MedWorm: Physiotherapy

Pocket Physio app launched for knee surgery patients

Hospital IT Europe — Wed, 08 Feb 2012 13:26:00 +0100

First physiotherapy app designed by orthopaedic provider to help improve patients’ recoveries (Source: Hospital IT Europe)

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Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review

European Spine Journal — Mon, 06 Feb 2012 19:37:05 +0100

Conclusions Based on these findings, the level of evidence for the association between PPGP and relaxin levels was found to be low. PPGP assessment and controlling for risk factors were found to increase bias leaving uncertainty in interpretation of these findings and a need for further research. Content Type Journal ArticleCategory Review ArticlePages 1-8DOI 10.1007/s00586-012-2162-xAuthors Daniela Aldabe, School of Physical Education, University of Otago, 56 Union Street, Dunedin, 9016 New ZealandDaniel Cury Ribeiro, Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin, 9016 New ZealandStephan Milosavljevic, Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, 325 Great King Str...

Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence

BMC Medical Informatics and Decision Making - Latest articles — Mon, 06 Feb 2012 05:00:00 +0100

The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n=5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus - semi-interquartile range (SIQR) (Source: BMC Medical Informatics and Decision Making - Latest articles)

Alternative model of birth to reduce the risk of assisted vaginal delivery and perineal trauma

International Urogynecology Journal — Wed, 01 Feb 2012 17:14:21 +0100

Conclusion A combination of postural changes during the passive expulsive phase of labor and lateral position during active pushing time is associated with reductions in AVD and PT. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00192-012-1675-5Authors Carolina Walker, Department of Physiotherapy, European University of Madrid, c/ Villaviciosa de Odón s/n, 28260 Madrid, SpainTania Rodríguez, Department of Physiotherapy, European University of Madrid, c/ Villaviciosa de Odón s/n, 28260 Madrid, SpainAna Herranz, Department of Obstetrics and Gynecology, La Paz University Hospital, Madrid, SpainJosé A. Espinosa, Department of Obstetrics and Gynecology, Quiron University Hospital, Madrid, SpainEmília Sánchez, Blanquerna School of Health S...

Randomized controlled trial of a new portable calf compression device (Venowave) for prevention of venous thrombosis in high‐risk neurosurgical patients

Journal of Thrombosis and Haemostasis — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Venowave devices are effective in preventing VTE in high‐risk neurosurgical patients. (Source: Journal of Thrombosis and Haemostasis)

Short-Term Effect of Superficial Heat Treatment on Paraspinal Muscle Activity, Stature Recovery, and Psychological Factors in Patients With Chronic Low Back Pain

Archives of Physical Medicine and Rehabilitation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Use of the heat wrap was associated with a decrease in muscle activity and a short-term improvement in certain aspects of well-being for the CLBP patients. The results confirm the link between the biomechanical and psychological outcome measures. (Source: Archives of Physical Medicine and Rehabilitation)

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Answer to the letter to the editor of Srijit Das et al. doi:10.1007/s00586-012-2165-7

European Spine Journal — Tue, 31 Jan 2012 07:05:28 +0100

Content Type Journal ArticleCategory Letter to the editorPages 1-2DOI 10.1007/s00586-012-2166-6Authors Dariusz Czaprowski, Faculty of Physiotherapy, Józef Rusiecki University College in Olsztyn, Bydgoska 33, 10-243 Olsztyn, PolandTomasz Kotwicki, Department of Pediatric Orthopedics and Traumatology, University of Medical Sciences in Poznań, 28th June 1958 no. 135, 61-545 Poznań, Poland Journal European Spine JournalOnline ISSN 1432-0932Print ISSN 0940-6719 (Source: European Spine Journal)

Cervical radiculopathy: Study protocol of a randomised clinical trial evaluating the effect of mobilisations and exercises targeting the opening of intervertebral foramen [NCT01500044]

BMC Musculoskeletal Disorders — Tue, 31 Jan 2012 05:00:00 +0100

This study is a double-blind (participants and evaluators blinded) randomised clinical trial that will allow the comparison of patients with a cervical radiculopathy randomly assigned to one of two groups: one group will receive a 4-week rehabilitation program targeting the opening of intervertebral foramen, and the second group will receive a 4-week conventional rehabilitation program. Thirty-six subjects with cervical radiculopathy will be recruited from participating medical and physiotherapy clinics and will be evaluated at baseline, at the end of the 4-week program and four weeks following the end of the program. The primary outcome measure will be the validated Neck Disability Index questionnaire. Secondary outcome measures will include the short version of the Disabilities of the Ar...

Body Awareness Rating Questionnaire: Measurement properties.

Physiotherapy Theory and Practice — Mon, 30 Jan 2012 05:00:00 +0100

Authors: Dragesund T, Råheim M, Strand LI Abstract The purpose of present study was to investigate important measurement properties of the Body Awareness Rating Questionnaire (BARQ) subscales: Function; Mood; Feelings; and Awareness. Samples of 50 patients with prolonged musculoskeletal pain and psychosomatic disorders, and 50 gender and age-matched healthy persons participated in the study. Relative (ICC 2,1) and absolute reliability (S(w)) were calculated. Construct validity was examined by testing hypothesis using Pearson (r) or Spearman rank (r(s)) correlation. Discriminate ability was examined using a receiver operating characteristic (ROC) curve, the area under the curve (aROC) being the measure of discriminative validity. All patients reported more or less improvement after...

Vaginal weights for pelvic floor training: A multiple participant case report.

Physiotherapy Theory and Practice — Mon, 30 Jan 2012 05:00:00 +0100

Authors: Perkins J, Johnson CM Abstract Activity-related incontinence is a problem for women, many with limited access to specialty clinics and practitioners. Incontinence inhibits participation in health-promoting levels of physical activity. Vaginal weights are a treatment option available without a prescription for home use that may help some of these women. This multiple baseline across-participant case study investigated the use of weights in a 'hands-off' pelvic floor exercise program for pre-menopausal women. Three of four participants improved, but did not cure, their incontinence with use of the weights. A fourth participant was unable to successfully use the weights. Referral to a women's health physical therapist was suggested for her. Poor adherence was noted at follow-...

Translation and validation of the Swedish version of the mini-BESTest in subjects with Parkinson's disease or stroke: A pilot study.

Physiotherapy Theory and Practice — Mon, 30 Jan 2012 05:00:00 +0100

This study aimed to translate the mini-BESTest to Swedish, adapt it and investigate its validity in subjects with Parkinson's disease (PD) or stroke. The Mini-BESTest was translated and back-translated in accordance with Guillemin's guidelines. Discrepancies were discussed and solved by a panel and the test was culturally adapted. Concurrent validity of the final version was explored by correlating well-known clinical tests - the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test and the Falls Efficacy Scale (FES(s)) - with the new mini-BESTest in nine subjects with mild-to-moderate PD (60 years, range 46-85) and nine with chronic stroke (78 years, range 66-90). A high-to-very-high correlation was shown between the mini-BESTest and the BBS (PD: r(s) = 0.94, stroke: r(s) = 0.8...

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Insights from a physiotherapist's lived experience of osteoarthritis.

Physiotherapy Theory and Practice — Mon, 30 Jan 2012 05:00:00 +0100

Authors: Smythe E, Larmer PJ, McNair PJ Abstract Osteoarthritis (OA) of a hip joint, with subsequent total hip joint replacement surgery, is portrayed in the literature in terms of quantitative research studies, where the person living with the hip disappears in objective statistical analyses, or in qualitative studies where one person's story is fragmented within thematic findings. This phenomenological study of a physiotherapist's (Peter) lived experience of OA offers insights relevant to practice. In the initial stages of the disease, Peter was too close to 'see' the possibility of OA as a diagnosis. As the pain limited what he could do, he needed to reinvent ways of retaining his sense of 'self'. The pain worsened; there was nothing that relieved it. The experience became one o...

Rehabilitation of a patient with 'floating shoulder' and associated fractures: A case report.

Physiotherapy Theory and Practice — Mon, 30 Jan 2012 05:00:00 +0100

Discussion: The patient achieved a favorable outcome, in spite of having a long-duration wound infection and a second surgery for hardware removal. Further research should identify the optimal rehabilitation progression for patients with this type of surgery. PMID: 22288656 [PubMed - as supplied by publisher] (Source: Physiotherapy Theory and Practice)

Guidelines for the management of accidental tetanus in adult patients

Revista Brasileira de Terapia Intensiva — Fri, 27 Jan 2012 15:57:11 +0100

O tétano acidental, a despeito de ser uma doença prevenível por imunização, ainda é frequente nos países subdesenvolvidos e em desenvolvimento. Sua letalidade ainda é elevada e os estudos sobre a melhor forma de tratamento são escassos. Tendo em vista esta escassez e a importância clínica dessa doença, um grupo de especialistas reunidos pela Associação de Medicina Intensiva Brasileira (AMIB), desenvolveu recomendações baseadas na melhor evidencia disponível para o manejo do tétano no paciente necessitando cuidados intensivos. As recomendações incluem aspectos relativos à admissão do paciente tetânico na unidade de terapia intensiva, tratamento com imunoglobulinas, tratamento antibiótico, manejo da analgossedação e bloqueio neuromuscular, manejo da disautonomia e e...

Early intervention for adolescents with Patellofemoral Pain Syndrome - a pragmatic cluster randomised controlled trial.

BMC Musculoskeletal Disorders — Fri, 27 Jan 2012 05:00:00 +0100

This study is a single blind pragmatic cluster randomised controlled trial. Four upper secondary schools have been invited to participate in the study (approximately 2500 students, aged 15-19 years). Students are asked to answer an online questionnaire regarding musculoskeletal pain. The students who report knee pain are contacted by telephone and offered a clinical examination by a rheumatologist. Subjects who fit the inclusion criteria and are diagnosed with PFPS are invited to participate in the study. A minimum of 102 students with PFPS are then cluster-randomised into two intervention groups based on which school they attend. Both intervention groups receive written information and education. In addition to patient education, one group receives multimodal physiotherapy consisting prim...

Detainees tortured and denied medical care

MSF News — Thu, 26 Jan 2012 14:59:00 +0100

Detainees in the Libyan city of Misrata are being tortured and denied urgent medical care, leading Médecins Sans Frontières (MSF) to suspend its operations in detention centres in Misrata, MSF said today. MSF teams began working in Misrata’s detention centres in August, 2011, to treat war-wounded detainees. Since then, MSF doctors were increasingly confronted with patients who suffered injuries caused by torture during interrogation sessions. The interrogations were held outside the detention centres. In total, MSF treated 115 people who had torture-related wounds and reported all the cases to the relevant authorities in Misrata. Since January, several of the patients returned to interrogation centres have even been tortured again. Libya © Benoît Finck/MSF MSF staff during physio...

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The aerobic performance of trained and untrained handcyclists with spinal cord injury

European Journal of Applied Physiology — Wed, 25 Jan 2012 18:12:25 +0100

Abstract The purpose of this study was to compare the cardiorespiratory response and mechanical efficiency (ME) of highly trained spinal cord injured (SCI) handcyclists with untrained SCI men. Ten trained handcyclists (≥2 years training) and ten untrained but physically active SCI men completed an incremental exercise test to exhaustion and a sub-maximal test (50 and 80 W) on an electromagnetically braked arm ergometer. The trained participants completed a questionnaire on their training and race performance over the past year, including average training volume (in kilometers), number of training sessions per week and best 20-km time trial. The trained SCI men had higher × V \textO\user22 peak, peak power (p ≤ 0.001) and peak ...

Physical capacity of girls with mild and moderate idiopathic scoliosis: influence of the size, length and number of curvatures (Czaprowski et al.)

European Spine Journal — Wed, 25 Jan 2012 06:53:23 +0100

Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00586-012-2165-7Authors Vijayakumar Palaniswamy, Physiotherapy Programme, School of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, 50300 Kuala Lumpur, MalaysiaSrijit Das, Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, 50300 Kuala Lumpur, Malaysia Journal European Spine JournalOnline ISSN 1432-0932Print ISSN 0940-6719 (Source: European Spine Journal)

Physical Therapy Intervention Studies on Idiopathic Scoliosis - Review with the focus on Inclusion Criteria *

Scoliosis — Wed, 25 Jan 2012 05:00:00 +0100

Conclusion: There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive in adults or in adolescents followed from premenarchial status until skeletal maturity. However, papers on bracing are more frequently found and bracing can be regarded as evidence-based in the conservative management and rehabilitation of idiopathic scoliosis in adolescents. (Source: Scoliosis)

The influence of endurance exercise on the antioxidative status of human skin

European Journal of Applied Physiology — Tue, 24 Jan 2012 07:33:12 +0100

Abstract Oxidative stress is supposed to be responsible for a diversity of diseases. For protection purposes, the human organism exhibits a line-up of antioxidant substances functioning as radical catchers. As a result of neutralization of free radicals, antioxidants are destroyed. Therefore, the degradation of the antioxidants can be utilized as an indirect parameter for the measurement of free radical formation. As physical exercise may also induce oxidative stress, the aim of the present study was to determine the antioxidant substances, and more precisely, the carotenoid concentration in the skin of male volunteers during different sportive exposures (cycling and running with two different exercise intensities) with resonance Raman spectroscopic measurements. The resul...

Virtual reality in the rehabilitation of the arm after hemiplegic stroke: a randomized controlled pilot study.

Clinical Rehabilitation — Tue, 24 Jan 2012 05:00:00 +0100

Conclusion: A randomized controlled trial of virtual reality-mediated therapy comparable to conventional therapy would be feasible, with some suggested improvements in recruitment and outcome measures. Seventy-eight participants (39 per group) would be required for a main trial. PMID: 22275463 [PubMed - as supplied by publisher] (Source: Clinical Rehabilitation)

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[Chest physiotherapy and bronchiolitis in the hospitalised infant. Double-blind clinical trial.]

Anales de Pediatria — Tue, 24 Jan 2012 05:00:00 +0100

CONCLUSIONS: Results show that chest physiotherapy has not been effective in reducing hospital stay or length of oxygentherapy in patients with acute bronchiolitis, but in the positive study of children with respiratory syncytial virus in nasopharyngeal aspirate showed a reduced need hours of oxygen. hours (P=.042). PMID: 22281403 [PubMed - as supplied by publisher] (Source: Anales de Pediatria)

Comparison of embedded and added motor imagery training in patients after stroke: results of a randomised controlled pilot trial

Trials — Mon, 23 Jan 2012 05:00:00 +0100

Background: Motor imagery (MI) when combined with physiotherapy can offer functional benefits after stroke. Two MI integration strategies exist: added and embedded MI. Both approaches were compared when learning a complex motor task (MT): 'Going down, laying on the floor, and getting up again'. Methods: Outpatients after first stroke participated in a single-blinded, randomised controlled trial with MI embedded into physiotherapy (EG1), MI added to physiotherapy (EG2), and a control group (CG). All groups participated in six physiotherapy sessions. Primary study outcome was time (sec) to perform the motor task at pre and post-intervention. Secondary outcomes: level of help needed, stages of MT-completion, independence, balance, fear of falling (FOF), MI ability. Data were collected four ti...

Inversion therapy in patients with pure single level lumbar discogenic disease: a pilot randomized trial.

Disability and Rehabilitation — Mon, 23 Jan 2012 05:00:00 +0100

Conclusion: Intermittent traction with an inversion device resulted in a significant reduction in the need for surgery. A larger multicentre prospective randomized controlled trial is justified in patients with sciatica due to single level lumbar disc protrusions. [Box: see text]. PMID: 22263648 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)

Editorial Board

Physiotherapy — Sat, 21 Jan 2012 20:56:10 +0100

(Source: Physiotherapy)

Texting, Talking on Cellphone Slows Walking Pace: Study

The Doctors Lounge - Neurology — Sat, 21 Jan 2012 15:00:00 +0100

Findings may shed light on ways to improve functional walking in physical therapy patients (Source: The Doctors Lounge - Neurology)

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Enhancing meaningful learning and self‐efficacy through collaboration between dental hygienist and physiotherapist students – a scholarship project

International Journal of Dental Hygiene — Fri, 20 Jan 2012 16:15:03 +0100

Conclusion: The scholarship model made the teachers aware of the importance of evidence‐based teaching. Furthermore, the indicators for meaningful learning and increased self‐efficacy were high, and the students became more engaged by practising in a real situation, more aware of other health professions and reflected about tacit knowledge. (Source: International Journal of Dental Hygiene)

Changes in microcirculation of the trapezius muscle during a prolonged computer task

European Journal of Applied Physiology — Fri, 20 Jan 2012 07:05:31 +0100

Abstract The aim of this study is to investigate if there is a change in oxygen saturation and blood flow in the different parts of the trapezius muscle in office workers with and without trapezius myalgia during a standardized computer task. Twenty right-handed office workers participated; ten were recruited based on pain in the trapezius and ten as matching controls. Subjects performed a combination of typing and mousing tasks for 60 min at a standardized workstation. Muscle tissue oxygenation and blood flow data were collected from the upper trapezius (UT), the middle trapezius (MT) and the lower trapezius (LT), both on the left and right side at seven moments (at baseline and every tenth minute during the 1-h typing task) by use of the oxygen to see device. In all...

2011 SOSORT Guidelines: Orthopaedic and Rehabilitation Treatment of Idiopathic Scoliosis During Growth

Scoliosis — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion: These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas using a scientific method. According to results, it is possible to understand the lack of research in general on CTIS. SOSORT invites researchers to join, and clinicians to develop good research strategies to allow in the future to support or refute these recommendations according to new and stronger evidence. (Source: Scoliosis)

Targeted treatment in primary care for low back pain: the treatment system and clinical training programmes used in the IMPaCT Back study (ISRCTN 55174281)

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Discussion. This paper describes in detail the IMPaCT Back study’s subgrouping for targeted treatment system and the training and mentoring packages aimed at equipping clinicians to deliver it, within the IMPaCT Back study. Study registration. ISRCTN55174281. (Source: Family Practice)

Analysis of symptoms, clinical signs and oxygen support in patients with bronchiolitis before and after chest physiotherapy during hospitalization

Revista Paulista de Pediatria — Wed, 18 Jan 2012 06:37:28 +0100

OBJETIVO:Avaliar os efeitos da fisioterapia em pacientes pediátricos, internados com bronquiolite. MÉTODOS:O estudo incluiu 29 pacientes menores de um ano, com diagnóstico médico de bronquiolite aguda, sem cardiopatia congênita não corrigida, neuropatia, doença pulmonar de base ou que necessitassem de suporte ventilatório, no período de março a julho de 2009. Foi avaliada, por meio de questionário, a opinião dos pais ou responsáveis acerca das condições clínicas do paciente antes e após a primeira sessão de fisioterapia. Foram realizadas manobras de desobstrução brônquica, como drenagem postural, tapotagem, vibração, aceleração de fluxo expiratório e aspiração nasotraqueal. A avaliação foi realizada diariamente por meio de exame físico antes do atendimento fi...

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Respiratory therapy in children with sickle cell disease and acute chest syndrome

Revista Paulista de Pediatria — Wed, 18 Jan 2012 06:37:28 +0100

CONCLUSIONS: Physiotherapy techniques with incentive spirometry device, positive expiratory pressure and non-invasive ventilation can be performed in children with sickle cell disease and acute chest syndrome, with a C recommendation level. (Source: Revista Paulista de Pediatria)

Bobath Concept versus constraint-induced movement therapy to improve arm functional recovery in stroke patients: a randomized controlled trial.

Clinical Rehabilitation — Wed, 18 Jan 2012 05:00:00 +0100

Conclusions: Constraint-induced movement therapy and the Bobath Concept have similar efficiencies in improving functional ability, speed and quality of movement in the paretic arm among stroke patients with a high level of function. Constraint-induced movement therapy seems to be slightly more efficient than the Bobath Concept in improving the amount and quality of affected arm use. PMID: 22257503 [PubMed - as supplied by publisher] (Source: Clinical Rehabilitation)

Electromyographic analysis of anterior temporalis and superficial masseter muscles in mandibular angle fractures—a pilot study

Oral and Maxillofacial Surgery — Tue, 17 Jan 2012 07:07:48 +0100

Discussion Electrodiagnostic testing is a potentially valuable tool for the management of patients who have suffered craniomaxillofacial trauma. Electromyography is being employed in clinical practice, and allows the inclusion of quantitative data on the qualitative aspects of a diagnosis. These data are often of significant importance in the correct management of therapy and patient follow-up, particularly if the subject is at risk of developing a different and/or more serious disease. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s10006-012-0312-2Authors Saurab Bither, Christian Dental College, Brown Road, Ludhiana, IndiaUma Mahindra, Rural Dental College, Pravara Medical Trust, Loni Bk., Maharashtra, IndiaRajshekhar Halli, Bharti Vidy...

Tracheostomy in the Critically Ill: Does It Change Respiratory Dynamics?

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:59 +0100

Conclusions: There is no significant difference in respiratory physiology or dead space with tracheostomy compared to endotracheal tube. the benefits of tracheostomy are likely secondary to increased patient comfort, decreased sedation and ability to participate in lung physiotherapy. (Source: Journal of Surgical Research)

Osteoarthritis year in review: rehabilitation and outcomes.

Rural Remote Health — Sat, 14 Jan 2012 05:00:00 +0100

CONCLUSIONS: Interventions of manual therapy for hip and knee OA provided limited evidence of effectiveness. These studies are of limited quality due to lack of blinding and disclosure of co-intervention. Tele-rehabilitation may be a viable option to improve access to rehabilitation post joint replacement for those in rural and remote areas. Data continue to support the need to include performance measures as well as patient-reported outcomes in evaluating outcomes in OA. Additionally, measures of participation should be considered as core outcomes. PMID: 22261405 [PubMed - as supplied by publisher] (Source: Rural Remote Health)

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Pelvic floor muscle training for urgency urinary incontinence in women: a systematic review

International Urogynecology Journal — Fri, 13 Jan 2012 16:50:23 +0100

The objective of this study is to evaluate the effectiveness of existing physiotherapy modalities for the treatment of urge urinary incontinence (UUI). A systematic review was performed for primary studies of physiotherapy techniques for UUI published in English between 1996 and August 2010 in major electronic databases. Only randomized clinical trials that reported outcomes separately for women with UUI were included. Outcomes assessed were reduction in UUI, urinary frequency, and nocturia. Data from 13 full-text trials including the modalities of pelvic floor muscles exercises with or without biofeedback, vaginal electrical stimulation, magnetic stimulation, and vaginal cones were analyzed. The methodologic quality of these trials was fair. Significant improvement in UUI was report...

Defensive coping styles, anxiety and chronic low back pain

Physiotherapy — Fri, 13 Jan 2012 05:00:00 +0100

Psychological factors, such as anxiety, are associated with differences in pain perception and the prevalence of chronic pain conditions , such as chronic low back pain (CLBP) . Within other clinical populations, anxiety has also been considered in the context of high or low defensiveness to identify distinct coping styles, which have been associated with differences in treatment response and health outcomes . This has rarely been considered within CLBP. (Source: Physiotherapy)

An Early Mobilization Protocol Successfully Delivers More and Earlier Therapy to Acute Stroke Patients: Further Results From Phase II of AVERT

Neurorehabilitation and Neural Repair — Thu, 12 Jan 2012 05:00:00 +0100

Conclusions. The authors detailed usual care and intervention therapy provided to patients from admission to 14 days after stroke. The therapy schedule was markedly different in the intervention arm, but whether this schedule reduces complications or improves outcome is unknown. (Source: Neurorehabilitation and Neural Repair)

Chronic Stroke Survivors Benefit From High-Intensity Aerobic Treadmill Exercise: A Randomized Control Trial

Neurorehabilitation and Neural Repair — Thu, 12 Jan 2012 05:00:00 +0100

Conclusion. This trial demonstrates that TAEX effectively improves cardiovascular fitness and gait in persons with chronic stroke. (Source: Neurorehabilitation and Neural Repair)

Therapeutic interventions for acute hamstring injuries: a systematic review

British Journal of Sports Medicine — Thu, 12 Jan 2012 05:00:00 +0100

Conclusions There is a lack of high quality studies on the treatment of acute hamstring injuries. Only limited evidence was found to support the use of stretching, agility and trunk stability exercises, intramuscular actovegin injections or slump stretching. Further research is needed using an appropriate control group, randomisation and blinding. (Source: British Journal of Sports Medicine)

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External devices (including orthotics) to control excessive foot pronation

British Journal of Sports Medicine — Thu, 12 Jan 2012 05:00:00 +0100

Cheung RT, Chung RC, Ng GY. Efficacies of different external controls for excessive foot pronation: a meta-analysis. Br J Sports Med 2011;45:743–51. Background Foot pronation during the early stance phase of gait allows the foot to accommodate to the irregularities of the ground surface and to attenuate ground reaction forces. Pronation involves multiple joint movements at the rearfoot and midfoot, and may influence more proximal segments leading to internal rotation of the lower limb and hip.1 Excessive foot pronation may promote non-physiological stresses on bone and musculo-tendinous structures of the lower limb and subsequent injury.2 Several overuse injuries have been attributed to excessive foot pronation. Injuries might occur at the foot level, such as plantar fasciitis, as we...

[Hemolytic uremic syndrome with severe neurological involvement: How should it be managed?]

Archives de Pediatrie — Thu, 12 Jan 2012 05:00:00 +0100

We report on 2 cases and discuss the treatment. CASE REPORT 1: A 2.5-year-old girl presented with generalized seizures during gastroenteritis. Blood tests revealed features of HUS and a pyramidal syndrome was found on physical examination. Brain MRI, 24h after admission, showed lesions in the periventricular and subcortical area. She was started on peritoneal dialysis (PD) and daily plasma exchanges (PE) for 10 days. Her neurological condition improved quickly as well as the findings of the second brain MRI performed after PE. One year later she had no apparent neurological or renal sequelae. CASE REPORT 2: A 2.5-year-old boy presented with generalized seizures during gastroenteritis for 3 days, leading to a diagnosis of HUS. He also had a severe pyramidal syndrome with spastic tetraparesi...

Continuing conservative care versus crossover to radiofrequency kyphoplasty: a comparative effectiveness study on the treatment of vertebral body fractures

European Spine Journal — Tue, 10 Jan 2012 16:59:55 +0100

Conclusion For the vast majority of patients with a VAS ≥5, conservative care did not provide meaningful clinical improvement. In contrast, nearly all patients who underwent radiofrequency kyphoplasty had rapid substantial improvement. Surgery was clearly much more effective than conservative care and should be offered to patients much sooner. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00586-012-2148-8Authors Rahel Bornemann, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freund-Str. 25, 53105 Bonn, GermanyMichael Hanna, Mercury Medical, 603 W. 115th St., Suite 459, New York, NY 10025, USAKoroush Kabir, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum ...

Effects of chest physiotherapy and aerobic exercise training on physical fitness in young children with cystic fibrosis.

Italian Journal of Pediatrics — Tue, 10 Jan 2012 05:00:00 +0100

Background: Cystic fibrosis is a multisystem disease where the main problems are existing in the respiratory system. Aerobic exercise programs are effective in increasing physical fitness and muscle endurance in addition to chest physiotherapy.ObjectiveThe aim of this study was to evaluate the effects of chest physiotherapy and aerobic exercise training on physical fitness in young children with cystic fibrosis. Methods: Sixteen patients with cystic fibrosis, between the ages 5-13 years, were included in this study. All children were assessed at the beginning and at the end of 6 week of the training. Modified Bruce protocol was used for assessing the cardiovascular endurance. The sit-up test was used to evaluate the dynamic endurance of abdominal muscles, standing long jump was used to tes...

Objective evaluation of anterior knee laxity; comparison of the KT-1000 and GNRB® arthrometers

Knee Surgery, Sports Traumatology, Arthroscopy — Mon, 09 Jan 2012 19:38:12 +0100

Conclusion This clinical study demonstrates the superior intra- and inter-examiner reproducibility of the GNRB® over the KT-1000. There appears to be some technological advantages to using the GNRB® including pressure control of the patella, accuracy of the displacement transducer, control of the load on the calf, and control of hamstring activity. Level of evidence Diagnostic study, Level I. Content Type Journal ArticleCategory KneePages 1-6DOI 10.1007/s00167-011-1869-2Authors Michel Collette, Orthopaedic Department, Clinique Edith Cavell, 32 rue Edith Cavell, 1180 Brussels, BelgiumJulie Courville, Physiotherapy Department, Clinique Edith Cavell, 32 rue Edith Cavell, 1180 Brussels, BelgiumMarc Forton, Physiotherapy Department, Clinique Edith Cave...

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Comparing Gait Performance of People with Charcot‐Marie‐Tooth Disease Who Do and Do Not Wear Ankle Foot Orthoses

Physiotherapy Research International — Mon, 09 Jan 2012 05:00:00 +0100

Conclusions. People who regularly wore AFOs were more severely affected, had a slower maximum walking speed, higher energy cost of walking and worse perceived walking ability. Walking ability in this group was related to fatigue, perceived exertion during walking and perceived walking ability. Gait function of people not using AFOs was determined by lower limb muscle function. People prescribed AFOs, those who do not wear them and those not prescribed AFOs were similar in presentation, suggesting that people choose to wear orthoses when their condition becomes sufficiently severe. Copyright © 2012 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

Double lumen bi-cava cannula for veno-venous extracorporeal membrane oxygenation as bridge to lung transplantation in non-intubated patient

Interactive CardioVascular and Thoracic Surgery — Mon, 09 Jan 2012 05:00:00 +0100

We report the case of a non-intubated patient who benefited from veno-venous (VV) ECMO. A 35-year old cystic fibrosis man presented a severe respiratory decompensation with refractory hypercapnia. We opted for an ECMO instead of mechanical ventilation (MV). We implanted a double lumen bi-cava cannula (DLC) (Avalon EliteTM) in the right jugular vein. Before ECMO implantation, the patient presented refractory respiratory failure (pH = 7.1, PaO2 = 83 mmHg, PaCO2 = 103 mmHg). We proposed that the patient be placed on the high emergency lung transplantation waiting list after failure to wean him from ECMO. This registration was effective 10 days after ECMO implantation. The patient was grafted the next day. Under ECMO, mean PaO2, PaCO2 and TCA were 80.6&n...

Physiotherapy students' experience, confidence and attitudes on the causes and management of violent and aggressive behaviour. - Stubbs B, Rayment N, Soundy A.

SafetyLit: All (Unduplicated) — Fri, 06 Jan 2012 15:21:09 +0100

OBJECTIVES: Healthcare professionals are at risk of experiencing violent and aggressive behaviour from patients. This is most notable in those with least experience, such as students, yet little reported research has considered the experiences of physiothe... (Source: SafetyLit: All (Unduplicated))

Effects of light emitting diode (LED) therapy and cold water immersion therapy on exercise-induced muscle damage in rats

Lasers in Medical Science — Thu, 05 Jan 2012 17:06:08 +0100

Abstract The aim of this work is to analyze the effects of LED therapy at 940 nm or cold water immersion therapy (CWI) after an acute bout of exercise on markers of muscle damage and inflammation. Thirty-two male Wistar rats were allocated into four groups: animals kept at rest (control), exercised animals (E), exercised + CWI (CWI), and exercised + LED therapy (LED). The animals swam for 100 min, after which blood samples were collected for lactate analysis. Animals in the E group were returned to their cages without treatment, the CWI group was placed in cold water (10°C) for 10 min and the LED group received LED irradiation on both gastrocnemius muscles (4 J/cm2 each). After 24 h, the animals were killed and the soleus muscles were submitted to histological an...

Biofeedback Treatment for Overactive Bladder

Current Bladder Dysfunction Reports — Thu, 05 Jan 2012 06:52:54 +0100

Abstract For several decades, biofeedback has been utilized to help patients gain control of urinary problems. First described in the 1950s, pelvic floor muscle training employing biofeedback techniques has re-emerged as many patients seek to improve their urinary symptoms without medications or invasive procedures. Developing evidence and clinical agreement suggest that the pelvic floor musculature plays an important and often overlooked role in the etiology of lower urinary tract symptoms. New techniques involving computerized visual feedback and electrical stimulation or magnetic stimulation seek to improve the efficacy of pelvic floor muscle exercises. However, findings from the literature for increased response to these exercises with intensity of biofeedback programs...

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Home-based exercise therapy in ankylosing spondylitis: short-term prospective study in patients receiving tumor necrosis factor alpha inhibitors

Rheumatology International — Wed, 04 Jan 2012 16:50:16 +0100

Abstract The importance of exercise and regular physiotherapy in patients with ankylosing spondylitis (AS) under treatment with tumor necrosis factor alpha inhibitors (TNFα inhibitors) was reported in some studies, but the literature on this topic is still scarce. The aim of this study was to assess the effects of home-based exercise therapy on functional capacity, disease activity, spinal mobility, quality of life, emotional state and fatigue in patients with AS receiving TNFα inhibitors. Forty-two AS patients were trained on the disease, and home-based exercise program was demonstrated to all the patients. At baseline and at the end of 10 week, we evaluated Bath AS Disease Activity Index, Bath AS Functional Index, Bath AS Metrology Index, Multidimensional Assessme...

NHS Confederation home care call backed

HSJ — Wed, 04 Jan 2012 10:20:00 +0100

The NHS Confederation’s call to prioritise treating people in their home rather than hospital has been backed by the Chartered Society of Physiotherapy. (Source: HSJ)

Traumatic Patellar Dislocation: Nonoperative Treatment Compared With MPFL Reconstruction Using Patellar Tendon

The American Journal of Sports Medicine — Tue, 03 Jan 2012 05:00:00 +0100

Conclusion: Treatment with MPFL reconstruction using the patellar tendon produced better results, based on the analyses of posttreatment recurrences and the better final results of the Kujala questionnaire after a minimum follow-up period of 2 years. (Source: The American Journal of Sports Medicine)

Medial plica syndrome: A review of the literature

Clinical Anatomy — Tue, 03 Jan 2012 05:00:00 +0100

The effects of whole-body vibration training on gait and walking ability - A systematic review comparing two quality indexes.

Physiotherapy Theory and Practice — Tue, 03 Jan 2012 05:00:00 +0100

Conclusion: There is low-quality evidence for WBV training having effects on gait and walking ability. Further research is needed. The evidence did not alter between the quality indexes. PMID: 22214345 [PubMed - as supplied by publisher] (Source: Physiotherapy Theory and Practice)

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Frozen shoulder.

The Journal of Bone and Joint Surgery. British volume — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Robinson CM, Seah KT, Chee YH, Hindle P, Murray IR Abstract Frozen shoulder is commonly encountered in general orthopaedic practice. It may arise spontaneously without an obvious predisposing cause, or be associated with a variety of local or systemic disorders. Diagnosis is based upon the recognition of the characteristic features of the pain, and selective limitation of passive external rotation. The macroscopic and histological features of the capsular contracture are well-defined, but the underlying pathological processes remain poorly understood. It may cause protracted disability, and imposes a considerable burden on health service resources. Most patients are still managed by physiotherapy in primary care, and only the more refractory cases are referred for speciali...

A case study in bilateral radial head fractures in apparently trivial trauma: a subtle diagnosis.

Ortopedia, Traumatologia, Rehabilitacja — Fri, 30 Dec 2011 05:00:00 +0100

We present a case series of three patients with bilateral type 1 radial head fractures (one case having type 3 on one side) managed with brief immobilization followed by active physiotherapy and full, uneventful recovery. The emphasis in these cases is the need for a high index of suspicion in the diagnosis of multiple injuries, no matter how `trivial` the mechanism of injury and, unless the history of the mode of trauma is highly suggestive, such injuries can be missed easily and cause long term problems for the patient. PMID: 22248465 [PubMed - in process] (Source: Ortopedia, Traumatologia, Rehabilitacja)

Immediate and long-term effects of selected physiotherapy methods in patients with carpal tunnel syndrome.

Ortopedia, Traumatologia, Rehabilitacja — Fri, 30 Dec 2011 05:00:00 +0100

Conclusions: Ultrasound therapy combined with massage and kinesiotherapy brings the expected, long-term effects in patients with carpal tunnel syndrome. PMID: 22248460 [PubMed - in process] (Source: Ortopedia, Traumatologia, Rehabilitacja)

Same tools, but a shift of context

Journal of Science and Medicine in Sport — Thu, 29 Dec 2011 03:19:41 +0100

In a recent discussion with colleagues and graduate students we explored the growth of the physical activity and health research and practice areas over the past 15 or so years. Interestingly, the graduate students in our discussion were somewhat surprised to learn that many people now working in this area, did in fact not receive their original training in this area, but rather in other disciplines ranging from psychology, medicine, and epidemiology to sport and exercise science, physical education, and public health, just to mention a few. Others include architecture and urban design, town planning, physiotherapy, information technology, nursing, health promotion, physiology, etc. In summarising our discussion I used the phrase “same tools, but a shift of context”. (Source: Journal o...

Feedback Device for Improvement of Coordination of Reach-to-Grasp After Stroke

Archives of Physical Medicine and Rehabilitation — Thu, 29 Dec 2011 01:24:28 +0100

Conclusions: GRASP is potentially beneficial as an adjunct to physiotherapy training of reach-to-grasp coordination after stroke. (Source: Archives of Physical Medicine and Rehabilitation)

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No effect on performance tests from a neuromuscular warm-up programme in youth female football: a randomised controlled trial

Knee Surgery, Sports Traumatology, Arthroscopy — Tue, 27 Dec 2011 17:01:46 +0100

Conclusions The study showed that a neuromuscular warm-up programme carried out during 11 weeks did not improve performance in youth female football. This could indicate that the programme does not contain sufficient stimulus to improve performance. A low player attendance at training sessions, and low specificity between exercises in the warm-up programme and the evaluated performance tests may also contribute to the lack of effect. Level of evidence I. Content Type Journal ArticleCategory Sports MedicinePages 1-8DOI 10.1007/s00167-011-1846-9Authors Hanna Lindblom, Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, SwedenMarkus Waldén, Department of Orthopaedics, Hässleholm-Krist...

The good, the bad, and the ugly of evidence-based practice.

Adapted Physical Activity Quarterly : APAQ — Tue, 27 Dec 2011 13:18:51 +0100

Authors: Bouffard M, Reid G Abstract The evidence-based practice (EBP) movement has been extremely influential over the last 20 years. Fields like medicine, physiotherapy, occupational therapy, nursing, psychology, and education have adopted the idea that policy makers and practitioners should use interventions that have demonstrated efficiency and effectiveness. This apparently straightforward idea is beginning to affect adapted physical activity; however, researchers and practitioners in our field often appear to be unaware of fundamental questions related to them. The major purpose of this paper is to outline and discuss 10 of these fundamental questions. This analysis leads us to conclude that EBP is a good direction to pursue in adapted physical activity if we develop a type o...

Upper extremity neurodynamic tests: Range of motion asymmetry may not indicate impairment.

Physiotherapy Theory and Practice — Tue, 27 Dec 2011 05:00:00 +0100

Authors: Covill LG, Petersen SM Abstract Upper extremity (UE) neurodynamic tests are used to examine neural tissue in patients with neuro-musculoskeletal disorders. Although comparisons between involved and uninvolved limbs are made clinically, minimal data exist reflecting the normal variation between sides. The purpose of this study was to determine if within-subject differences exist between limbs in the UE component of neurodynamic tests of the median, radial, and ulnar nerves. Sixty-one healthy subjects were examined. Difference between limbs for the median nerve-biased test was significant (right = 16.4° ± 11.4°, left = 20.1° ± 13.7°; p = 0.045). There was no significant difference between limbs for the radial or ulnar nerve-biased tests. Correlation...

Negative correlation between body mass index category and physical activity perceptions in children.

Physiotherapy Theory and Practice — Tue, 27 Dec 2011 05:00:00 +0100

Authors: Van Zant RS, Toney J Abstract Children's physical activity (PA) choices are influenced by their perceived ability (adequacy) and inclination toward (predilection) PA. The study's purpose was to determine the association of body mass index (BMI) category with PA perceptions in sixth-grade children. A total of 267 children (119 boys, 148 girls; age 11+ y; ht 1.53 SD 0.08 m; wt 49.0 SD 13.5 kg; BMI 20.7 SD 4.8) provided informed consent and completed the study. All were measured for body weight and height and completed the Children's Self-perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA) scale. Spearman rank-order correlation analysis was conducted between total CSAPPA score (and three factor scores of adequacy, predilection, and enjoyment) and BM...

Improvement in pain intensity, spine stiffness, and mobility during a controlled individualized physiotherapy program in ankylosing spondylitis

Rheumatology International — Sat, 24 Dec 2011 16:44:44 +0100

In this study we assessed the functional status of AS patients in relation to disease duration and activity. Furthermore, in volunteering patients we analyzed the efficacy of a controlled, individualized physiotherapeutic program. Altogether, clinical data of 75 AS patients were retrospectively analyzed. Anthropometrical data, duration since diagnosis and disease activity, pain intensity, tender points, sacroiliac joint involvement determined by X-ray, functional condition, and physical activity level were recorded. Subjective, functional, and physical tests were performed. Out of the 75 patients, 10 volunteered to undergo a complex physical exercise program twice a week for 3 months. The program included 1.5 h of general posture reeducation, manual mobilization of the spi...

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Water Immersion to the Femur Level Affects Cerebral Cortical Activity in Humans: Functional Near-Infrared Spectroscopy Study.

Brain Topography — Fri, 23 Dec 2011 05:00:00 +0100

Authors: Sato D, Onishi H, Yamashiro K, Iwabe T, Shimoyama Y, Maruyama A Abstract Water immersion is widely used in physiotherapy and may even improve the functional outcomes of hemiplegic patients after stroke. To investigate the cortical responses to water immersion, functional near-infrared spectroscopy (fNIRS) was used to measure cortical activations in the primary somatosensory area (S1), parietal association area (PAA), supplementary motor area (SMA), and primary motor area (M1). Nine healthy adult males were rested in a sitting position for 15 min with simultaneous measurements of fNIRS, blood pressure, and skin temperature. The fNIRS signal and other physiological parameters were measured under three conditions, the non-immersed condition (baseline control), as the immersi...

Does exercise training change physical activity in people with COPD? A systematic review and meta-analysis.

Chronic Respiratory Disease — Thu, 22 Dec 2011 05:00:00 +0100

Authors: Ng LW, Mackney J, Jenkins S, Hill K Abstract A systematic review and meta-analysis was conducted to examine the effect of exercise training on daily physical activity (PA) in people with chronic obstructive pulmonary disease (COPD). MEDLINE, PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro) and Cochrane Central Register of Controlled Trials were searched from their inception to week 27 of 2010, using the keywords 'COPD,' 'exercise,' 'therapy' and 'physical activity.' All studies except case reports were eligible for inclusion provided they investigated the effects of ≥4 weeks of supervised exercise training on PA in patients with COPD. Study quality for the randomised trials (RTs) and single-group interventional studies was rated using the PEDro scale and D...

Isometric knee extension force measured using a handheld dynamometer with and without belt-stabilization.

Physiotherapy Theory and Practice — Thu, 22 Dec 2011 05:00:00 +0100

Authors: Bohannon RW, Kindig J, Sabo G, Duni AE, Cram P Abstract Although evidence suggests that tester strength limits the magnitude of isometric force that can be measured using a handheld dynamometer (HHD), previous studies have not investigated the actual limits of force magnitude that can be measured by trained testers when a belt is or is not used to stabilize the dynamometer. Therefore, the primary aims of this study were to determine: 1) the magnitude of knee extension forces that could be measured with a HHD with and without belt-stabilization and 2) the relationship between tester characteristics and knee extension strength measured with and without belt-stabilization. The characteristics of 20 trained testers (10 men, 10 women) were determined. Thereafter, they measured ...

Stride activity level in young and middle-aged adults with hip disorders.

Physiotherapy Theory and Practice — Thu, 22 Dec 2011 05:00:00 +0100

Conclusions: Subjects with hip disorders demonstrate reduced TDS compared with controls; however, some subgroups demonstrated TDS similar to controls. In addition, symptomatic subjects demonstrated relatively high TDS while reporting poor function. Accelerometers can be used in clinical populations to provide additional information about activity not represented by traditional functional measures. PMID: 22191475 [PubMed - as supplied by publisher] (Source: Physiotherapy Theory and Practice)

Longitudinal gait analysis of a person with a transfemoral amputation using three different prosthetic knee/foot pairs.

Physiotherapy Theory and Practice — Thu, 22 Dec 2011 05:00:00 +0100

Authors: Barr JB, Wutzke CJ, Threlkeld AJ Abstract Using gait analysis, we documented kinetic and temporospatial changes over a 7-year period in a single healthy individual with a transfemoral amputation walking with three different knees and matched foot components. The knee/foot pairs in chronological order were Four Bar Endolite knee/Endolite Dynamic Response foot; Ossur Total Knee 2000/Pathfinder I foot; and C-Leg knee/IC40 C-walk foot. The design of the suspension and socket were unchanged across the three prostheses. We found an increase in the braking component of A-P ground reaction force on the intact limb while using the C-Leg compared to the other two prosthetic fabrications. There was progressive change across the three component combinations, which included increased s...

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The inter-rater and intra-rater reliability of a modified "severity scale for assessment of plagiocephaly" among physical therapists.

Physiotherapy Theory and Practice — Thu, 22 Dec 2011 05:00:00 +0100

In conclusion, the modified "severity scale for assessment of plagiocephaly" has satisfying statistical agreement. Reliability is affected by the number of years of experience of the PTs. PMID: 22191437 [PubMed - as supplied by publisher] (Source: Physiotherapy Theory and Practice)

Adult norms of the perceptual threshold of touch (PTT) in the hands and feet in relation to age, gender, and right and left side using transcutaneous electrical nerve stimulation.

Physiotherapy Theory and Practice — Thu, 22 Dec 2011 05:00:00 +0100

The objectives of this study were to establish adult norms of the perceptual threshold of touch (PTT) for the hands and feet according to age and gender and to determine the effect of right/left side, handedness, height, weight, and body mass index (BMI) on the PTT. The PTT was assessed by using a high-frequency transcutaneous electrical nerve stimulator (Hf/TENS) with self-adhesive skin electrodes in 346 adults. The PTT was identified as the level registered in mA at which the participants perceived a tingling sensation. The PTT for all participants was a median of 3.75 mA (range 2.50-7.25) in the hands and a median of 10.00 (range 5.00-30.00) in the feet. With increasing age an increase of the PTT was found. Men reported higher PTT than women. The right hand had higher PTT than the lef...

Timing of Aquatic Therapy After Joint Replacement Matters

Rheumatology News - Doctors Lounge — Wed, 21 Dec 2011 15:00:00 +0100

Starting within days of the operation seems beneficial for those with new knees, but not hips (Source: Rheumatology News - Doctors Lounge)

Treatment of patellar tendinopathy—a systematic review of randomized controlled trials

Knee Surgery, Sports Traumatology, Arthroscopy — Tue, 20 Dec 2011 16:45:41 +0100

Conclusion Physical training, and particularly eccentric training, appears to be the treatment of choice for patients suffering from patellar tendinopathy. However, type of exercise, frequency, load, and dosage must also be analyzed. Other treatment methods, such as surgical treatment, sclerosing injections, and shockwave therapy, must be investigated further before recommendations can be made regarding their use. Ultrasound can likely be excluded as a treatment for patellar tendinopathy. There is a persistent lack of well-designed studies with sufficiently long-term follow-up and number of patients to draw strong conclusions regarding therapy. Level of evidence II. Content Type Journal ArticleCategory KneePages 1-15DOI 10.1007/s00167-011-1825-1A...

Bet 3: The effectiveness of therapeutic ultrasound in the treatment of acute sciatica

Emergency Medicine Journal — Tue, 20 Dec 2011 05:00:00 +0100

Report by: Ioannis Paneris Search checked by: Michael Callaghan Institution: Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK Clinical scenario A 30-year-old male gym enthusiast presents with a 3-week history of sudden onset of back pain, after lifting heavy weight, His pain radiates from the lumbar spine to the right posterior thigh lateral calf and foot and has associated mild paraesthesia. He has had treatment with Ultrasound (US) before for a different condition and he is asking if US could be useful in this case. Three-part question IN (Adults with acute sciatica) IS (therapeutic ultrasound beneficial) AT (decreasing pain and improving function)? Search strategy National library for health web interface. {(lumbar OR (low ADJ back)) AND (sciatica OR radicul*...

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Randomized Controlled Trial of a New Portable Calf Compression Device (Venowave) for Prevention of Venous Thrombosis in High‐Risk Neurosurgical Patients.

Journal of Thrombosis and Haemostasis — Tue, 20 Dec 2011 05:00:00 +0100

Conclusions: Venowave devices are effective in preventing VTE in high risk neurosurgical patients. (Source: Journal of Thrombosis and Haemostasis)

Comparison of postdischarge physiotherapy versus usual care following primary total knee arthroplasty for osteoarthritis: an exploratory pilot randomized clinical trial.

Clinical Rehabilitation — Fri, 16 Dec 2011 05:00:00 +0100

Conclusions: Successful recruitment and retention rates were achieved. The intervention appeared feasible and acceptable but may be suboptimal in intensity given recent research. A sample size of 1271 participants would be required for a fully powered randomized controlled trial using the main outcome. However new outcomes, potentially of greater validity and responsiveness, require consideration. PMID: 22180446 [PubMed - as supplied by publisher] (Source: Clinical Rehabilitation)

Robotic Training May Provide Long-Term Benefits Post-StrokeRobotic Training May Provide Long-Term Benefits Post-Stroke

Medscape Today Headlines — Thu, 15 Dec 2011 21:17:59 +0100

A new study finds that patients with the most severe stroke deficits benefit the most from robotic gait training added to conventional physiotherapy. Medscape Medical News (Source: Medscape Today Headlines)

3D surface anatomy guide

MEDEV News — Thu, 15 Dec 2011 11:18:17 +0100

The world’s first 3D surface anatomy guide for medical and physiotherapy students, surgical trainees and artists has been developed in Ireland through a unique collaboration between anatomists, artists and engineers. Launched today in the Royal Hibernian Academy (RHA) in Dublin, the two year project, funded by Science Foundation Ireland and the Royal College of Surgeons Ireland (RCSI), has resulted in an on-line 3D guide which shows the motions of muscles and the sites of structures from the surface inwards. It shows how, by using movement, colour, illustration and 3D technology, anatomists, engineers and artists can collaborate to teach the body from the outside in. (Source: MEDEV News)

A Predictive Model of Suitability for Minimally Invasive Parathyroid Surgery in the Treatment of Primary Hyperthyroidism

World Journal of Surgery — Thu, 15 Dec 2011 06:43:35 +0100

Conclusions A scoring model encompassing preoperative biochemical and imaging data can be successfully employed to predict suitability for minimally invasive surgery in the majority of patients with single-gland disease. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-011-1377-zAuthors Dara O. Kavanagh, Department of Breast & Endocrine Surgery, St. Vincents University Hospital, Elm Park, Dublin 4, IrelandPatricia Fitzpatrick, Department of Medicine, Physiotherapy & Population Science, School of Public Health Medicine, University College Dublin, Belfield, Dublin 4, IrelandEddie Myers, Department of Breast & Endocrine Surgery, St. Vincents University Hospital, Elm Park, Dublin 4, IrelandRory Kennelly, Department of Breast & Endocrine Surgery, St. Vincents Unive...

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When does mechanical plantar stimulation promote sensory re-weighing: standing on a firm or compliant surface?

European Journal of Applied Physiology — Wed, 14 Dec 2011 16:32:31 +0100

Abstract The purpose of this study was to investigate the effect of different types of mechanical stimulation of the sole on standing postural stability in healthy, young adults. Fifty subjects (34 women, 16 men; mean age 23 ± 2 (mean ± SE)) stood barefoot on fixed force plates both with open and closed eyes on firm surface and then on compliant surface (foam). A modified Clinical Test of Sensory Interaction on Balance protocol was employed to assess the center of gravity (COG) excursions along anteroposterior (AP) and mediolateral (ML) axes on each surface and visual condition. After the baseline measurement, a stimulation was applied with an elastic spiked layer topped to the firm and then foam surface, and the COG excursions were measured during the...

Eritrea: Physiotherapy Center in Barentu Hospital Rendering Commendable Service

AllAfrica News: Health and Medicine — Wed, 14 Dec 2011 08:32:46 +0100

The Physiotherapy Center in Barentu Referral Hospital is rendering commendable service, according to Mr. Kidane Gebremichael, expert in physiotherapy. (Source: AllAfrica News: Health and Medicine)

Computed tomography scan diagnosis of occult groin hernia

Hernia — Tue, 13 Dec 2011 17:06:42 +0100

Conclusion This prospective non-contrast CT study of patients with undiagnosed chronic groin pain detected the majority of occult hernias requiring surgical intervention. These results suggest that CT can be a useful adjunct to the evaluation of patients presenting with chronic undiagnosed groin pain, but that experienced clinical judgment remains a critical element in the diagnostic pathway. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s10029-011-0899-5Authors J. F. W. Garvey, Groin Pain Clinic, Suite G01, BMA House, 135 Macquarie Street, Sydney, NSW 2000, Australia Journal HerniaOnline ISSN 1248-9204Print ISSN 1265-4906 (Source: Hernia)

Management of muscle haematomas in patients with severe haemophilia in an evidence‐poor world

Haemophilia — Mon, 12 Dec 2011 05:00:00 +0100

Summary. Treatment studies in haemophilia focus on joint bleeds; however, some 10–25% of bleeds occur in muscles. This review addresses management of muscle haematoma in severe haemophilia, defines gaps in the published evidence, and presents a combined clinician and physiotherapist perspective of treatment modalities. The following grade 2C recommendations were synthesized: (i) Sport and activity should be based on individual factor levels, bleeding history and physical characteristics, (ii) Musculoskeletal review aids the management of children and adults, (iii) ‘Time to full recovery’ should be realistic and based on known timelines from the healthy population, (iv) Diagnosis should be carried out by both a clinician and physiotherapist, (v) Severe muscle bleeds should be treat...

Determining priority for joint replacement: comparing the views of orthopaedic surgeons and other professionals.

Med J Aust — Mon, 12 Dec 2011 05:00:00 +0100

CONCLUSION: Both orthopaedic surgeons and non-orthopaedic professionals considered pain the most important factor in establishing urgency and priority for joint replacement. Only the non-orthopaedic professionals considered psychosocial factors important when determining priority for surgery. Broader community discussion about prioritisation for elective surgery is needed to facilitate agreement about which patients factors should be considered. PMID: 22171869 [PubMed - in process] (Source: Med J Aust)

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Donor-site-related functional problems following anterior cruciate ligament reconstruction: development of a self-administered questionnaire

Knee Surgery, Sports Traumatology, Arthroscopy — Sat, 10 Dec 2011 16:54:41 +0100

Conclusions The questionnaire “Donor-site-Related Functional Problems following Anterior Cruciate Ligament (ACL) Reconstruction” is a patient-reported questionnaire with high content validity and reliability for the evaluation of donor-site-related functional problems after ACL reconstruction, with autograft harvested from the hamstring tendon or patellar tendon. The results of this study support the use of this questionnaire as a standardized outcome measure for both research purposes and in clinical settings. Content Type Journal ArticleCategory KneePages 1-11DOI 10.1007/s00167-011-1812-6Authors Susanna Aufwerber, Department of Physical Therapy, Karolinska University Hospital, 171 76 Stockholm, SwedenMaria Hagströmer, Division of Physiotherapy, Department of...

Menstrual cycle and knee joint position sense in healthy female athletes

Knee Surgery, Sports Traumatology, Arthroscopy — Thu, 08 Dec 2011 18:25:43 +0100

Conclusion The result of this study suggests that healthy female athletes have different levels of knee JPS across a menstrual cycle. JPS accuracy decreases in menses, when circulating sex-hormones levels are low. Therefore, female athletes are at higher risk of injury at menses and improving their awareness regarding the knee injury risk factors can be a fundamental step toward preventing injuries. Level of evidence Case series, Level IV. Content Type Journal ArticleCategory Sports MedicinePages 1-6DOI 10.1007/s00167-011-1811-7Authors Rose Fouladi, Sports Science and Physical Education Department, Tehran University, Tehran, IranReza Rajabi, Sports Science and Physical Education Department, Tehran University, Tehran, IranNasrin Naseri, Physiother...

Assertiveness: a necessary social ability in the professionals of nursing and physiotherapy

Texto e Contexto - Enfermagem — Thu, 08 Dec 2011 00:57:17 +0100

Los profesionales de la salud están constantemente interrelacionados con otras personas, en algunas ocasiones de éstas relaciones se derivan situaciones angustiantes y conflictivas. El objetivo del presente estudio es conocer la asertividad de estudiantes universitarios de enfermería y fisioterapia. Es un estudio de corte transversal. Se incluyeron 225 estudiantes. El instrumento empleado fue el Inventario de Asertividad de Rathus. Los resultados muestran que la edad es un elemento fundamental para que las personas sean asertivas; a medida que aumenta la edad, aumenta la asertividad indirecta por cada año en (0.04) y disminuye la no asertividad (p=0.004). Lo anterior, permite concluir que la asertividad como habilidad relacional debe ser contemplada como requisito en la formación de l...

Worldwide Wednesday Wrap-Up

Red Cross Chat — Thu, 08 Dec 2011 00:06:09 +0100

This Worldwide Wednesday Wrap-Up is courtesy of Scott Waggoner, from Cross Blog: Award-winning Red Cross news and views from Oregon and beyond Welcome to the Worldwide Wednesday Wrap-Up, in which we consolidate the international Red Cross and Red Crescent news into one list of bite-sized links for you. It’s a non-comprehensive sampling of the larger and/or more intriguing aspects of our global work… PAKISTAN: This year alone, more than 12,000 people have benefited from services in physical rehabilitation centers supported by the ICRC in Peshawar, Quetta and Muzaffarabad, Pakistan. The centers provide custom-made artificial limbs and supportive devices, crutches and wheelchairs designed according to the needs of the patients. Physiotherapy helps patients learn how to use new de...

A Possible Mobile Health App to Compliment EMR #mhs11

ICMCC: The International Council on Medical and Care Compunetics — Wed, 07 Dec 2011 16:15:11 +0100

Source: John, EMR and HIPAA Content: “One of the really interesting companies that I’ve seen at both the Digital Health Conference in NYC and now at the mHealth Summit in DC is a company called Force Therapeutics. This company is part of the Startup Health crew of companies and have a pretty interesting product for [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

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Promoting mobility after hip fracture (ProMo): study protocol and selected baseline results of a year-long randomized controlled trial among community-dwelling older people.

BioMed Central — Wed, 07 Dec 2011 05:00:00 +0100

DiscussionTen weeks post hip fracture only half of the participants were compliant to Standard Care. No follow-up for Standard Care or mobility recovery occurred. There is a need for rehabilitation and follow-up for mobility recovery after hip fracture. However, the effectiveness of the ProMo program can only be assessed at the end of the study.Trial registration: Current Controlled Trials ISRCTN53680197 (Source: BioMed Central)

Comparison of Two Resistance Training Protocols, 6RM versus 12RM, to Increase the 1RM in Healthy Young Adults. A Single‐Blind, Randomized Controlled Trial

Physiotherapy Research International — Wed, 07 Dec 2011 05:00:00 +0100

Conclusion. Both 6RM and 12RM training protocols improve maximum strength in recreationally active healthy young adults, with no significant difference between the protocols. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

Microcurrent Therapy in the Management of Chronic Tennis Elbow: Pilot Studies to Optimize Parameters

Physiotherapy Research International — Wed, 07 Dec 2011 05:00:00 +0100

ConclusionMonophasic MCT of peak current intensity 50 μA applied for tens of hours may be effective in reducing symptoms and promoting tendon normalization in chronic tennis elbow. Hyperaemia may help predict treatment outcome. A full‐scale trial of the therapy is warranted. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

Tailored skills training for practitioners to enhance assessment of prognostic factors for persistent and disabling back pain: Four quasi-experimental single-subject studies.

Physiotherapy Theory and Practice — Tue, 06 Dec 2011 05:00:00 +0100

Authors: Demmelmaier I, Denison E, Lindberg P, Asenlöf P Abstract The well-known gap between guidelines and behaviour in clinical practice calls for effective behaviour change interventions. One example showing this gap is physiotherapists' insufficient assessment of psychosocial prognostic factors in back pain (i.e., yellow flags). The present study aimed to evaluate an educational model by performing a tailored skills training intervention for caregivers and studying changes over time in physiotherapists' assessment of prognostic factors in telephone consultations. A quasi-experimental single-subject design over 36 weeks was used, with repeated measurements during baseline, intervention, and postintervention phases. Four physiotherapists in primary health care audiorecorded a to...

Cognitive behavioural therapy and its relevance to nursing.

British Journal of Nursing — Tue, 06 Dec 2011 05:00:00 +0100

Cognitive behavioural therapy and its relevance to nursing. Br J Nurs. 2011 Dec 6;20(22):1443-1447 Authors: Currid TJ, Nikc 711 Evic AV, Spada MM Abstract Over the last 20 years, cognitive behavioural therapy (CBT) has gained considerable momentum in mental healthcare practice. Its extensive evidence base for the treatment of mental health problems is well documented with the National Institute for Health and Clinical Excellence (2007a; b), which has recommended CBT as a key treatment modality in its best practice guidelines. More recently, the use of CBT has widened to a diverse range of physical healthcare environments, including dentistry, occupational therapy, palliative care and physiotherapy (Chartered Society of Physiotherapists, 2004; Buchanan and Zakrzewska, 2008; ...

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Parental Weight (Mis)Perceptions: Factors Influencing Parents’ Ability to Correctly Categorise Their Child’s Weight Status

Maternal and Child Health Journal — Sat, 03 Dec 2011 16:49:09 +0100

This study investigates parents’ ability to correctly classify their child’s weight status. The influence of parent and child socio-demographic and lifestyle factors on parental misclassification of their child’s weight status is explored. A representative sample of Irish children (aged 5–12 (n = 596) years, aged 13–17 years (n = 441)) and their parents (n = 1885) were recruited to participate in a national dietary survey. Parental perceptions of their child’s weight and their own weight were measured. Anthropometric measurements (weight and height) were objectively measured for parents and children. Body Mass Index (BMI) scores were derived and categorised as normal, overweight or obese using standard references. Over 80% of parents of o...

Quadriceps femoris muscle function prior and after total knee arthroplasty in women with knee osteoarthritis

Knee Surgery, Sports Traumatology, Arthroscopy — Fri, 02 Dec 2011 18:08:40 +0100

Conclusions The present study indicated reduced maximal and explosive strength of quadriceps femoris muscle in the operated leg 3 and 6 months after TKA with no significant changes in voluntary activation, and capacity for rapid contraction and relaxation. Level of evidence Prospective comparative study, Level II. Content Type Journal ArticleCategory KneePages 1-9DOI 10.1007/s00167-011-1808-2Authors Doris Vahtrik, Institute of Exercise Biology and Physiotherapy, University of Tartu, 5 Jakobi Street, 51014 Tartu, EstoniaHelena Gapeyeva, Institute of Exercise Biology and Physiotherapy, University of Tartu, 5 Jakobi Street, 51014 Tartu, EstoniaHerje Aibast, Institute of Exercise Biology and Physiotherapy, University of Tartu, 5 Jakobi Street, 5101...

Know thyself: the Quantified Self devotees who live by numbers

Guardian Unlimited Science — Fri, 02 Dec 2011 07:30:00 +0100

A band of hackers, patients, geeks and fitness freaks are using technology to fine-tune their livesA large man in an orange shirt is hopping up and down on one leg at the front of the hall explaining how the exercises had no effect on his sleep patterns. A researcher from Liverpool tells how he learned about the effects on his body of calorie-laden sandwiches, drinking sessions and Christmas feasting by monitoring his heart rate non-stop for a year. Elsewhere speakers with Parkinson's disease, chronic social anxiety and back problems explain how tracking their personal data helped ease their symptoms.Welcome to the sometimes wacky and often intriguing world of the Quantified Self, an eclectic band of hackers, geeks, fitness freaks, patients and early adopters that, from its birth in Califo...

Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: Design of a randomised controlled trial

BMC Musculoskeletal Disorders — Fri, 02 Dec 2011 05:00:00 +0100

The objective is to present the design of a randomised controlled trial (RCT) aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline. Methods: The design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited from physiotherapy clinics and an out-patient hospital department in Denmark. Patients will be randomised to either a pain management (control) group or a combined pain...

Early mobilization out of bed after ischaemic stroke reduces severe complications but not cerebral blood flow: a randomized controlled pilot trial.

Clinical Rehabilitation — Fri, 02 Dec 2011 05:00:00 +0100

Conclusion: We found an apparent reduction in severe complications and no increase in total complications with an early mobilization protocol after acute ischaemic stroke. No influence on neurological three-month outcomes or on cerebral blood flow was seen. These results justify larger trials comparing mobilization protocols with possibly even faster mobilization out of bed than explored here. PMID: 22144725 [PubMed - as supplied by publisher] (Source: Clinical Rehabilitation)

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Interferential and burst-modulated biphasic pulsed currents yield greater muscular force than Russian current.

Physiotherapy Theory and Practice — Fri, 02 Dec 2011 05:00:00 +0100

Conclusions: The results of this investigation suggest that IFC and burst-modulated BP current are viable waveform options for purposes of eliciting muscle force. These findings offer significant new evidence with strong clinical implications when selecting waveform parameters for elicitation of muscle force for NMES. PMID: 22136099 [PubMed - as supplied by publisher] (Source: Physiotherapy Theory and Practice)

The Relationship of Lower Limb Muscle Strength and Knee Joint Hyperextension during the Stance Phase of Gait in Hemiparetic Stroke Patients

Physiotherapy Research International — Thu, 01 Dec 2011 05:00:00 +0100

ConclusionsWeak ankle plantarflexors, in particular gastrocnemius, may have an important role in the presence of knee hyperextension. The results of this study did not support a role for weak hamstrings or quadriceps in knee hyperextension during gait. Further research is needed to clarify the role of gastrocnemius during the stance phase and to determine if strengthening weak gastrocnemius reduces knee hyperextension. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

Defining, Agreeing on, and Testing an International Physical Therapy Core Data Set: Results of a Feasibility Study Involving Seven Countries.

Physical Therapy — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSIONS:/b>It is possible to develop an agreed international dataset and means of data collection. Testing appears to support its acceptability and relevance for use in practice. Participants highly valued the opportunity to undertake international collaborations which may benefit their profession nationally and internationally. Further testing and use of the dataset is advocated before final validation sought. PMID: 22135707 [PubMed - as supplied by publisher] (Source: Physical Therapy)

Thoracic Hyperkyphosis: A Survey of Australian Physiotherapists

Physiotherapy Research International — Thu, 01 Dec 2011 05:00:00 +0100

ConclusionsThoracic hyperkyphosis is commonly encountered by physiotherapists. Measurement of treatment efficacy is highly subjective, and the treatment modalities employed are diverse. Many physiotherapists based their management of hyperkyphosis on their undergraduate education alone. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

Sexual Health in Patients with Rheumatoid Arthritis: Experiences, Needs and Communication with Health Care Professionals

Musculoskeletal Care — Thu, 01 Dec 2011 05:00:00 +0100

AbstractPain, fatigue and decreased joint mobility caused by rheumatoid arthritis (RA) often decrease sexual health in RA patients. Regular physiotherapy interventions in patients with RA are often aimed at improving those factors. The aim of the present study was to explore the experiences and views of patients concerning the impact of RA on their sexual health, the possible impact of physiotherapy interventions, and communication in clinical situations. A self‐administered questionnaire was sent to patients with RA at two rehabilitation clinics in Sweden. The questionnaire included questions concerning the impact of RA on intimate relationships and sexual function, as well as experiences of physiotherapy and sexual health communication with health professionals. The questionnaire was a...

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Validity of Measuring the Sit to Walk Movement with an Inertial Sensor

Physiotherapy Research International — Thu, 01 Dec 2011 05:00:00 +0100

ConclusionsThis study demonstrated excellent agreement between a motion analysis system and inertial sensors for recording time events during the STW movement, suggesting clear potential for this technique. Copyright © 2012 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

Effectiveness of electrical stimulation on rehabilitation after ligament and meniscal injuries: a systematic review.

Sao Paulo Medical Journal — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION: There is evidence that ES coupled with conventional rehabilitation exercises may be effective in improving muscle strength and function two months after surgery. PMID: 22249798 [PubMed - in process] (Source: Sao Paulo Medical Journal)

Spondyloarthritides

Best Practice and Research. Clinical Rheumatology — Thu, 01 Dec 2011 05:00:00 +0100

The most important clinical features of the spondyloarthritides (SpA) are not only inflammatory back pain (IBP) but also peripheral (enthesitis) and extra-articular symptoms. For clinical purposes, two forms related to the predominant clinical manifestation – axial and peripheral SpA – and five subgroups– ankylosing spondylitis (AS), SpA associated with psoriasis and inflammatory bowel disease (IBD), reactive arthritis and undifferentiated SpA – are differentiated. Axial SpA including AS is the most frequent subtype of SpA, followed by psoriatic arthritis and undifferentiated SpA, while reactive arthritis and IBD-related SpA are less frequent. The prevalence of SpA has been shown to be similar to rheumatoid arthritis. The outcome of the disease is influenced by the degree of diseas...

Repeated Falls: a Key Outcome or an Adverse Event?

Physiotherapy Research International — Thu, 01 Dec 2011 05:00:00 +0100

(Source: Physiotherapy Research International)

[The lumbar disc herniation - management, clinical aspects and current recommendations].

Praxis — Wed, 30 Nov 2011 05:00:00 +0100

Authors: Stienen MN, Cadosch D, Hildebrandt G, Gautschi OP Abstract Lumbar disc herniation has a high prevalence and strong social-medical impact. Patients suffer from lower back pain that radiates from the spine. Loss of sensation or paresis adds to the clinical picture. The diagnosis should be confirmed by imaging in patients considered for surgery. High remission rates initially warrant conservative treatment (adequate analgesia and physiotherapy) in many patients. If this treatment does not lead to significant alleviation within 5-8 weeks, surgery should be performed to reduce the risk of chronic nerve affection. Posterior interlaminar fenestration is the intervention primarily conducted for this diagnosis. A relapse in the same region occurs in up to 10% of patients after mont...

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Increased Muscle Activation Following Motor Imagery During the Rehabilitation of the Anterior Cruciate Ligament.

Applied Psychophysiology and Biofeedback — Wed, 30 Nov 2011 05:00:00 +0100

This study aimed to assess the therapeutic effects of MI on the activation of lower limb muscles, as well as on the time course of functional recovery and pain after surgery of the anterior cruciate ligament (ACL). Twelve patients with a torn ACL were randomly assigned to a MI or control group, who both received a series of physiotherapy. Electromyographic activity of the quadriceps, pain, anthropometrical data, and lower limb motor ability were measured throughout a 12-session therapy. The data provided evidence that MI elicited greater muscle activation, even though imagery practice did not result in pain decrease. Muscle activation increase might originate from a redistribution of the central neuronal activity, as there was no anthropometric change in lower limb muscles after imagery pr...

A prospective audit of referral patterns to a dedicated Foot and Ankle surgical service

The Foot — Tue, 29 Nov 2011 12:16:27 +0100

Conclusion: Only 65% of GP referrals to this surgical service were deemed appropriate as they progressed directly to surgery. However, it is important to establish what constitutes ‘appropriate’ since within the remaining 35% of referrals only 66 (5.8%) required no intervention at all. Of the residual group who required ‘treatment’ approximately 17% required steroid injection or orthoses and 143 (13%) received advice and went away to contemplate the consultation. Referral pathways could be improved by greater communication between GP and foot and ankle service with the construction and implementation of referral guidelines which would enhance the referral and treatment pathway to the service. (Source: The Foot)

Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts

BMC Medical Education — Tue, 29 Nov 2011 05:00:00 +0100

Conclusions: During the first two years in the workforce, there was a transitory decline in the self-reported practice and sense of relevance of EBP, despite increases in confidence and knowledge. The pattern of progression of EBP skills beyond these early professional working years is unknown. (Source: BMC Medical Education)

Evaluation of back pain

Paediatrics and Child Health — Mon, 28 Nov 2011 18:39:52 +0100

This article provides an overview of the important and common causes of back pain in children, and highlights key features in the history and examination that should raise suspicion of an underlying disorder and prompt further investigation. (Source: Paediatrics and Child Health)

Bone and joint infections

Paediatrics and Child Health — Mon, 28 Nov 2011 18:39:52 +0100

This article will discuss the clinical presentations of paediatric bone and joint infections. The approach to clinical assessment, laboratory and radiological investigations, and management of these conditions, will be discussed. Caring for patients with bone and/or joint infections, often involves several specialities; emergency department doctors, general paediatricians, orthopaedic surgeons, radiologists, paediatric rheumatologists, and the paediatric physiotherapy teams. Early and close collaboration between teams will result in prompt investigation with age appropriate care. (Source: Paediatrics and Child Health)

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Kenya: Limuru's Nazareth Hospital Gets New Facilities

AllAfrica News: Health and Medicine — Mon, 28 Nov 2011 13:31:35 +0100

The newly installed physiotherapy and eye units at the Nazareth Hospital in Limuru district are now fully functional, the hospital administrator has said. (Source: AllAfrica News: Health and Medicine)

Guide rates best and worst hospitals in 2011

NHS News Feed — Mon, 28 Nov 2011 00:15:00 +0100

The Daily Telegraph has today revealed the findings of the latest Dr Foster Hospital Guide. The guide, published annually, closely scrutinises a range of healthcare data to measure hospital performance and detect trends that could save lives. As well as listing the hospital trusts in England that score above and below average on a range of different mortality measures, this year’s guide also found that: The rate of patient deaths in England is 20% lower than it was 10 years ago, in part because of improved hospital care. For certain conditions, patients admitted to hospital at the weekend are less likely to get treated quickly and have a higher chance of dying. Hospitals that perform certain operations infrequently pose a significantly greater risk to patients than those which c...

Combined Therapy (Ultrasound and Interferential Current) in Patients with Fibromyalgia: Once or Twice in a Week?

Physiotherapy Research International — Sat, 26 Nov 2011 10:20:37 +0100

ConclusionThere is no advantage in increasing the number of sessions of combined therapy in terms of reducing generalized pain, quality of life and sleep quality for patients with FM. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

Virtual reality rehabilitation of balance: assessment of the usability of the Nintendo Wii(®) Fit Plus.

Disability and Rehabilitation. Assistive Technology. — Fri, 25 Nov 2011 05:00:00 +0100

Conclusions: This study has quantified the usability of the NWFP as a treatment for balance impairment showing high levels of usability and enjoyment with no serious adverse effects. The results of this study may assist physiotherapists in devising novel balance rehabilitation programmes. [Box: see text]. PMID: 22117107 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation. Assistive Technology.)

Functional Outcomes, Exercise Capacity and Recovery of Patients After Cardiac Surgery

Heart, Lung and Circulation — Fri, 25 Nov 2011 02:38:01 +0100

This study aims to investigate the recovery of daily function, exercise tolerance and activity in the short to medium term post open heart surgery. There is limited current literature on functional recovery, quality of life and exercise capacity after cardiac surgery, with most of these studies utilising subjective self-report instruments and questionnaires rather than exercise tests to measure functional capacity. There is emerging evidence that pre-operative exercise testing can inform risk assessment and functional outcomes in patients undergoing aortic valve replacement . Pre-operative physiotherapy may have the capacity to improve function and surgical outcomes, yet the patient groups who may benefit from this are poorly defined. (Source: Heart, Lung and Circulation)

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'Physical Activity at Home (PAAH)', Evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design

BMC Public Health - Latest articles — Thu, 24 Nov 2011 05:00:00 +0100

DiscussionThe planned 18 month follow-up post intervention will provide an indication of the effectiveness of the group and home based interventions in terms of adherence to physical activity, health benefits and cost. If the physiotherapy-led home based physical activity program is successful it could provide an alternative option for physical activity program delivery across a number of settings.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12611000890932. (Source: BMC Public Health - Latest articles)

Medical management of children with achondroplasia: Evaluation of an Australasian cohort aged 0–5 years

Journal of Paediatrics and Child Health — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions: Access to geneticists and paediatricians within the first year is high as recommended by the 2005 American Academy of Pediatrics guidelines. Utilisation of craniocervical magnetic resonance imaging/computed tomography, polysomnography studies and formal speech review appears low, reflecting more emphasis on clinical monitoring for cervical cord compression and disordered sleep breathing as well as possible difficulties in accessing services for polysomnography and speech pathology. Grommet insertion, tonsillectomy/adenoidectomy and cervicomedullary decompression rates are similar to results reported previously. Over half of the children accessed physiotherapy and/or occupational therapy services, warranting consideration of these professionals in future guideline recommenda...

Medical care delivery at the Inaugural Youth Olympic Games Singapore 2010

British Journal of Sports Medicine — Wed, 23 Nov 2011 05:00:00 +0100

Conclusion The dispersed nature of the Games venues provided challenges to the organisation of medical cover for the participants. Organisers in future Games can make use of the data to plan for future Games of a similar nature. (Source: British Journal of Sports Medicine)

Non hereditary idiopathic multicentric oseolysis: A case report

Bone — Tue, 22 Nov 2011 16:58:00 +0100

Idiopathic multicentric osteolysis (IOM) is a rare disease characterized by osteolysis of carpus and tarsus, with inflammation and pain. It is classified into 5 Types, 1: Hereditary IOM with dominant transmission. 2: Hereditary IOM with recessive transmission. 3: Non hereditary IOM, associated with nephropathy and hypertension. 4: Gorham syndrome: massive osteolysis and replacement of bone by lymphatic or blood vessel tissue. 5: Winchester syndrome: IOM with deafness, short stature, mental retardation and osteoporosis. A 50year old male with history of pain, swelling and deformity in wrists and feet since he was 4years, presented functional involvement of feet and hands. At 34years he had referred proteinuria, edema and hypertension, and developed chronic renal failure. He underwent dialys...

Physical capacity of girls with mild and moderate idiopathic scoliosis: influence of the size, length and number of curvatures

European Spine Journal — Mon, 21 Nov 2011 06:32:37 +0100

Conclusion The maximum oxygen intake and the output during the PWC170 test is lower in girls with moderate scoliosis than in the control group. The value of maximum oxygen intake and output obtained during the PWC170 test in girls with mild scoliosis does not differ significantly from the values obtained in the control group. The number of vertebrae involved in scoliotic deformation and the number of curvatures cause significant decrease in only the relative value of the output obtained during an exercise test. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00586-011-2068-zAuthors Dariusz Czaprowski, Faculty of Physiotherapy, Józef Rusiecki University College in Olsztyn, Bydgoska 33, 10-243 Olsztyn, PolandTomasz Kotwicki, Department of...

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The active cycle of breathing technique: A systematic review and meta-analysis

Respiratory Medicine — Mon, 21 Nov 2011 05:00:00 +0100

Conclusion: The overall body of evidence was classified as good (good volume, quality and consistency, excellent generalisability). High level, variable risk of bias research evidence favours ACBT over most alternatives for short-term improvements in secretion clearance. (Source: Respiratory Medicine)

Psychosocial interventions for the management of chronic orofacial pain.

Cochrane Database of Systematic Reviews — Sun, 20 Nov 2011 22:06:03 +0100

CONCLUSIONS: There is weak evidence to support the use of psychosocial interventions for chronic orofacial pain. Although significant effects were observed for outcome measures where pooling was possible, the studies were few in number and had high risk of bias. However, given the non-invasive nature of such interventions they should be used in preference to other invasive and irreversible treatments which also have limited or no efficacy. Further high quality trials are needed to explore the effects of psychosocial interventions on chronic orofacial pain. PMID: 22071849 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Surgical versus non-surgical interventions for treating patellar dislocation.

Cochrane Database of Systematic Reviews — Sun, 20 Nov 2011 22:06:03 +0100

CONCLUSIONS: There is insufficient high quality evidence to confirm any significant difference in outcome between surgical or non-surgical initial management of people following primary patellar dislocation, and none examining this comparison in people with recurrent patellar dislocation. Adequately powered randomised, multi-centre controlled trials, conducted and reported to contemporary standards are recommended. PMID: 22071844 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Varus Femoral Osteotomy Improves Sphericity of the Femoral Head in Older Children With Severe Form of Legg-Calvé-Perthes Disease.

Clinical Orthopaedics and Related Research — Sat, 19 Nov 2011 05:00:00 +0100

CONCLUSIONS: In children aged 6.0 to 10.0 years, in whom the whole femoral head is affected, femoral head sphericity 5 years after femoral osteotomy was better than that after physiotherapy. LEVEL OF EVIDENCE: Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID: 22101403 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)

Respiratory physiotherapy in the pre and postoperative myocardial revascularization surgery

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

This study aimed at updating the knowledge regarding the respiratory physiotherapy performance in the pre and postoperative period of the myocardial revascularization surgery enhancing the prevention of lung complications. The Physiotherapy uses several techniques in the preoperative period; such as: the incentive spirometry, exercises of deep breathing, cough, inspiratory muscle training, earlier ambulation and physiotherapeutic orientations. While in the postoperative period, the objective is the treatment after lung complications took place, performed by means of physiotherapeutic maneuvers and noninvasive respiratory devices, aiming at improving the respiratory mechanism, the lung reexpansion and the bronchial hygiene. Respiratory physiotherapy is an integral part in the care managemen...

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K Taping(Kumbrink)

Springer Medicine titles — Fri, 18 Nov 2011 00:02:19 +0100

An Illustrated Guide - Basics - Techniques - IndicationsBirgit Kumbrink's bestselling guide to K Taping - finally available in English! This richly illustrated hands-on guidebook features a highly successful therapeutic approach to treating orthopedic, traumatological and many other conditions. It serves both as a perfect companion to training courses and as a reference book and refresher for health care professionals who have completed their ... (Source: Springer Medicine titles)

Early incontinence after radical prostatectomy: A community based retrospective analysis in 911 men and implications for preoperative counseling.

Urologic Oncology — Thu, 17 Nov 2011 05:00:00 +0100

CONCLUSION: Preoperative counseling of patients should provide them with realistic expectations for P-RP-I and motivate them to conservative therapy, as it reduces the duration and degree of urinary incontinence. PMID: 22100069 [PubMed - as supplied by publisher] (Source: Urologic Oncology)

Work ability: Concept and assessment from a physiotherapeutic perspective. An interview study.

Physiotherapy Theory and Practice — Wed, 16 Nov 2011 05:00:00 +0100

Authors: Stigmar K, Ekdahl C, Grahn B Abstract The aim of this study was to ascertain experiences and perceptions among physiotherapists (PTs) in Sweden regarding the concept of work ability as well as their perspectives of their professional role in work ability assessments. We conducted an in-depth interview study with four male and twelve female physiotherapists working in the field of occupational health care, orthopaedics, primary health care or rehabilitation. Qualitative content analysis was applied to the data. Work ability was perceived as the ability to perform work tasks as requested. Having the potential to adjust at work and to allocate resources, having an attachment to the workplace and time factors were vital. The physiotherapists were striving for a well-defined ro...

Effects of a 5-h hilly running on ankle plantar and dorsal flexor force and fatigability

European Journal of Applied Physiology — Tue, 15 Nov 2011 16:59:20 +0100

In conclusion, significant isometric strength loss was only detected for PF after a 5-h hilly run and was partly due to low-frequency fatigue. This study contradicted the hypothesis that neuromuscular alterations due to prolonged hilly running are predominant for DF. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00421-011-2220-9Authors François Fourchet, National Sports Medicine Programme, ASPIRE Health Centre—ASPETAR, 2006 Asian Games Road, Doha, QatarGrégoire P. Millet, Department of Physiology, Faculty of Biology and Medicine, ISSUL Institute of Sport Sciences, University of Lausanne, Bâtiment Vidy, 1015 Lausanne, SwitzerlandKatja Tomazin, Faculty of Sport, University of Ljubljana, Ljubljana, SloveniaKenny Guex, Department of Physiotherapy, HEC...

Gender, educational and age differences in meanings that underlie global self-rated health

International Journal of Public Health — Thu, 10 Nov 2011 06:45:55 +0100

Conclusions Investigators using the single question on self-rated health for comparing health across different population groups should be aware that the meaning of the question varies across different socio-demographic groups. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00038-011-0320-2Authors Wim Peersman, Department of General Practice and Primary Health Care, Ghent University, Campus Heymans, 1K3, De Pintelaan 185, 9000 Ghent, BelgiumDirk Cambier, Department of Rehabilitation Sciences and Physiotherapy Ghent, Artevelde University College, Ghent University, Campus Heymans, 1B3, De Pintelaan 185, 9000 Ghent, BelgiumJan De Maeseneer, Department of General Practice and Primary Health Care, Ghent University, Campus Heymans, 1K3, De Pint...

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Student perceptions of the effectiveness of triads to learning in undergraduate sports therapy curriculum: an exploratory study

British Journal of Sports Medicine — Thu, 10 Nov 2011 05:00:00 +0100

Triads, a type of Peer Assisted Learning used in clinical education settings are documented in medical and health professions research, (Burke et al. MT 2007;29:577–82, Henning et al. JAT 2006,41:102–8). Considering the rise in sports medicine curricula in the UK this pedagogical strategy is largely uninvestigated. This exploratory study aims firstly to implement a new pedagogy and secondly to evaluate student learning potential using triads within an undergraduate curriculum from a UK perspective. 21 Year 2 BSc (Hons) Sports Therapy students at University of Worcester, England completed a questionnaire survey answered in retrospect of classes in Sports Massage and Exercise Therapy in academic year 09–10. A mixed-methods research design employed a survey which focused on ...

Answers

Archives of Disease in Childhood - Education and Practice — Thu, 10 Nov 2011 05:00:00 +0100

From questions on page 209 The answer is A, lichen planus (LP). This patient presents with the classic ‘6 Ps’ seen in LP: purple, planar, pruritic, polygonal plaques and papules. Its surface has subtle white dots and lines in a reticulated pattern, called Wickham's striae. This finding is often visible only on close inspection. LP has a predilection for flexoral surfaces, though scalp, mucous membranes, nail and genital involvement may occur as well. Papular lesions erupting in a linear fashion after mechanical trauma, such as scratching, is known as the Koebner phenomenon. Paediatric cases comprise only 2–3% of LP and occur more frequently in children of African heritage. Although the exact aetiology is unknown, genetic predisposition and autoimmune processes may play a ...

Mapping Patient-Specific Functional Scale (PSFS) Items to the International Classification of Functioning, Disability and Health (ICF).

Physical Therapy — Thu, 10 Nov 2011 05:00:00 +0100

CONCLUSIONS:/b>The ICF activity component was most commonly represented by patient-nominated PSFS items, the participation component was moderately represented, and impairment was least represented. Hence, the PSFS would complement impairment-based clinical outcome measures. PMID: 22074939 [PubMed - as supplied by publisher] (Source: Physical Therapy)

Isometric Muscle Training of the Spine Musculature in Patients With Spinal Bony Metastases Under Radiation Therapy

BMC Cancer — Wed, 09 Nov 2011 05:00:00 +0100

This study is a prospective, randomized, monocentre, controlled explorative intervention study in the parallel-group design to determine the multidimensional effects of a course of exercises at first under physiotherapeutic instruction and subsequently performed by the patients independently for strengthening the paravertebral muscles of patients with metastases of the vertebral column parallel to their percutaneous radiotherapy. On the days of radiation treatment the patients in the control group shall be given physical treatment in the form of respiratory therapy and the so-called "hot roll". The patients will be randomized into one of the two groups: differentiated muscle training or physiotherapy with thirty patients in each group.DiscussionThe aim of the study is to evaluate the feasi...

Why still in hospital after fast-track hip and knee arthroplasty?

Acta Orthopaedica — Wed, 09 Nov 2011 05:00:00 +0100

Authors: Husted H, Lunn TH, Troelsen A, Gaarn-Larsen L, Kristensen BB, Kehlet H Abstract Background and purpose Length of stay (LOS) following total hip and knee arthroplasty (THA and TKA) has been reduced to about 3 days in fast-track setups with functional discharge criteria. Earlier studies have identified patient characteristics predicting LOS, but little is known about specific reasons for being hospitalized following fast-track THA and TKA. Patients and methods To determine clinical and logistical factors that keep patients in hospital for the first postoperative 24?72 hours, we performed a cohort study of consecutive, unselected patients undergoing unilateral primary THA (n = 98) or TKA (n = 109). Median length of stay was 2 days. Patients were operated with spinal anesthes...

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Conservative treatment with spontaneous stabilization of Grade II isthmic spondylolisthesis L5/S1 in a forty-four-year old woman, with a six-year follow-up: a case report.

European Journal of Physical and Rehabilitation Medicine — Wed, 09 Nov 2011 05:00:00 +0100

Authors: Ferrari S, Costa F, Fornari M Abstract Spondylolisthesis is a pathological condition caused by the slipping of a vertebral body, compared to the underlying structure, following structural and/or degenerative changes to the spine. Studies have attempted evidence to the connection between the natural history of spondylolisthesis, the degree and progression of the slip factor, as well as the pain and disability. Studies have reported a high level of heterogeneity of these factors in different patients as well as difficulty in predicting behaviour. It has been suggested that vertebral instability, independent of the slip factor, could be considered the most important factor to be treated conservatively or surgically. Furthermore, it appears that some patients may manifest comp...

Diagnosis and treatment of psychogenic parkinsonism

Journal of Neurology, Neurosurgery and Psychiatry — Mon, 07 Nov 2011 05:00:00 +0100

Parkinson's disease (PD) is the most common movement disorder encountered in movement disorder clinics but psychogenic parkinsonism (PP) is relatively rare. Based on a study of 32 patients, coupled with a comprehensive review of the literature, the diagnosis, clinical phenomenology, epidemiology, natural history, imaging and treatment, this article provides a critical review of PP. In addition to other PD-like symptoms, patients with PP often exhibit abrupt onset, typically in response to a stressful event, followed by a fluctuating course, early disability, bilateral shaking and slowness, non-decremental slowness when performing repetitive movements, voluntary resistance against passive movement without cogwheel rigidity, distractibility, generalised and ‘give-way’ weakness, s...

Editorial Board

Physiotherapy — Fri, 04 Nov 2011 19:50:54 +0100

(Source: Physiotherapy)

Violence towards those who care

Physiotherapy — Fri, 04 Nov 2011 19:50:54 +0100

It seems that hardly a month goes by without the report of an attack on a healthcare worker. The Care Quality Commission described the results of an annual survey where 8% of staff reported experiencing physical violence from patients, relatives or other members of the public. Violence was more likely to be reported by frontline staff such as ambulance workers (18%), where 27% also reported being subjected to bullying, harassment and abuse from patients and relatives . The NHS Counter Fraud and Security Management Service, set up to protect the NHS on a number of fronts, stated that there were 56 718 reported physical assaults against NHS staff in England in 2009/10. This equates to a staggering 150 assaults each day . Healthcare workers are not alone and firefighters often face similar ch...

Timing May Be Key to Successful Back Surgery

Orthopedics News - Doctors Lounge — Fri, 04 Nov 2011 19:00:00 +0100

Waiting longer than six months to repair herniated disc may hinder recovery, study says (Source: Orthopedics News - Doctors Lounge)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Postural control, motor skills, and health-related quality of life in children with hearing impairment: a systematic review

European Archives of Oto-Rhino-Laryngology — Fri, 04 Nov 2011 16:55:08 +0100

The objective of this review was to systematically analyze the available information in the literatures regarding the postural control, motor skills, and health-related quality of life in children with hearing impairment. Searches of data sources PubMed, MEDLINE, CINHAL, EMBASE, SCOPUS, ISI of web science, Cochrane Library, and AMED database were performed from the earliest to 7 February 2011. Study eligibility criteria included non-interventional studies that addressed postural control, motor skills, and health-related quality of life in children with hearing impairment. For each eligible article, data were extracted using custom-designed forms by a single investigator. Collected data included study demographics, study design, study population, sample size, outcome measures, and res...

Efficacy comparisons of the intraarticular steroidal agents in the patients with knee osteoarthritis

Rheumatology International — Fri, 04 Nov 2011 16:52:26 +0100

Abstract Osteoarthritis is a chronic disease that causes serious pain and limitations in activities. Intraarticular corticosteroid injections combined with pharmacological treatment and physiotherapy have been used for years to control the local inflammation and relieve pain in the patients with osteoarthritis. There are several animal experiments which suggested that the intraarticular corticosteroid injections impair cartilage protein synthesis. However, there are no serious evidences suggesting the increase of cartilage impairment. The aim of our study was to compare the efficacy of placebo and intraarticular corticosteroid agents in the patients with symptomatic knee osteoarthritis. One hundred and twenty patients with painful knee osteoarthritis were included in the p...

A pilot study to explore the effectiveness of "early" rehabilitation after a hospital admission for chronic heart failure.

Physiotherapy Theory and Practice — Fri, 04 Nov 2011 04:00:00 +0100

A pilot study to explore the effectiveness of "early" rehabilitation after a hospital admission for chronic heart failure. Physiother Theory Pract. 2011 Nov 4; Authors: Houchen L, Watt A, Boyce S, Singh S Abstract People with chronic heart failure (CHF) experience acute exacerbations of their symptoms. These episodes are costly to patients and the health service. The study was a single group, pretest and posttest design. Seventeen patients with left ventricular systolic dysfunction (LVSD) started rehabilitation within 4 weeks of hospital discharge. The 6 week rehabilitation programme included exercise and self-management education. The hospital anxiety and depression scale (HADS), the incremental and endurance shuttle walking tests (ISWT/ESWT) were assessed at baseline and ...

Effects of low-level laser therapy in combination with physiotherapy in the management of rotator cuff tendinitis

Lasers in Medical Science — Thu, 03 Nov 2011 16:55:09 +0100

The objective of this study was to evaluate the possible additive effects of low-power laser treatment in combination with conventional physiotherapy endeavors in these patients. A total of 50 patients who were referred to the Physical Medicine and Rehabilitation Clinic with shoulder pain and rotator cuff disorders were selected. Pain severity measured with visual analogue scale (VAS), abduction, and external rotation range of motion in shoulder joint was measured by goniometry, and evaluation of daily functional abilities of patients was measured by shoulder disability questionnaire. Twenty-five of the above patients were randomly assigned into the control group and received only routine physiotherapy. The other 25 patients were assigned into the experimental group and received conv...