Australian Journal of Physiotherapy最新文献

{"title":"The Walking Index for Spinal Cord Injury","authors":"Lisa Harvey, Ralph Marino","doi":"10.1016/S0004-9514(09)70067-4","DOIUrl":"10.1016/S0004-9514(09)70067-4","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Page 66"},"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)70067-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993073","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}

{"title":"People with low back pain who have externalised beliefs need to see greater improvements in symptoms to consider exercises worthwhile: an observational study","authors":"Vinícius Cunha Oliveira ,&nbsp;Paulo H. Ferreira ,&nbsp;Manuela L. Ferreira ,&nbsp;Letícia Tibúrcio ,&nbsp;Rafael Zambelli Pinto ,&nbsp;Warley Oliveira ,&nbsp;Rosângela Dias","doi":"10.1016/S0004-9514(09)70007-8","DOIUrl":"10.1016/S0004-9514(09)70007-8","url":null,"abstract":"<div><h3>Question</h3><p>Does health locus of control predict the smallest worthwhile effect of motor control exercise or spinal manipulative therapy when adjusted for severity of pain?</p></div><div><h3>Design</h3><p>Cross-sectional observational study.</p></div><div><h3>Participants</h3><p>86 people with non-specific low back pain who had not yet commenced physiotherapy intervention.</p></div><div><h3>Outcome measures</h3><p>Predictors were severity of pain measured over the last 7 days using an 11-point scale from 0 to 10, and external and internal health loci of control measured using Form C of the Multidimensional Health Locus of Control scale. The outcome of interest was smallest worthwhile effect which was measured in terms of the percentage perceived change necessary to make two evidence-based physiotherapy interventions for non-specific low back pain (motor control exercise and spinal manipulative therapy) worthwhile. Data were collected before intervention commenced.</p></div><div><h3>Results</h3><p>Multivariate analysis showed that when adjusted for pain and internal locus of control, external locus of control predicted the smallest worthwhile effect for motor control exercise (β 0.79; CI 0.10 to 1.48), explaining 0.07 of the variance. None of the predictors significantly predicted the smallest worthwhile effect for spinal manipulative therapy.</p></div><div><h3>Conclusion</h3><p>Patients with low back pain who have externalised beliefs and agree more strongly with the notion that others are responsible for their condition report higher estimates of smallest worthwhile effect of an active intervention such as motor control exercise than patients who do not have externalised beliefs.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Pages 271-275"},"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)70007-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28522536","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}

{"title":"Ability to negotiate stairs predicts free-living physical activity in community-dwelling people with stroke: an observational study","authors":"Matar Abdullah Alzahrani,&nbsp;Catherine M. Dean,&nbsp;Louise Ada","doi":"10.1016/S0004-9514(09)70008-X","DOIUrl":"10.1016/S0004-9514(09)70008-X","url":null,"abstract":"<div><h3>Question</h3><p>Which clinical measures of walking performance best predict free-living physical activity in community-dwelling people with stroke?</p></div><div><h3>Design</h3><p>Cross-sectional observational study.</p></div><div><h3>Participants</h3><p>42 community-dwelling stroke survivors.</p></div><div><h3>Outcome measures</h3><p>Predictors were four clinical measures of walking performance (speed, automaticity, capacity, and stairs ability). The outcome of interest was free-living physical activity, measured as frequency (activity counts) and duration (time on feet), collected using an activity monitor called the Intelligent Device for Energy Expenditure and Physical Activity.</p></div><div><h3>Results</h3><p>Time on feet was predicted by stairs ability alone (B 166, 95% CI 55 to 278) which accounted for 48% of the variance. Activity counts were also predicted by stairs ability alone (B 6486, 95% CI 2922 to 10 050) which accounted for 58% of the variance.</p></div><div><h3>Conclusion</h3><p>The best predictor of free-living physical activity in community-dwelling people with stroke was stairs ability.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Pages 277-281"},"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)70008-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28522537","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}

{"title":"Proprioceptive training reduces the risk of ankle sprain recurrence in athletes","authors":"Christine Lin","doi":"10.1016/S0004-9514(09)70009-1","DOIUrl":"10.1016/S0004-9514(09)70009-1","url":null,"abstract":"<div><h3>Question</h3><p>Does a home-based proprioceptive exercise program reduce the one-year incidence of recurrent lateral ankle sprain in athletes?</p></div><div><h3>Design</h3><p>Randomised controlled trial.</p></div><div><h3>Setting</h3><p>Participants were recruited through primary care clinics as well as through advertisements in magazines, on the internet, and at sports tournaments in The Netherlands.</p></div><div><h3>Participants</h3><p>522 athletes aged 12–70 years with a lateral ankle sprain in the preceding 2 months were allocated to one of two groups, using concealed allocation. The groups were comparable at baseline with respect to age, sex, hours of sports exposure, and history of ankle sprains.</p></div><div><h3>Interventions</h3><p>Athletes in both groups were free to seek and use any treatment they chose for their original ankle sprain. When any such interventions were complete and the athlete had returned to sport, only the intervention group additionally received an 8-week, unsupervised home-based proprioceptive training program, designed by physiotherapists. The program consisted of 3 sessions per week of up to 30 minutes each. An instructional DVD, exercise sheets, balance board, and web-based resources were provided to the intervention group. Exercises were gradually increased in difficulty and training load during the 8-week program.</p></div><div><h3>Outcomes</h3><p>The primary outcome was incidence of ankle sprain in the 1-year follow-up period, reported monthly on a web-based questionnaire. Reported ankle injury data were rated by a blinded assessor as acute ankle sprains or other ankle injuries. Participants who reported an ankle injury also completed a cost diary to record costs of healthcare and lost productivity until recovery.</p></div><div><h3>Results</h3><p>86% of participants were followed up at 12 months. 33% of athletes in the control group reported an ankle sprain during follow-up, compared with 22% in the intervention group, which is an absolute risk reduction of 12% (95% CI 4 to 19) and number needed to treat of 9 (95% CI 26 to 5). Ankle sprains were further classified as those leading to loss of sports time, and those leading to costs of healthcare or lost productivity. Regardless of the classification used, significant reductions in the risk of ankle sprain were still evident after adjustment for age, type of sport, and level of sport.</p></div><div><h3>Conclusion</h3><p>A home-based proprioceptive training program for athletes reduces the risk of ankle re-sprain in the following year, particularly for those who do not seek other treatment.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Page 283"},"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)70009-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28522538","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}

{"title":"A home-based program of simple quadriceps exercises reduces knee pain and improves knee function in overweight people with knee pain","authors":"Nadine Foster","doi":"10.1016/S0004-9514(09)70010-8","DOIUrl":"10.1016/S0004-9514(09)70010-8","url":null,"abstract":"<div><h3>Question</h3><p>Does a program of quadriceps exercises or dietary advice, or both, reduce knee pain and improve knee function in people living in the community with knee pain?</p></div><div><h3>Design</h3><p>Factorial, randomised, controlled trial.</p></div><div><h3>Setting</h3><p>Five general practices in the United Kingdom with interventions delivered through home visits.</p></div><div><h3>Participants</h3><p>Community dwellers aged at least 45 years, who were overweight or obese (BMI ≥ 28) and complained of knee pain on most days of the past month. Randomisation of 389 participants allotted 82 to the quadriceps exercise group, 122 to the dietary advice group, 109 to the quadriceps exercise and dietary advice group, and 76 to a control group.</p></div><div><h3>Interventions</h3><p>The exercise groups were taught the exercises at home by a dietitian and received up to 6 further home visits over 24 months. Exercise participants were asked to complete ≥ 2 exercises a day, with 5 to 20 repetitions of each exercise. The exercises progressed from quadriceps setting exercises, to exercises with elasticised bands, to functional activities such as stepping up and down off a step. The dietary groups received individualised advice to reduce weight, newsletters with recipe ideas, and one home visit per month over 24 months. The control group received an advice leaflet.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was pain reduction by ≥ 30% on the pain subscale of the Western Ontario McMaster (WOMAC) osteoarthritis index at 24 months. Secondary outcome measures were change in the WOMAC pain, stiffness, and physical function subscales, hospital anxiety and depression rating scale, and the bodily pain and physical function domains of the Short Form 36 (SF-36).</p></div><div><h3>Results</h3><p>289 (74%) participants completed the study. At 24 months, those in the exercise groups were more likely to experience &gt; 30% reduction in pain compared to the non-exercise groups (relative risk 1.36, 95% CI 1.05 to 1.76) with number needed to treat of 9 (95% CI 5 to 55). Compared to the non-exercise groups the exercise groups showed improvement in WOMAC physical function of −3.64 units (95% −6.01 to −1.27), WOMAC stiffness (−0.35 units, 95% CI −0.66 to −0.03), and improvements in the SF-36 subscales of bodily pain and physical function. The dietary advice groups lost weight (2.95 kg, 95% CI 1.44 to 4.46 kg) and reduced depression at 24 months compared to the non-dietary groups, but showed no evidence of an effect on any other outcomes.</p></div><div><h3>Conclusion</h3><p>A 2-year homebased quadriceps exercise program reduced knee pain and increased knee function in overweight and obese people with knee pain. The effect size was moderate. Dietary advice resulted in a modest weight loss that did not change pain or function, but did reduce depression.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Page 284"},"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)70010-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28522539","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}

{"title":"Community-based pulmonary rehabilitation is effective for people with chronic obstructive pulmonary disease (COPD)","authors":"Zoe McKeough","doi":"10.1016/S0004-9514(09)70013-3","DOIUrl":"10.1016/S0004-9514(09)70013-3","url":null,"abstract":"<div><h3>Question</h3><p>Does community-based pulmonary rehabilitation improve quality of life, respiratory exacerbations, exercise performance, and lung function in people with COPD?</p></div><div><h3>Design</h3><p>Randomised, controlled trial with concealed allocation and blinded outcome assessment.</p></div><div><h3>Setting</h3><p>Two hospitals in The Netherlands.</p></div><div><h3>Participants</h3><p>People with COPD (GOLD Stages 2 or 3) and impaired exercise capacity (&lt; 70% of predicted peak work during incremental cycle ergometry). Prior rehabilitation and major co-morbidities were exclusion criteria. Randomisation of 199 participants allotted 102 to an intervention group and 97 to a control group.</p></div><div><h3>Interventions</h3><p>All participants had their medications optimised before randomisation. Over 4 months, the intervention group visited a local physiotherapist twice a week for 30-minute intensive exercise training (endurance cycling and walking, upper and lower limb strength/endurance exercises). They were instructed to do the exercises for 30 minutes twice daily at home and to walk and cycle outside. They also completed an individualised education program using a booklet and, if required, received smoking cessation counselling (minimal intervention strategy) and 4 visits from a dietitian for counselling and supplements. This was followed by a 20-month maintenance program, involving monthly visits to the physiotherapist for monitoring and encouragement. After an exacerbation, participants were allowed 6 extra training sessions over 3 weeks. Extra dietitian and nursing appointments were made if indicated. The control group participants received brief smoking cessation advice and advice to eat more if malnourished, from their respiratory physician.</p></div><div><h3>Outcome measures</h3><p>The primary outcomes were the St George's Respiratory Questionnaire (SGRQ) total score and the number of exacerbations. Secondary outcomes were SGRQ domain scores, the modified Medical Research Council (MRC) dyspnoea scale, a cycle endurance test, the sixminute walk test distance (6MWD), strength of respiratory and limb muscles, fat-free mass, and lung function. At 24 months, perceived effectiveness of care was rated on a 5-point Likert scale.</p></div><div><h3>Results</h3><p>Follow-up was 93% at 4 months and 79% at 24 months. At 4 months, improvement in SGRQ score was significantly better in the intervention group by 4.2 points (95% CI 3.9 to 4.5), but exacerbations did not significantly differ, RR 1.01 (95% CI 0.57 to 1.79). Other outcomes that were significantly better in the intervention group were SGRQ activity and impact scores, MRC score, cycle endurance time, peak work, 6MWD, handgrip force, and fat-free mass. At 24 months, SGRQ, cycle endurance time, and 6WMD remained significantly better in the intervention group and exacerbations remained not significantly different. The intervention was perceived as significantly more effective","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Page 287"},"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)70013-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28522542","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}

{"title":"Is progressive resistance exercise ineffective in increasing muscle strength in young people with cerebral palsy?","authors":"Nicholas F. Taylor","doi":"10.1016/S0004-9514(09)70095-9","DOIUrl":"10.1016/S0004-9514(09)70095-9","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 222"},"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)70095-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28340606","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}

{"title":"Interruption of sedation for early rehabilitation improves outcomes in ventilated, critically ill adults","authors":"Dale M. Needham,&nbsp;Satish Chandolu,&nbsp;Jennifer Zanni","doi":"10.1016/S0004-9514(09)70086-8","DOIUrl":"10.1016/S0004-9514(09)70086-8","url":null,"abstract":"<div><h3>Question</h3><p>Does early provision of rehabilitation improve the likelihood of functional independence at discharge in ventilated, critically ill patients?</p></div><div><h3>Design</h3><p>Randomised, controlled trial with concealed allocation and blinded assessment of some outcomes.</p></div><div><h3>Setting</h3><p>Two tertiary medical centres in the USA.</p></div><div><h3>Participants</h3><p>Adults in a medical intensive care unit (ICU) who had been on mechanical ventilation for less than 72 hours and were expected to continue for at least another 24 hours, and who had been functionally independent two weeks before admission. Exclusion criteria included: rapid onset neuromuscular disease, cardiopulmonary arrest, irreversible disorders with high mortality, and raised intracranial pressure. Randomisation of 104 participants allotted 49 to receive the early intervention and 55 to a control group.</p></div><div><h3>Interventions</h3><p>Both groups received sedation guided by the Richmond Agitation Sedation Scale and underwent daily interruption of sedatives or narcotics or both, unless contraindicated. Weaning from mechanical ventilation and insulin for glycaemic control were also protocol-directed. During the daily interruption of sedation, the intervention group commenced rehabilitation as appropriate to their clinical status: passive movements for those who were unresponsive, and active assisted or active movements in supine for those who were responsive. If well tolerated, these exercises were progressed to sitting balance activities, activities of daily living, transfer training, pre-gait exercises, and walking. Extensive physiological stability criteria guided whether the intervention could be initiated or continued. Overall progression of the intervention was continued until the participant regained functional independence or was discharged from hospital.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was return to functional independence by discharge from hospital (ie, able to walk, bathe, dress, groom, transfer, and toilet independently). Secondary outcome measures included the number of hospital days with delirium, the duration of mechanical ventilation, lengths of stay in the ICU and in hospital, and adverse events.</p></div><div><h3>Results</h3><p>All participants were followed up. Functional independence at discharge was more likely in the intervention group (59% vs 35%, <em>p</em> = 0.02). The intervention group also had fewer days of delirium in hospital (median 2 vs 4 days, <em>p</em> = 0.02), and shorter duration of mechanical ventilation (median 3.4 vs 6.1 days, <em>p</em> = 0.02). Adverse events were rare and discontinuation of the intervention (most commonly, due to perceived patient-ventilator asynchrony) occurred in only 4% of all intervention sessions.</p></div><div><h3>Conclusion</h3><p>Early rehabilitation during daily interruption of sedation was safe and well tolerated. It reduced the duration of ","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 210"},"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)70086-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28386815","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}

{"title":"Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)","authors":"Ilana Ackerman","doi":"10.1016/S0004-9514(09)70088-1","DOIUrl":"10.1016/S0004-9514(09)70088-1","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 213"},"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)70088-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28386817","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}

{"title":"Rehabilitation for low back pain","authors":"Sandra Brauer","doi":"10.1016/S0004-9514(09)70089-3","DOIUrl":"https://doi.org/10.1016/S0004-9514(09)70089-3","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 215"},"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)70089-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91625175","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}