Australian Journal of Physiotherapy最新文献

{"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":"<div><h3>Question</h3><p>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?</p></div><div><h3>Design</h3><p>Cluster-randomised, controlled trial.</p></div><div><h3>Setting</h3><p>18 general practices in the UK.</p></div><div><h3>Participants</h3><p>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.</p></div><div><h3>Interventions</h3><p>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.</p></div><div><h3>Outcome measures</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>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":"Diabetes predicts decreased quality of life among community-dwelling seniors undertaking progressive resistance exercise: an observational study","authors":"Kotaro Tamari","doi":"10.1016/S0004-9514(09)70082-0","DOIUrl":"10.1016/S0004-9514(09)70082-0","url":null,"abstract":"<div><h3>Question</h3><p>What baseline characteristics predict good or poor quality of life among community-dwelling seniors undertaking a three-month progressive resistance exercise program?</p></div><div><h3>Design</h3><p>A prospective cohort observational study.</p></div><div><h3>Participants</h3><p>63 Japanese men and women over 65 years with mild disability.</p></div><div><h3>Outcome measures</h3><p>Health-related quality of life was measured using the Short Form 36. Predictors included age, sex, body mass index, presence of chronic diseases, frequency of exercise, number of falls, and activity limitations measured before undertaking the exercise program.</p></div><div><h3>Results</h3><p>The presence of diabetes negatively predicted a good outcome (OR 0.20, 95% CI 0.05 to 0.88) and positively predicted a poor outcome (OR 4.40, 95% CI 1.21 to 18.86) when adjusted for age, sex and body mass index. The accuracy of the prediction of a good outcome was 1.25 (LR+) and 0.44 (LR−). The accuracy of the prediction of a poor outcome was 7.15 (LR+) and 0.87 (LR−).</p></div><div><h3>Conclusion</h3><p>The quality of life improved in a community-dwelling elderly population with mild disability who undertook a three-month group-based progressive resistance exercise program. However, those with diabetes mellitus were more likely to experience decreased quality of life. Therefore, health care providers need to monitor carefully participants with this disease who are undertaking progressive resistance exercise.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Pages 201-205"},"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)70082-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28340603","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":"Constraint-induced movement therapy after injection of Botulinum toxin improves spasticity and motor function in chronic stroke patients","authors":"Colleen G. Canning","doi":"10.1016/S0004-9514(09)70012-1","DOIUrl":"10.1016/S0004-9514(09)70012-1","url":null,"abstract":"<div><h3>Question</h3><p>Does injection of Botulinum toxin followed by constraint-induced movement therapy improve spasticity and upper limb motor function more than the same injection followed by rehabilitation based on neurodevelopmental techniques?</p></div><div><h3>Design</h3><p>Randomised trial with concealed allocation and blinded outcome assessment.</p></div><div><h3>Setting</h3><p>Rehabilitation department of a tertiary hospital in Taiwan.</p></div><div><h3>Participants</h3><p>Adults at least one year after a stroke with a Modified Ashworth Scale (MAS) score of 3 or more in the elbow, wrist, or finger flexors, and with at least 10 degrees of active interphalangeal and metacarpophalangeal extension and 20 degrees of wrist extension. Fixed contractures, major co-morbidities, and previous Botulinum toxin injection or surgery for spasticity were exclusion criteria. Randomisation of 32 participants allotted 16 to each group.</p></div><div><h3>Interventions</h3><p>Both groups received a total dose of 1000 units of Botulinum toxin type A, injected at standard muscular sites in the affected upper limb, and commenced their 3-month rehabilitation regimen the following day. The intervention group underwent intensive training of the affected upper limb for 2 hours, 3 times per week, while the non-affected upper limb was restrained for at least 5 hours per day. Selected tasks were progressed in complexity, with some assistance with movements and verbal feedback and encouragement. The control group received 1 hour each of physiotherapy and occupational therapy, 3 times per week. Therapy was based on neurodevelopmental techniques, focusing on normalising tone, and movement patterns.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was the MAS (0 = no spasticity, 4 = rigid in flexion or extension). Secondary outcomes included the Motor Activity Log (MAL), comprising two 6-point scales of amount of use and quality of movement, and the Action Research Arm Test (ARAT), which rates 19 tasks from 0 (no movement possible) to 3 (normal movement), to give a total score out of 57.</p></div><div><h3>Results</h3><p>29 participants completed the study. At 6 months, the treatment group had significantly greater reduction in MAS scores for the elbow (0.7, 95% CI 0.1 to 1.3), wrist (0.7, 95% CI 0.2 to 1.2), and fingers (1.2, 95% CI 0.9 to 1.5). Also at 6 months, the treatment group had significantly greater improvement in amount of use (1.1, 95% CI 0.8 to 1.4), quality of movement (0.9, 95% CI 0.6 to 1.2), and ARAT scores (7, 95% CI 4 to 10).</p></div><div><h3>Conclusion</h3><p>Injection of Botulinum toxin followed by constraint-induced movement therapy improves spasticity and upper limb motor function more than the same injection followed by rehabilitation based on neurodevelopmental techniques.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Page 286"},"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)70012-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28522541","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":"Hydrotherapy and Tai Chi each provide clinical improvements for older people with osteoarthritis","authors":"Shylie Mackintosh","doi":"10.1016/S0004-9514(08)70050-3","DOIUrl":"10.1016/S0004-9514(08)70050-3","url":null,"abstract":"<div><h3>Question</h3><p>For people with osteoarthritis of the hip or knee, do hydrotherapy or Tai Chi give worthwhile improvements in pain and physical function?</p></div><div><h3>Design</h3><p>Randomised, 3-arm, parallel, controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis.</p></div><div><h3>Setting</h3><p>Tertiary hospital, Sydney, Australia.</p></div><div><h3>Participants</h3><p>Adults aged 59–85 years, with osteoarthritis of the hip or knee meeting American College of Rheumatology criteria, recruited through advertisements, social clubs for older people, and referral from local general practitioners and rheumatologists. 55 participants were randomised to hydrotherapy, 56 to Tai Chi, and 41 to a control group.</p></div><div><h3>Interventions</h3><p>Participants in either of the two treatments groups were required to attend classes (max 15 participants) for one hour, twice per week for 12 weeks. Hydrotherapy involved lower limb exercise in waist-deep water, including walking, free-standing and bar work, running, and stairs. Tai Chi included a 10-minute warm-up followed by a modification of 24 forms of Sun style Tai Chi. Participants were allowed to purchase, if they desired, a Tai Chi video to assist with home practice. The control group were waitlisted for 12 weeks and then randomly allocated to one of the two treatments.</p></div><div><h3>Outcomes</h3><p>The primary outcomes were pain and physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included the SF-12 general health status questionnaire; the Depression, Anxiety and Stress Scale of psychological well being; the participant's global assessment of treatment effectiveness and current status of the joint that had originally been the most painful; and physical performance measures (50-foot walk test, stair climb test, and Up and Go test). Outcomes were assessed at the end of the 12-week treatment period, and 12 weeks later.</p></div><div><h3>Results</h3><p>At the end of treatment, pain had improved by 6 points (95% CI 0 to 13) more in the hydrotherapy group than the control group. Similarly, physical function had improved by 10 points (95% CI 4 to 14) more in the hydrotherapy group and by 10 points (95%CI 3 to 17) more in the Tai Chi group. The hydrotherapy group also showed significant treatment benefits in the physical component summary of the SF-12 and the three physical performance measures. Twelve weeks later, comparisons with a no-treatment control group were not possible, but the outcomes that had improved significantly during treatment had mostly been maintained.</p></div><div><h3>Conclusion</h3><p>Older people with osteoarthritis of the hip or knee can obtain clinically worthwhile improvements in physical function from hydrotherapy or Tai Chi.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"54 2","pages":"Page 143"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(08)70050-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27451799","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":"Physical activity by elderly patients undergoing inpatient rehabilitation is low: an observational study","authors":"Paul Smith ,&nbsp;Mary Galea ,&nbsp;Michael Woodward ,&nbsp;Catherine Said ,&nbsp;Michael Dorevitch","doi":"10.1016/S0004-9514(08)70028-X","DOIUrl":"10.1016/S0004-9514(08)70028-X","url":null,"abstract":"<div><h3>Question</h3><p>Are there differences in physical activity between older adults undergoing inpatient rehabilitation and those living in the community? Are there differences in physical activity within and between these two groups on weekdays compared to weekends? Are there differences in physical activity within and between these two groups over the day?</p></div><div><h3>Design</h3><p>An observational study.</p></div><div><h3>Participants</h3><p>Twenty-five elderly patients (aged 81 years) undergoing rehabilitation and 25 age- and gender-matched community-dwelling people (aged 80 years).</p></div><div><h3>Outcome measures</h3><p>The Positional Activity Logger was used to measure the frequency and duration of time spent upright (uptime), over three consecutive days, including a weekend day.</p></div><div><h3>Results</h3><p>The inpatient group achieved a median daily uptime of 1.3 hours which was significantly less than the community group's median of 5.5 hours (<em>p</em> &lt; 0.001). Uptime for inpatients was significantly greater on weekdays (1.6 hours) when therapy was available than on weekend days (1.1 hours) when therapy was generally not available (<em>p</em> &lt; 0.001), whereas uptime for community participants was no different on weekdays (5.9 hours) than on weekend days (4.8 hours) (<em>p</em> = 0.05). Median uptime was significantly less for the inpatient group than for the community group at all times of day (<em>p</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Elderly patients undergoing rehabilitation spend much of the day less physically active than their community peers.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"54 3","pages":"Pages 209-213"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(08)70028-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27612133","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 high-intensity lumbar extensor strengthening program is little better than a low-intensity program or a waiting list control group for chronic low back pain: a randomised clinical trial","authors":"Chris C. Harts ,&nbsp;Pieter H. Helmhout ,&nbsp;Rob A. de Bie ,&nbsp;J. Bart Staal","doi":"10.1016/S0004-9514(08)70062-X","DOIUrl":"10.1016/S0004-9514(08)70062-X","url":null,"abstract":"<div><h3>Question</h3><p>Is eight weeks of high-intensity strengthening of the isolated lumbar extensors more effective than low-intensity strengthening or no strengthening? Are any gains maintained 16 weeks later?</p></div><div><h3>Design</h3><p>Randomised, three-arm trial with concealed allocation, assessor blinding, and intention-to-treat-analysis. Participants in the waiting list control group were randomised again, after the first 8 weeks, to either the high-intensity or the low-intensity strengthening program.</p></div><div><h3>Participants</h3><p>Sixty-five army personnel with non-specific chronic low back pain.</p></div><div><h3>Intervention</h3><p>The high-intensity training group received 10 sessions of 15 to 20 repetitions for the isolated lumbar extensor muscles. The low-intensity training group received a nonprogressive, low-intensity resistance protocol.</p></div><div><h3>Outcome measures</h3><p>Primary outcomes were global perceived effect and disability. Secondary outcomes were health-related quality of life, fear of movement/(re-)injury, and isometric lumbar extensor muscle strength. Measures were taken before and after the training and 16 weeks later.</p></div><div><h3>Results</h3><p>At eight weeks, SF-36 overall score was on average 7% (95% CI 1 to 13) greater in the high-intensity training group compared with the low-intensity training group and the waiting list control group, and self-assessed decrease of back symptoms was on average 39% (95% CI 14 to 64) greater in the high-intensity training group compared with the waiting list control group. There was no difference in improvement between the groups for any other outcome at 8 weeks or 24 weeks.</p></div><div><h3>Conclusions</h3><p>Although some beneficial effects were found, the results of this high-intensity strengthening program of the isolated lumbar extensor muscles do not clearly support the generally-claimed beneficial influence of exercise for chronic non-specific low back pain.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"54 1","pages":"Pages 23-31"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(08)70062-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27285444","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":"Increasing intensity during treadmill walking does not adversely affect walking pattern or quality in newly-ambulating stroke patients: an experimental study","authors":"Suzanne S. Kuys ,&nbsp;Sandra G. Brauer ,&nbsp;Louise Ada ,&nbsp;Trevor G. Russell","doi":"10.1016/S0004-9514(08)70066-7","DOIUrl":"10.1016/S0004-9514(08)70066-7","url":null,"abstract":"<div><h3>Question</h3><p>Does walking on a treadmill at increasing intensities adversely affect walking pattern or reduce walking quality during treadmill walking? Are any changes influenced by walking ability?</p></div><div><h3>Design</h3><p>A within-participant, repeated measures experimental study.</p></div><div><h3>Participants</h3><p>18 individuals with a first stroke who were undergoing inpatient rehabilitation.</p></div><div><h3>Intervention</h3><p>Walking on a treadmill at intensities of 30%, 40%, 50% and 60% heart rate reserve in the one session.</p></div><div><h3>Outcome measures</h3><p>During treadmill walking practice, walking pattern was measured as linear and angular kinematics while walking quality was measured using the Rivermead Gait Analysis scale and a visual analogue scale.</p></div><div><h3>Results</h3><p>Walking on the treadmill at 60% heart rate reserve, step length of the paretic limb was 0.05 m (95% CI 0.01 to 0.10) longer, step length of the non-paretic limb was 0.09 m (95% CI 0.05 to 0.12) longer, and hip flexion at mid swing was 4 degrees (95% CI 1 to 6) greater than at 30% heart rate reserve. At 60% heart rate reserve, hip and knee extension at mid stance were respectively 3 and 4 degrees more flexed than at 30% heart rate reserve. Walking ability did not affect changes in walking pattern. Walking quality did not change with increasing treadmill intensity.</p></div><div><h3>Conclusion</h3><p>Walking on a treadmill at increasing intensity did not adversely affect walking pattern or reduce walking quality in newly-ambulating stroke patients. This study adds some support for the inclusion of walking on a treadmill at higher intensities in rehabilitation for newly-ambulating stroke patients.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"54 1","pages":"Pages 49-54"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(08)70066-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27285447","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":"NIPSV for acute cardiogenic pulmonary oedema does not increase the risk of myocardial infarction compared to CPAP","authors":"Josep Masip","doi":"10.1016/S0004-9514(08)70049-7","DOIUrl":"10.1016/S0004-9514(08)70049-7","url":null,"abstract":"<div><h3>Question</h3><p>Acute cardiogenic pulmonary oedema (ACPO) can be managed with either non-invasive pressure support ventilation (NIPSV) or non-invasive continuous positive airway pressure (CPAP). Does management with NIPSV increase the risk of myocardial infarction compared to management with CPAP?</p></div><div><h3>Design</h3><p>Randomised controlled trial with concealed allocation.</p></div><div><h3>Setting</h3><p>High-dependency unit of a hospital emergency department in Turin, Italy.</p></div><div><h3>Patients</h3><p>52 adults with severe ACPO, defined as acute dyspnoea, &gt; 30 breaths per minute, use of accessory respiratory muscles, oxygen saturation (SpO₂) &lt; 90% with F_iO₂ 60%, and radiological signs of ACPO. Patients with signs of acute coronary syndrome (ACS) on hospital admission were excluded from the study.</p></div><div><h3>Interventions</h3><p>All patients received standard medications (diuretic, nitroglycerin, morphine) and oxygen. NIPSV was applied by a Pulmonetics Systems LTV 1000 ventilator. CPAP was administered by means of a flow generator (Whisper-Flow) with an expiratory (PEEP) valve. Patients randomised to NIPSV (n = 25) received sufficient inspiratory pressure (IPAP) to generate a tidal volume of ∼7 mL/kg, and oxygen to maintain SpO₂ at ∼93%, via an oronasal mask. Expiratory pressure (EPAP) was gradually increased until SpO₂ ≥ 96% (maximum of 12 cmH₂O). Those randomised to CPAP (n = 27) commenced at 5 cmH₂O via an oronasal mask with oxygen to maintain SpO₂ at ∼93%. The CPAP was gradually increased until SpO₂ ≥ 96% (maximum of 12 cmH₂O). Treatment failure was defined as cardiac arrest, respiratory distress and arterial blood gas deterioration for &gt; 60 min, PaO₂/F_iO₂ &lt; 100 mmHg, coma or psychomotor agitation, haemodynamic instability, or life-threatening arrhythmias. Otherwise, treatment continued until the participant met objective criteria of recovery.</p></div><div><h3>Outcomes</h3><p>The primary outcome was the rate of acute myocardial infarction (AMI). Secondary outcomes included rate of endotracheal intubation, death, duration of ventilatory assistance, and lengths of stay in the hospital and high-dependency unit.</p></div><div><h3>Results</h3><p>In the NIPSV group, the average EPAP and IPAP applied were 7 ± 1 and 15 ± 3 cm H₂O, respectively. In the CPAP group, the mean pressure applied was 9 ± 2 cm H₂O. AMI occurred in four patients on NIPSV and eight patients on CPAP, which was not significantly different, absolute risk reduction (ARR) 0.14, 95% CI –0.10 to 0.34. Also not significantly different were the number of intubations with only one in the NIPSV group, ARR –0.04, 95% CI –0.20 to 0.09, and the number of deaths with three in the NIPSV group and two in the CPAP group, ARR –0.05, 95% CI –0.23 to 0.13. The lengths of stay in hospital an","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"54 2","pages":"Page 142"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(08)70049-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27451798","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":"Short-term progressive resistance exercise may not be effective at increasing wrist strength in people with tetraplegia: a randomised controlled trial","authors":"Joanne Glinsky ,&nbsp;Lisa Harvey ,&nbsp;Monique Korten ,&nbsp;Craig Drury ,&nbsp;Shane Chee ,&nbsp;Simon C. Gandevia","doi":"10.1016/S0004-9514(08)70043-6","DOIUrl":"10.1016/S0004-9514(08)70043-6","url":null,"abstract":"<div><h3>Questions</h3><p>Is an 8-week progressive resistance exercise program effective for increasing strength in the wrist muscles of people with tetraplegia? Is it effective for improving muscle endurance and participants’ perceptions about use of their hands for activities of daily living?</p></div><div><h3>Design</h3><p>Randomised controlled trial with concealed allocation, assessor blinding, and intentionto-treat analysis.</p></div><div><h3>Participants</h3><p>Thirty-two people with tetraplegia and neurological weakness of their wrist flexor or extensor muscles.</p></div><div><h3>Intervention</h3><p>The wrist muscles of one randomly-chosen hand were trained 3 times a week for 8 weeks. The control group received no intervention.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was strength measured as maximal voluntary isometric torque in Nm. The secondary outcomes were muscle endurance measured as fatigue resistance and participants’ perceptions about use of their hands using the Canadian Occupational Performance Measure.</p></div><div><h3>Results</h3><p>The mean effect on maximal voluntary isometric torque was 0.2 Nm (95% CI –0.5 to 0.8). This represents an 8% increase of mean initial strength; less than the 20% deemed clinically worthwhile at the commencement of the study. The mean effect on fatigue resistance was 0.1 (95% CI 0.0 to 0.2). The mean effect on participants’ perceptions of performance was –0.3 (95% CI –1.9 to 1.2) and satisfaction was –0.3 (95% CI –1.6 to 1.0).</p></div><div><h3>Conclusion</h3><p>The results indicate that progressive resistance exercise has no effect on participants’ perceptions about hand function. However, it is not yet clear whether progressive resistance exercise programs improve strength and endurance in muscles with neurologically-induced weakness following tetraplegia.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"54 2","pages":"Pages 103-108"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(08)70043-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27451883","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":"Exercise improves cancer-related fatigue","authors":"Margaret L. McNeely","doi":"10.1016/S0004-9514(08)70030-8","DOIUrl":"10.1016/S0004-9514(08)70030-8","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"54 3","pages":"Page 216"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(08)70030-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27710780","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}