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Muscle Architecture and Subcutaneous Fat Measurements of Rectus Femoris and Vastus Lateralis at Optimal Length Aided by a Novel Ultrasound Transducer Attachment. 在新型超声波传感器附件的帮助下,以最佳长度测量股直肌和腹外肌的肌肉结构和皮下脂肪。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI: 10.3138/ptc-2021-0016
Brittany D Bulbrook, Jaclyn N Chopp-Hurley, Emily G Wiebenga, Janet M Pritchard, Anthony A Gatti, Peter J Keir, Monica R Maly

Purpose: This cross-sectional study determines the sensitivity of muscle architecture and fat measurements of the rectus femoris (RF) and vastus lateralis (VL) muscles from ultrasound images acquired with varying transducer tilt, using a novel transducer attachment, in healthy adults. Secondary objectives were to estimate intrarater and interrater reliability of image measurement and acquisition, respectively. Methods: Thirty healthy adults participated (15 women and 15 men; 25 [SD 2.5] y). Ultrasound image acquisition was conducted by two raters at different transducer tilts relative to the skin: estimated perpendicular, and five measured angles (80°, 85°, 90°, 95°, 100°) using the transducer attachment. Muscle thickness (MT), subcutaneous fat thickness (FT), pennation angle (PA), and fascicle length (FL) were measured. Sensitivity and reliability were assessed using intra-class correlation coefficients (ICCs) and standard error of measurements (SEMs). Results: MT and FT for RF and VL were not sensitive to transducer tilt. However, PA and FL were sensitive to transducer tilt. MT and FT for both muscles showed high ICCs and low SEMs for intrarater and interrater reliability. For PA of both muscles, standardizing transducer tilt improved interrater ICCs and lowered SEMs. Conclusion: MT and FT measurements of RF and VL acquired at 60° knee flexion are robust to varying transducer tilt angles. PA measurements benefit from standardizing transducer tilt.

目的:这项横断面研究确定了使用新型换能器附件从不同换能器倾斜度下采集的超声图像中测量健康成人股直肌(RF)和股外侧肌(VL)肌肉结构和脂肪的灵敏度。次要目标是分别评估图像测量和采集的内部和内部可靠性。方法:30 名健康成年人(15 名女性和 15 名男性;25 [SD 2.5] 岁)参加了此次研究。超声图像采集由两名评定者在不同的换能器相对于皮肤的倾斜角度下进行:估计垂直角度和使用换能器附件测量的五个角度(80°、85°、90°、95°、100°)。肌肉厚度 (MT)、皮下脂肪厚度 (FT)、垂线角度 (PA) 和筋膜长度 (FL) 均已测量。使用类内相关系数(ICC)和测量标准误差(SEM)评估灵敏度和可靠性。结果RF和VL的MT和FT对换能器倾斜不敏感。但 PA 和 FL 对传感器倾斜敏感。两块肌肉的 MT 和 FT 显示出较高的 ICC 和较低的 SEM。就两块肌肉的 PA 而言,将换能器倾斜标准化可提高评分者之间的 ICCs,降低 SEMs。结论在膝关节屈曲60°时采集的RF和VL的MT和FT测量结果对不同的换能器倾斜角度有很好的适应性。PA测量可从标准化的传感器倾斜角度中获益。
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引用次数: 0
Reliability and Validity of Shoulder and Handgrip Strength Testing. 肩部和手部力量测试的可靠性和有效性。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI: 10.3138/ptc-2021-0041
Nicholas Robert Biasini, Brian Bannon, Michael Pellegrino, Abdullah Qaderi, William Trinh, Sharon Switzer-McIntyre, W Darlene Reid, Karina Tamy Kasawara

Purpose: This study aimed to estimate the intra- and inter-rater reliability of the JTECH computerized, wireless apparatus and its validity (compared to established devices) for measurements of maximal shoulder isometric strength and handgrip strength among healthy adults with no shoulder pathology. Methods: Twenty healthy young adults had shoulder strength tested with JTECH and Micro-FET2 hand-held dynamometers, and the handgrip strength was tested using JTECH and Jamar handgrip dynamometers. Assessments were performed by the same rater to determine intra-rater reliability and convergent validity, at least two days apart, while on a third visit, the other rater performed measures to determine inter-rater reliability. Results: The JTECH computerized, wireless devices demonstrated good to excellent intra-rater reliability (ICCs (2,1) = 0.78-0.97) and inter-rater reliability for strength measures (ICCs (2,1) = 0.76-0.95). The JTECH computerized device compared to the Micro-FET2 hand-held dynamometer showed substantial concurrent validity for shoulder flexion (R2 = 0.87), extension (R2 = 0.87), abduction (R2 = 0.88), and adduction (R2 = 0.85). Substantial concurrent validity was shown for the JTECH computerized device and Jamar handgrip dynamometers (R2 = 0.92). Conclusions: The JTECH computerized, wireless devices demonstrated high intra- and inter-rater reliability and substantial concurrent validity for shoulder isometric strength and handgrip strength in healthy adults.

目的:本研究旨在评估 JTECH 计算机化无线仪器的内部和评定者之间的可靠性及其有效性(与现有设备进行比较),以测量无肩部病变的健康成年人的最大肩部等长力量和手握力量。测量方法使用 JTECH 和 Micro-FET2 手持式测力计对 20 名健康的年轻人进行肩部力量测试,并使用 JTECH 和 Jamar 手持式测力计测试手握力量。评估由同一评分者进行,以确定评分者内部信度和收敛效度,至少相隔两天;在第三次访问时,由另一名评分者进行测量,以确定评分者之间的信度。结果:JTECH 计算机化无线设备的评分者内部可靠性(ICCs (2,1) = 0.78-0.97)和评分者间强度测量可靠性(ICCs (2,1) = 0.76-0.95)均达到良好至优秀水平。与 Micro-FET2 手持式测力计相比,JTECH 计算机化设备在肩关节屈曲(R2 = 0.87)、伸展(R2 = 0.87)、外展(R2 = 0.88)和内收(R2 = 0.85)方面显示出很高的并发效度。JTECH 计算机化设备和 Jamar 手握式测力计(R2 = 0.92)显示出很高的并发有效性。结论:JTECH 计算机化无线设备在健康成年人的肩部等长力量和手握力量方面表现出较高的评分者内部和评分者之间的可靠性以及较强的并发有效性。
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引用次数: 0
Clinician's Commentary on Chagas et al.1. 临床医生对查格斯等人的评论1。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI: 10.3138/ptc-2021-0006-cc
Lesley Katchburian
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引用次数: 0
What Does Cochrane Say About … Health Care Professional Education? 科克伦对......医疗保健专业教育有何看法?
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI: 10.3138/ptc-75-1-cochrane
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引用次数: 0
Clinician's Commentary on Malik et al.1. 临床医生对 Malik 等人的评论1。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI: 10.3138/ptc-2021-0051-cc
Lisa Wickerson
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引用次数: 0
A Pan-Canadian Perspective on Education and Training Priorities for Physiotherapists. Part 2: Professional Interactions and Context of Practice. 泛加拿大视角下的物理治疗师教育与培训重点。第二部分:专业互动与实践背景。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI: 10.3138/ptc-2020-0122
Michelle J Kleiner, David M Walton

Purpose: Canadian physiotherapists who participated in the Physio Moves Canada (PMC) project of 2017 identified the state of training programmes as a threat facing professional growth of the discipline. One purpose of the project was to identify priority areas for physiotherapist training programmes as identified by academics and clinicians across Canada. Method: The PMC project included a series of interviews and focus groups conducted across clinical sites in every Canadian province and in Yukon Territory. Data were interpreted using descriptive thematic analysis; identified sub-themes were returned to participants for reflection. Results: Overall, 116 physiotherapists and 1 physiotherapy assistant participated in 10 focus groups and 26 semi-structured interviews. Results are presented using the curriculum guidelines of the time for organization. Here we describe two themes: Physiotherapy Professional Interactions, further defined by interpersonal and interprofessional competencies, and Context of Practice further defined by advocacy, leadership, community awareness, and business competencies. Conclusions: Participants appear to express a desire for programmes to train reflexive and adaptable primary health care practitioners with strong foundational knowledge and clinical expertise, complemented by interpersonal and interprofessional skills to empower physiotherapists to effectively care and advocate for patients, to lead health care teams, and to share ideas to inspire change towards a future of physiotherapy practice.

目的:参与 2017 年 "加拿大物理移动"(PMC)项目的加拿大物理治疗师认为,培训计划的现状是该学科专业发展面临的威胁。该项目的目的之一是确定加拿大各地学术界和临床医生确定的理疗师培训计划的优先领域。方法:PMC 项目包括在加拿大各省和育空地区的临床站点开展的一系列访谈和焦点小组活动。采用描述性主题分析法对数据进行解释;确定的次主题将返回给参与者进行思考。结果:共有 116 名物理治疗师和 1 名物理治疗助理参加了 10 个焦点小组和 26 个半结构式访谈。结果采用当时的课程指南进行组织。在此,我们将描述两个主题:物理治疗专业互动,由人际关系和跨专业能力进一步定义;实践背景,由宣传、领导力、社区意识和业务能力进一步定义。结论:学员们似乎表达了这样一种愿望,即培训具有反思能力和适应能力的初级卫生保健从业人员,使其具备扎实的基础知识和临床专业知识,并辅之以人际交往和跨专业技能,从而使物理治疗师能够有效地护理和宣传患者,领导卫生保健团队,并分享想法,激励物理治疗实践的未来变革。
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引用次数: 0
Clinician's Commentary on Kleiner and Walton1. 克莱纳和沃尔顿的临床评论1。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI: 10.3138/ptc-2020-0121-cc
Sarah C Marshall
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引用次数: 0
Effect of Physical Activity During Chemotherapy on Cognitive Function in Cancer Survivors: A Systematic Review and Meta-Analysis. 化疗期间的体育锻炼对癌症幸存者认知功能的影响:系统回顾与元分析》。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI: 10.3138/ptc-2021-0032
Priyanshi S Akbari, Yusra Hassan, Lisa Archibald, Tania Tajik, Kaitlin Dunn, Mara Berris, Jenna Smith-Turchyn

Purpose: To determine if cancer survivors who perform physical activity (PA) during chemotherapy have improved levels of cognitive function compared to those who do not. Method: E-databases (Ovid MEDLINE, Embase, CINAHL, PsycINFO, AMED) were searched from inception to February 4, 2020. Quantitative studies that assessed cognitive outcomes for adults with any cancer type who received chemotherapy concurrent with PA were selected. Risk of bias was assessed using Cochrane's RoB 2, ROBINS-I, and Newcastle-Ottawa scales. A meta-analysis was performed using standardized mean difference (SMD). Results: Twenty-two studies (15 randomized controlled trials [RCTs] and 7 non-RCTs) met the inclusion criteria. The meta-analysis demonstrated that combined resistance and aerobic training had a small yet statistically significant effect on social cognition compared to usual care (SMD 0.23 [95% CI: 0.04, 0.42], p = 0.020). Conclusions: Combined resistance and aerobic exercise may benefit social cognition in cancer survivors undergoing chemotherapy. Due to high risk of bias and low quality of evidence of included studies, we recommend further investigation to support these findings and make specific PA recommendations.

目的:确定在化疗期间进行体育锻炼(PA)的癌症幸存者与未进行体育锻炼的癌症幸存者相比,认知功能水平是否有所提高。研究方法:检索从开始到 2020 年 2 月 4 日的电子数据库(Ovid MEDLINE、Embase、CINAHL、PsycINFO、AMED)。筛选出的定量研究评估了任何癌症类型的成人在接受 PA 化疗的同时的认知结果。采用 Cochrane's RoB 2、ROBINS-I 和 Newcastle-Ottawa 等量表对偏倚风险进行评估。使用标准化平均差 (SMD) 进行了荟萃分析。研究结果22 项研究(15 项随机对照试验和 7 项非随机对照试验)符合纳入标准。荟萃分析表明,与常规护理相比,联合阻力训练和有氧训练对社会认知有微小但具有统计学意义的影响(SMD 0.23 [95% CI: 0.04, 0.42], p = 0.020)。结论抗阻力运动和有氧运动相结合可能对接受化疗的癌症幸存者的社会认知能力有益。由于所纳入研究的偏倚风险较高且证据质量较低,我们建议进一步调查以支持这些发现,并提出具体的PA建议。
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引用次数: 0
Development of the Gross Motor Function Family Report (GMF-FR) for Children with Cerebral Palsy. 开发脑瘫儿童粗大运动功能家庭报告 (GMF-FR)。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 eCollection Date: 2023-01-01 DOI: 10.3138/ptc-2021-0006
Paula S C Chagas, Peter Rosenbaum, F Virginia Wright, Lesley Pritchard, Marilyn Wright, Aline Martins Toledo, Ana Cristina R Camargos, Egmar Longo, Hércules R Leite

Purpose: To describe the initial steps in the development of a family-completed, modified version of the Gross Motor Function Measure (GMFM-88) to report gross motor function of young people with cerebral palsy in their natural environments. Methods: Development of the Gross Motor Function - Family Report (GMF-FR) was based on expert opinion involving 13 experienced clinicians and researchers, in four steps: (1) item identification to target items that reflect functional gross motor performance; (2) item selection; (3) critical analysis of the items; and (4) item and scoring modification. Results: Several modifications to existing items and scoring were made, including wording changes to optimize ease of families' understanding, the addition of photographs to illustrate all items, changes to the items to enable use of furniture instead of specialized equipment, and modifications to scoring criteria to ensure a focus on functional motor skills. Ultimately, 30 items were selected, and specific testing/scoring instructions were created for each item. Conclusions: GMF-FR is a new family-report tool, based on the GMFM-88. When validated, it can be used as a telehealth outcome measure to capture family-reported functional motor skill performance in home and community environments.

目的:描述开发由家庭填写的粗大运动功能测量(GMFM-88)修订版的初始步骤,以报告脑瘫青少年在自然环境中的粗大运动功能。方法:粗大运动功能--家庭报告(GMF-FR)的开发基于专家意见,有 13 位经验丰富的临床医生和研究人员参与,分为四个步骤:(1) 确定反映粗大运动功能表现的项目;(2) 选择项目;(3) 对项目进行批判性分析;(4) 修改项目和评分。结果:对现有的项目和评分标准进行了若干修改,包括修改措辞以方便家庭理解、增加照片以说明所有项目、修改项目以使用家具而不是专门设备,以及修改评分标准以确保侧重于功能性运动技能。最终选定了 30 个项目,并为每个项目制定了具体的测试/评分说明。结论:GMF-FR 是基于 GMFM-88 的一种新的家庭报告工具。经过验证后,该工具可用作远程保健结果测量工具,以获取家庭和社区环境中家庭报告的功能性运动技能表现。
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引用次数: 0
Introducing a Clinical Practice Guideline in Physiotherapy to Address Sexuality in Adults with a Neuromuscular Disorder 引入物理治疗的临床实践指南,以解决成人的性与神经肌肉障碍
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-02-08 DOI: 10.3138/ptc-2022-0005
I. Fisette-Paulhus, M. Morin, J. Fortin, C. Gagnon
We present the development and the key elements of a clinical practice guideline (CPG) in physiotherapy aiming to address sexuality, more specifically impairments and limitations that can interfere with sexual activity in adults with a neuromuscular disorder (NMD). The CPG was based on the Rare Knowledge Mining Methodological Framework (RKMMF) and included a literature review, consultation with physiotherapists, and validation by an interdisciplinary team. The EX-PLISSIT (extended, permission, limited information, specific suggestions, intensive therapy) model and the Competency Profile for physiotherapists in Canada were also used as frameworks to divide the CPG into sections. Here, we present the methodology for the CPG development and key elements related to physiotherapy assessment and treatment related to sexual activity in people with NMDs. An extensive CPG was developed through a literature review, consultations, and a validation process. A total of 75 articles were included in the review. Twelve physiotherapists and four health professionals reviewed the CPG. Physiotherapists should address the following in their assessment: relationships; assistance required during sexual activity; urinary, vaginal, or anorectal symptoms; erectile dysfunction; pain; fatigue; and the impact of the NMD on sexuality. Interventions can target physical activity, positioning, muscle weakness, fatigue, decreased range of motion, erectile dysfunction, sensitivity disorders, lubrication, pain, incontinence, and cardiorespiratory implications. The CPG promotes the importance of addressing sexuality and proposes different interventions that physiotherapists should integrate into their practice.
我们介绍了物理治疗临床实践指南(CPG)的发展和关键要素,旨在解决性问题,更具体地说,是可能干扰成年神经肌肉障碍(NMD)性活动的障碍和限制。CPG以稀有知识挖掘方法论框架(RKMMF)为基础,包括文献综述、物理治疗师咨询和跨学科团队的验证。加拿大物理治疗师的EX-PLISIT(扩展、许可、有限信息、具体建议、强化治疗)模式和能力简介也被用作将CPG划分为多个部分的框架。在这里,我们介绍了CPG开发的方法,以及与NMDs患者的物理治疗评估和性活动相关的治疗相关的关键要素。通过文献综述、咨询和验证过程,制定了一个广泛的CPG。共有75篇文章被纳入审查。12名物理治疗师和4名卫生专业人员审查了CPG。物理治疗师应该在评估中解决以下问题:关系;性活动期间所需的协助;泌尿、阴道或肛门直肠症状;勃起功能障碍;疼痛疲劳以及NMD对性的影响。干预措施可以针对身体活动、体位、肌肉无力、疲劳、活动范围减少、勃起功能障碍、敏感性障碍、润滑、疼痛、失禁和心肺影响。CPG宣传了解决性问题的重要性,并提出了理疗师应将其纳入实践的不同干预措施。
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引用次数: 0
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Physiotherapy Canada
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