Advances in physiotherapy最新文献

{"title":"A systematic review of the rehabilitation of LISS plate fixation of proximal tibial fractures","authors":"T. Smith, C. Hedges, K. Schankat","doi":"10.3109/14038190902906326","DOIUrl":"https://doi.org/10.3109/14038190902906326","url":null,"abstract":"Abstract This study aimed systematically to review the evidence-base to determine the optimal rehabilitation for patients following Less Invasive Stabilization System (LISS) plate fixation for proximal tibial fractures. The electronic databases AMED, Cinhal, Medline and EMBASE were reviewed from their inception to October 2008, sources of grey literature and a pertinent hand search of specialist orthopaedic and physiotherapy journals was undertaken. Study methodology was assessed using the Critical Appraisal Skills Programme (CASP) tool. A total of nine publications including 391 patients with 398 proximal tibial fractures after LISS management were reviewed. The results suggested that range of motion exercises have been commenced immediately post-operatively; braces and casts are sometimes used, particularly for patients with concomitant ligamentus injury; and weight-bearing status has been initially restricted as either non- or toe-touch. There did not appear to be a substantial difference in clinical, radiological outcomes or complication rates between differing exercise or weight-bearing protocols. The literature, however, exhibited numerous methodological weaknesses such as reviewing small, underpowered samples, and poorly detailing the physiotherapy strategies used. It is therefore recommended that randomized controlled trials are now undertaken to compare different post-operative rehabilitation programmes for patients following LISS fixation of proximal tibial fractures.","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"12 1","pages":"100 - 110"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038190902906326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69366295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rating body awareness in persons suffering from eating disorders – A cross-sectional study","authors":"U. Thörnborg, M. Mattsson","doi":"10.3109/14038190903220362","DOIUrl":"https://doi.org/10.3109/14038190903220362","url":null,"abstract":"Abstract In patients with eating disorders (ED) body awareness is of interest and the connection between body awareness and self-esteem has been discussed. The aim was to study the concordance of physiotherapist's (PT) observation and patient's own report of bodily expression in patients with ED. Characteristics of ED patients’ specific bodily expression and implications of the findings for clinical practice were also of interest. Two assessment scales were used, the Body Awareness Scale – Health (BAS-H), based on observations and the Interview Scale Body Ego (ISBE). Total scales and subscales were compared. Altogether 87 ED patients (Total Group, TG) were assessed. Twenty-six patients had anorexia nervosa (AN), 20 bulimia nervosa (BN) and 41 patients ED not otherwise specified (EDNOS). Significant correlations between total BAS-H and total ISBE (r = 0.48–0.57) were found for AN, EDNOS and TG groups. In the subscale centring, correlations were found for all groups (r = 0.42–0.60). In the subscale relations , correlations were found for AN, EDNOS and TG groups (r = 0.43–0.60). The ED patients were characterized by withheld breathing and restrictive expressions of body movements and emotions. Body awareness and self-awareness seemed to be reduced. Body Awareness Therapy might well be offered as a therapeutic tool in establishing a realistic body image.","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"12 1","pages":"24 - 34"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038190903220362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69366697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing behavioural medicine in physiotherapy treatment. Part II: Adherence to treatment protocol","authors":"M. Sandborgh, P. Åsenlöf, P. Lindberg, E. Denison","doi":"10.3109/14038190903480672","DOIUrl":"https://doi.org/10.3109/14038190903480672","url":null,"abstract":"Abstract Objectives: In a controlled clinical trial, targeted and tailored treatment strategies, based on cognitive–behavioural treatment principles were investigated. The intervention was aimed at patients with persistent musculoskeletal pain in primary healthcare. A preliminary examination indicated low treatment integrity for the tailored treatment. Therefore, the aim in this study was to evaluate physiotherapists' treatment adherence to a treatment tailored to physical, cognitive and behavioural factors of importance for the performance of patients' prioritized activities. Explorative study, Part II. Materials and Methods: Treatment documents for 18 patients, treated by four specially trained physiotherapists, were utilized for assessment of treatment adherence. A treatment integrity measure was developed, tested and used for evaluation of adherence to the treatment protocol. Results: Physiotherapists' adherence to the treatment manual was low concerning treatment components and the overall sequencing of the treatment. Intrapersonal physical and cognitive factors, and situational variations tied to the performance of prioritized activities targeted in treatment, were rarely found or specified in treatment documents. Statements about functional and causal relationships between determinants for activity performance were not documented or unspecified. Conclusion: The physiotherapists' adherence to the treatment protocol was low despite the pre-intervention training programme and supervision during the intervention period.","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"24 1","pages":"13 - 23"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038190903480672","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69366630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Awareness Rating Questionnaire – Development of a self-administered questionnaire for patients with long-lasting musculoskeletal and psychosomatic disorders","authors":"Tove Dragesund, A. Ljunggren, A. Kvåle, L. Strand","doi":"10.3109/14038191003706545","DOIUrl":"https://doi.org/10.3109/14038191003706545","url":null,"abstract":"Abstract Body awareness is an essential focus when physiotherapists treat patients with musculoskeletal and psychosomatic disorders and is important in such treatment as Norwegian Psychomotor Physiotherapy (NPMP). The purpose of this study was to develop a self-administered questionnaire to capture body awareness as defined within NPMP. A pool of 66 items reflecting aspects of body awareness was developed based on suggestions from NPMP specialists and patients. A sample of 300 persons scored each item on a 7-point Likert scale. Internal consistency was examined by Cronbach's α test, and by exploratory factor analysis (EFA). The α test resulted in a reduction of 21 items. EFA of the remaining 45 items demonstrated four factors that were named Function, Mood, Feelings and Awareness. Six items with the highest loadings within each of the sub-scales were maintained, leading to a 24-item questionnaire called the Body Awareness Rating Questionnaire (BARQ). Unidimensionality was satisfactory for the whole questionnaire (α=0.78) as well as for the sub-scales. Evidence for satisfactory internal consistency of BARQ was demonstrated but measurement properties like construct validity and reliability should also be demonstrated before BARQ can be recommended for clinical use.","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"12 1","pages":"87 - 94"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038191003706545","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69367483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioural medicine in healthcare and in physiotherapy","authors":"G. Sundelin","doi":"10.3109/14038191003675674","DOIUrl":"https://doi.org/10.3109/14038191003675674","url":null,"abstract":"Physical activity is today considered by healthcare professionals an effective complement or alternative for medical treatment. A crucial problem, however, is the poor patient compliance to advice about physical activity. When considering human movement from a behavioural medicine perspective, the focus is on what people do, think and feel. An integrated physiotherapy and behavioural medicine approach therefore implies that cognitions, emotions, physical and social environment are as important as physical prerequisites for movement behaviour. During the last decade, the behavioural medicine perspective in physiotherapy has been developed in clinical intervention studies. So far, most studies concern patients with musculoskeletal pain, e.g. low-back pain (1), whiplash-associated disorders (2) and musculoskeletal pain (3). These studies, with treatment individually tailored to patients’ problems and aiming to change patients’ behaviour, show an encouraging positive outcome trend. Reduced disability, fear-avoidance as well as increased pain control and perceived ability to manage future activities, have been found. At present, studies are needed to investigate long-term cost-effectiveness of physiotherapy with a behavioural medicine approach. Interestingly, in one high-quality study, costs were compared between orthopaedic manual therapy and a rehabilitation programme with cognitive–behavioural approach mostly delivered by physiotherapists. In a 7-year follow-up, the patients in the rehabilitation programme had reduced sickness absence, whereas sickness absence had increased in the manual therapy group (4). From a health economics point of view, it is time to think carefully where to invest the decreasing economical and human resources in healthcare. A behavioural change approach to patients presupposes a behavioural change also in physiotherapists (5). By studying the physiotherapists’ adherence to a treatment protocol in a randomized controlled trial, Sandborgh and her co-workers contribute in this issue with two papers to this new area of research. The implementation process of a behavioural medicine approach in physiotherapy necessitates further studies and constitutes a challenge for both clinicians and researchers. Further contributions in this issue are studies on Body Awareness Therapy in persons suffering from eating disorders, by Thörnborg and Mattsson, and on gender perspective on physiotherapy treatment in patients with neck and back pain, by Stenberg and Ahlgren. In a qualitative study, Olofsson and coworkers illuminate athletes’ experiences of their injury, rehabilitation and recovery after anterior cruciate ligament repair, and Thelandersson and coworkers present how systemic and haemodynamic parameters react to passive exercise. Enberg and coworkers demonstrate two occupational stress models to analyse work experiences of novice occupational therapists and physiotherapists in public sector employment. A book review on Chronic pain. P","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"12 1","pages":"1 - 1"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038191003675674","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69367127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From loss towards restoration: Experiences from anterior cruciate ligament injury","authors":"L. Olofsson, A. Fjellman-Wiklund, K. Söderman","doi":"10.3109/14038190903165120","DOIUrl":"https://doi.org/10.3109/14038190903165120","url":null,"abstract":"Abstract The objective of this study was to illuminate anterior cruciate ligament (ACL)-reconstructed athletes’ experience of their injury, rehabilitation and recovery. Seven persons, aged 19–57 years, were interviewed on one occasion in autumn 2004, between 10 and 31 months after the ACL reconstruction. They were selected to reach a maximum variation sample according to gender, age, activity level, time between injury and ACL reconstruction and time between surgery and the interview. The analyses were carried out using the Grounded Theory method of constant comparison. One core category “From loss towards restored belief in one's ability” and three categories emerged. The core category represents the process starting when the informants were injured. The process contained phases that interacted with each other but more importantly were drawn out over a long period, especially the mental recovery. The informants used different procedures to manage situations that arose and strived towards restored belief in their ability. This study illuminates the complexity of the recovery process. The patients’ belief in their own ability took a long time to restore. It is important for physiotherapists to understand what patients with ACL injuries need while waiting for surgery. The process of rehabilitation can further equip people with the means to manage problems that can arise and help to strengthen their belief in their ability, as well as helping them with physical training.","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"12 1","pages":"50 - 57"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038190903165120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69366904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrovascular and systemic haemodynamic parameters during passive exercise","authors":"Anneli Thelandersson, Å. Cider, R. Volkmann","doi":"10.3109/14038191003615332","DOIUrl":"https://doi.org/10.3109/14038191003615332","url":null,"abstract":"Abstract Passive range of motion exercises (PROM) are often used in immobilized patients but are scarcely investigated. The aim of this study was therefore to investigate the safety of PROM with respect to intracranial, cerebrovascular and systemic haemodynamic parameters in critically ill patients at a neurosurgical intensive care unit (NICU). Twelve consecutively enrolled NICU patients underwent monitoring of their intracranial (ICP) and systemic blood pressures (BP), heart rate, cerebral blood flow velocities (CBFV) and pulsatility index (PI) during PROM treatment. Cerebral perfusion pressure (CPP) was calculated. For comparison, 12 healthy age- and gender-matched controls underwent similar testing except for ICP and CPP assessments. Patients had a lower ICP after PROM (p=0.006) but unaffected BP. Control subjects had lower BP during and after PROM (p=0.01). CBFV data and PI remained unchanged during PROM in both patients and controls, but with a significantly higher PI in the patient group than the controls. PROM can safely be used in critically ill NICU patients.","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"45 13 1","pages":"58 - 63"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038191003615332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69366967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing behavioural medicine in physiotherapy treatment. Part I: Clinical trial","authors":"M. Sandborgh, P. Lindberg, P. Åsenlöf, E. Denison","doi":"10.3109/14038190903480664","DOIUrl":"https://doi.org/10.3109/14038190903480664","url":null,"abstract":"Abstract Objective: To investigate the capacity of the Pain Belief Screening Instrument (PBSI) to discriminate between subgroups for targeting of treatment, investigate effects of treatment tailored to patients' individual and functional goals, and identify a suitable treatment dosage for patients with low risk of disability. Explorative study, Part I. Design: Randomized, controlled clinical trial with four treatment conditions. Methods: Patients in primary healthcare (n=45) with musculoskeletal pain for ≥4 weeks were included. PBSI-identified subgroups were validated by comparing scores on four established instruments. Measures of disability and patients' ratings of global outcome were used to examine treatment effect. Results: PBSI data adequately defined patients with either high or low risk of disability. Patients in the tailored treatment rated global outcome as better than in the non-tailored treatment. No differences were found on disability measures. For the low-risk group, the brief tailored treatment was as effective as the non-targeted control treatment. Conclusion: The PBSI adequately defined subgroups. Tailored treatment was partially superior to physical exercise treatment. Targeting by treatment dosage was effective for low-risk patients but remains to be investigated for high-risk patients. Treatment integrity for tailored treatments was compromised and is to be further explored in the following study.","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"12 1","pages":"12 - 2"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038190903480664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69366573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter- and intra-tester reliability of selected clinical tests in examining patients with early phase lumbar spine and sacroiliac joint pain and dysfunction","authors":"M. Paatelma, E. Karvonen, A. Heinonen","doi":"10.3109/14038190903582154","DOIUrl":"https://doi.org/10.3109/14038190903582154","url":null,"abstract":"Abstract Of all patients with low back pain (LBP), 85% are diagnosed as “non-specific lumbar pain”. It has been postulated that the only reliable test is a straight leg raise test for detecting sciatic pain, and for other diagnostic subgroups, tests are of varying value. Only a few standardized tests exist to test function, inspection, mobility, pain, muscle flexibility or stability for patients with early phase lumbar spine and sacroiliac joint pain and dysfunction in the non-laboratory setting. The aim of this study was therefore to examine the inter- and intra-tester reliability of selected standardized clinical tests. Fifteen eligible, consecutive and voluntary LBP patients (aged 18–56 years), whose pain had lasted less than 3 months were recruited by an invitation letter. Patients were examined by two physiotherapists specialized in orthopaedic manual therapy. These PTs examined the same patients at a 1-week interval, changing the examination order at the second session. The assessment consisted of seven categories: history, observation of posture, function of low back and lower extremities, stability tests, pain provocation and mobility tests, neurological and neurodynamic tests, and tests of muscle tightness. In analysing these seven test categories, the mean inter-tester kappa was 0.5 (95% CI –0.05 to 1.20) and intra-tester kappa 0.6 (95% CI –0.40 to 1.28). Overall inter- and intra-tester reliability was at an acceptable level, except for the inspection test category, where agreement was poor. However, the reliability of individual tests ranged from poor to very good. In conclusion, when assessing LBP patients in the early phase (<12-week duration), reliability of one or more tests were acceptable on a group level with inter- and intra-tester reliability in every test category. However, our results need confirmation in a larger sample, especially when this great number of examination findings is tested, to reduce the likelihood of spurious findings.","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"12 1","pages":"74 - 80"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038190903582154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69366956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of early physiotherapy after an acute ankle sprain","authors":"Kristi Hultman, A. Fältström, U. Öberg","doi":"10.3109/14038190903174262","DOIUrl":"https://doi.org/10.3109/14038190903174262","url":null,"abstract":"Abstract Ankle sprain is one of the most common injuries treated in emergency departments (ED). In clinical practice, these injuries are expected to heal by themselves, often without any treatment other than short information about the RICE regime (rest, ice, compression and elevation). Still, remaining symptoms are reported to occur in 30% of the cases. The aim of this study was to evaluate the effect of early physiotherapy intervention after an acute ankle sprain. Sixty-five patients were recruited from the ED at a general hospital in Sweden (mean age = 35 years; 30 women), and allocated into an intervention group with early physiotherapy or a control group. Both groups were evaluated 6 weeks and 3 months after their injury. As primary outcome, the disease-specific Foot and Ankle Outcome Score (FAOS) was used. The patients also rated their physical activity ability and how satisfied they were with their ankle on a visual analogue scale (VAS). The intervention group made significant improvements compared with the control group at both evaluations measured with FAOS and the VAS questions. These findings indicate that early physiotherapy intervention has a positive effect on patient-focused foot and ankle function after an acute ankle sprain.","PeriodicalId":87870,"journal":{"name":"Advances in physiotherapy","volume":"95 1","pages":"65 - 73"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14038190903174262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69366920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}