Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70097-2
Aline Scianni, Jane Butler, Louise Ada, Luci Texeira-Salmela
{"title":"Results present a challenge for clinicians and researchers","authors":"Aline Scianni, Jane Butler, Louise Ada, Luci Texeira-Salmela","doi":"10.1016/S0004-9514(09)70097-2","DOIUrl":"10.1016/S0004-9514(09)70097-2","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 223"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70097-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114791712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70094-7
Benedict M. Wand, Rebecca Hunter, Neil E. O’Connell, Louise Marston
{"title":"The conclusion was drawn from the data","authors":"Benedict M. Wand, Rebecca Hunter, Neil E. O’Connell, Louise Marston","doi":"10.1016/S0004-9514(09)70094-7","DOIUrl":"10.1016/S0004-9514(09)70094-7","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 221"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70094-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128932787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70055-8
Maarten R. Prins, Peter van der Wurff
Question
Do females with patellofemoral pain syndrome have decreased hip muscle strength compared with the unaffected side and with healthy controls?
Design
A systematic review of observational studies published up to January 2008.
Participants
Females with patellofemoral pain syndrome and healthy controls.
Outcome measures
Strength for at least one hip muscle group had to be included in the study. Hip muscle strength was recorded as force or torque.
Results
Five cross-sectional studies with a mean Newcastle-Ottawa Assessment Scale score of 6 out of 9 met the inclusion criteria. Strong evidence was found for a deficit in hip external rotation, abduction and extension strength, moderate evidence for a deficit in hip flexion and internal rotation strength, and no evidence for a deficit in hip adduction strength compared with healthy controls. Moderate evidence was found for a decrease in hip external rotation and abduction strength but no evidence for a decrease in hip extension, flexion, adduction and internal rotation strength compared with the unaffected side.
Conclusion
Females with patellofemoral pain syndrome demonstrate a decrease in abduction, external rotation and extension strength of the affected side compared with healthy controls.
{"title":"Females with patellofemoral pain syndrome have weak hip muscles: a systematic review","authors":"Maarten R. Prins, Peter van der Wurff","doi":"10.1016/S0004-9514(09)70055-8","DOIUrl":"10.1016/S0004-9514(09)70055-8","url":null,"abstract":"<div><h3>Question</h3><p>Do females with patellofemoral pain syndrome have decreased hip muscle strength compared with the unaffected side and with healthy controls?</p></div><div><h3>Design</h3><p>A systematic review of observational studies published up to January 2008.</p></div><div><h3>Participants</h3><p>Females with patellofemoral pain syndrome and healthy controls.</p></div><div><h3>Outcome measures</h3><p>Strength for at least one hip muscle group had to be included in the study. Hip muscle strength was recorded as force or torque.</p></div><div><h3>Results</h3><p>Five cross-sectional studies with a mean Newcastle-Ottawa Assessment Scale score of 6 out of 9 met the inclusion criteria. Strong evidence was found for a deficit in hip external rotation, abduction and extension strength, moderate evidence for a deficit in hip flexion and internal rotation strength, and no evidence for a deficit in hip adduction strength compared with healthy controls. Moderate evidence was found for a decrease in hip external rotation and abduction strength but no evidence for a decrease in hip extension, flexion, adduction and internal rotation strength compared with the unaffected side.</p></div><div><h3>Conclusion</h3><p>Females with patellofemoral pain syndrome demonstrate a decrease in abduction, external rotation and extension strength of the affected side compared with healthy controls.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Pages 9-15"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70055-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70072-8
Cathy Nall
{"title":"Primary care physiotherapy in the Emergency Department","authors":"Cathy Nall","doi":"10.1016/S0004-9514(09)70072-8","DOIUrl":"10.1016/S0004-9514(09)70072-8","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Page 70"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70072-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70073-X
Patrick Maher
{"title":"Sexual boundaries between physiotherapists and patients","authors":"Patrick Maher","doi":"10.1016/S0004-9514(09)70073-X","DOIUrl":"10.1016/S0004-9514(09)70073-X","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Page 71"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70073-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70058-3
Chung-Wei Christine Lin , Anne M. Moseley , Robert D. Herbert , Kathryn M. Refshauge
Question
What predicts short- and medium-term activity limitation in people after ankle fracture?
Design
Inception cohort observational study.
Participants
Adults with ankle fracture recruited within days following cast removal from physiotherapy departments of teaching hospitals in Sydney, Australia.
Outcome measures
The predictive value of variables that were injury-related (fracture management, fracture severity, angle of the ankle during cast immobilisation, and time from cast removal to baseline) and performance-related (activity limitation, pain, mobility, and dorsiflexion range of motion measured soon after cast removal) were examined in one dataset (n = 150) using univariate linear regression. Significant variables (p ≤ 0.20) were further examined with a multivariate linear model. A clinical prediction rule was derived then validated using data from an independent dataset (n = 94).
Results
Fracture management, fracture severity, baseline activity limitation, pain, mobility, and dorsiflexion had significant but weak univariate associations with activity limitation. Only pain and dorsiflexion range of motion contributed independently to the clinical prediction rule. When applied to the validation data, the rule explained 12% of the short-term and 9% of the medium-term variance in activity limitation.
Conclusion
Performance-related variables were stronger predictors than injury-related variables. A clinical prediction rule consisting of pain and dorsiflexion range of motion explained a small amount of the variance in short- and medium-term activity limitation, suggesting that it may be appropriate to identify people with high levels of pain and restricted dorsiflexion after ankle fracture and target intervention accordingly.
{"title":"Pain and dorsiflexion range of motion predict short- and medium-term activity limitation in people receiving physiotherapy intervention after ankle fracture: an observational study","authors":"Chung-Wei Christine Lin , Anne M. Moseley , Robert D. Herbert , Kathryn M. Refshauge","doi":"10.1016/S0004-9514(09)70058-3","DOIUrl":"10.1016/S0004-9514(09)70058-3","url":null,"abstract":"<div><h3>Question</h3><p>What predicts short- and medium-term activity limitation in people after ankle fracture?</p></div><div><h3>Design</h3><p>Inception cohort observational study.</p></div><div><h3>Participants</h3><p>Adults with ankle fracture recruited within days following cast removal from physiotherapy departments of teaching hospitals in Sydney, Australia.</p></div><div><h3>Outcome measures</h3><p>The predictive value of variables that were injury-related (fracture management, fracture severity, angle of the ankle during cast immobilisation, and time from cast removal to baseline) and performance-related (activity limitation, pain, mobility, and dorsiflexion range of motion measured soon after cast removal) were examined in one dataset (n = 150) using univariate linear regression. Significant variables (<em>p</em> ≤ 0.20) were further examined with a multivariate linear model. A clinical prediction rule was derived then validated using data from an independent dataset (n = 94).</p></div><div><h3>Results</h3><p>Fracture management, fracture severity, baseline activity limitation, pain, mobility, and dorsiflexion had significant but weak univariate associations with activity limitation. Only pain and dorsiflexion range of motion contributed independently to the clinical prediction rule. When applied to the validation data, the rule explained 12% of the short-term and 9% of the medium-term variance in activity limitation.</p></div><div><h3>Conclusion</h3><p>Performance-related variables were stronger predictors than injury-related variables. A clinical prediction rule consisting of pain and dorsiflexion range of motion explained a small amount of the variance in short- and medium-term activity limitation, suggesting that it may be appropriate to identify people with high levels of pain and restricted dorsiflexion after ankle fracture and target intervention accordingly.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Pages 31-37"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70058-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28213294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70011-X
Ruth Dentice
Question
Does regular airway clearance using an oscillating positive expiratory pressure (PEP) device improve quality of life, sputum volume, respiratory function, and exercise capacity in people with bronchiectasis?
Design
Randomised, crossover, controlled trial with 3-month intervention periods separated by a 1-month washout period.
Setting
Acute teaching hospital in Scotland.
Participants
20 adults with radiologically diagnosed bronchiectasis and chronic sputum expectoration, who were not performing regular physiotherapy for airway clearance. Smoking, asthma, emphysema, and cystic fibrosis were exclusion criteria.
Interventions
While in the intervention arm, participants performed 20–30 minutes of airway clearance twice daily. Each session consisted of three cycles of 10 breaths through an oscillating positive expiratory pressure (PEP) device called the Acapella, followed by the forced expiratory technique and coughing. Each participant's technique was reviewed by a physiotherapist monthly during the intervention arm. During the control arm, the device was retained by the investigators and participants performed no physiotherapy for airway clearance. Throughout the study, both groups received all other standard management including antibiotics when exacerbation criteria were met. Any changes to the participants’ usual medication regimen were noted.
Outcome measures
The primary outcome was the Leicester Cough Questionnaire (LCQ) – a 19-point, patient-reported measure of the impact of cough severity on quality of life with three domains (physical, psychological, and social). Secondary outcomes included the St George's Respiratory Questionnaire (SGRQ), 24-hour sputum volume, lung function, maximum respiratory pressures, and the incremental shuttle walk test, measured at the end of each intervention arm.
Results
All participants completed the study with no adverse events during airway clearance. During the 3-month intervention period, the total LCQ score showed significantly greater improvement than during the control period: difference in medians for total LCQ score 1.3 points, p = 0.002. Each of the three domains within the LCQ also showed significant benefits. Other outcomes that showed significantly greater improvements due to the airway clearance intervention were the SGRQ (difference in medians 8.5 points, p = 0.005), 24-hr sputum volume (difference in medians 3 ml, p = 0.02), and the incremental shuttle walk distance (difference in medians 40 m, p = 0.001). The groups did not differ significantly on the remaining secondary outcomes.
Conclusion
Regular airway clearance with oscillating PEP improves diseaserelated quality of life and exercise capacity in people with bronchiectasis.
问题:使用振荡呼气正压(PEP)装置定期气道清除率是否能改善支气管扩张患者的生活质量、痰量、呼吸功能和运动能力?随机、交叉、对照试验，3个月的干预期与1个月的洗脱期分开。苏格兰急诊教学医院的设置。参与者20名影像学诊断为支气管扩张和慢性痰咳的成年人，他们没有进行常规的气道清除物理治疗。吸烟、哮喘、肺气肿和囊性纤维化是排除标准。在干预组，参与者每天进行两次20-30分钟的气道清理。每个疗程包括三个周期，每10次呼吸，通过振荡呼气正压(PEP)装置，称为Acapella，然后是用力呼气技术和咳嗽。在干预期间，每个参与者的技术每月由物理治疗师进行评估。在对照组，研究人员保留设备，参与者不进行气道清除物理治疗。在整个研究过程中，两组均接受了所有其他标准管理，包括在达到恶化标准时使用抗生素。参与者通常的药物治疗方案的任何变化都被记录下来。主要结果是莱斯特咳嗽问卷(LCQ) -一个19分的，由患者报告的咳嗽严重程度对生活质量的影响，包括三个方面(身体，心理和社会)。次要结果包括在每个干预组结束时测量的圣乔治呼吸问卷(SGRQ)、24小时痰量、肺功能、最大呼吸压力和增量穿梭行走测试。结果所有参与者在气道清除过程中均无不良事件发生。在3个月的干预期内，总LCQ得分较对照组有显著改善:总LCQ得分中位数差异1.3分，p = 0.002。在LCQ的三个领域中的每一个也显示出显著的好处。其他由于气道清除干预而表现出显著改善的结果是SGRQ(中位数差8.5分，p = 0.005)， 24小时痰量(中位数差3 ml, p = 0.02)和增加穿梭步行距离(中位数差40 m, p = 0.001)。两组在其余次要结果上没有显著差异。结论振荡式PEP定期气道清除率可改善支气管扩张患者的疾病相关生活质量和运动能力。
{"title":"Airway clearance physiotherapy improves quality of life in people with bronchiectasis","authors":"Ruth Dentice","doi":"10.1016/S0004-9514(09)70011-X","DOIUrl":"10.1016/S0004-9514(09)70011-X","url":null,"abstract":"<div><h3>Question</h3><p>Does regular airway clearance using an oscillating positive expiratory pressure (PEP) device improve quality of life, sputum volume, respiratory function, and exercise capacity in people with bronchiectasis?</p></div><div><h3>Design</h3><p>Randomised, crossover, controlled trial with 3-month intervention periods separated by a 1-month washout period.</p></div><div><h3>Setting</h3><p>Acute teaching hospital in Scotland.</p></div><div><h3>Participants</h3><p>20 adults with radiologically diagnosed bronchiectasis and chronic sputum expectoration, who were not performing regular physiotherapy for airway clearance. Smoking, asthma, emphysema, and cystic fibrosis were exclusion criteria.</p></div><div><h3>Interventions</h3><p>While in the intervention arm, participants performed 20–30 minutes of airway clearance twice daily. Each session consisted of three cycles of 10 breaths through an oscillating positive expiratory pressure (PEP) device called the Acapella, followed by the forced expiratory technique and coughing. Each participant's technique was reviewed by a physiotherapist monthly during the intervention arm. During the control arm, the device was retained by the investigators and participants performed no physiotherapy for airway clearance. Throughout the study, both groups received all other standard management including antibiotics when exacerbation criteria were met. Any changes to the participants’ usual medication regimen were noted.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was the Leicester Cough Questionnaire (LCQ) – a 19-point, patient-reported measure of the impact of cough severity on quality of life with three domains (physical, psychological, and social). Secondary outcomes included the St George's Respiratory Questionnaire (SGRQ), 24-hour sputum volume, lung function, maximum respiratory pressures, and the incremental shuttle walk test, measured at the end of each intervention arm.</p></div><div><h3>Results</h3><p>All participants completed the study with no adverse events during airway clearance. During the 3-month intervention period, the total LCQ score showed significantly greater improvement than during the control period: difference in medians for total LCQ score 1.3 points, <em>p</em> = 0.002. Each of the three domains within the LCQ also showed significant benefits. Other outcomes that showed significantly greater improvements due to the airway clearance intervention were the SGRQ (difference in medians 8.5 points, <em>p</em> = 0.005), 24-hr sputum volume (difference in medians 3 ml, <em>p</em> = 0.02), and the incremental shuttle walk distance (difference in medians 40 m, <em>p</em> = 0.001). The groups did not differ significantly on the remaining secondary outcomes.</p></div><div><h3>Conclusion</h3><p>Regular airway clearance with oscillating PEP improves diseaserelated quality of life and exercise capacity in people with bronchiectasis.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Page 285"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70011-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28522540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70059-5
Petra von Heideken Wågert, Yngve Gustafson, Lillemor Lundin-Olsson
Questions
What is the physical ability of very old people? Is physical ability affected by age or sex? Is it affected by type of housing, level of independence in activities of daily living, cognition, or nutrition?
Design
A population-based cross-sectional observational study.
Participants
Half the 85-year-old population, and the total population aged 90 and ≥ 95 (range 95–103) in Umeå, Sweden who were measured in the Umeå 85+ Study (n = 238).
Outcome measures
Usual and fastest gait speed (m/s) over 2.4 metres, three consecutive chair stands (s), the Berg Balance Scale, and ability to perform the measures (yes/no).
Results
The median (10th to 90th percentile) usual gait speed was 0.49 m/s (0.23–0.75), time to perform the chair stands test was 12.6 seconds (8.5–20.2), and the Berg Balance Scale score was 45 (0–54). Men had greater physical ability than women. An age-related decline in physical ability was seen in women, but not in men. The Berg Balance Scale showed no floor or ceiling effects, but gait speed and chair stands resulted in a floor effect, especially for women.
Conclusion
There were large variations in physical ability in these very old people. These data provide valuable reference values of physical ability in the oldest age groups for commonly-used clinical measures.
{"title":"Large variations in walking, standing up from a chair, and balance in women and men over 85 years: an observational study","authors":"Petra von Heideken Wågert, Yngve Gustafson, Lillemor Lundin-Olsson","doi":"10.1016/S0004-9514(09)70059-5","DOIUrl":"10.1016/S0004-9514(09)70059-5","url":null,"abstract":"<div><h3>Questions</h3><p>What is the physical ability of very old people? Is physical ability affected by age or sex? Is it affected by type of housing, level of independence in activities of daily living, cognition, or nutrition?</p></div><div><h3>Design</h3><p>A population-based cross-sectional observational study.</p></div><div><h3>Participants</h3><p>Half the 85-year-old population, and the total population aged 90 and ≥ 95 (range 95–103) in Umeå, Sweden who were measured in the Umeå 85+ Study (n = 238).</p></div><div><h3>Outcome measures</h3><p>Usual and fastest gait speed (m/s) over 2.4 metres, three consecutive chair stands (s), the Berg Balance Scale, and ability to perform the measures (yes/no).</p></div><div><h3>Results</h3><p>The median (10<sup>th</sup> to 90<sup>th</sup> percentile) usual gait speed was 0.49 m/s (0.23–0.75), time to perform the chair stands test was 12.6 seconds (8.5–20.2), and the Berg Balance Scale score was 45 (0–54). Men had greater physical ability than women. An age-related decline in physical ability was seen in women, but not in men. The Berg Balance Scale showed no floor or ceiling effects, but gait speed and chair stands resulted in a floor effect, especially for women.</p></div><div><h3>Conclusion</h3><p>There were large variations in physical ability in these very old people. These data provide valuable reference values of physical ability in the oldest age groups for commonly-used clinical measures.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Pages 39-45"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70059-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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