for carefully structured clinical trials that have progressed through the phases of research.(4.)
- Author response. [Comment, Letter]
- Phys Ther 2014 Sep; 94(9):1356-8.
- Author response. [Comment, Letter]
- Phys Ther 2014 Sep; 94(9):1354-5.
- An Investigation of Cervical Spinal Posture in Cervicogenic Headache. [JOURNAL ARTICLE]
- Phys Ther 2014 Oct 9.
Cervicogenic headache (CGH) is defined as headache symptoms originating from the cervical spine. Cervical dysfunction from abnormal posture has been proposed to aggravate or cause CGH, but there are conflicting reports as to whether there is an association between posture and CGH.To evaluate differences in cervical spinal posture, measured on radiographs, between patients with probable CGH and asymptomatic control participants.Single blinded comparative measurement design.Differences in postural variables from radiographs between CGH (n=30) and aged and gender matched asymptomatic control participants (n=30) were determined using paired t-tests or the non-parametric equivalent. Postural variables were general cervical lordosis (GCL, Cobb angle C2-C7), upper cervical lordosis (UCL, sagittal alignment C2 compared with C3-C4) and C2 spinous process horizontal deviation. Logistic regression determined postural variables increasing the likelihood of CGH.There were no significant differences in posture between CGH and controls (mean GCL, CGH group 10.97°, SD 7.50, controls 7.17, SD 5.69, P = 0.06; UCL CGH 11.86°, SD 6.46, controls 9.44, SD 4.28, P = 0.10; C2 spinous process horizontal deviation CGH 3.00mm, SD 1.66, controls 2.86, SD 2.04, P = 0.77). However, there was a significant association between greater GCL and an increased likelihood of having CGH (OR=1.08, 95% CI 1.001, 1.191, P=0.042).The findings are limited to an association between GCL and posture, as cause and effect cannot be determined.The association between greater GCL and increased likelihood of having CGH suggests that GCL might be considered in the management of patients with CGH. However, as the data do not support posture as a cause of CGH, it is unknown whether addressing posture would reduce CGH.