Physiotherapy Research International [journal]
- A Single Session of Mirror-based Tactile and Motor Training Improves Tactile Dysfunction in Children with Unilateral Cerebral Palsy: A Replicated Randomized Controlled Case Series. [JOURNAL ARTICLE]
- Physiother Res Int 2016 Aug 17.
This replicated randomized controlled crossover case series investigated the effect of mirror-based tactile and motor training on tactile registration and perception in children with unilateral cerebral palsy (UCP).Six children with UCP (6-18 years; median 10 years, five male, three-left hemiplegia, four-manual ability classification system (MACS) I, one MACS II and one MACS III) participated. They attended two 90-minute sessions - one of mirror-based training and one of standard practice, bimanual therapy - in alternated order. Tactile registration (Semmes Weinstein Monofilaments) and perception (double simultaneous or single-point localization) were assessed before and after each session. Change was estimated using reliable change index (RCI).Tactile perception improved in four participants (RCI > 1.75), with mirror-based training, but was unchanged with bimanual therapy (RCI < 1.0 for all participants). Neither intervention affected tactile registration.Mirror-based training demonstrates potential to improve tactile perception in children with UCP. Copyright © 2016 John Wiley & Sons, Ltd.
- Why in the World? [EDITORIAL]
- Physiother Res Int 2016 Aug 16.
- Factor Analysis of the Community Balance and Mobility Scale in Individuals with Knee Osteoarthritis. [JOURNAL ARTICLE]
- Physiother Res Int 2016 Aug 12.
The clinical assessment of balance is an important first step in characterizing the risk of falls. The Community Balance and Mobility Scale (CB&M) is a test of balance and mobility that was designed to assess performance on advanced tasks necessary for independence in the community. However, other factors that can affect balancing ability may also be present during performance of the real-world tasks on the CB&M. It is important for clinicians to understand fully what other modifiable factors the CB&M may encompass. The purpose of this study was to evaluate the underlying constructs in the CB&M in individuals with knee osteoarthritis (OA).This was an observational study, with a single testing session. Participants with knee OA aged 50 years and older completed the CB&M, a clinical test of balance and mobility. Confirmatory factor analysis was then used to examine whether the tasks on the CB&M measure distinct factors. Three a priori theory-driven models with three (strength, balance, mobility), four (range of motion added) and six (pain and fear added) constructs were evaluated using multiple fit indices.A total of 131 participants (mean [SD] age 66.3 [8.5] years, BMI 27.3 [5.2] kg m(-2) ) participated. A three-factor model in which all tasks loaded on these three factors explained 65% of the variance and yielded the most optimal model, as determined using scree plots, chi-squared values and explained variance. The first factor accounted for 49% of the variance and was interpreted as lower limb muscle strength. The second and third factors were interpreted as mobility and balance, respectively.The CB&M demonstrated the measurement of three distinct factors, interpreted as lower limb strength, balance and mobility, supporting the use of the CB&M with people with knee OA for evaluation of these important factors in falls risk and functional mobility. Copyright © 2016 John Wiley & Sons, Ltd.
- The Pain Attitudes and Beliefs Scale for Physiotherapists: Dimensionality and Internal Consistency of the Norwegian Version. [JOURNAL ARTICLE]
- Physiother Res Int 2016 May 20.
The Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) is a self-administered instrument developed to assess the strength of two possible treatment orientations of physiotherapists towards the management of low back pain. The aim of this study was to translate the PABS-PT into Norwegian from the original 36-item Dutch version and to examine its dimensionality and internal consistency.The Norwegian version was generated in a forward-backward translation procedure. To examine construct validity, a cross-sectional web-based survey was conducted. A convenience sample of 3849 physiotherapists was invited to fill out the Norwegian PABS-PT, together with demographic and professional data. Only therapists who had been involved in back pain management for the last 6 months were included. Principal factor and Cronbach's alpha analyses were performed to determine the factor structure and internal consistency, respectively.The PABS-PT was successfully translated into Norwegian. Responses from 921 therapists were obtained (response rate 24.8%), and of these, 647 could be included in the factor analysis. Analysis revealed two factors, labelled 'biomedical' and 'biopsychosocial' treatment orientation, which confirmed the structure of the original Dutch version. Thirty-six items were reduced to 19, with 13 items loading on factor I and six items on factor II, explaining 18.1% and 7.1%, respectively, of the total variance. Cronbach's alpha of the biomedical sub-scale was 0.79 and 0.57 for the bio-psychosocial sub-scale.The Norwegian version of the PABS-PT appears to be equivalent to the original Dutch version, showing a similar structure and internal consistency. The two factors accounted for low explained variance, which may be indicative for problematic construct validity. Psychometric properties and usefulness will be further examined. Copyright © 2016 John Wiley & Sons, Ltd.
- A Non-surgical Intervention for Triangular Fibrocartilage Complex Tears. [CASE REPORTS]
- Physiother Res Int 2016 May 16.
The current literature contains no reports of treatment options other than surgery following failed conservative management of a triangular fibrocartilage complex (TFCC) tear. The purpose of this study is to describe the use of a novel brace as a non-surgical intervention for TFCC tears.This paper is a case study of a subject with a magnetic resonance imaging-confirmed TFCC tear. As an alternative to surgery, he consented to wear a novel brace for 12 weeks after conservative management of his injury had failed. His recovery from injury was monitored with a weight-bearing tolerance test and the disabilities of the arm, shoulder and hand (DASH) outcome measure.An increase in weight-bearing tolerance and upper extremity use was evident immediately after donning the brace. After 12 weeks, the subject demonstrated a return to normal weight-bearing tolerance and normal DASH outcome measure scores. These improvements were still evident at a 1-year follow-up appointment.Utilizing this novel brace resulted in functional status improvement in a subject with a TFCC tear as demonstrated by significant changes in his DASH outcome measure scores. This case study demonstrates the first non-surgical alternative treatment for a TFCC tear after conservative management has failed. Copyright © 2016 John Wiley & Sons, Ltd.
- Short-term Clinical Course of Knee Pain in Children and Adolescents: A Feasibility Study Using Electronic Methods of Data Collection. [JOURNAL ARTICLE]
- Physiother Res Int 2016 May 16.
Musculoskeletal disorders, such as knee pain, are common in children and adolescents, but there is a lack of high quality research that evaluates the clinical course of these conditions. The objective of this study was to evaluate the feasibility of conducting a prospective study of children and adolescents with knee pain using electronic methods of data collection.Children and adolescents with knee pain that presented to primary care physiotherapy clinics were enrolled and followed-up on a weekly basis via short messaging service (SMS) until their knee pain had recovered (i.e. two consecutive weeks of no pain). Feasibility was assessed in terms of recruitment, retention and response rates to SMS and an online questionnaire. Baseline and 6-month follow-up measures included pain, disability, physical function, physical activity and health related quality of life. Kaplan-Meier survival analysis was used to estimate the median time to knee pain recovery.Thirty participants (mean age 13.0 ± 2.2 years, 53% boys) were recruited over 26 months. The overall response rate to weekly SMS follow-up was 71.3% (809 received/1135 sent). One third of participants stopped responding to SMS prior to recovery, and these participants typically had a much lower response rate during the time they remained in the study. At 6-month follow-up, 80% of the cohort completed the final online questionnaire, and 29% of participants still reported current knee pain (≥1/10 VAS). The median time for knee pain recovery was 8 weeks (95%CI: 5, 10).Electronic data collection alone seems insufficient to track pain recovery in young people and may need to be supplemented with more traditional data collection methods. Researchers should consider further measures to address slow recruitment rates and high attrition when designing large prospective studies of children and adolescents in the future. Copyright © 2016 John Wiley & Sons, Ltd.
- Peer Review: Professionally Important and an Opportunity to Contribute. [Editorial]
- Physiother Res Int 2016 Jun; 21(2):67-9.
- What are the Main Physical Functioning Factors Associated With Falls Among Older People With Different Perceived Fall Risk? [JOURNAL ARTICLE]
- Physiother Res Int 2016 Mar 7.
Fall risk perceptions may influence the judgement over physical and functional competencies to avoid falls. However, few studies have explored the physical functioning characteristics associated with falls among older people with low perceived fall risk. This study aimed to identify the prevalence of falls and physical functioning factors associated with falling among community-dwelling older adults with low and high perceived fall risk.We conducted a cross-sectional population based study with 773 community-dwelling elders. Perceived fall risk was investigated using Falls Efficacy Scale International. We considered fallers those who reported at least one fall in the previous 12 months. Physical functioning measures used were grip strength, usual gait speed, sit-to-stand test, five step test, timed up and go test, one-legged stance test, anterior and lateral functional reach test.At least one fall was reported by 103 (30%) participants with low perceived fall risk and by 196 (46%) participants with high perceived fall risk. The odds of falling were lower among those with greater grip strength and with a greater stance time in one-legged test, and the odds of falling among elders with high perceived fall risk were higher among those who took more time in performing the five step test.We believe that our results highlight the need of not neglecting the risk of falls among active older adults with low perceived fall risk, particularly in those elders that show reduced stability in a small base of support and a lower leg strength. In addition, we suggest that elders with high perceived fall risk should be assessed using anticipatory postural adjustment tests. Particularly, our results may help physiotherapists to identify eligible elders with different perceptions of fall risk for tailored interventions aimed at reducing falls. Copyright © 2016 John Wiley & Sons, Ltd.
- Non-invasive Ventilation as Airway Clearance Technique in Cystic Fibrosis. [JOURNAL ARTICLE]
- Physiother Res Int 2016 Feb 29.
For patients with cystic fibrosis, chest physiotherapy is crucial for evacuating airway secretions. Because chest physiotherapy increases energy expenditure, fatigue and dyspnoea, non-invasive ventilation (NIV) could be beneficial for severely ill patients during airway clearance. The aim of the study is to evaluate and compare the effects between NIV and positive expiratory pressure (PEP) on airway clearance.Prospective, randomized trial compares PEP to NIV. Thirty-two subjects, mean age 31 years, mean forced expiratory volume in 1 second 47% (±14) and mean forced vital capacity 69% (±13), completed a 3-month randomized trial comparing NIV with standard PEP treatment as airway clearance technique. Lung functions testing, 6-minute walk test, blood gases, sputum culture and inflammatory parameters were measured before and after the treatment period.There was a significant reduction in lung clearance index (LCI) following NIV compared with PEP (p = 0.01). LCI is performed within the lung function testing.Non-invasive ventilation was shown to be a good alternative to PEP in chest physiotherapy for patients with cystic fibrosis who are severely ill.
- Evidence-based Practice Intentions and Long-term Behaviours of Physiotherapy Graduates Following an Intensive Education Programme. [JOURNAL ARTICLE]
- Physiother Res Int 2016 Feb 24.
Assisting physiotherapists to implement research evidence into clinical practice is essential to ensure the quality of practice and encourage lifelong learning and professional progression. However, many physiotherapists report barriers to implementing research, and there is little evidence regarding the sustainability of intended evidence-based practice (EBP) behaviours following EBP education programmes. This paper reports on intended and actual long-term EBP behaviours of physiotherapy students who completed an intensive EBP training programme embedded within a post-graduate coursework programme.An intensive 3-week course in quantitative health research methods and EBP was delivered annually from 2007 to 2014 as part of the programme to national and international students. Following the course, students were asked about their intention of using evidence to inform their future clinical practice. An online survey was used to evaluate EBP behaviours of graduates.Of a possible total of 202 students, contact details for 193 students were sourced, and 65 students responded to the survey (34% response rate). At course completion, 174 students (86%) indicated that they intended to use research to guide their clinical decisions at least once a week. At follow-up, most graduates reported frequently using research to inform their clinical practice; indicated by a mean score of 6.5 (±1.9) from a possible range of 0 (not at all) to 10 (all the time). On average, students reported spending 2.2 (±2.2) hours accessing and reading research evidence per week. The most common barriers to implementing evidence were lack of time, limited access to evidence sources and a perceived lack of generalizability of research findings to specific patient groups.Graduates of an intensive EBP training programme embedded within an existing post-graduate physiotherapy programme regularly implemented EBP in clinical practice. Barriers to evidence implementation were time, access to research and perceived lack of generalizability of research findings. Copyright © 2016 John Wiley & Sons, Ltd.