Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Physiotherapy Research International [journal]
- Development and Reliability of the Functional Evaluation Scale for Duchenne Muscular Dystrophy, Gait Domain: A Pilot Study. [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 17.
The progression of Duchenne muscular dystrophy (DMD) results in the emergence of multiple and varied synergies to compensate muscle weakness and to deal with the demands of the functional tasks (e.g. gait). No functional evaluation instrument for individuals with DMD allows the detailed description (subjective qualitative evaluation) and compensatory movement scoring (objective quantitative evaluation) exclusively of gait. For this reason, clinicians and therapists face difficulties in assessment and decision-making of this functional activity. This study aimed to elaborate the gait domain of the Functional Evaluation Scale for DMD (FES-DMD-GD) and test its intra-rater and inter-rater reliabilities and its relationship with age and timed motor performance.We listed all the compensatory movements observed in 102 10-m gait videos of 51 children with DMD. Based on this report, the FES-DMD-GD was created and submitted to the review of 10 experts. After incorporating the experts suggestions, three examiners scored the videos using the FES-DMD-GD. The intra-rater and inter-rater reliabilities was calculated. Spearman correlation tests investigated the relationships between FES-DMD-GD and age and timed motor performance (p < 0.05).The FES-DMD-GD was composed of three phases and had 14 items to quantify compensatory movements on gait. Intra-class correlation coefficients ranged from acceptable (0.74) to excellent (0.99). FES-DMD-GD correlated to age and timed motor performance.This pilot version of FES-DMD-GD showed reliability and correlated to age and timed motor performance. Copyright © 2014 John Wiley & Sons, Ltd.
- United States Physical Therapists' Knowledge About Joint Hypermobility Syndrome Compared with Fibromyalgia and Rheumatoid Arthritis. [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 12.
Joint hypermobility syndrome (JHS) is one of the most common inherited connective tissue disorders. It causes significant pain and disability for all age groups, ranging from developmental delay among children to widespread chronic pain in adults. Experts in JHS assert that the condition is under-recognized and poorly managed.The aim of this study was to assess US physical therapists' knowledge about JHS compared with other causes of widespread pain and activity limitations: fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis.Cross-sectional, Internet-based survey of randomly selected members of the American Physical Therapy Association and descriptive statistics were used to explore physical therapists' knowledge about JHS, fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis, and chi square was used to compare knowledge about the different conditions.The response rate was 15.5% (496). Although 36% recognized the Beighton Scale for assessing joint hypermobility, only 26.8% of respondents were familiar with the Brighton Criteria for diagnosing JHS. Few respondents (11-19%) realized that JHS has extra-articular features such as anxiety disorder, fatigue, headache, delayed motor development, easy bruising and sleep disturbance. Physical therapists working in environments most likely to see patients with JHS underestimated the likely prevalence in their patient population.The results suggest that many physical therapists in the United States are not familiar with the diagnostic criteria, prevalence or common clinical presentation of JHS. Copyright © 2014 John Wiley & Sons, Ltd.
- Reliability of the Timed Up and Go test and Ten-Metre Timed Walk Test in Pregnant Women with Pelvic Girdle Pain. [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 10.
There is a lack of functional objective tests available to measure functional status in women with pelvic girdle pain (PGP). The purpose of this study was to establish test-retest and intertester reliability of the Timed Up and Go (TUG) test and Ten-metre Timed Walk Test (10mTWT) in pregnant women with PGP.A convenience sample of women was recruited over a 4-month period and tested on two occasions, 1 week apart to determine test-retest reliability. Intertester reliability was established between two assessors at the first testing session. Subjects were instructed to undertake the TUG and 10mTWT at maximum speed. One practise trial and two timed trials for each walking test was undertaken on Day 1 and one practise trial and one timed trial on Day 2.Seventeen women with PGP aged 31.1 years (SD [standard deviation] = 2.3) and 28.7 weeks pregnant (SD = 7.4) completed gait testing. Test-retest reliability using the intraclass correlation coefficient (ICC) was excellent for the TUG (0.88) and good for the 10mTWT (0.74). Intertester reliability was determined in the first 13 participants with excellent ICC values being found for both walking tests (TUG: 0.95; 10mTWT: 0.94).This study demonstrated that the TUG and 10mTWT undertaken at fast pace are reliable, objective functional tests in pregnant women with PGP. While both tests are suitable for use in the clinical and research settings, we would recommend the TUG given the findings of higher test-retest reliability and as this test requires less space and time to set up and score. Future studies in a larger sample size are warranted to confirm the results of this study. Copyright © 2014 John Wiley & Sons, Ltd.
- Physical Activity Levels During Acute Inpatient Admission After Hip Fracture are Very Low. [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 4.
Hip fractures are very common in older adults and result in serious health consequences. Early mobilization post-surgical intervention for hip fractures is very important. The purpose of this study was to determine physical activity levels during an acute inpatient admission of patients after surgery for hip fracture.The observational study was completed on an orthopaedic ward in an acute general hospital. Twenty patients (18 women, mean age ± standard deviation, 79.1 ± 9.3 years) post-surgical intervention for a hip fracture were included. Physical activity levels were measured using an accelerometer to record the percentage of time spent in lying/sitting, standing and walking, number of steps taken and average energy expenditure.Physical activity levels were extremely low, with participants spending an average of 99% of the day either lying or sitting and a little more than 1% of the day either standing or walking (16 min). Participants took an average of 35.7 ± 80.4 steps per day. Patients received more physiotherapy intervention on weekdays compared with weekends. There was no significant difference in activity levels between weekdays to weekends. No measures of physical activity were associated with length of stay. A mild to moderate association (r = 0.26-0.41) was observed between the measures of physical activity and the amount of physiotherapy received during the weekdays.Physical activity levels during an acute inpatient admission surgery for hip fracture are very low. Patients may have difficulty completing basic activities of daily living post-discharge into the community. Physical activity should be optimized as early in the rehabilitation process as able. Copyright © 2014 John Wiley & Sons, Ltd.
- The Bobath Concept in Walking Activity in Chronic Stroke Measured Through the International Classification of Functioning, Disability and Health. [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 4.
The aim of this study is to evaluate the effectiveness of a rehabilitation programme based on the Bobath concept in order to improve walking activity in patients with chronic stroke and to show the usefulness of the International Classification of Functioning, Disability and Health (ICF) as a tool for gathering functioning information.This study is a repeated measures study. The setting of this study is an outpatient neurological rehabilitation centre based on a multidisciplinary approach. Twenty-four participants suffering from chronic stroke (>1 year and a half and <5 years post-stroke) and mean age of 65.58 (standard deviation 10.73) were the participants of the study. Multidisciplinary approach based on the Bobath concept principles with three weekly individual physiotherapy sessions of 45 min each over a 6-month period was the intervention for this study. The measures used were Modified Emory Functional Ambulation Profile, 10-m walk test, 6-min walk test, muscle strength testing and subsequent codification of these results into ICF qualifiers.The results of the study showed significant improvement in activities of walking long distances, on different surfaces and around obstacles. There was no significant improvement in the activity of walking short distances or for muscle power functions.A rehabilitation programme based on the Bobath Concept improved walking activities in people with chronic stroke. For this intervention, the use of the ICF qualifiers was sensitive in perceiving post-treatment changes. Copyright © 2014 John Wiley & Sons, Ltd.
- Trunk Muscle Activation During Different Quadruped Stabilization Exercises in Individuals with Chronic Low Back Pain. [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 4.
The aim of this study was to compare the trunk muscle activities and the local/global activity ratios of the abdominal, back and trunk muscles during stabilization exercises such as one arm raise (AR), one leg raise (LR), and opposing arm/leg raise (ALR) in patients with chronic low back pain (LBP).Ten individuals with chronic LBP (five men and five women) participated in this study. The external oblique abdominis, internal oblique abdominis, multifidus, thoracic part of the lumbar iliocostalis and the local/global activity ratio were assessed, while quadruped stabilization exercises were performed (AR, LR, and ALR); each exercise was carried out three times.One-way repeated ANOVA was used to measure the differences in the trunk muscle activity and the local/global activity ratio. Post hoc analyses were performed (α = 0.05/3 = 0.017). In the right internal oblique, muscle activity during LR was significantly greater than that during AR. In the bilateral multifidus and lumbar iliocostalis, each ALR muscle activity was significantly greater than those of AR and LR. In addition, the local/global activity ratios of the back and trunk muscle in LR and ALR were significantly greater compared with AR.LR should be recommended over AR for individuals with chronic LBP. Moreover, the application of ALR should be approached carefully on the basis of progress and ability to stabilize the spine in this patient population. Copyright © 2014 John Wiley & Sons, Ltd.
- Are Established Methods of Physiotherapeutic Management for Long-term Neurological Conditions Applicable to 'Orphan' Conditions such as Syringomyelia? [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 4.
Syringomyelia is a rare or 'orphan' condition with the potential to cause significant disability and detrimental effects to quality of life. Syringomyelia shares similar symptoms to those common in other long-term neurological conditions, including spinal cord injury and multiple sclerosis. In these more prevalent conditions, physiotherapy is utilized widely and is effective in optimizing physical, psychological and social parameters. Therefore, we theorized that physiotherapy might be transferable to, and beneficial to syringomyelia patients. As a paucity of literature exists in this area, we aimed to evaluate the existing uptake and perceived efficacy of physiotherapy.An exploratory, mixed methodology was selected to derive sufficient qualitative data for analysis. Specifically designed questionnaires and semi-structured interviews yielded data on uptake and perceived physiotherapy efficacy. One hundred patients from a National Health Service tertiary syringomyelia service were invited to participate.The questionnaire and interviews were completed by 49 and 20 patients, respectively. Of the small number of patients receiving physiotherapy, the majority reported beneficial effects on pain modulation and quality of life. Stretching and hydrotherapy were deemed effective for relief of pain and stiffness. Additionally, physiotherapy was reported to provide similar benefits to surgical intervention.Syringomyelia patients report physiotherapy to provide benefits for symptom management and quality of life. Such findings suggest that established rehabilitation techniques in more common conditions may be transferable to those less prevalent. Uptake of physiotherapy was limited, seemingly because of inadequate information, knowledge and resources. To address these deficiencies, further studies should be planned investigating the effectiveness of physiotherapy modalities, such as hydrotherapy, in parallel or in conjunction with surgery and/or pharmacology. Additionally, syringomyelia could be represented alongside similar pathologies in research trials to initiate further research questions and drivers for funding. Copyright © 2014 John Wiley & Sons, Ltd.
- Analyzing Movements Development and Evaluation of the Body Awareness Scale Movement Quality (BAS MQ). [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 2.
Limitations in everyday movements, physical activities are/or pain are the main reasons for seeking help from a physiotherapist. The purpose of this study was to investigate the psychometric properties of the Body Awareness Scale Movement Quality (BAS MQ) focusing on factor structure, validity and reliability and to explore whether BAS MQ could discriminate between healthy individuals and patients. BAS MQ assesses both limitations and resources concerning functional ability and quality of movements.The total sample in the study (n = 172) consisted of individuals with hip osteoarthritis (OA) (n = 132), individuals with psychiatric disorders (n = 33) and healthy individuals (n = 7). A factor analysis of the BAS MQ was performed for the total group. Inter-rater reliability was tested in a group of individuals with hip OA (n = 24). Concurrent validity was tested in a group of individuals with hip OA (n = 89). The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), the 6-Minute Walk Test (6MWT) and the Hip Osteoarthritis Outcome Score (HOOS) were chosen in the validation process.The factor analysis revealed three factors that together explained 60.8% of the total variance of BAS MQ. The inter-rater reliability was considered good or very good with a kappa value of 0.61. Significant correlations between BAS MQ and SF-36, HOOS and 6MWT in the subjects with hip OA confirmed the validity. The BAS MQ was able to discriminate between healthy individuals and individuals with physical and psychiatric limitations.Results of the study revealed that BAS MQ has a satisfactory factor structure. The inter-rater reliability and validity were acceptable in a group of individuals with hip OA. BAS MQ could be a useful assessment tool for physiotherapists when evaluating the quality of everyday movements in different patient groups. Copyright © 2014 John Wiley & Sons, Ltd.
- Feedback Received While Practicing Everyday Activities During Rehabilitation After Stroke: An Observational Study. [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 2.
The provision of feedback is important for effective skill learning. The purpose of this study was to examine the nature of feedback provided during the practice of everyday activities (such as standing up, walking, and reaching and grasping objects) during stroke rehabilitation, both when the therapist was present and when the patient was practicing alone.Design: A cross-sectional observational study of the feedback received during rehabilitation by people who had had a stroke was conducted. Forty unique patient-therapist dyads were observed during 30 minutes of actual practice of everyday activities with data collected through behavioural mapping. The following was recorded: the activity practiced, whether the therapist was present, whether feedback was provided verbally or by equipment, and the content of feedback. Participants: A sample of all therapists providing rehabilitation within one Australian health service and their patients who had had a stroke. Measures: Quantity, frequency, mode (verbal or equipment) and content (information feedback, motivational statements, unrelated or none) of feedback during the practice of everyday activities were determined.For 68% of the time that patients were practicing activities, they received ≥1 occasion of feedback/minute. When the therapist was present, the frequency of motivational statements was more than four times greater, at 1.32 (SD 0.6) occasions/minute, than information feedback. For 25% of the time, the therapist was not present, and no feedback was provided.Given the importance of specific content for learning, therapists could replace some motivational statements with information feedback. When practicing alone, information feedback could be provided by commercially available biofeedback or customized equipment. Copyright © 2014 John Wiley & Sons, Ltd.
- Effects of 12 Weeks of Supervised Exercise After Endovascular Treatment: A Randomized Clinical Trial. [JOURNAL ARTICLE]
- Physiother Res Int 2014 Dec 2.
This study aimed to assess the effects of supervised exercise training (SET) after percutaneous transluminal angioplasty (PTA) compared with PTA alone on physical function, limb hemodynamics and health-related quality of life in patients with intermittent claudication.Fifty patients who all underwent PTA for intermittent claudication were included in the study. Both groups received usual post-operative care. In addition, the intervention group performed two sessions of hospital-based SET and one home-based exercise session per week for 12 weeks after PTA. The control group did not receive any additional follow-up regarding exercise. The primary outcome was the result of a standardized 6-minute walk test. Secondary outcomes were the treadmill maximum walking distance, treadmill pain-free walking distance, ankle-brachial index, pulse volume recording on the leg and ultrasound scanning. Health-related quality of life was measured using the Short Form 36 and the Claudication Scale.All measures, except for the Short Form 36 domain of mental health, showed statistically significant positive changes from baseline to 3 months for both groups (p < 0.05). At 3 months, there was a trend towards better results for the intervention group compared with the control group. The median improvement from baseline to 3 months for the 6-minute walk test was 66 m for the intervention group and 45 m for the control group. For maximum walking distance, the median improvement was 251 m for the intervention group and 93 m for the control group.Supervised exercise training after endovascular treatment for patients with intermittent claudication led to greater positive changes after 3 months in the intervention group compared with the control group. The present study's trends of better results with SET after PTA add to the emerging existing evidence, which should encourage physiotherapy practice to offer SET for this patient group. Copyright © 2014 John Wiley & Sons, Ltd.