Australian Journal of Physiotherapy最新文献

{"title":"Duration of anaesthesia, type of surgery, respiratory co-morbidity, predicted VO2max and smoking predict postoperative pulmonary complications after upper abdominal surgery: an observational study","authors":"Rebecca L. Scholes ,&nbsp;Laura Browning ,&nbsp;Ewa M. Sztendur ,&nbsp;Linda Denehy","doi":"10.1016/S0004-9514(09)70081-9","DOIUrl":"10.1016/S0004-9514(09)70081-9","url":null,"abstract":"<div><h3>Question</h3><p>Can the risk of developing postoperative pulmonary complications be predicted after upper abdominal surgery?</p></div><div><h3>Design</h3><p>Prospective observational study.</p></div><div><h3>Participants</h3><p>268 consecutive patients undergoing elective upper abdominal surgery who received standardised pre- and postoperative prophylactic respiratory physiotherapy.</p></div><div><h3>Outcome measures</h3><p>Predictors were 17 preoperative and intraoperative risk factors. A postoperative pulmonary complication was diagnosed when four or more of the following criteria were present: radiological evidence of collapse/consolidation, temperature &gt; 38°C, oxyhaemoglobin saturation &lt; 90%, abnormal sputum production, sputum culture indicating infection, raised white cell count, abnormal auscultation findings, or physician's diagnosis of pulmonary complication.</p></div><div><h3>Results</h3><p>35 participants (13%) developed postoperative pulmonary complications. Five risk factors predicted postoperative pulmonary complications: duration of anaesthesia (OR 4.3, 95% CI 1.7 to 10.8); surgical category (OR 2.3, 95% CI 1.1 to 4.7); current smoking (OR 2.1, 95% CI 1.0 to 4.5); respiratory co-morbidity (OR 2.1, 95% CI 1.0 to 4.4); and predicted maximal oxygen uptake (OR 2.0, 95% CI 1.0 to 4.3). A clinical rule for predicting the development of postoperative pulmonary complications predicted 82% of participants who developed complications. The odds of high risk participants developing pulmonary complications were 8.4 (95% CI 3.3 to 21.3) times that of low risk participants.</p></div><div><h3>Conclusion</h3><p>This clinical rule for predicting the risk of developing postoperative pulmonary complications from five risk factors may prove useful in prioritising postoperative respiratory physiotherapy. Further research is needed to validate the rule.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Pages 191-198"},"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)70081-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28340602","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":"Lumbar spinal stenosis","authors":"Sandra Brauer","doi":"10.1016/S0004-9514(09)70068-6","DOIUrl":"10.1016/S0004-9514(09)70068-6","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Page 67"},"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)70068-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129027409","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 non-specific chronic low back pain who have participated in exercise programs have preferences about exercise: a qualitative study","authors":"Susan C. Slade,&nbsp;Elizabeth Molloy,&nbsp;Jennifer L. Keating","doi":"10.1016/S0004-9514(09)70041-8","DOIUrl":"10.1016/S0004-9514(09)70041-8","url":null,"abstract":"<div><h3>Question</h3><p>What factors do participants in exercise programs for chronic low back pain perceive to be important for engagement and participation?</p></div><div><h3>Design</h3><p>Qualitative study of three focus groups.</p></div><div><h3>Participants</h3><p>18 adults with chronic low back pain who had participated in exercise programs for chronic low back pain.</p></div><div><h3>Results</h3><p>All focus group results concurred and two significant themes emerged from the focus group data. The first was that the experience of exercise informed participant preferences with respect to exercise environment and type of exercise. Participants described a range of positive and negative experiences, a desire to master exercise techniques, and a preference for exercise that matched their abilities and prior skills. The second significant theme was the helpful and empowering skills of the care-provider, and care-seeker ability to identify and articulate their own needs. Participants regarded carer expertise favourably when positive results were achieved early in the interaction, but were frustrated when they were not listened to and symptoms were aggravated. The relationship was enhanced by effective communication. Participants also recognised they needed to be aware of their own skills and abilities and, and that financial or family support incentives encouraged their adherence to a program.</p></div><div><h3>Conclusion</h3><p>People are likely to prefer and participate in exercise programs that are designed with consideration of their preferences, circumstances, and past exercise experiences. We propose that information about patient exercise preferences should be collected systematically.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 115-121"},"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)70041-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28192344","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 typically need to feel ‘much better’ to consider intervention worthwhile: an observational study","authors":"Manuela Loureiro Ferreira ,&nbsp;Paulo Henrique Ferreira ,&nbsp;Robert Dale Herbert ,&nbsp;Jane Latimer","doi":"10.1016/S0004-9514(09)70042-X","DOIUrl":"10.1016/S0004-9514(09)70042-X","url":null,"abstract":"<div><h3>Question</h3><p>How much of an effect do five common physiotherapy interventions need to have for patients with low back pain to perceive they are worth their cost, discomfort, risk, and incovenience? Are there any differences between the interventions? Do specific characteristics of people with low back pain predict the smallest important difference?</p></div><div><h3>Design</h3><p>Cross-sectional, observational study.</p></div><div><h3>Participants</h3><p>77 patients with non-specific low back pain who had not yet commenced physiotherapy intervention.</p></div><div><h3>Outcome measures</h3><p>The smallest worthwhile effect was measured in terms of global perceived change (0 to 4) and percentage perceived change.</p></div><div><h3>Results</h3><p>Participants perceived that intervention would have to make them ‘much better’, which corresponded to 1.7 (SD 0.7) on the 4-point scale, or improve their symptoms by 42% (SD 23), to make it worthwhile. There was little distinction made between interventions, regardless of whether smallest worthwhile effects were quantified as global perceived change (<em>p</em> = 0.09) or percentage perceived change (<em>p</em> = 1.00). Severity of symptoms independently (<em>p</em> = 0.01) predicted percentage perceived change explaining 9% of the variance, so that for each increase in severity of symptoms of 1 point out of 10 there was an increase of 4% in the percentage perceived change that participants considered would make intervention worthwhile.</p></div><div><h3>Conclusions</h3><p>Typically people with low back pain feel that physiotherapy intervention must reduce their symptoms by 42%, or make them feel ‘much better’ for intervention to be worthwhile.</p><p><em><strong>eAddenda</strong></em>: <span>Appendix 1</span><svg><path></path></svg>, <span>Table 3</span><svg><path></path></svg> available at AJP. physiotherapy.asn.au</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 123-127"},"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)70042-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28192345","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":"Aerobic exercise improves lung function in children with intellectual disability: a randomised trial","authors":"Mohammad A. Khalili ,&nbsp;Mark R. Elkins","doi":"10.1016/S0004-9514(09)70077-7","DOIUrl":"10.1016/S0004-9514(09)70077-7","url":null,"abstract":"<div><h3>Question</h3><p>In children with intellectual disability, is lung function lower than in healthy peers and does it improve with exercise?</p></div><div><h3>Design</h3><p>Randomised trial with intention-to-treat analysis and assessor blinding.</p></div><div><h3>Participants</h3><p>Forty-four 12-year old children with Down syndrome or other intellectual disability with an average IQ of 42 (SD 8).</p></div><div><h3>Intervention</h3><p>The experimental group performed aerobic exercise for 30 minutes, five days per week, for eight weeks. The exercise was supervised walking, running, and cycling, with a target of moderate intensity. The control group continued usual activities and performed no specific exercise.</p></div><div><h3>Outcome measures</h3><p>Lung function as FEV₁ and FVC in litres was measured with spirometry at baseline and after the intervention at eight weeks. Prior to the baseline measures, all participants underwent familiarisation of spirometry for one week.</p></div><div><h3>Results</h3><p>At baseline, FEV₁ of the children with intellectual disability was a mean of 87% (95% CI 83 to 91) and FVC was 94% (95% CI 91 to 97) of predicted normal values. After intervention, FEV₁ had increased by 160 ml (95% CI 30 to 290) and FVC by 330 ml (95% CI 200 to 460) more in the experimental group than the control group.</p></div><div><h3>Conclusion</h3><p>An 8-week program of aerobic exercise improves lung function in children with intellectual disability significantly.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Pages 171-175"},"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)70077-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28417086","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":"Urinary incontinence is associated with an increase in falls: a systematic review","authors":"Pauline E. Chiarelli ,&nbsp;Lynette A. Mackenzie ,&nbsp;Peter G. Osmotherly","doi":"10.1016/S0004-9514(09)70038-8","DOIUrl":"10.1016/S0004-9514(09)70038-8","url":null,"abstract":"<div><h3>Question</h3><p>Is urinary incontinence associated with falls in community-dwelling older people?</p></div><div><h3>Design</h3><p>A systematic review and meta-analysis of observational studies investigating falls and urinary incontinence.</p></div><div><h3>Participants</h3><p>Community-dwelling older people.</p></div><div><h3>Outcome measures</h3><p>Falls rather than fracture or injury, and any type of urinary incontinence.</p></div><div><h3>Results</h3><p>Odds ratios of nine studies were included in the meta-analysis. The odds of falling were 1.45 (95% CI 1.36 to 1.54) in the presence of any type of urinary incontinence. The odds of falling were 1.54 (95% CI 1.41 to 1.69) in the presence of urge incontinence. The odds of falling were 1.11 (95% CI 1.00 to 1.23) in the presence of stress incontinence. The odds of falling were 1.92 (95% CI 1.69 to 2.18) in the presence of mixed incontinence.</p></div><div><h3>Conclusion</h3><p>Urge urinary incontinence, but not stress urinary incontinence, is associated with a modest increase in falls. Falls prevention programs need to include an assessment of incontinence and referral for interventions to ameliorate the symptoms of urge incontinence.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 89-95"},"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)70038-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28191272","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":"Instillation of normal saline before suctioning reduces the incidence of pneumonia in intubated and ventilated adults","authors":"Julie C. Reeve","doi":"10.1016/S0004-9514(09)70044-3","DOIUrl":"10.1016/S0004-9514(09)70044-3","url":null,"abstract":"<div><h3>Question</h3><p>Does the instillation of normal saline before suctioning reduce the incidence of ventilator-associated pneumonia in intubated and ventilated adults?</p></div><div><h3>Design</h3><p>Randomised, controlled trial with blinded outcome assessment.</p></div><div><h3>Setting</h3><p>The medical/surgical intensive care unit of a tertiary oncology hospital in Brazil.</p></div><div><h3>Participants</h3><p>Adults expected to require at least 72 hours of mechanical ventilation via an endotracheal or tracheostomy tube. Previous ventilation within the past month and contraindications to bronchoscopy were exclusion criteria. Randomisation of 262 participants allotted 130 to the intervention group and 132 to a control group.</p></div><div><h3>Interventions</h3><p>Closed tracheal suction systems with heat and moisture exchangers were used with both groups and were changed regularly. All patients were nursed with backrest elevation to 45 degrees. Medical or nursing staff, who were blinded to group allocations, requested suctioning when any of the following occurred: visible or audible secretions, ventilator-patient asynchrony, and increased peak inspiratory pressures or decreased tidal volumes attributed to secretions. Respiratory therapists performed the suctioning according to a standardised procedure that included preoxygenation. The therapists instilled 8 mL of normal saline prior to suctioning in the intervention group only.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was the incidence of ventilator-associated pneumonia (VAP). If VAP was suspected because of radiographic evidence plus either fever, leukocytosis, or purulent secretions, a bronchoscopy with standardised lavage was performed. VAP was considered confirmed if the bacterial density of the lavage fluid exceeded 1000 colony-forming units/mL. Secondary outcome measures included time to VAP, duration of mechanical ventilation, length of stay and mortality in the intensive care unit, unscheduled ventilation circuitry changes due to secretions, and number of suctions per day.</p></div><div><h3>Results</h3><p>All participants completed the study. Significantly fewer participants in the saline group developed VAP (14/130) than in the control group (31/132), relative risk reduction 0.54 (95% CI 0.18 to 0.74). This indicates that one patient will avoid developing VAP for every 8 patients in which saline instillation is used. Significant benefits of saline instillation were also seen in the incidence of VAP (9 vs 21 per 1000 days of mechanical ventilation, <em>p</em> = 0.01) and in the time to first VAP (<em>p</em> = 0.02). The groups did not differ significantly on the remaining secondary outcomes.</p></div><div><h3>Conclusion</h3><p>Instillation of normal saline before tracheal suctioning decreases the incidence of VAP in mechanically ventilated adults.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Page 136"},"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)70044-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28250259","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":"Multidisciplinary assessment of elderly people with a history of multiple falls reduces the risk of further falls","authors":"Sarah E. Lamb","doi":"10.1016/S0004-9514(09)70047-9","DOIUrl":"10.1016/S0004-9514(09)70047-9","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Question&lt;/h3&gt;&lt;p&gt;Does assessment by a multidisciplinary team, or assessment by a community nurse with the ability to refer to other professionals, reduce further falls in recurrent fallers?&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;p&gt;Cluster-randomised, controlled trial.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;p&gt;18 general practices in the UK.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;p&gt;Adults aged at least 65 years, living in the community, who had experienced 2 or more falls in the past year, and who did not present to an emergency department for their most recent fall. Inability to participate for one year, abbreviated mental test score less than 7, and nursing home placement were exclusion criteria. Randomisation of 516 participants allotted 213 to care by the multidisciplinary team (secondary care), 141 to care by the community nurse (primary care), and 162 to usual care.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;p&gt;Participants allocated to secondary care attended a multidisciplinary clinic (comprising a doctor, nurse, physiotherapist, and occupational therapist) with referral for investigations, interventions (including Homecheck), and follow-up if necessary. Participants allocated to primary care were assessed by a community nurse who identified risk factors for falls and could refer to other professionals. Participants in the usual care group were assessed by their usual primary care physicians, who provided management at their own discretion.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome measures&lt;/h3&gt;&lt;p&gt;The primary outcome was the proportion of participants in each group who had at least one fall during the follow-up period of 12 months. Other outcomes were death, move to institutional care, change in Barthel score, change in the timed Get Up and Go score, fall-related fractures, and hospitalisations. Participants lost to follow-up were assumed to have had an adverse outcome.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;466 participants contributed data to the primary outcome, with an adverse outcome assumed for a further 39 participants on falls and other dichotomous outcomes. At 12 months, 75% of the secondary care group, 87% of the primary care group, and 84% of the usual care group had fallen. Secondary care prevented significantly more falls than usual care (adjusted odds ratio 0.52, 95% CI 0.35 to 0.79). The secondary care group also had a significantly more positive Barthel index than the usual care group. The groups did not significantly differ on the other outcomes. The data were also analysed without imputing adverse outcomes for participants who were lost to follow-up. Compared to the usual care group, the secondary care group had significantly fewer falls, fractures, hospitalisations, and deaths.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;Multidisciplinary assessment of elderly, recurrent fallers reduces the risk of further falls compared to usual care. Assessment of risk factors for falls by a community nurse with the potential to refer to other professionals did not have the same benef","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Page 139"},"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)70047-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28249610","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":"Electrical stimulation is a useful adjunct in the management of urinary incontinence in people with multiple sclerosis","authors":"Eleanor Lee-Bognar","doi":"10.1016/S0004-9514(09)70063-7","DOIUrl":"10.1016/S0004-9514(09)70063-7","url":null,"abstract":"<div><h3>Question</h3><p>Does neuromuscular electrical stimulation improve lower urinary tract dysfunction in people with multiple sclerosis (MS), when given in addition to pelvic floor exercises and electromyographic biofeedback?</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>Twelve health-care facilities in Northern Ireland.</p></div><div><h3>Participants</h3><p>Adults with MS with no hospital admissions in the preceding 3 months. They were required to have lower urinary tract dysfunction (involuntary leakage, &gt; 8 voids per day, nocturia, or voiding dysfunction) but not to score more than 7.5 on the Expanded Disability Status Scale (EDSS) from 0 (normal) to 10 (death due to MS). Symptomatic prolapse, prostatic hyperplasia, infection and contraindications to electrical stimulation were exclusion criteria. Randomisation of 74 participants allotted 37 to each of two groups.</p></div><div><h3>Interventions</h3><p>Both groups were taught skills and strategies to prevent incontinence and trained in pelvic floor muscle exercises. Both groups were taught to perform the exercises with electrical stimulation via a hand-held unit with a vaginal or anal probe. The treatment group received active stimulation while the control group received sham stimulation. Both groups performed the exercises daily for 9 weeks. The exercises were reviewed with electromyographic biofeedback at a weekly clinic visit.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was the number of leakage episodes per day as monitored by diary. Secondary outcome measures included gain in pad weight after use, voiding measures, symptom questionnaires, and assessment of pelvic floor muscle function using the Oxford classification and EMG. All outcomes were measured at 9, 16, and 24 weeks.</p></div><div><h3>Results</h3><p>In each group, 36 participants completed the study. At 9 weeks, the treatment group had significantly less incontinence, with 0.8 fewer episodes per day (95% CI 0.1 to 1.4) and 89 g lighter pads (95% CI 8 to 171) than the control group. The treatment group also had significantly larger voids, by 47 ml (95% CI 1 to 93), and significantly smaller post-void residual volumes. Symptoms were also rated as significantly less bothersome. At 24 weeks, however, pad weight was the only objective outcome that remained statistically significant. Nevertheless, patients in the treatment group still rated their symptoms as significantly less bothersome on two questionnaires.</p></div><div><h3>Conclusion</h3><p>For people with MS, the addition of electrical stimulation to a program of pelvic floor muscle training and EMG biofeedback induces several improvements in lower urinary tract dysfunction. Although some improvements were temporary, symptoms remained less bothersome for 24 weeks.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Page 62"},"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)70063-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993069","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":"Endurance and strength training have different benefits for people with peripheral arterial disease, but both improve quality of life","authors":"Sandeep Gupta","doi":"10.1016/S0004-9514(09)70064-9","DOIUrl":"10.1016/S0004-9514(09)70064-9","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Question&lt;/h3&gt;&lt;p&gt;Do treadmill training and resistance training improve the functional performance of patients with peripheral arterial disease (PAD)?&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;p&gt;Randomised, controlled trial with blinded outcome assessment and stratification for symptoms of intermittent claudication (IC).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;p&gt;Tertiary hospital in the USA.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;p&gt;Participants with an ankle brachial index of 0.95 or less were recruited from vascular clinics and the community. Key exclusion criteria were critical limb ischaemia, foot ulcers, amputation, inability to attend or perform the interventions, and usual exercise comparable to the study regimens. Randomisation of 156 participants allotted 51 to treadmill training, 52 to resistance training and 53 to a control group.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;p&gt;The treadmill group performed supervised treadmill exercise 3 times per week for 6 months. Participants aimed to increase to 40 minutes by week 8, after which the speed or grade of the treadmill was progressed. Participants with IC were encouraged to exercise to near maximal leg symptoms. Asymptomatic participants exercised at a perceived exertion of 12 to 14 on the Borg scale. The resistance group also performed supervised exercise 3 times per week for 6 months, including 3 sets of 8 repetitions of resisted lower limb exercises. External resistance was maintained above 50% of 1 repetition maximum and perceived exertion at 12 to 14. The control group attended 11 sessions that were designed to provide contact with a health professional but not to change behaviour.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome measures&lt;/h3&gt;&lt;p&gt;The primary outcomes were the change in the six-minute walk test (6MWT) and the short physical performance battery (SPPB) at 6 months. The SPPB assesses walking speed, balance, and sit-to-stand performance. Secondary outcome measures were treadmill endurance, lower limb strength, endothelial function measured non-invasively at the brachial artery, habitual physical activity measured over 7 days via an accelerometer, a walking impairment questionnaire (WIQ), and the SF-36 quality of life questionnaire.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Compared to control, treadmill training significantly improved 6MW distance (by 36 m, 95% CI 15 to 57), total treadmill time (by 3.4 min, 95% CI 2 to 4.8), pain-free treadmill time (by 1.6 min, 95% CI 0.3 to 2.9), endothelial function, and the Distance domain of the WIQ. Compared to control, resistance training significantly improved total treadmill time (by 1.9 min, 95% CI 0.5 to 3.3), knee extension strength (by 80 N, 95% CI 37 to 124), and the Distance and Stair Climbing domains of the WIQ. Both regimens produced significant, 7.5-point improvements in the Physical Functioning domain of the SF-36.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;Treadmill and resistance training have different benefits for people with peripheral arterial disease, but both improve qualit","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 1","pages":"Page 63"},"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)70064-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27993070","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}