Australian Journal of Physiotherapy最新文献

{"title":"Arthroscopic surgery provides no additional benefit over physiotherapy and medication for the treatment of knee osteoarthritis","authors":"May Arna Risberg","doi":"10.1016/S0004-9514(09)70045-5","DOIUrl":"10.1016/S0004-9514(09)70045-5","url":null,"abstract":"<div><h3>Question</h3><p>What is the effect of the addition of arthroscopy to physiotherapy and medication in patients with osteoarthritis (OA) of the knee?</p></div><div><h3>Design</h3><p>Randomised, controlled trial with blinded outcome assessment and intention-to-treat analysis.</p></div><div><h3>Setting</h3><p>A university sports medicine clinic in Ontario, Canada.</p></div><div><h3>Participants</h3><p>Adults with idiopathic or secondary moderate-to-severe OA of the knee (Grade 2, 3, or 4 radiographic severity on the modified Kellgren-Lawrence classification). Key exclusion criteria were large meniscal tears, inflammatory arthritis, previous arthroscopic treatment for knee OA and more than 5 degrees of lateral deformity. Randomisation of 188 participants allotted 94 to an intervention group and 94 to a control group.</p></div><div><h3>Interventions</h3><p>The intervention group underwent arthroscopy within 6 weeks after randomisation and a standard physiotherapy and medication regimen was initiated within 7 days after surgery. The control group initiated the same physiotherapy and medication regimen at an equivalent time. Physiotherapy was provided for 1 hour once a week for 12 weeks. It included range-of-motion and strengthening exercises to be performed at home twice daily, information about activities of daily living, instruction in the use of heat and cold, and an educational video. Exercises were individualised according to the severity of OA and age. After the 12-week period, participants were advised to continue the exercise program. Medications (potentially including paracetamol, non-steroidal anti-inflammatory drugs, hyaluronic acid, and glucosamine) were prescribed according to standard guidelines.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was the WOMAC score at 2 years follow up. The WOMAC is scored from 0 (worst) to 2400, with subscales for pain, stiffness, and physical function. Secondary outcomes included the Physical Component Summary Score of the Short Form-36 (0 to 100); the McMaster Toronto Arthritis patient preference (MACTAR) questionnaire (0 to 500); and the Arthritis Self- Efficacy Scale (ASES) (10 to 100).</p></div><div><h3>Results</h3><p>168 participants completed the study. After 2 years, the mean (SD) WOMAC scores were 874 (624) in the intervention group and 897 (583) in the control group, mean difference 23 (95% CI –208 to 161). The groups differed on the SF-36 by only 0.2 (95% CI –3.2 to 3.6), on the MACTAR questionnaire by only 6 (95% CI –37 to 49), and on each of the ASES subscales by less than 6 (all non-significant).</p><p><em><strong>Conclusion</strong></em>: The addition of arthroscopy to a regimen of physiotherapy and medication does not improve physical function, pain, or health-related quality of life in patients with moderate-to-severe OA of the knee.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Page 137"},"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)70045-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28249608","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":"When should an intervention be provided?","authors":"Terry P. Haines ,&nbsp;Steven McPhail ,&nbsp;Amanda Purcell","doi":"10.1016/S0004-9514(09)70091-1","DOIUrl":"10.1016/S0004-9514(09)70091-1","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 218"},"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)70091-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28340604","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":"Some benefit from physiotherapy intervention in the subgroup of patients with severe ankle sprain as determined by the ankle function score: a randomised trial","authors":"Rogier M. van Rijn ,&nbsp;Jos A.C. van Heest ,&nbsp;Philip van der Wees ,&nbsp;Bart W. Koes ,&nbsp;Sita M.A. Bierma-Zeinstra","doi":"10.1016/S0004-9514(09)70040-6","DOIUrl":"10.1016/S0004-9514(09)70040-6","url":null,"abstract":"<div><h3>Questions</h3><p>Do patients with a severe ankle injury (baseline ankle function score ≤ 40) do worse in the short-term than patients with a mild injury (score &gt; 40)? Does physiotherapy intervention have more effect on patients with a severe injury compared with a mild injury in the short- or long-term? Is self-reported recovery related to ankle function score over time?</p></div><div><h3>Design</h3><p>Subgroup analysis of a randomised trial.</p></div><div><h3>Participants</h3><p>102 adults with an acute lateral ankle sprain.</p></div><div><h3>Intervention</h3><p>The experimental group received physiotherapist-supervised exercises in addition to conventional intervention.</p></div><div><h3>Outcome measures</h3><p>Outcomes were self-reported recovery, pain, and instability all measured on a 10-point visual analogue scale, and incidence of re-sprain. Measurements were collected at baseline, 4 and 8 weeks, 3 and 12 months.</p></div><div><h3>Results</h3><p>Participants with a severe injury did worse in 3 out of 7 outcomes than those with a mild injury at 4 weeks but not at 8 weeks. There was no difference in effect of physiotherapy intervention in those with a severe injury compared with a mild injury, at 8 weeks or 12 months. However, there was an effect of physiotherapy intervention in those with a severe injury in 3 out of 7 outcomes at 8 weeks. Self-reported recovery was related to ankle function score at all points in time (r = 0.48 to 0.79).</p></div><div><h3>Conclusion</h3><p>The results of this study only partially support the recommendations regarding the use of the ankle function score in the ‘Acute Ankle Injury’ guideline of the Royal Dutch Society of Physiotherapists.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 107-113"},"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)70040-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28191274","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":"Were the techniques appropriate?","authors":"Beverley Giovanelli","doi":"10.1016/S0004-9514(09)70052-2","DOIUrl":"10.1016/S0004-9514(09)70052-2","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Page 144"},"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)70052-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28192347","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":"Rehabilitative ultrasound imaging is a valid measure of trunk muscle size and activation during most isometric sub-maximal contractions: a systematic review","authors":"Shane L. Koppenhaver ,&nbsp;Jeffrey J. Hebert ,&nbsp;Eric C. Parent ,&nbsp;Julie M. Fritz","doi":"10.1016/S0004-9514(09)70076-5","DOIUrl":"10.1016/S0004-9514(09)70076-5","url":null,"abstract":"<div><h3>Questions</h3><p>Is rehabilitative ultrasound imaging a valid measure of trunk muscle size and activation? Are rehabilitative ultrasound imaging measures sensitive to change?</p></div><div><h3>Design</h3><p>Systematic review of studies of criterion-related validity, construct validity, and sensitivity to change.</p></div><div><h3>Participants</h3><p>People with low back pain and asymptomatic controls.</p></div><div><h3>Outcome measure</h3><p>Trunk muscle size and activation measured by rehabilitative ultrasound imaging, MRI and/or EMG.</p></div><div><h3>Results</h3><p>37 studies were included. 10 studies investigated criterion-related validity and provided evidence that while ultrasound may be a valid measure of trunk muscle size, the validity of ultrasound to quantify muscle activation is context-dependent, depending on the muscle involved, the contraction strategy utilised, and the intensity of muscle contraction. 23 studies provided evidence of construct validity by demonstrating the ability of ultrasound measurement to differentiate individuals in terms of back pain, anthropometry, and postures. Six studies contained a limited amount of information about sensitivity to change.</p></div><div><h3>Conclusions</h3><p>It is valid to use rehabilitative ultrasound imaging to measure trunk muscle size and activation during most isometric sub-maximal contractions. Ultrasound measures appear sensitive to both positive and negative change.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Pages 153-169"},"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)70076-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28417085","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":"During computing tasks symptomatic female office workers demonstrate a trend towards higher cervical postural muscle load than asymptomatic office workers: an experimental study","authors":"Grace P.Y. Szeto ,&nbsp;Leon M. Straker ,&nbsp;Peter B. O'Sullivan","doi":"10.1016/S0004-9514(09)70005-4","DOIUrl":"10.1016/S0004-9514(09)70005-4","url":null,"abstract":"<div><h3>Questions</h3><p>Do symptomatic female office workers perform computing tasks with higher cervical postural muscle loads (in terms of higher amplitudes and less muscular rest) and more discomfort compared with asymptomatic individuals? Are these differences in postural muscle loads consistent across bilateral (typing) and unilateral (mousing) conditions?</p></div><div><h3>Design</h3><p>an experimental case-control study.</p></div><div><h3>Participants</h3><p>18 symptomatic female office workers and 21 asymptomatic female office workers.</p></div><div><h3>Intervention</h3><p>Three conditions (typing, mousing, and type-and-mouse) were performed in random order.</p></div><div><h3>Outcome measures</h3><p>Muscle load was measured as median amplitude and gap frequency using surface EMG of bilateral cervical erector spinae and upper trapezius. Discomfort was measured using a numerical rating scale.</p></div><div><h3>Results</h3><p>The case group demonstrated 4.3% (95% CI 0.1 to 8.4) higher amplitude during typing and 3.5% (95% CI 0.1 to 6.9) higher amplitude during type-and-mouse in the right cervical erector spinae compared with the control group. There was a similar difference between groups in the left cervical erector spinae which also demonstrated a 1.2 gaps/min (95% CI –2.3 to 0.0) lower frequency during typing. The case group had significantly higher discomfort during all conditions compared with the control group. The case group demonstrated higher median amplitudes and lower gap frequencies than the control group during bilateral conditions (typing and type-and-mouse) compared with unilateral conditions (mousing) for both muscle groups.</p></div><div><h3>Conclusion</h3><p>There was increased amplitude and decreased muscular rest in the cervical <em>erector spinae</em> of office workers performing typing and mousing tasks. These findings may represent a mechanism underlying computer-related musculoskeletal disorders.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Pages 257-262"},"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)70005-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28521045","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":"Telerehabilitation: a coming of age","authors":"Trevor G. Russell","doi":"10.1016/S0004-9514(09)70054-6","DOIUrl":"10.1016/S0004-9514(09)70054-6","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Pages 5-6"},"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)70054-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993061","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":"Combined pain self-management and antidepressant therapy are effective in patients with chronic musculoskeletal pain with depression","authors":"Julia Hush","doi":"10.1016/S0004-9514(09)70084-4","DOIUrl":"https://doi.org/10.1016/S0004-9514(09)70084-4","url":null,"abstract":"<div><h3>Question</h3><p>Does a combination of pain self-management and antidepressant therapy improve pain and depression in people with musculoskeletal pain and depression?</p></div><div><h3>Design</h3><p>Randomised, controlled trial with concealed allocation and blinded outcome assessment.</p></div><div><h3>Setting</h3><p>Six primary care clinics and five tertiary outpatient clinics in the USA.</p></div><div><h3>Participants</h3><p>Primary care patients were eligible if they had at least moderate pain in the low back, hip, or knee, present for at least 3 months despite analgesic medication, and depression of at least moderate severity. People taking antidepressants but who still met the inclusion criteria were eligible. Severe cognitive impairment, major psychoses, and current pain-related disability claims were exclusion criteria. Randomisation of 250 participants allotted 123 to an intervention group and 127 to a control group.</p></div><div><h3>Interventions</h3><p>The intervention group participated in the Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) program. During the initial 3 months (Step 1), this group optimised their antidepressant medication according to an algorithm based on clinical response, with a potential increased dose at 3 weeks and change of medication at 6 weeks for those who had not improved. During the following 3 months (Step 2), fortnightly pain self-management sessions were conducted by a nurse care manager, modelled on the Stanford self-management program. Participants were taught to modify their behaviour through behavioural plans and problem-solving techniques. During the final 6 months (Step 3), two telephone calls from the nurse care manager were used to assess symptoms and adherence, and to adjust management if required. The control group were informed that they had depressive symptoms and that they should seek advice about treatment, but received no other intervention unless a psychiatric emergency arose.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was a combined improvement in both depression and pain. Depression was assessed using the 20-item Hopkins Symptom Checklist and pain severity using the Brief Pain Inventory. Global improvement in pain was also assessed.</p></div><div><h3>Results</h3><p>205 (82%) participants completed the final assessment. At 12 months, 26% of the intervention group achieved the primary outcome, compared with 8% of the control group (RR 3.3, 95% CI 1.8 to 5.4). For depression specifically, 37% of the intervention group had a 50% or greater reduction in depression severity from baseline compared with 16% of the control group (RR 2.3, 95% CI 1.5 to 3.2). When expressed in terms of major depression, 41% of the intervention group had major depression at 12 months compared to 68% of the control group (RR 0.6, 95% CI 0.4 to 0.8). A reduction in pain of at least 30% was more likely in the intervention group (41%) than the control group (17%) (RR 2.","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 208"},"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)70084-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91670854","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":"Management of spasticity in adults","authors":"","doi":"10.1016/S0004-9514(09)70016-9","DOIUrl":"https://doi.org/10.1016/S0004-9514(09)70016-9","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Page 290"},"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)70016-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89997266","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":"Did authors draw the right conclusion?","authors":"Audrey Long ,&nbsp;Stephen May","doi":"10.1016/S0004-9514(09)70093-5","DOIUrl":"10.1016/S0004-9514(09)70093-5","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 220"},"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)70093-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28340605","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}