Physiotherapy
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Ajouter le résultat dans votre panierDelegation by Allied Health Professionals to Allied Health Assistants: a mixed methods systematic review / P. Sarigiovannis in Physiotherapy, Vol. 112 (2021)
Titre : Delegation by Allied Health Professionals to Allied Health Assistants: a mixed methods systematic review Type de document : Article Auteurs : P. Sarigiovannis ; S. Jowett ; B. Saunders ; N. Corp ; A. Bishop Année de publication : 2021 Article en page(s) : p. Bishop Note générale : https://doi.org/10.1016/j.physio.2020.10.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Analyse coût-bénéfice ; Attitude ; Délégation au personnel ; Résultat thérapeutiqueRésumé : Background
Delegation by Allied Health Professionals (AHPs) to Allied Health Assistants (AHAs) was introduced in response to various challenges affecting modern health care delivery. However, the clinical and cost-effectiveness of using AHAs is relatively unexplored.
Objectives
The aim of this review was to synthesise the available evidence on; firstly, the clinical and cost-effectiveness of interventions delegated by AHPs to AHAs and secondly, AHPs’, AHAs’ and patients’ attitudes and beliefs towards delegation.
Data sources
MEDLINE, AMED, CINAHL, Cochrane Library, PsycINFO, PEDro, OTseeker and Web of Science databases were searched from inception until January 2019 without restrictions.
Study selection
Primary studies investigating the clinical and cost-effectiveness of any intervention delegated by an AHP, across the spectrum of clinical areas in relation to adult patients, as well as AHPs’, AHAs’ and patients’ attitudes and beliefs about delegation.
Data extraction & synthesis
Data were extracted by pairs of reviewers. Thematic analysis and synthesis of descriptive and analytical themes was conducted.
Results
Thirteen publications of variable methodological quality were included. Three studies reported quantitative research and ten qualitative research. No study explored the cost-effectiveness. Only one study investigated clinical effectiveness. Training for both AHPs and AHAs and having clear processes in place were identified as important facilitators of delegation.
Conclusion and implications of key findings
Delegation is not standardised across AHPs or within each profession. There are clear knowledge gaps regarding the clinical and cost-effectiveness of delegation by AHPs and patients’ attitudes and preferences. Further research is needed to facilitate the standardisation of delegation.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275030
in Physiotherapy > Vol. 112 (2021) . - p. Bishop[article]
Titre : The effect of spinal manipulative therapy on pain relief and function in patients with chronic low back pain: an individual participant data meta-analysis Type de document : Article Auteurs : Annemarie de Zoete ; Sidney M. Rubinstein ; Michiel R. de Boer ; Raymond Ostelo ; Martin Underwood ; Jill A. Hayden ; Laurien M. Buffart ; Maurits W. van Tulder Année de publication : 2021 Article en page(s) : p. 121-134 Note générale : https://doi.org/10.1016/j.physio.2021.03.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Lombalgie ; Manipulations de l'appareil locomoteur ; RachisRésumé : Background
A 2019 review concluded that spinal manipulative therapy (SMT) results in similar benefit compared to other interventions for chronic low back pain (LBP). Compared to traditional aggregate analyses individual participant data (IPD) meta-analyses allows for a more precise estimate of the treatment effect.
Purpose
To assess the effect of SMT on pain and function for chronic LBP in a IPD meta-analysis.
Data sources
Electronic databases from 2000 until April 2016, and reference lists of eligible trials and related reviews.
Study selection
Randomized controlled trials (RCT) examining the effect of SMT in adults with chronic LBP compared to any comparator.
Data extraction and data synthesis
We contacted authors from eligible trials. Two review authors independently conducted the study selection and risk of bias. We used GRADE to assess the quality of the evidence. A one-stage mixed model analysis was conducted. Negative point estimates of the mean difference (MD) or standardized mean difference (SMD) favors SMT.
Results
Of the 42 RCTs fulfilling the inclusion criteria, we obtained IPD from 21 (n = 4223). Most trials (s = 12, n = 2249) compared SMT to recommended interventions. There is moderate quality evidence that SMT vs recommended interventions resulted in similar outcomes on pain (MD −3.0, 95%CI: −6.9 to 0.9, 10 trials, 1922 participants) and functional status at one month (SMD: −0.2, 95% CI −0.4 to 0.0, 10 trials, 1939 participants). Effects at other follow-up measurements were similar. Results for other comparisons (SMT vs non-recommended interventions; SMT as adjuvant therapy; mobilization vs manipulation) showed similar findings. SMT vs sham SMT analysis was not performed, because we only had data from one study. Sensitivity analyses confirmed these findings.
Limitations
Only 50% of the eligible trials were included.
Conclusions
Sufficient evidence suggest that SMT provides similar outcomes to recommended interventions, for pain relief and improvement of functional status. SMT would appear to be a good option for the treatment of chronic LBP.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275033
in Physiotherapy > Vol. 112 (2021) . - p. 121-134[article]
Titre : Pilates improves physical performance and decreases risk of falls in older adults: a systematic review and meta-analysis Type de document : Article Auteurs : Rubén Fernández-Rodríguez ; Celia Álvarez-Bueno ; Asunción Ferri-Morales ; Ana Torres-Costoso ; Diana P. Pozuelo-Carrascosa ; Vincente Martínez-Vizcaíno Année de publication : 2021 Article en page(s) : p. 163-177 Note générale : https://doi.org/10.1016/j.physio.2021.05.008 Langues : Anglais (eng) Descripteurs : HE Vinci
Méthodes Pilates ; Prévention ; Thérapies corps-esprit ; Traitement par les exercices physiques ; VieillissementRésumé : Background
Falls are the leading cause of injury-related deaths in older adults. Physical exercise is a suitable strategy to reduce the risk of falls, but there is little research on the effectiveness of specific exercise modalities.
Objectives
To estimate the effectiveness of Pilates compared to habitual or non-exercise on physical performance and the risk of falls in older adults.
Data sources
Five databases were searched through April 15, 2021.
Study selection
Randomized controlled trial in people aged ≥60 years. Outcomes: balance, strength, flexibility, functionality, and risk of falls.
Data synthesis
Pooled standardized mean differences were calculated using a random-effects model. Subgroup analyses based on Pilates’ modality, the existence of a detailed exercise protocol, supervision by a certified instructor, and overall risk of bias were performed.
Results
Thirty-nine studies were included in the systematic review and meta-analyses. The meta-analyses indicated a moderate effect of Pilates on balance (ES = 0.36; 95% CI = 0.21 to 0.50), strength (ES = 0.63; 95% CI = 0.44 to 0.81), flexibility (ES = 0.41; 95% CI = 0.16 to 0.67), and functionality (ES = 0.51; 95% CI = 0.32 to 0.72) as well as a large effect on the risk of falls (ES = 0.90; 95% CI = 0.41 to 1.38) in older adults when compared with control groups. The level of certainty of the findings was low for balance, flexibility, and functionality and moderate for strength and falls.
Conclusion and implications of key findings
Pilates may promote the autonomy of older people in their daily living activities.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275035
in Physiotherapy > Vol. 112 (2021) . - p. 163-177[article]
Titre : Reframing how we care for people with persistent non-traumatic musculoskeletal pain. Suggestions for the rehabilitation community Type de document : Article Auteurs : Jeremy S. Lewis ; Emma K. Stokes ; Boris Gojanovic ; Pamela Gellatly ; Chidozie Mbada ; Saurab Sharma ; Ina Diener ; Peter O' Sullivan Année de publication : 2021 Article en page(s) : p. 143-149 Note générale : https://doi.org/10.1016/j.physio.2021.04.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Appareil locomoteur ; Douleur ; Kinésithérapie (spécialité) ; Organisation ; Procédure ; SoinsRésumé : There have been repeated calls to re-evaluate how clinicians provide care for people presenting with persistent non-traumatic musculoskeletal conditions. One suggestion is to move away from the ‘we can fix and cure you’ model to adopting an approach that is more consistent with approaches used when managing other persistent non-communicable diseases; education, advice, a major focus on self-management including lifestyle behavioural change, physical activity and medications as required. Currently the global delivery of musculoskeletal care has many of the elements of a ‘super wicked problem’, namely conflict of interest from stake-holders due to the consequences of change, prevailing expectation of a structural diagnosis and concomitant fix for musculoskeletal pain, persistent funding of high risk, more expensive care when low risk more economic viable options that don’t impact on the quality of outcome exist, and an unquestionable need to find a solution now with the failure resulting in a growing social and economic burden for future generations. To address these issues, 100 participants included clinicians, educators and researchers from low-, middle- and high-income countries, eight presenters representing the physiotherapy, sport medicine and the orthopaedic professions and the insurance industry, together with three people who shared their lived experiences of persistent musculoskeletal pain, discussed the benefits and barriers of implementing change to address this problem. This paper presents the results from the stakeholders’ contextual analysis and forms the basis for the proposed next steps from an action and advocacy perspective. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275038
in Physiotherapy > Vol. 112 (2021) . - p. 143-149[article]
Titre : This is the day your life must surely change [11]: Prioritising behavioural change in musculoskeletal practice Type de document : Article Auteurs : Jeremy Lewis ; Colette Ridehalgh ; Ann Moore ; Kevin Hall Année de publication : 2021 Article en page(s) : p. 158-162 Note générale : https://doi.org/10.1016/j.physio.2021.05.007 Langues : Anglais (eng) Descripteurs : HE Vinci
Comportement ; Douleur chronique ; Douleur musculosquelettiqueRésumé : Behavioural change is the modification or transformation of behaviour. Health behaviour has been defined as, ‘any activity undertaken for the purpose of preventing or detecting disease or for improving health and wellbeing’ (Bennell et al., 2019 [1]). For a smoker it is acting on the decision to stop or reduce the number of cigarettes smoked, for someone with a higher than ideal body mass index, it is acting to reduce weight and for someone who isn’t achieving ideal levels of exercise (Briggs et al., 2020 [2]) it is the decision and action to increase metabolic activity. With increased understanding of the importance of self-management and impact of lifestyle, clinicians supporting people presenting with musculoskeletal symptoms have recognized that behavioural change is an essential component of the care we need to prioritize. It is about sharing the benefits of lifestyle choices that promote health, discussing how to introduce and maintain them, and supporting people through their journey of change, so the change becomes the new normal. Behavioural change science assumes that (i) morbidity and mortality are due in part to certain behaviours and (ii) these behaviours are modifiable. The aim of this debate article is to discuss reasons why clinicians must include long term behavioural change into their management plan and methods they may use to facilitate the change ensuring recipients are empowered to act and make today the day their ‘lives will surely change’. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275040
in Physiotherapy > Vol. 112 (2021) . - p. 158-162[article]
Titre : An evaluation of the measurement properties of the Olerud Molander Ankle Score in adults with an ankle fracture Type de document : Article Auteurs : Rebecca McKeown ; Helen Parsons ; David R. Ellard ; Rebecca S. Kearney Année de publication : 2021 Article en page(s) : p. 1-8 Note générale : https://doi.org/10.1016/j.physio.2021.03.015 Langues : Anglais (eng) Descripteurs : HE Vinci
Fractures de la cheville ; Mesures des résultats rapportés par les patients (PROM) ; Qualité de vie ; RéadaptationRésumé : Objectives
The aim of this study is to evaluate the measurement properties of the Olerud Molander Ankle Score in adults with an ankle fracture.
Methods
Patients completed outcome measure questionnaires at baseline, six, 10- and 16-weeks postinjury as part of an ongoing clinical trial on ankle fracture rehabilitation. The internal consistency, convergent validity, structural validity and interpretability of the Olerud Molander Ankle Score was assessed. This was achieved through using the respective analysis methods of Cronbach's alpha, correlation coefficients, principal component analysis, evaluation of floor and ceiling scores and estimation of the minimally important change using anchor-based methods.
Results
The Olerud Molander Ankle Score showed adequate convergent validity against hypotheses set in relation to scores of comparator instruments. Principal component analysis demonstrated that the measure has two subscales: ankle function and ankle symptoms. The internal consistency of the measure and the ankle function subscale was sufficient, but inconclusive for the ankle symptoms subscale. There were no floor and ceiling effects present within the scores and the estimated minimally important change was 9.7 points.
Conclusion
The Olerud Molander Ankle Score demonstrates sufficient measurement properties and is likely to be primarily measuring the construct of patient reported function following ankle fracture. Further research should evaluate the relevance of other domains to individuals recovering from and ankle fracture, such as social participation and psychological wellbeing. The development of a core outcome set would be advantageous to standardise outcome measurement collection in this area.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275050
in Physiotherapy > Vol. 112 (2021) . - p. 1-8[article]
Titre : Choosing Wisely Brazil: top 5 low-value practices that should be avoided in musculoskeletal physical therapy Type de document : Article Auteurs : F.J.J. Reis ; N. Meziat-Filho ; R.J. Soares ; L.C.L. Correia Année de publication : 2021 Article en page(s) : p. 9-15 Note générale : https://doi.org/10.1016/j.physio.2021.03.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Éducation du patient comme sujet ; Maladies ostéomusculaires ; Prise de décision clinique ; Techniques de physiothérapieRésumé : Background
The Choosing Wisely initiative aims to promote discussions among healthcare professionals and patients about low-value, or potentially harmful, health practices.
Objectives
To describe the process of development of the Brazilian Choosing Wisely list for musculoskeletal physical therapy.
Methods
The Brazilian Choosing Wisely list was developed in accordance with the recommendations of the American Board of Internal Medicine. A three-step procedure was used. First, an expert panel was selected, and a modified Delphi approach was used to obtain a list of evidence-based statements. Second, members of the research team performed content analysis. Third, a national survey was conducted to present selected statements to a sample of physical therapists. Participants were invited to vote considering the level of importance of selected statements for physical therapists and patients.
Results
The expert panel comprised 17 physical therapists. The median age of the expert panel was 33 [interquartile range (IQR) 29 to 37; range 26 to 60] years and the median length of professional experience was 12 (IQR 10 to 18) years. A list of eight recommendations was presented to a national sample composed of 1127 physical therapists. The median length of professional experience of the national sample was 10 (IQR 5 to 15) years. Based on the number of votes, the five most important recommendations were included in the Brazilian Choosing Wisely list for musculoskeletal physical therapy. Descriptive and frequency analysis were used to report the results.
Conclusion
The Brazilian Choosing Wisely list for musculoskeletal physical therapy provides an opportunity for physical therapists, patients, society and policy makers to collaboratively discuss tests and treatments that are unnecessary or potentially harmful.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275051
in Physiotherapy > Vol. 112 (2021) . - p. 9-15[article]
Titre : Development of stratified normative data and reference equations for the timed up and down stairs test for healthy children 6–14 years of age Type de document : Article Auteurs : Tamara Del Corral ; Jorge Vivas-Mateos ; María Castillo-Pelaz ; Sandra Aguilar-Zafra ; Ibai López-de-Uralde-Villanueva Année de publication : 2021 Article en page(s) : p. 31-40 Note générale : https://doi.org/10.1016/j.physio.2021.03.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Aptitudes motrices ; Enfant (6-12 ans) ; Montée d'escalier ; Performance psychomotriceRésumé : Objectives
To generate normative data on healthy children aged 6–14 years for the timed up and down stairs (TUDS) test, and to provide reference equations.
Design and setting
Cross-sectional study at two primary schools.
Participants
Healthy children 6–14 years of age.
Main outcomes measures
Anthropometric data and Minnesota Leisure-Time Physical Activity Questionnaire from children were collected before the start of the TUDS test. Heart rate, blood pressure and perceived exertion were measured at the beginning and at the end of the test. Two trials of the TUDS test were performed with 15-minute of rest on the same day and the better of the two trials was used in the analyses. The reference equations were established using the anthropometric variables as possible predictors of the TUDS test.
Results
Two hundred fifty eight children (125 boys and 133 girls) were assessed. The mean TUDS test score decreased significantly from 6 to 14 years of age in boys and girls alike, with statistically significant differences between the three age range groups. A significant difference was found between girls and boys in TUDS test score. The 56% of the variation in TUDS test score could be explained by age, height, and weight in boys [TUDSsec score = (9.967 − (0.182 × Ageyears) + (0.025 × Weightkg) − (2.546 × Heightm)], while 50% could be explained in girls [TUDSsec score = 10.553 − (0.194 × Ageyears) + (0.019 × Weightkg) − (2.406 × Heightm)]. The inclusion of physical level activity increased the variability explained (boys: 59%; girls: 51%).
Conclusions
TUDS score improved as the age of the children increased, with boys achieving better values than girls within each age group. TUDS test score can be easily predicted from age, height, and weight. The inclusion of the child's physical activity level increased the variance explained by the equation.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275058
in Physiotherapy > Vol. 112 (2021) . - p. 31-40[article]
Titre : Experiences of training and delivery of Physical therapy informed by Acceptance and Commitment Therapy (PACT): a longitudinal qualitative study Type de document : Article Auteurs : Melissa N. Galea Holmes ; Vari Wileman ; Lance M. McCracken ; Duncan J. Critchley ; Marie K. March ; Sam Norton ; Rona Moss-Morris ; Sandra Noonan ; Massimo Barcellona ; Emma Godfrey Année de publication : 2021 Article en page(s) : p. 41-48 Note générale : https://doi.org/10.1016/j.physio.2020.12.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Kinésithérapie (spécialité) ; Lombalgie ; Recherche qualitative ; Thérapie d'acceptation et d'engagement (ACT)Résumé : Objectives
Physiotherapy informed by Acceptance and Commitment Therapy (PACT) is a novel intervention that is related to improved disability and functioning in people with chronic lowback pain. This study explored physiotherapists experiences over time of the PACT training programme and intervention delivery.
Design
A longitudinal qualitative study using semi-structured, in-depth, individual interviews at three time points was conducted.
Methods
A phenomenological approach underpinned the methods. Interviews followed topic-guides developed a priori. Transcribed interviews were coded inductively to generate themes. Data were member checked by participants and validated by two researchers.
Participants
Eight clinical physiotherapists from three secondary care centres in the United Kingdom (n = 5 female; age, 24 to 44 years; duration of practice, 3 to 14 years) were included.
Results
Five themes emerged from the data. Experiential learning techniques were challenging but valued because they bridged theoretical principles and concepts with practice. Ongoing individual and group supervision was beneficial, but required tailoring and tapering. PACT delivery extended physiotherapy skills and practice, including techniques that acknowledged and addressed patient treatment expectations. With experience, participants desired greater flexibility and autonomy to tailor PACT delivery.
Conclusions
PACT training and delivery were acceptable to physiotherapists. Existing skills were developed and additional, applicable approaches were provided that addressed psychosocial and behavioural aspects of chronic low back pain.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275071
in Physiotherapy > Vol. 112 (2021) . - p. 41-48[article]
Titre : Methodology of exercise resources development for professionals providing services for people with Parkinson’s: a technical report Type de document : Article Auteurs : Bhanu Ramaswamy ; Julie Jones ; Katherine Baker ; Beccy Oliver Année de publication : 2021 Article en page(s) : p. 49-54 Note générale : https://doi.org/10.1016/j.physio.2020.10.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Maladie de Parkinson ; Ressources en santéRésumé : Abstract
The complexity of motor and non-motor symptoms seen in Parkinson’s, with their variability and progressive nature, have a significant and potentially detrimental effect on mobility and subsequent quality of life for those with the condition.
A considerable body of evidence now exists advocating the positive value of physical activity and exercise on both the motor and non-motor symptoms of Parkinson’s, whilst limiting the impact and effects of the secondary complications. The literature is signposting to early adoption of higher intensity exercise, with reported benefits at a neurophysiological level, and a potential to influence a diminution in the rate of progression of the condition. It lacks clarity about structure of activity throughout the course of Parkinson’s, and occasionally raises conflicting information about the differences in physical activity and ‘best’ exercise.
This report describes the method for development of two Parkinson’s exercise resources for professionals co-ordinated through the charity Parkinson’s UK. The process uses the six-step Analytic Hierarchy Process to understand how the growing number of questions asked by people with Parkinson’s, and by professionals about physical activity and exercise has informed: a) An Exercise Framework resource, which provides an understanding of what style of exercise might be beneficial, and just as significantly, takes into account the individual’s changing needs and abilities over the course of Parkinson’s, and b) An adaptable teaching template (PowerPoint Presentation) containing the supporting evidence for use by the exercise prescribing community.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275074
in Physiotherapy > Vol. 112 (2021) . - p. 49-54[article]
Titre : Obesity bias and stigma, attitudes and beliefs among entry-level physiotherapy students in the Republic of Ireland: a cross sectional study Type de document : Article Auteurs : G. O' Donoghue ; S. McMahon ; A. Holt ; M. Nedai ; T. Nybo ; C.L. Peiris Année de publication : 2021 Article en page(s) : p. 55-63 Note générale : https://doi.org/10.1016/j.physio.2021.03.016 Langues : Anglais (eng) Descripteurs : HE Vinci
Etudiants en kinésithérapie ; Obésité ; Prejugé ; StéréotypesRésumé : Objective
To explore entry-level physiotherapy students’ attitudes and beliefs relating to weight bias and stigmatisation in healthcare.
Design
Cross sectional survey of physiotherapy students.
Methods
All final year physiotherapy students (n = 215) enrolled in entry-level physiotherapy programmes in the Republic of Ireland were invited to participate. Each received a questionnaire, consisting of 72 questions, within four key sections. Descriptive statistics and frequencies were used to analyse the data.
Results
A response rate of 83% (179/215) was achieved. Whilst physiotherapy students, overall, had a positive attitude towards people with obesity, 29% had a negative attitude towards people with obesity, 24% had a negative attitude towards managing this population and most (74%) believed obesity was caused by behavioural and individual factors. Over one third of students (35%) reported that they would not be confident in managing patients with obesity and more than half (54%) felt treating patients with obesity was not worthwhile.
Conclusion
This study provides preliminary findings to suggest that weight stigma-reduction efforts are warranted for physiotherapy students. Helping students to understand that obesity is a complex, chronic condition with multiple aspects requiring a multi-faceted approach to its management might be the first step towards dispelling these negative attitudes towards patients living with obesity. Inclusion of a formal obesity curriculum should perhaps now be part of the contemporary physiotherapy students’ education.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275075
in Physiotherapy > Vol. 112 (2021) . - p. 55-63[article]
Titre : Development of entrustable professional activities for a physiotherapy undergraduate programme in Singapore Type de document : Article Auteurs : Rahizan Zainuldin ; Hai Yang Tan Année de publication : 2021 Article en page(s) : p. 64-71 Note générale : https://doi.org/10.1016/j.physio.2021.03.017 Langues : Anglais (eng) Descripteurs : HE Vinci
Compétence clinique ; Enseignement ; Kinésithérapie (spécialité) ; SingapourRésumé : Background
The concept of entrustable professional activities (EPAs) as an assessment framework is new to undergraduate physiotherapy training in Singapore. The physiotherapy community was tasked to develop EPAs to reflect the core professional activities of an entry-level physiotherapist for its undergraduate programme.
Methods
A qualitative participatory approach was used to develop entry-level EPAs for undergraduate physiotherapy students. Four phases occurred; (1) formation and training of the EPA writing workgroup from different sectors of the physiotherapy industry in Singapore; (2) conceptualization of the framework; (3) writing EPAs and; (4) iteration of EPAs through reflection, revision and consensus building.
Results
Five core activities were identified for undergraduate physiotherapy students to perform upon graduation and were developed into entry-level EPAs. These entry-level EPAs were subsequently termed as core EPAs to reflect the core practices expected at entry level across specialties and sectors in Singapore. These EPAs were mapped to five competency domains and 12 competency descriptors. The sources of information to support entrustment decisions were (1) short practice observation, (2) entrustment-based discussion and (3) case notes evaluation. Remote supervision was selected as the level of entrustment that physiotherapy students must attain at graduation.
Conclusion
The development of EPAs utilized a ground-up and cross-sector approach to define entry-level EPAs as core physiotherapy activities expected to be performed and assessed during clinical training by undergraduate physiotherapy students. Future research is needed to validate the use of EPAs as an assessment framework for undergraduate physiotherapy education.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275079
in Physiotherapy > Vol. 112 (2021) . - p. 64-71[article]
Titre : Illness perceptions as an independent predictor of chronic low back pain and pain-related disability: a prospective cohort study Type de document : Article Auteurs : Joannes M. Hallegraeff ; Emiel van Trijffel ; Ronald W. Kan ; Martijn S. Stenneberg ; Michiel F. Reneman Année de publication : 2021 Article en page(s) : p. 72-77 Note générale : https://doi.org/10.1016/j.physio.2020.12.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Douleur chronique ; Kinésithérapie (spécialité) ; Lombalgie ; Perception ; Pronostic ; RisqueRésumé : Objectives
To investigate whether illness perceptions, measured with the Brief Illness Perception Questionnaire, are an independent predictor of chronic low back pain and pain-related disability at 12 weeks.
Design
A prospective, observational cohort study.
Setting
26 outpatient primary care physiotherapy practices throughout the Netherlands.
Participants
Acute nonspecific low back pain patients between the age of 18 and 60 years, with or without radiating pain, and a pain-free episode of at least three months before onset.
Interventions
Standard physiotherapy care according to Dutch clinical practice guidelines.
Outcome measure
Chronic low back pain defined as pain ≥3/10 on the Numeric Pain Rating Scale and as pain-related disability ≥19/70 on the Pain Disability Index measured after 12 weeks.
Results
Two hundred and four people with acute nonspecific low back pain completed both assessments. In the multivariable analyses, adjusted for pain intensity, disability, duration, radiating pain, depressed mood, associations of illness perceptions were OR 1.04 (95% CI: 1.01 to 1.08) for pain and 1.04 (95% CI: 0.99 to 1.09) for pain-related disability.
Conclusions
Illness perceptions independently predicted chronic low back pain but not pain-related disability at 12 weeks. The added predictive value of illness perceptions was relatively low.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275080
in Physiotherapy > Vol. 112 (2021) . - p. 72-77[article]
Titre : Treatment targets of exercise for persistent non-specific low back pain: a consensus study Type de document : Article Auteurs : Lianne Wood ; Annette Bishop ; Martyn Lewis ; Rob Smeets ; Gert Bronfort ; Jill A. Hayden ; Nadine E. Foster Année de publication : 2021 Article en page(s) : p. 78-86 Note générale : https://doi.org/10.1016/j.physio.2021.03.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Consensus ; Exercice physique ; Lombalgie ; ThérapeutiqueRésumé : Objectives
Despite several hundred previous randomised controlled trials (RCTs), the key treatment targets of exercise for persistent non-specific low back pain (NSLBP) remain unclear. This study aimed to generate consensus about the key treatment targets of exercise interventions for patients with NSLBP.
Design
Consensus was generated using modified nominal group technique in two, sequential, workshops. The results of a previous systematic review informed the first, national, workshop idea generation and the results of this workshop informed the second, international, workshop. The authors generated a starting list of 30 treatment targets from the systematic review. A pre-specified consensus threshold of 75% was used in the voting stage.
Participants
Workshop participants included people with experience of using exercise to manage their persistent NSLBP, clinicians who prescribe exercise for persistent NSLBP, and researchers who design and evaluate exercise interventions in RCTs. All participants generated, voted and ranked the treatment targets in each workshop using an online platform.
Results
A total of 39 participants contributed to the consensus (15 in the national workshop and 24 in the international workshop), comprising two people with NSLBP, six clinicians and 31 researchers/clinicians. A total of 40 exercise treatment targets were generated, and 25 were retained after voting and ranking. The prioritised targets of exercise for persistent NSLBP were: improving function, improving quality of life, reducing pain, meeting patient-specific goals and reducing fear of movement.
Conclusions
Future RCTs of exercise should specify the targets of their exercise intervention and consider assessing these treatment targets as well as including mediation analyses.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275081
in Physiotherapy > Vol. 112 (2021) . - p. 78-86[article]
Titre : Three short sessions of physiotherapy during rehabilitation after hip fracture were no more effective in improving mobility than a single longer session: a randomised controlled trial Type de document : Article Auteurs : Catherine Senserrick ; Katherine Lawler ; Grant D. Scroggie ; Kim Williams ; Nicholas F. Taylor Année de publication : 2021 Article en page(s) : p. 87-95 Note générale : https://doi.org/10.1016/j.physio.2020.12.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Essai contrôlé randomisé ; Fractures de la hanche ; Kinésithérapie (spécialité) ; RéadaptationRésumé : Objectives
To determine if three short daily sessions of physiotherapy for rehabilitation inpatients after hip fracture is more effective than providing one long daily session in improving mobility.
Design
A single-blinded randomised controlled trial.
Setting
Two inpatient rehabilitation wards at a hospital in Melbourne, Australia.
Participants
Seventy-six rehabilitation inpatients after hip fracture. The key exclusion criterion was not being allowed to weight bear.
Interventions
All participants received multidisciplinary rehabilitation. Experimental participants received three 15-minute sessions of physiotherapy 5 days per week until discharge. Control participants received one 45-minute session of physiotherapy 5 days per week until discharge.
Main outcome measures
The primary outcome, mobility, was assessed with the de Morton Mobility Index 2 weeks after admission and at discharge. Secondary outcomes were Functional Independence Measure mobility (transfers, ambulation, steps), physical activity measured with an accelerometer, length of stay, discharge destination, readmissions within 30 days of discharge, and patient and physiotherapist satisfaction.
Results
Sixty-seven (88%) participants completed mobility assessment at discharge and 34 (45%) at 2 weeks. There were a greater proportion of missed sessions in the experimental group (84% adherence vs 95%). There was no between-group difference in mobility at discharge (MD −1.9 points, 95%CI−6.9 to 3.2) or at 2 weeks (MD −3.5 points, 95%CI−15.4 to 8.4). There were no between-group differences in any secondary outcomes.
Conclusions: Providing inpatient physiotherapy rehabilitation in three shorter sessions resulted in more missed sessions and likely did not improve mobility outcomes compared with providing one longer session for patients recovering from hip fracture.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275082
in Physiotherapy > Vol. 112 (2021) . - p. 87-95[article]
Titre : The prevalence of serious pathology in musculoskeletal physiotherapy patients – a nationwide register-based cohort study Type de document : Article Auteurs : Cecilie Rud Budtz ; Rikke Pilegaard Hansen ; Janus Nikolaj Laust Thomsen ; David Høyrup Christiansen Année de publication : 2021 Article en page(s) : p. 96-102 Note générale : https://doi.org/10.1016/j.physio.2021.03.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Appareil locomoteur ; Aptitude physique ; Kinésithérapie (spécialité) ; Médecins de premier recours ; PrévalenceRésumé : Introduction
Musculoskeletal conditions are the single largest contributor to years lived with disability worldwide. Most musculoskeletal conditions can be managed in primary care, but for a small proportion of these patients the symptoms are caused by serious pathology. Although the general practitioner usually performs initial screening for serious pathology, evaluation and treatment by physiotherapists are often part of the treatment pathway. It is however unclear, how many patients in primary care physiotherapy have symptoms caused by serious pathology.
Objective
To estimate the prevalence of neoplasm, cauda equina syndrome, spinal fracture, infection and inflammatory pathology among patients referred for musculoskeletal physiotherapy.
Methods
The study was a nationwide register-based cohort study. The authors identified all referrals for primary care musculoskeletal physiotherapy in the Danish National Health Insurance Service Register from 2014 to 2017. Records of hospital contacts were extracted from the Danish National Patient Register within 180 days from first physiotherapy contact, identifying all diagnoses of serious pathology. Prevalence estimates of the serious pathology categories were reported.
Results
A total of 1 568 704 courses of treatment were included in the analysis. The overall prevalence of serious pathology was 2.30%. The prevalence of neoplasm was 2.11%, cauda equina syndrome 0.01%, fractures 0.13%, infections 0.01% and inflammatory pathology 0.06%. Higher prevalence's were observed among patients with a previous history of serious pathology, aged above 50 and with comorbidites.
Conclusions
Although serious pathology among patients referred by the General Practitioner to musculoskeletal physiotherapy is rare, the present study found an overall prevalence of serious pathology which exceeded the guideline endorsed prevalence estimates.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275083
in Physiotherapy > Vol. 112 (2021) . - p. 96-102[article]
Titre : Comprehensive reporting of pelvic floor muscle training for urinary incontinence: CERT-PFMT Type de document : Article Auteurs : Susan C. Slade ; Meg E. Morris ; Helena Frawley ; Jean Hay-Smith Année de publication : 2021 Article en page(s) : p. 103-112 Note générale : https://doi.org/10.1016/j.physio.2021.03.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Entraînement en résistance ; Guides de bonnes pratiques cliniques comme sujet ; Incontinence urinaire ; Muscles ; Plancher pelvien ; Recommandations comme sujetRésumé : Aim
To produce a pelvic floor muscle training variation of the Consensus on Exercise Reporting Template (CERT-PFMT).
Methods
Qualitative methods were used to explore the perspectives of physiotherapists who have postgraduate continence and pelvic floor rehabilitation qualifications on using research evidence to implement pelvic floor muscle training for urinary incontinence. The same experienced facilitator guided the discussions with questions derived from systematic reviews and content experts. The face-to-face focus groups were audio-recorded and verbatim transcripts were thematically analysed. For each CERT item the authors collated participant quotations that identified required explanation or elaboration for the CERT-PFMT. Systematic reviews of pelvic floor muscle training for urinary incontinence were searched by the research team for examples of good reporting.
Results
Twenty- nine continence physiotherapists participated in one of seven focus groups. Participants agreed that all key elements they needed for replicating pelvic floor muscle training interventions from a research report were provided in the published CERT checklist. CERT items 2 (qualifications), 6 (motivation), 7 (progression rules), 8 (exercise description), 13 (intervention description) and 15 (starting level) required additional explanations for pelvic floor muscle training. Clinicians reported that original CERT explanations for items 1, 3–5, 8–12, 14 and 16 could be used without modification.
Conclusions
The CERT-PFMT reporting guideline has been designed with clinician input to inform how to document pelvic floor muscle training to enable replication in clinical practice. It can be used for research protocols, to construct manuscripts reporting pelvic floor muscle training for urinary incontinence and by journal editors and reviewers.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275084
in Physiotherapy > Vol. 112 (2021) . - p. 103-112[article]
Titre : Heterogeneity among patients with subacromial pain – variabilities within clinical presentation and its impact on daily life Type de document : Article Auteurs : Jenny M. Nordqvist ; Birgitta E. Öberg ; Lars E. Adolfsson ; Theresa M. Holmgren ; Kajsa M. Johansson Année de publication : 2021 Article en page(s) : p. 113-120 Note générale : https://doi.org/10.1016/j.physio.2020.10.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Amplitude articulaire ; Coiffe des rotateurs ; Dyskinésies ; Soins de santé primaires ; Syndrome de conflit sous-acromialRésumé : Objective
The primary aim was to describe the variability within clinical presentation of patients with subacromial pain in primary care, secondly to investigate associations between clinical presentation and self-reported pain intensity, shoulder function, level of anxiety and depression, and health-related quality of life.
Design and setting
A cross-sectional study based on data from two clinical studies in primary care, one randomized controlled trial and one implementation study. Three components: active range of motion (AROM), rotator cuff function and scapular kinematics were analyzed to describe variability within clinical presentation and patient-reported measurements were used to investigate the impact on daily life.
Participants
Patients aged 30-67 years, describing pain for more than two weeks, with positive signs for a minimum of three out of the following five clinical tests: impingement sign according to Neer, impingement test according to Hawkins-Kennedy, Pattes maneuver, Jobe’s test, and painful arc.
Results
Among the 164 patients included, 24% displayed dysfunction in one, 50% two and 24% in all three components. Limited AROM was seen in 46%, rotator cuff dysfunction in 91% and scapular dyskinesia in 57% of the patients.
Conclusions
These results reveal a heterogeneity among primary care patients with subacromial pain confirming a large variability regarding the components AROM, rotator cuff function and scapular kinematics. All three components appear unique (not significantly correlated) where a rotator cuff dysfunction is very frequent while limited AROM and scapular dyskinesia are more inconsistent. There are significant, but rather weak, associations between clinical presentation and impact on daily life.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275088
in Physiotherapy > Vol. 112 (2021) . - p. 113-120[article]
Titre : Current practice and barriers to ICU-acquired weakness assessment: a cross-sectional survey Type de document : Article Auteurs : Yuchen Wu ; Zhigang Zhang ; Biantong Jiang ; Guoqiang Wang ; Huaping Wei ; Bin Li ; Xiping Shen ; Caiyun Zhang Année de publication : 2021 Article en page(s) : p. 135-142 Note générale : https://doi.org/10.1016/j.physio.2021.01.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Évaluation de résultat (soins) ; Maladie grave ; Unités de soins intensifsRésumé : Background
Intensive-care-unit-acquired weakness (ICU-AW) not only leads to difficulty weaning off mechanical ventilation, prolonged hospital stay and increased medical costs, but also reduces the patient’s quality of life after discharge and increases the 1-year mortality rate. Early identification and intervention can improve the prognosis of critically ill patients. However, much remains unknown about current clinical practice for ICU-AW assessment by ICU staff in China.
Objectives
To investigate current practices and barriers to ICU-AW assessment among ICU staff, and provide insights to improve ICU-AW assessment in ICUs in China.
Methods
Qualitative interviews were used to construct a survey questionnaire (test–retest reliability 0.92, validity 0.96). This survey was subsequently completed by 3206 ICU staff from 31 provinces, municipalities and autonomous regions in China.
Results
In total, 3206 ICU staff responded to the survey (response rate 90%): 616 doctors (19%), 2371 nurses (74%), 129 respiratory therapists (4%), 51 physiotherapists (2%) and 39 dieticians (1%). Only 27% of the respondents had treated/cared for patients with ICU-AW. Reported methods for ICU-AW assessment were clinical experience (53%), ICU-AW assessment tools (12%), and physiotherapy consultation (35%). Forty-three percent of respondents felt that their ICU-AW-related knowledge did not meet clinical needs, only 10% had received ICU-AW-related training, and 19% proactively assessed whether their patients had ICU-AW. In terms of frequency of assessment, 42%, 16% and 11% of respondents considered that ICU-AW should be assessed daily, every 3 days, and on ICU admission and discharge, respectively. The Medical Research Council scale, electrophysiological assessment and the Manual Muscle Testing scale were considered to be optimal tools for ICU-AW diagnosis by 79%, 70%, and 73% of respondents, respectively. The main reported barriers to ICU-AW assessment were lack of knowledge, cognitive impairment among patients, and lack of ICU-AW assessment guidelines and procedures.
Conclusion
Current practices for ICU-AW assessment are non-specific, and the main barriers include lack of skills and knowledge.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275092
in Physiotherapy > Vol. 112 (2021) . - p. 135-142[article]
Titre : Is there a relationship between sagittal cervical spine mobility and generalised joint hypermobility? A cross-sectional study of 1000 healthy Australians Type de document : Article Auteurs : Leslie L. Nicholson ; Marnee J. McKay ; Jennifer N. Baldwin ; Joshua Burns ; Winky Cheung ; Sally Yip ; Cliffton Chan Année de publication : 2021 Article en page(s) : p. 150-157 Note générale : https://doi.org/10.1016/j.physio.2020.12.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Amplitude articulaire ; Flexibilité (corps humain) ; Instabilité articulaire ; RachisRésumé : Objectives
The primary aim was to determine the association between sagittal cervical mobility and the presence and extent of GJH across the lifespan. Secondary aims were to determine which features explain variability in cervical range of motion (CROM) and to establish the sagittal cervical hypermobile range in both genders across the lifespan.
Design
Cross-sectional observational study. Spearman’s rho determined the relationship between presence and extent of GJH and CROM, age, gender and ethnicity. Multiple regression identified the factors explaining variability in CROM. The hypermobile CROM was identified as the upper 5% of flexion, extension and combined ranges for age and gender.
Setting
University laboratory in Sydney Australia.
Participants
One thousand healthy individuals, aged 3–101 years.
Outcome measures
Cervical active range of motion was assessed using an inclinometer, extent of and presence of generalised joint hypermobility were assessed using the Beighton scoring system and age- and gender-specific criteria respectively.
Results
CROM correlated positively with GJH (Beighton score as a continuous or dichotomous age and gender specific variable) (rho = 0.12–0.50; p Conclusions
Increased sagittal CROM was observed in individuals identified with GJH. Extension CROM decreased with age more than flexion; the greatest loss in the second and third decades. CROM screening is warranted for patients identified with GJH and for rehabilitation goal-setting.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=275095
in Physiotherapy > Vol. 112 (2021) . - p. 150-157[article]
Paru le : 01/06/2021
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Titre : Rehabilitation to enable recovery from COVID-19: a rapid systematic review Type de document : Article Auteurs : Victoria A. Goodwin ; Louise Allan ; Alison Bethel ; Alison Cowley ; Jane L. Cross ; Jo Day ; Avril Drummond ; Abi J. Hall ; Martin Howard ; Naomi Morley ; Jo Thompson Coon ; Sarah E. Lamb Année de publication : 2021 Article en page(s) : p. 4-22 Note générale : https://doi.org/10.1016/j.physio.2021.01.007 Langues : Anglais (eng) Descripteurs : HE Vinci
COVID-19 ; Réadaptation ; Revue systématiqueRésumé : Objectives
To establish the evidence for rehabilitation interventions tested in populations of patients admitted to ICU and critical care with severe respiratory illness, and consider whether the evidence is generalizable to patients with COVID-19.
Methods
The authors undertook a rapid systematic review. Medline (via OvidSP), CINAHL Complete (via EBSCOhost), Cochrane Library, Cochrane Database of Systematic Reviews and CENTRAL (via Wiley), Epistemonikos (via Epistemonikos.org), PEDro (via pedro.org.au) and OTseeker (via otseeker.com) searched to 7 May 2020. The authors included systematic reviews, RCTs and qualitative studies involving adults with respiratory illness requiring intensive care who received rehabilitation to enhance or restore resulting physical impairments or function. Data were extracted by one author and checked by a second. TIDier was used to guide intervention descriptions. Study quality was assessed using Critical Skills Appraisal Programme (CASP) tools.
Results
Six thousand nine hundred and three titles and abstracts were screened; 24 systematic reviews, 11 RCTs and eight qualitative studies were included. Progressive exercise programmes, early mobilisation and multicomponent interventions delivered in ICU can improve functional independence. Nutritional supplementation in addition to rehabilitation in post-ICU hospital settings may improve performance of activities of daily living. The evidence for rehabilitation after discharge from hospital following an ICU admission is inconclusive. Those receiving rehabilitation valued it, engendering hope and confidence.
Conclusions
Exercise, early mobilisation and multicomponent programmes may improve recovery following ICU admission for severe respiratory illness that could be generalizable to those with COVID-19. Rehabilitation interventions can bring hope and confidence to individuals but there is a need for an individualised approach and the use of behaviour change strategies. Further research is needed in post-ICU settings and with those who have COVID-19.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=269354
in Physiotherapy > Vol. 111 (2021) . - p. 4-22[article]
Titre : Digital interventions for promoting exercise adherence in chronic musculoskeletal pain: a systematic review and meta-analysis Type de document : Article Auteurs : J.W Bunting ; T.M. Withers ; N.R. Heneghan ; C.J. Greaves Année de publication : 2021 Article en page(s) : p. 23-30 Note générale : https://doi.org/10.1016/j.physio.2020.08.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Arthrose ; Exercice physique ; Revue systématique ; SqueletteRésumé : Background
Chronic musculoskeletal disorders are the second largest contributor to disability globally. Exercise is typically recommended by physiotherapists to manage symptoms. However, adherence to the prescribed exercise programme is often poor. Adjunctive digital interventions offer potential to enhance exercise adherence.
Objectives
To review evidence on the effectiveness of digital interventions for improving exercise adherence in people with chronic musculoskeletal conditions. The study is reported in line with PRISMA guidance and was registered with PROSPERO (CRD42019124502).
Data Sources
MEDLINE, Embase and PsycInfo were searched using a comprehensive search strategy. The reference lists of all included papers and relevant systematic reviews identified during the search were scanned for relevant articles.
Study appraisal and synthesis methods
Two researchers independently checked articles for inclusion and extracted data.
Results
The search returned a total of 4257 results of which five trials were included in the review and two studies were included in a random effects meta-analysis. There was no statistically significant difference in exercise adherence (SMD: 0.23; 95% CI: −0.10, 0.57). Studies that were not suitable for inclusion in the meta-analysis reported similar results. Heterogeneity of effects was high and study quality ranged from low to moderate. All of the meta-analysed data related to osteoarthritis of the hip and/or knee.
Conclusion
We found no evidence that digital interventions enhance adherence to therapeutic exercise in patients with chronic musculoskeletal disorders. However, further, high quality research is required to draw definitive conclusions on their effectiveness and to identify key components that are associated with effectiveness.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=269357
in Physiotherapy > Vol. 111 (2021) . - p. 23-30[article]
Titre : Implementing patient direct access to musculoskeletal physiotherapy in primary care: views of patients, general practitioners, physiotherapists and clinical commissioners in England Type de document : Article Auteurs : Chinonso N. Igwesi-Chidobe ; Annette Bishop ; Katrina Humphreys ; Emily Hughes ; Joanne Protheroe ; John Maddison ; Bernadette Bartlam Année de publication : 2021 Article en page(s) : p. 31-39 Note générale : https://doi.org/10.1016/j.physio.2020.07.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Auto-recommandation par un médecin ; Kinésithérapie et physiothérapie ; Prestations des soins de santé ; Soins de santé primairesRésumé : Purpose
Musculoskeletal problems are the leading cause of chronic disability. Most patients in the UK seek initial care from general practitioners (GPs), who are struggling to meet demand. Patient direct access to National Health Service physiotherapy is one possible solution. The purpose of this study was to understand the experiences of patients, GPs, physiotherapists and clinical commissioners on direct access in a region in England with it commissioned.
Methods
The study was informed by Normalisation Process Theory (NTP). Data collection was via semi-structured individual face-to-face and telephone interviews with 22 patients and 20 health care professionals (HCPs). Data were analysed thematically using NPT.
Results
Three themes emerged: understanding physiotherapy and the direct access pathway; negotiating the pathway; making the pathway viable. HCPs saw direct access as acceptable. Whilst patients found the concept of direct access, those with complex conditions continued to see their GP as first point of contact. Some GPs and patients reported a lack of clarity around the pathway, reflected in ambiguous paperwork and inconsistent promotion. Operational challenges emerged in cross-disciplinary communication and between HCPs and patients, and lack of adequate resources.
Conclusion
Direct access to NHS musculoskeletal physiotherapy is acceptable to patients and HCPs. There is need to ensure: effective communication between HCPs and with patients, clarity on the scope of physiotherapy and the direct access pathway, and sufficient resources to meet demand. Patient direct access can free GPs to focus on those patients with more complex health conditions who are most in need of their care.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=269361
in Physiotherapy > Vol. 111 (2021) . - p. 31-39[article]
Titre : Economic evaluation of patient direct access to NHS physiotherapy services Type de document : Article Auteurs : Miaoqing Yang ; Annette Bishop ; Jon Sussex ; Martin Roland ; Sue Jowett ; Edward C.F. Wilson Année de publication : 2021 Article en page(s) : p. 40-47 Note générale : https://doi.org/10.1016/j.physio.2020.12.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Analyse coût-bénéfice ; Auto-recommandation par un médecin ; Kinésithérapie et physiothérapie ; SqueletteRésumé : Objectives
Our aim was to undertake an economic evaluation of patient direct access to physiotherapy in the UK NHS by comparing the number of patients treated, waiting time, cost and health gain from a direct access pathway versus traditional GP-referral to NHS physiotherapy.
Design
The authors used a discrete event simulation (DES) model to represent a hypothetical GP practice of 10,000 patients. Costs were measured from the perspective of the NHS and society. Outcomes were predicted waiting times, the total number of patients with musculoskeletal conditions who received physiotherapy and quality adjusted life years (QALYs) gained, each estimated over a one year period. Model inputs were based on a pilot cluster randomised controlled trial (RCT) conducted in four general practices in Cheshire, UK, and other sources from the literature.
Results
Direct access could increase the number of patients receiving at least one physiotherapy appointment by 63%, but without investment in extra physiotherapist capacity would increase waiting time dramatically. The increase in activity is associated with a cost of £4999 per QALY gained.
Conclusions
Direct access to physiotherapy services would be cost-effective and benefit patients given current cost per QALY thresholds used in England. This is because physiotherapy itself is cost-effective, rather than through savings in GP time. Direct access without an increase in supply of physiotherapists would increase waiting times and would be unlikely to be cost saving for the NHS owing to the likely increase in the use of physiotherapy services.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=269363
in Physiotherapy > Vol. 111 (2021) . - p. 40-47[article]
Titre : Providing patients with direct access to musculoskeletal physiotherapy: the impact on general practice musculoskeletal workload and resource use. The STEMS-2 study Type de document : Article Auteurs : Annette Bishop ; Ying Chen ; Joanne Protheroe ; Reuben O. Ogollah ; James Bailey ; Martyn Lewis ; Kelvin Jordan ; Nadine E. Foster Année de publication : 2021 Article en page(s) : p. 48-56 Note générale : https://doi.org/10.1016/j.physio.2020.04.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Auto-recommandation par un médecin ; Ergonomie ; Kinésithérapie et physiothérapie ; SqueletteRésumé : Objectives
This study examined the real-world impact of patient direct access to NHS physiotherapy (self-referral) on (a) general practice consultations for musculoskeletal (MSK) conditions and (b) specified clinical management for patients with MSK conditions.
Design and setting
Natural experiment in four general practices and the associated physiotherapy service.
Methods
Anonymised routinely collected data were obtained. MSK coded GP consultations, recorded fit notes, MSK-related prescription medication, X-rays and MRI requests, and referrals to secondary care for patients consulting with MSK conditions were identified and trends described across a 6-year period (June 2011 to June 2017). Joinpoint regression analysis was used to identify any significant changes in GP MSK consultation trends before and after the introduction of self-referral to physiotherapy. Physiotherapy service data examined access methods used by patients (GP referred, GP recommended self-referral, true self-referral) and the number of physiotherapy sessions.
Results
Direct access resulted in inconsistent impact on general practices. In one arm of the experiment a significant increase in GP consultations was observed and in one arm was stable. Exploratory examination of clinical management showed only requests for X-rays (arm 1) and possibly requests for MRI (arm 2) changed over time. Physiotherapy service referrals showed a low uptake of true self-referral (10% and 6%) in each arm respectively.
Conclusion
This is the first study to examine the real-world impact of patient direct access to physiotherapy at general practice level. We found no consistent impact of patient direct access on GP MSK workload. Impact on some clinical management was observed but not consistently in the direction suggested by previous studies.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=269367
in Physiotherapy > Vol. 111 (2021) . - p. 48-56[article]
Titre : Women with diastasis recti abdominis might have weaker abdominal muscles and more abdominal pain, but no higher prevalence of pelvic floor disorders, low back and pelvic girdle pain than women without diastasis recti abdominis Type de document : Article Auteurs : Sandra Gluppe ; Marie Ellström Engh ; Kari Bø Année de publication : 2021 Article en page(s) : p. 57-65 Note générale : https://doi.org/10.1016/j.physio.2021.01.008 Langues : Anglais (eng) Descripteurs : HE Vinci
Douleur abdominale ; Force musculaire ; Lombalgie ; Plancher pelvienRésumé : Objective
To investigate whether women with diastasis recti abdominis (DRA) have weaker abdominal muscles and higher prevalence of pelvic floor disorders (PFD), low back, pelvic girdle and abdominal pain than women without DRA.
Design
Cross sectional study of women with and without DRA.
Setting
University study.
Participants
Seventy-two parity and age matched women with and without DRA.
Main outcome measures
Maximal abdominal muscle strength and endurance were assessed with a dynamometer and with a curl-up test. Women reported whether they experienced PFD, low back pain, pelvic girdle pain or abdominal pain. Those experiencing PFD or pain completed the Pelvic Floor Distress Inventory-short form 20 (PFDI-20), the Oswestry Disability Index (ODI), the Pelvic Girdle Questionnaire (PGQ) or questions about abdominal pain, respectively.
Results
Maximal abdominal strength standing with 30° hip flexion was significantly lower in women with DRA (mean difference −12.9 Nm, 95%CI: −24.4 to −1.5; P = 0.028), but adjusted analyses showed no significant difference (mean difference −11.9 Nm, 95%CI: −26.5 to 2.6; P = 0.106). Adjusted analyses showed significant higher prevalence of abdominal pain in women with DRA (OR: 0.02, 95%CI: 0.00 to 0.61, P = 0.026). There was no difference between the groups in PFD, low back and pelvic girdle pain.
Conclusion
Women with DRA tend to have weaker abdominal muscles and higher prevalence of abdominal pain, but no higher prevalence of PFD, low back or pelvic girdle pain than women without DRA.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=269369
in Physiotherapy > Vol. 111 (2021) . - p. 57-65[article]
Titre : Development of a physiotherapist-led exercise programme for traumatic tears of the rotator cuff for the SPeEDy study Type de document : Article Auteurs : Chris Littlewood ; Catrin Astbury ; Howard Bush ; Jo Gibson ; Stacey Lalande ; Caroline Miller ; Lisa Pitt ; Helen Tunnicliffe ; Rachel Winstanley Année de publication : 2021 Article en page(s) : p. 66-73 Note générale : https://doi.org/10.1016/j.physio.2020.07.008 Langues : Anglais (eng) Descripteurs : HE Vinci
Epaule ; Exercice physique ; Kinésithérapie et physiothérapie ; Lésions de la coiffe des rotateursRésumé : Objectives
The SPeEDy study (Surgery vs. physiotherapist-led exercise for traumatic tears of the rotator cuff) is a two-arm, parallel group, pilot and feasibility randomised controlled trial aiming to evaluate the feasibility of a future main trial. In this paper, the development process and the resultant physiotherapist-led exercise programme used in the SPeEDy study is described.
Methods
Thirteen physiotherapists and three patients met to discuss and develop the key principles that should underpin the exercise programme.
Results
Taking in to account the current research evidence and incorporating expert clinical and patient opinion, the group developed an individualised, structured and progressive physiotherapist-led exercise programme based on the principle of self dosing. Exercise prescription within the programme is based on establishing the current functional capacity of the patient in relation to the most challenging shoulder movements and is supported over approximately six contact sessions across a 12-week period.
Conclusion
The SPeEDy study aims to recruit 76 participants across eight hospitals and will provide high quality evidence about the feasibility of a future main randomised controlled trial in a clinical area where there is a lack of evidence from randomised controlled trials to support clinical decision-making.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=269370
in Physiotherapy > Vol. 111 (2021) . - p. 66-73[article]
Titre : Diagnostic accuracy of patient interview items and clinical tests for cervical radiculopathy Type de document : Article Auteurs : Marije L.S. Sleijser-Koehorst ; Michel W. Coppieters ; Rob Epping ; Servan Rooker ; Arianne P. Verhagen Année de publication : 2021 Article en page(s) : p. 74-82 Note générale : https://doi.org/10.1016/j.physio.2020.07.007 Langues : Anglais (eng) Descripteurs : HE Vinci
Arthrose ; Cervicalgie ; Névrite du plexus brachial ; Reproductibilité des résultatsRésumé : Objective
To determine the diagnostic accuracy of patient interview items and clinical tests to diagnose cervical radiculopathy.
Design
A prospective diagnostic accuracy study.
Participants
Consecutive patients (N = 134) with a suspicion of cervical radiculopathy were included. A medical specialist made the diagnosis of cervical radiculopathy based on the patient's clinical presentation and corresponding Magnetic Resonance Imaging findings. Participants completed a list of patient interview items and the clinical tests were performed by a physiotherapist.
Main outcome measures
Diagnostic accuracy was determined in terms of sensitivity, specificity, and positive (+LR) and negative likelihood ratios (−LR). Sensitivity and specificity values ≥0.80 were considered high. We considered +LR ≥ 5 and −LR ≤ 0.20 moderate, and +LR ≥ 10 and −LR ≤ 0.10 high.
Results
The history items ‘arm pain worse than neck pain’, ‘provocation of symptoms when ironing’, ‘reduction of symptoms by walking with your hand in your pocket’, the Spurling test and the presence of reduced reflexes showed high specificity and are therefore useful to increase the probability of cervical radiculopathy when positive. The presence of ‘paraesthesia’ and ‘paraesthesia and/or numbness’ showed high sensitivity, indicating that the absence of these patient interview items decreases the probability of cervical radiculopathy. Although most of these items had potentially relevant likelihood ratios, none showed moderate or high likelihood ratios.
Conclusions
Several patient interview items, the Spurling test and reduced reflexes are useful to assist in the diagnosis of cervical radiculopathy. Because there is no gold standard for cervical radiculopathy, caution is required to not over-interpret diagnostic accuracy values.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=269386
in Physiotherapy > Vol. 111 (2021) . - p. 74-82[article]
Titre : Persons with Multiple Sclerosis Exhibit Strength Asymmetries in both Upper and Lower Extremities Type de document : Article Auteurs : John W. Farrell III ; Robert W. Motl ; Yvonne C. Learmonth ; Lara A. Pilutti Année de publication : 2021 Article en page(s) : p. 83-91 Note générale : https://doi.org/10.1016/j.physio.2020.07.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Asymétrie faciale ; Faiblesse musculaire ; Force musculaire ; Sclérose en plaquesRésumé : Objective
To characterize strength asymmetries in the upper and lower extremities in persons with multiple sclerosis (PwMS) with severe disability, and examine associations between asymmetries and functional, symptomatic, and participatory outcomes.
Design
Cross-sectional.
Setting
University research laboratory.
Participants
25 PwMS with Expanded Disability Status Scale scores between 6.0-8.0.
Main outcome measures
Bilateral strength and asymmetry scores for muscle groups at the ankle, knee, and shoulder joints in addition to grip strength.
Results
Significant differences were observed between all contralateral strength measures, with asymmetry scores ranging between 20-32%. A high prevalence of asymmetry (i.e., score > 10%) was observed for all strength measures, with 92% of participants having four or more affected measures. Significant associations were observed between dorsiflexion asymmetry and physical health-related quality of life (ρ= -0.69; p
Conclusions
A high prevalence of asymmetry in the upper and lower extremities was observed, with asymmetry scores exceeding those previously reported in PwMS with mild-to-moderate disability. Rehabilitation strategies should consider a full body approach to address strength asymmetries.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=269389
in Physiotherapy > Vol. 111 (2021) . - p. 83-91[article]
Paru le : 01/03/2021
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Titre : Experiences of venue based exercise interventions for people with stroke in the UK: a systematic review and thematic synthesis of qualitative research Type de document : Article Auteurs : Rachel E. Young ; David Broom ; Karen Sage ; Kay Crossland ; Christine Smith Année de publication : 2021 Article en page(s) : p. 5-14 Note générale : https://doi.org/10.1016/j.physio.2019.06.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Exercice physique ; Recherche qualitative ; Revue systématique ; Royaume-UniRésumé : Background
The physical benefits of exercise following stroke are research evidenced and the UK stroke population is increasingly encouraged to engage with exercise interventions. A synthesis of qualitative research is required to further understand the perceived experience and psychosocial effect of exercise for people with stroke.
Objectives
To provide a systematic search and synthesis of evidence about the experiences and reported impact of participation in venue based exercise following stroke in the UK.
Data sources
Eligible studies were identified through a rigorous search of Medline, Cinahl, AMED, PsycINFO, SportDiscus, Proquest and ETHOS from January 2000 until December 2017.
Study eligibility criteria
Full text qualitative studies or service evaluations conducted in the UK which explored the reported experience of venue based exercise amongst people with stroke.
Study synthesis and appraisal
Included studies were evaluated through application of the Consolidated Criteria for Reporting Qualitative Research. Data synthesis using a thematic approach generated descriptive and analytical themes.
Results
Six research studies and one service evaluation met the inclusion criteria; methodological quality was variable. These studies highlighted that people with stroke gain confidence and renewed identity through exercise participation. Perceived improvements in physical function were reported and participants enjoyed stroke specific exercise programmes in de-medicalised venues.
Limitations
The studies only accessed people who had completed the exercise programmes; non-completers were not represented.
Conclusion
Venue based exercise programmes have a positive effect on perceived wellbeing following stroke. Further research into the reasons for discontinuation of exercise participation following stroke is required.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265422
in Physiotherapy > Vol. 110 (2021) . - p. 5-14[article]
Titre : Is adding pelvic floor muscle training to an exercise intervention more effective at improving pain in patients with non-specific low back pain? A systematic review of randomized controlled trials Type de document : Article Auteurs : Stéphanie Bernard ; Evelyne Gentilcore-Saulnier ; Hugo Massé-Alarie ; Hélène Moffet Année de publication : 2021 Article en page(s) : p. 15-25 Note générale : https://doi.org/10.1016/j.physio.2020.02.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Lombalgie ; Plancher pelvien ; Revue systématique ; Traitement par les exercices physiquesRésumé : Background
Pelvic floor muscles (PFM) contribute to optimal control of the lumbopelvic spine. PFM function appears altered in some people with nonspecific low back pain (LBP).
Objective
To systematically review if adding PFM training (PFMT) to another exercise intervention can be more effective at improving pain and function in people with nonspecific LBP than without PFMT.
Data sources
The authors conducted a literature search on Medline, Embase, CINAHL, Cochrane Central and Web of Sciences up to October 2018.
Eligibility criteria
(1) Participants with nonspecific LBP; (2) additional PFMT to an exercise intervention; (3) comparison to the same intervention without PFMT; (4) included minimally one planned outcome; and (5) a randomized controlled trial. Two reviewers performed screening, data extraction (primary outcome; pain severity, secondary outcome; physical function) and risk of bias assessment.
Synthesis methods
Meta-analysis was performed using mean difference and 95% confidence intervals.
Results
Six studies were included (n = 200 participants). Participants with PFMT had lower pain severity in comparison with the group without PFMT (mean difference: −0.61, 95%CI [−0.91, −0.31], P Limitations
Small groups and high heterogenicity limit our findings.
Conclusion
There is very low-quality evidence that there is a small benefit of adding PFMT to another exercise intervention on pain severity in nonspecific LBP. Longer duration for an integrated lumbopelvic exercise program including PFMT is likely to impact pain outcomes positively.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265423
in Physiotherapy > Vol. 110 (2021) . - p. 15-25[article]
Titre : Identifying factors that predict attrition among first year physiotherapy students: a retrospective analysis Type de document : Article Auteurs : Jennifer M. Ryan ; Tara Potier ; Alison Sherwin ; Elizabeth Cassidy Année de publication : 2021 Article en page(s) : p. 26-33 Note générale : https://doi.org/10.1016/j.physio.2017.04.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Echantillon ; Ethnies ; Etudiants en kinésithérapie ; Modèles logistiquesRésumé : Background
A number of first year students leave physiotherapy programmes every year. A high attrition rate has implications for the student and the academic institution.
Objectives
To report the rate of attrition among first year physiotherapy students, and to identify contributing factor.
Design
Retrospective analysis.
Setting
University.
Participants
Electronic student records for enrolled students 2010 to 2013.
Measures
Independent variables; gender, age at entry, mode of admission, place of residence, ethnicity, fee status, level of education, disability, whether a student obtained a B in A level Biology, and whether a student repeated A level examinations. Logistic regression analysis was conducted to identify the relationship between independent variables and drop-out (failure to continue to the second year).
Results
Data from 338 students were included in the analysis. The percentage drop-out was 17%; 38 students (11%) failed, and 20 students (6%) withdrew voluntarily. Black and Asian students had greater odds of drop-out for any reason (Odds Ratio (OR): 6.23; 95% Confidence Interval (CI) 1.79 to 21.63, and OR: 6.43; 95% CI: 3.03 to 13.68 respectively), and due to failure (OR: 5.50, 95% CI: 1.27 to 23.70, and OR: 7.19; 95% CI: 3.02 to 17.08, respectively) compared to white British students. Students who lived off-campus were more likely to withdraw from the programme irrespective of ethnicity (OR: 4.65; 95% CI: 1.41 to 15.34).
Conclusion
A significant number of students from ethnic minority backgrounds failed to progress. Specific strategies to retain students from ethnic minority backgrounds should be implemented. Students who live off-campus may be at high risk of drop-out; reasons for this should be investigated.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265425
in Physiotherapy > Vol. 110 (2021) . - p. 26-33[article]
Titre : Comparison of an expiratory flow accelerator device versus positive expiratory pressure for tracheobronchial airway clearance after lung cancer lobectomy: a preliminary study Type de document : Article Auteurs : Nicola Rotolo ; Maria Cattoni ; Michele D'Andria ; Laura Cavanna ; Giorgia Patrizio ; Andrea Imperatori ; Antonello Nicolini Année de publication : 2021 Article en page(s) : p. 34-41 Note générale : https://doi.org/10.1016/j.physio.2019.01.011 Langues : Anglais (eng) Descripteurs : HE Vinci
Complications postopératoires ; Débit expiratoire de pointe ; Kinésithérapie (spécialité) ; Tumeurs du poumon ; Ventilation en pression positive continueRésumé : Objective
A new type of device has recently been introduced in chest physiotherapy as an aid to tracheo-bronchial airway clearance: expiratory flow accelerator (EFA). It promotes mucus clearance without generating any pressure gradient, allowing patients to breathe at tidal volume against no resistance.
Design
Pilot randomized controlled study.
Setting
Tertiary hospital.
Participants
Fifty adult patients who underwent lung cancer lobectomy were randomized to undergo chest physiotherapy with EFA (n = 26) or PEP (n = 24).
Interventions
EFA; PEP bottle.
Main outcomes
Incidence of postoperative pulmonary complications (PPC) and length of stay. Secondary outcomes: trends in inspiratory capacity, respiratory rate, oxygen saturation, and dyspnoea. Patients rated user-friendliness of the two devices on a 5-point Likert scale.
Results
A slightly different incidence of PPCs was observed between the EFA and PEP group. Nevertheless, the length of stay was similar in the two groups. No substantial differences were seen in trends of inspiratory capacity, respiratory rate, oxygen saturation, dyspnoea between the two groups. Patient-reported user-friendliness of the two devices did not differ significantly, although the use of the EFA device appeared less strenuous.
Conclusions
Results of this pilot study point to the use of EFA as an alternative treatment option rather than as a replacement for the PEP bottle in chest physiotherapy following lung cancer lobectomy. EFA may be preferable for weaker patients and/or with airway leakages in whom PEP has limited indications. Further investigation in a larger sample is required to statistically confirm the findings.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265430
in Physiotherapy > Vol. 110 (2021) . - p. 34-41[article]
Titre : Immediate effects of cervical mobilisations on neck muscle activity during active neck movements in patients with non-specific neck pain. A double blind placebo controlled trial Type de document : Article Auteurs : Ion Lascurain-Aguirrebeña ; Di J. Newham ; Xabat Casado-Zumeta ; Aitana Lertxundi ; Duncan J. Critchley Année de publication : 2021 Article en page(s) : p. 42-53 Note générale : https://doi.org/10.1016/j.physio.2019.07.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Cervicalgie ; Electromyographie ; Essai contrôlé randomisé ; MobilisationRésumé : Background
Cervical mobilisations are used to treat people with neck pain but their mechanisms of action are unclear. One theorised reason for induced analgesia is effect on neck muscle activity.
Objectives
To assess the effects of cervical mobilisations on muscle activity during active neck movements and whether changes in muscle activity are associated with changes in symptoms.
Design
Double-blind randomised placebo controlled trial.
Setting
Primary care.
Participants
40 patients (aged 19 to 80 years, 24 female) with non-specific neck pain.
Interventions
One session of cervical mobilisations or motionless manual contact (placebo).
Main outcome measures: sternocleidomastoid (SCM), scalene (SCA), upper trapezius (UT) and erector spinae (ES) surface electromyography (SEMG) during active neck flexion, extension, side flexion and rotation was measured immediately before and after the intervention. Patients were classified as responders according to change in symptoms assessed using the Global Rating of Change Scale (GROC).
Results
Compared with placebo, patients receiving mobilisation showed an increase in contralateral UT and ES SEMG during rotation and contralateral and ipsilateral SCM, SCA and UT during side flexion (P Conclusion
Cervical mobilisations caused increased neck SEMG, mostly due to increased movement range and speed. Change in muscle activity is unlikely to be a major mechanism of action of cervical mobilisations in symptomatic improvement with physiological neck movements. (ClinicalTrials.gov record number: 2016/066).Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265432
in Physiotherapy > Vol. 110 (2021) . - p. 42-53[article]
Titre : Electromyographic biofeedback improves upper extremity function: a randomized, single-blinded, controlled trial Type de document : Article Auteurs : Cristina Lirio-Romero ; Maria Torres-Lacomba ; Antonio Gómez-Blanco ; Alberto Acero-Cortés ; Ana Retana-Garrido ; Pedro de la Villa-Polo ; Beatriz Sánchez-Sánchez Année de publication : 2021 Article en page(s) : p. 54-62 Note générale : https://doi.org/10.1016/j.physio.2020.02.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Electromyographie ; Membre supérieur ; Récupération fonctionnelle ; Rétroaction biologique (psychologie)Résumé : Objective
To examine the effects of a 6-week surface electromyographic biofeedback intervention on the re-learning of upper extremity motor function in subjects with paretic upper extremity after stroke.
Design
A randomized controlled trial.
Setting
State Centre of Attention to Brain Injury, Madrid, Spain.
Participants
Thirty-eight participants in the sub-acute post-stroke stage were recruited and randomly allocated into either the surface electromyographic biofeedback (sEMG-BFB) or sham biofeedback (BFB) groups.
Interventions
The sEMG-BFB group (n = 19) received the intervention focused on re-learning scapulothoracic control during arm-reaching tasks involving shoulder abduction. The sham BFB group (n = 19) received a sham intervention.
Outcome measures
Upper extremity motor function assessed using the Fugl-Meyer Assessment-Upper Extremity Scale (66 points), the glenohumeral active range of motion, and the electromyographic amplitude signal of the middle deltoid and upper trapezius muscles were collected at baseline, after the intervention, and at the one-month follow-up.
Results
Compared with the sham BFB group, the sEMG-BFB group experienced significant increases in upper extremity motor function after the intervention. The mean differences between groups were as follows: 4.79 points (95% CI 2.92 to 6.66) after the intervention; 6.55 points (95% CI 3.75 to 9.34) at the one-month follow-up; improved active range of motion 15.75 points (95% CI 6 to 30) after the intervention and electromyographic activity in the upper trapezius muscle changed in favour of the sEMG-BFB.
Conclusions
In the short term, a 6-week sEMG-BFB intervention effectively improved paretic upper limb motor function. Future research is needed to determine if the sEMG-BFB intervention has any long-term effects.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265433
in Physiotherapy > Vol. 110 (2021) . - p. 54-62[article]
Titre : What is the best clinical assessment tool for identification of adults aged ≥80 years at high risk of falls? Type de document : Article Auteurs : Paola Errera Magnani ; Jaqueline Mello Porto ; Maiara Baena Genovez ; Nathalia Fernanda Grecco Zanellato ; Isabella Camargo Alvarenga ; Paulo Ferreira dos Santos ; Daniela Cristina Carvalho de Abreu Année de publication : 2021 Article en page(s) : p. 63-69 Note générale : https://doi.org/10.1016/j.physio.2020.03.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Chutes accidentelles ; Évaluation des symptômes ; Risque ; Sujet âgé ; Sujet âgé de 80 ans ou plus ; VieillissementRésumé : Objectives
To assess the Balance Evaluation Systems Test (BESTest), Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go (TUG) test and gait speed to determine which is the most appropriate test for identification of adults aged ≥80 years at higher risk of falls, and to investigate the clinical usefulness of the combination of such tests by cumulative post-test probability (PoTP) for predicting the risk of falls.
Design
Longitudinal prospective study.
Participants
Ninety-eight older adults (aged 80–102 years).
Interventions
Older adults were submitted to the clinical tests and followed-up in order to record the occurrence of falls. The capacity of the clinical tests to detect which older adults are at higher risk of falls was measured using the receiver operating characteristic curve, followed by calculation of PoTP for predicting the risk of falls.
Results
The BESTest and the Mini-BESTest demonstrated the best PoTP for predicting the risk of falls for a positive test (70%), followed by the TUG test (66%) and gait speed (63%). When performed in combination, a positive result on the TUG test, gait speed and Mini-BESTest increased the probability of older adults falling within the next 6 months from 50% to 89%; a negative result on these three tests decreased the probability of older adults falling within the next 6 months from 50% to 3%.
Conclusion
The combination of TUG test, gait speed and Mini-BESTest provided the best approach. If all three tests are positive, there is an 89% chance of identifying an older person at risk of falling. If all three tests are negative, there would only be a 3% chance of obtaining a false-negative result.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265434
in Physiotherapy > Vol. 110 (2021) . - p. 63-69[article]
Titre : An exploration of the experiences of people living with painful ankle osteoarthritis and the non-surgical management of this condition Type de document : Article Auteurs : Gillian Yeowell ; Richard A. Samarji ; Michael J. Callaghan Année de publication : 2021 Article en page(s) : p. 70-76 Note générale : https://doi.org/10.1016/j.physio.2020.04.008 Langues : Anglais (eng) Descripteurs : HE Vinci
Arthrose ; Bien-être ; Cheville ; Douleur ; Qualité de vieRésumé : Objectives
Osteoarthritis (OA) of the ankle joint is associated with life-long joint pain and disability if not appropriately managed. There is a dearth of research concerning ankle OA and the impact on those living with the condition.
Aim
To explore the experiences of people living with painful OA ankle and their views about the non-surgical management of this condition.
Design
Qualitative design, using semi-structured interviews.
Participants
Nine participants, recruited from an orthopaedic clinic at a UK hospital and the general population. All had a clinical and radiographic diagnosis of OA ankle. Interviews were digitally recorded and transcribed verbatim. Thematic analysis was undertaken to identify emerging themes. Ethical approval was obtained.
Results
Nine semi-structured interviews were undertaken. Eight participants were male, median age = 55 years (IQR = 42.5–64.5). Mechanism of onset was due to trauma (falls, repeated inversion injuries or road traffic collisions) (n = 7), or the effects of haemophilia (n = 2). The median duration of symptoms was 2 years (IQR = 1.5–10). Data saturation was achieved. Four themes were identified:
•
Signs and symptoms
•
Impact on participation
•
Impact on self-identity & mental wellbeing
•
Views on non-surgical management
Conclusions
This is the first study to explore the experiences of people with symptomatic OA ankle. Our findings suggest that those with OA ankle suffer with severe pain, which has a substantial negative impact on a person's physical and mental wellbeing. The findings of this study may be used to inform future research.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265435
in Physiotherapy > Vol. 110 (2021) . - p. 70-76[article]
Titre : PDSAFE’ - a multi-dimensional model of falls-rehabilitation for people with Parkinson’s. A mixed methods analysis of therapists’ delivery and experience Type de document : Article Auteurs : S. Hulbert ; K. Chivers-Seymour ; R. Summers ; S. Lamb ; V. Goodwin ; L. Rochester ; A. Nieuwboer ; A. Rowsell ; S. Ewing ; A. Ashburn Année de publication : 2021 Article en page(s) : p. 77-84 Note générale : https://doi.org/10.1016/j.physio.2020.08.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Chutes accidentelles ; Kinésithérapie et physiothérapie ; Maladie de Parkinson ; Raisonnement clinique ; RéadaptationRésumé : Objective
To explore the clinical reasoning of physiotherapists using PDSAFE; according to disease severity and their experiences of treatment delivery in a large fall-prevention trial for people with Parkinson’s (PwP).
Design
A descriptive study of delivering PDSAFE. Semi-structured interviews explored therapists’ experiences.
Setting
A two-group, home-based, multi-centred, single-blinded, randomised controlled trial showed no overall effect on fall reduction between groups but demonstrated a significant secondary effect relating to disease severity with benefits to balance, falls efficacy and near-falls for all.
Participants
Physiotherapists with a background in neurology and older-person rehabilitation were trained in the delivery of PDSAFE
Intervention
A multi-dimensional, individually tailored and progressive, home-based programme.
Results
Fifteen physiotherapists contributed to the 2587 intervention sessions from the PDSAFE trial and six of those physiotherapists took part in the interviews. The personalised intervention was reflected in the range of strategies and exercises prescribed. Most commonly prescribed fall-avoidance strategies were ‘Avoiding tripping’, ‘Turning’ and ‘Freezing Cues’ and all possible combinations of balance and strength training within the programme were selected. PwP with greater disease severity were more likely to have received less challenging strategies, balance and strengthening exercises than those with lower disease severity.
Therapists considered the focus on fall events and fall avoidance strategies an improvement on ‘impairment only’ treatment. The presence of cognitive deficits, co-morbidities and dyskinesia were the most challenging aspects of delivering the intervention.
Conclusion
Falls management for PwP is complex and compounded by the progressive nature of the condition. Physiotherapists both delivered and positively received PDSAFE. (248 words)Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=265445
in Physiotherapy > Vol. 110 (2021) . - p. 77-84[article]
Paru le : 01/12/2020
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Titre : The therapeutic management of back pain with and without sciatica in the emergency department: a systematic review Type de document : Article Auteurs : Jane Ashbrook ; Nikolaos Rogdakis ; Michael J. Callaghan ; Gillian Yeowell ; Peter Charles Goodwin Année de publication : 2020 Article en page(s) : p. 13-32 Note générale : https://doi.org/10.1016/j.physio.2020.07.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Lombalgie ; Sciatalgie ; Service hospitalier d'urgencesRésumé : Introduction
An increasing number of patients are attending the Emergency Department (ED) with back pain with or without sciatica. There is evidence to suggest that medical management is varied and inconsistent.
Objective
The purpose of this study was to review the literature to determine the evidence base for the therapeutic management of adults presenting with back pain with or without sciatica in the ED.
Methods
A systematic review of the literature included the therapeutic management of patients presenting in the ED. Articles published in peer review journals in English language up to August 2018 were searched for in the following data-bases: MEDLINE, EMBASE, SCOPUS, CINAHL, ZETOC, PubMed, The Cochrane Library (Cochrane Database of Systematic Reviews), Web of Science, Open Grey and ETHOS. A narrative synthesis approach was followed.
Results
Twenty two studies, including 17 randomised control trials, one randomised control pilot study, two cohort studies, one cohort pilot study and one retrospective audit were included. The Downs and Black methodological quality scores ranged from 16 to 31 with a mean score of 24 out of a possible 32.
Conclusion
Evidence suggests that Naproxen alone should be considered as first line management in cases of back pain without sciatica. Intra-venous corticosteroids should be considered in the management of cases of severe sciatica. More high quality trials are needed to determine an evidence-based management protocol for the treatment of acute low back pain in the ED, specifically focusing on non-pharmacological management and the first line management of patients presenting with LBP with sciatica.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261676
in Physiotherapy > Vol. 109 (2020) . - p. 13-32[article]
Titre : Psychometric properties of the Single Assessment Numeric Evaluation (SANE) in patients with shoulder conditions. A systematic review Type de document : Article Auteurs : Goris Nazari ; Joy C. MacDermid ; Pavlos Bobos ; Rochelle Furtado Année de publication : 2020 Article en page(s) : p. 33-42 Note générale : https://doi.org/10.1016/j.physio.2020.02.008 Langues : Anglais (eng) Descripteurs : HE Vinci
Articulation glénohumérale ; Évaluation de résultat (soins) ; PsychométrieRésumé : Background
Musculoskeletal injuries (i.e. shoulder pain) is the third most commonly reported symptom. The development of the Single Assessment Numeric Evaluation (SANE) scale has presented clinicians and researchers with a more efficient approach in measuring function. Therefore, it is important to establish the reliability, validity and responsiveness properties of this scale, prior to its application in research and clinic.
Objectives
To identify, critically appraise and synthesize the reported psychometric properties of the SANE scale in patients with shoulder related pathologies.
Data sources
Medline, Embase, Scopus and CINAHL databases from inception till February 2019 were searched. Two independent reviewers carried out the systematic electronic searches in each database and screened the retrieved studies and assessed their eligibility.
Study selection or eligibility criteria
Randomized/prospective studies, that included patients with shoulder joint related pathologies, that reported on the psychometric properties (reliability, validity, responsiveness) of SANE scale.
Study appraisal and synthesis methods
The “Quality Appraisal for Clinical Measurement Research Reports Evaluation Form” – a 12-item structured clinical measurement specific appraisal tool was used to assess studies. A qualitative synthesis was performed, and main results summarized based on the shoulder conditions, reported properties and study quality.
Results
Nine studies were included. The quality ranged from 82% to 95% – very good to excellent quality. SANE scale reliability measures indicated excellent reliability properties. The Intra-class Correlation Coefficient (ICC) was ≥0.80 and Standard Error of Measurement (SEM) ranged from 4.23 to 7.82 points. Validity measures displayed correlations of 0.50–0.88 (moderate to very strong correlations) between the SANE scale and other patient reported outcomes (American Shoulder and Elbow Surgeons, Rowe score, Simple Shoulder Test, Physical Function Computerized Adaptive Test). Four studies assessed SANE scale responsiveness measures. Effect sizes of 1.5 and 0.83; and minimal clinically important differences that ranged from 27.25 to 37.05 (anchor-based approach) and 11.80 to 18.1 (distribution-based approach) were reported.
Limitations
Caution must be used when interpreting our ICCs values.
Conclusion implications of key findings
Very good to excellent quality evidence indicated that the SANE scale demonstrates evidence of a reliable, valid and responsive tool in patients with shoulder related pathologies.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261679
in Physiotherapy > Vol. 109 (2020) . - p. 33-42[article]
Titre : Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials Type de document : Article Auteurs : Lucas Rodrigues Nascimento ; Layla Alvarenga da Silva ; João Victor Matos Araújo Barcellos ; Luci Fuscaldi Teixeira-Salmela Année de publication : 2020 Article en page(s) : p. 43-53 Note générale : https://doi.org/10.1016/j.physio.2020.08.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Démarche ; Équilibre postural ; Orthèses ; RéadaptationRésumé : Background
Foot-drop is a common impairment after stroke, which reduces walking ability.
Objective
To examine the efficacy of interventions aimed at reducing foot-drop, i.e., ankle-foot orthoses and functional electrical stimulation, on walking speed and balance after stroke.
Data sources
MEDLINE, EMBASE, Cochrane, PsycINFO, and PEDro databases.
Eligibility criteria
The review included only parallel, randomized trials. Participants were ambulatory adults after stroke. The experimental interventions were the use of an ankle-foot orthosis or functional electrical stimulation.
Data synthesis
Outcome data related to walking speed and balance were extracted from the eligible trials and combined in random-effects meta-analyses. The quality of trials was assessed by the PEDro scores and the quality of evidence was determined according the Grading of Recommendations Assessment, Development, and Evaluation system.
Results
Eleven trials involving 1135 participants were included. The mean PEDro score of the trials was 5.8 (ranging from 4 to 7). Ankle-foot orthoses (MD 0.24 m/s; 95% CI 0.06 to 0.41) and functional electrical stimulation (MD 0.09 m/s; 95% CI 0.03 to 0.14) significantly increased walking speed, compared with no intervention/placebo. Results regarding balance were inconclusive. Ankle-foot orthoses were not superior to functional electrical stimulation for improving walking speed (MD 0.00 m/s; 95% CI -0.06 to 0.05) or balance (MD 0.27 points on the Berg Balance Scale; 95% CI -0.85 to 1.39) after stroke.
Conclusions
This systematic review provided moderate-quality evidence that both ankle-foot orthoses and functional electrical stimulation improve walking speed after stroke, but the effects on balance remain unclear.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261684
in Physiotherapy > Vol. 109 (2020) . - p. 43-53[article]
Titre : Evaluation of the implementation of the Back Skills Training (BeST) programme using online training: a cohort implementation study Type de document : Article Auteurs : Thavapriya Sugavanam ; Esther Williamson ; Beth Fordham ; Zara Hansen ; Helen Richmond ; Amanda Hall ; Usama Ali ; Bethan Copsey ; Sarah E. Lamb Année de publication : 2020 Article en page(s) : p. 4-12 Note générale : https://doi.org/10.1016/j.physio.2020.07.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Cognition ; Lombalgie ; Mise en oeuvre des programmes de santéRésumé : Objectives
1) Evaluate implementation of the Back Skills Training (BeST) programme, a group cognitive behavioural approach for patients with low back pain (LBP) developed for a clinical trial, into the National Health Service (NHS) in the United Kingdom; 2) Compare patient outcomes with the BeST Trial results.
Design
Two stage observational cohort implementation study.
Participants
Stage 1: NHS Clinicians enrolled in BeST online training. Stage 2: Patients with LBP attending NHS physiotherapy departments and enrolled in the BeST programme.
Intervention
An online training and implementation programme.
Outcomes
Stage 1: LBP attitudes and beliefs, self-rated competence, intention and actual implementation were collected before, immediately, 4- and 12-months post-training. Stage 2: Patients rated pain, function, recovery and satisfaction before and up to one year after attending the BeST programme.
Results
Stage 1: 1324 clinicians (157 NHS Trusts) enrolled in the training; 586 (44%) clinicians (101 NHS Trusts) completed training; 443/586 (76%) clinicians provided post-training data; 253/443 (57%) clinicians intended to implement the programme; 148/381 (39%) clinicians (54 NHS Trusts) provided follow-up data; 49/148 (33.1%) clinicians (27 NHS Trusts) implemented the programme. Attitudes and beliefs shifted towards a biopsychosocial model post-training. Stage 2: 923 patients were enrolled. Patients reported improvements in function (mean change: 1.55; 95%CI: 1.25, 1.86) and pain (−0.84; −1.1, −0.58) at follow-up. The majority rated themselves improved and satisfied with the programme.
Conclusion
Online training had good reach into NHS Trusts although, not everyone went onto implement the programme. Improvements in function that were consistent with the original trial were demonstrated.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261686
in Physiotherapy > Vol. 109 (2020) . - p. 4-12[article]
Titre : Enhancing the assessment of cardiorespiratory fitness using field tests Type de document : Article Auteurs : A. Marques ; P. Rebelo ; C. Paixão ; S. Almeida ; C. Jácome ; J. Cruz ; A. Oliveira Année de publication : 2020 Article en page(s) : p. 54-64 Note générale : https://doi.org/10.1016/j.physio.2019.06.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Capacité cardiorespiratoire ; Membre supérieur ; Test de marche ; Valeurs de référenceRésumé : Objective
To establish normative values and reference equations of the 6-minute walk test (6MWT), incremental shuttle walk test (ISWT) and unsupported upper limb exercise test (UULEX) for Portuguese adults.
Design
Cross-sectional study. Descriptive statistics and differences between age decades and genders were explored using univariate general linear models to compute reference values. Reference equations were established with a forward stepwise multiple regression.
Setting
General community.
Participants
In total, 645 adult volunteers without disabilities [43% male, mean age 55.1 (standard deviation 23.6) years] were recruited from the university campus and surrounding community.
Intervention
Not applicable.
Main outcome measures
Data on age, gender, height, weight, body mass index and smoking status were collected using a structured questionnaire. Physical activity was evaluated using the Brief Physical Activity Assessment Tool. Participants performed two repetitions of the 6MWT, ISWT and UULEX, and the best repetition was used for analysis.
Results
Overall, performance was better in males than in females, and decreased with age. Participants’ performance was significantly reduced after the sixth decade of life compared with the other decades (P Conclusion
Leg or arm exercise field tests are affected significantly by age and gender. These results will aid health professionals to interpret the results of field tests obtained from healthy or diseased adult populations.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261688
in Physiotherapy > Vol. 109 (2020) . - p. 54-64[article]
Titre : The effectiveness of graded motor imagery for reducing phantom limb pain in amputees: a randomised controlled trial Type de document : Article Auteurs : Katleho Limakatso ; Victoria J. Madden ; Shamila Manie ; Romy Parker Année de publication : 2020 Article en page(s) : p. 65-74 Note générale : https://doi.org/10.1016/j.physio.2019.06.009
Under a Creative Commons licenseLangues : Anglais (eng) Descripteurs : HE Vinci
Amputés ; Membre fantôme ; Neurones miroirsRésumé : Objective
To investigate whether graded motor imagery (GMI) is effective for reducing phantom limb pain (PLP) in people who have undergone limb amputations.
Design
A single-blinded randomised, controlled trial.
Setting
Physiotherapy out-patient departments in three secondary level hospitals in Cape Town, South Africa.
Participants
Twenty-one adults (≥18 years) who had undergone unilateral upper or lower limb amputations and had self-reported PLP persisting beyond three months.
Interventions
A 6-week GMI programme was compared to routine physiotherapy. The study outcomes were evaluated at baseline, 6 weeks, 3 months and 6 months.
Outcome measures
The pain severity scale of the Brief Pain Inventory (BPI) was used to assess the primary outcome — PLP. The pain interference scale of the BPI and the EuroQol EQ-5D-5L were used to assess the secondary outcomes — pain interference with function and health-related quality of life (HRQoL) respectively.
Results
The participants in the experimental group had significantly greater improvements in pain than the control group at 6 weeks and 6 months. Further, the participants in the experimental group had significantly greater improvements than the control group in pain interference at all follow-up points. There was no between-group difference in HRQoL.
Conclusion
The results of the current study suggest that GMI is better than routine physiotherapy for reducing PLP. Based on the significant reduction in PLP and pain interference within the participants who received GMI, and the ease of application, GMI may be a viable treatment for treating PLP in people who have undergone limb amputations.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261689
in Physiotherapy > Vol. 109 (2020) . - p. 65-74[article]
Titre : Exercise interventions are delayed in critically ill patients: a cohort study in an Australian tertiary intensive care unit Type de document : Article Auteurs : Marc R. Nickels ; Leanne M. Aitken ; James Walsham ; Lisa J. Crampton ; Adrian G. Barnett ; Steven M. McPhail Année de publication : 2020 Article en page(s) : p. 75-84 Note générale : https://doi.org/10.1016/j.physio.2019.06.011 Langues : Anglais (eng) Descripteurs : HE Vinci
Études de cohortes ; Kinésithérapie (spécialité) ; Lever précoce ; Maladie grave ; Réadaptation ; Unités de soins intensifsRésumé : Objectives
This study aims to (i) describe the time to exercise commencement (sitting and upright activities) relative to ICU admission and relative to achievement of initial neurological, respiratory and cardiovascular stability; (ii) examine factors associated with whether sitting and upright activities occurred in ICU; and (iii) examine factors associated with time taken to commence these activities after stability has been achieved.
Design
Five-year historical cohort study.
Setting
An Australian tertiary mixed medical, surgical, trauma ICU.
Participants
The cohort (n = 3222, mean (SD) age 54 (18) years, 67% male) included consecutive ICU patients with length of stay over 48 hours admitted to a tertiary ICU who achieved stability.
Main outcome measures
Time from stability to patients’ first completed sitting and upright activities was calculated. Logistic regression (and Cox proportional hazard models) examined whether sitting and upright activities in ICU occurred (and time to these events).
Interventions
None.
Results
For patients who completed exercise interventions (n = 1845/3222, 57%), this commenced a median (IQR) 2.3 (1.3–4.4) days after stability for upright activities and 2.7 (1.5–5.7) days for sitting. A large proportion of patients did not complete exercise interventions despite achieving stability (n = 1377/3222, 43%). Elective surgical admissions, lower illness severity and older age were associated with completion (and earlier completion) of sitting and upright activity (P Conclusions
Many stable patients did not commence sitting or upright activity in ICU despite known benefits, or commencement was somewhat delayed. Opportunities may exist to improve patient outcomes through timely implementation of exercise-based interventions.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261691
in Physiotherapy > Vol. 109 (2020) . - p. 75-84[article]
Titre : Pelvic floor muscle function in women with and without urinary incontinence: are strength and endurance the only relevant functions? a cross-sectional study Type de document : Article Auteurs : Gabriella Ferreira Vieira ; Fernanda Saltiel ; Ana Paula Gonçalves Miranda-Gazzola ; Renata Noce Kirkwood ; Elyonara Mello Figueiredo Année de publication : 2020 Article en page(s) : p. 85-93 Note générale : https://doi.org/10.1016/j.physio.2019.12.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Incontinence urinaire ; Kinésithérapie (spécialité) ; Plancher pelvienRésumé : Objectives
To investigate if pelvic floor muscle functions (PFMFs), besides strength and endurance, are associated with the occurrence of urinary incontinence (UI) in women, and to investigate which functions predict the occurrence of UI.
Design
Cross-sectional study.
Setting
Public health service and community.
Participants
Two hundred and ten women (101 with UI and 109 without UI).
Main outcome measures
PFMF was investigated by the Pelvic Floor Sensory and Muscle Function Exam (Exame das Funções Sensoriais e Musculares do Assoalho Pélvico), a valid and reliable instrument that measures the following functions: tone, reaction, control (contraction), control (relaxation), coordination, strength and endurance. The International Consultation on Incontinence Questionnaire-Short Form was used to document the occurrence and type of UI. Sociodemographic and clinical data were collected through the questionnaire. Chi-squared test, Student’s t-test and Mann–Whitney test were used to evaluate the association of each function with UI. Two logistic regression models tested the predictive value of each function for UI: Model a included all of the above PFMFs and Model b included all of the above PFMFs except strength and endurance.
Results
Most sociodemographic and clinical risk factors differed between women with UI and women without UI. On univariate analysis, tone, reaction, control (contraction), coordination, strength and endurance were found to be significantly associated (P
Conclusions
Besides strength and endurance, pelvic floor muscle tone, reaction, control (contraction) and coordination were significantly associated with the occurrence of UI, and should be investigated further.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261714
in Physiotherapy > Vol. 109 (2020) . - p. 85-93[article]
Titre : Experiences of physiotherapy in mental health: an interpretative phenomenological analysis of barriers and facilitators to care Type de document : Article Auteurs : Laura Hemmings ; Andrew Soundy Année de publication : 2020 Article en page(s) : p. 94-101 Note générale : https://doi.org/10.1016/j.physio.2020.01.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Appareil locomoteur ; Communication ; Kinésithérapie (spécialité) ; Maladies ostéomusculaires ; Santé holistique ; Santé mentale ; Soins centrés sur le patientRésumé : Background
Service users with severe mental illness (SMI) are at increased risk of physical health co-morbidity such as musculoskeletal pain, neurological impairment, obesity and COPD; many of which require input from physiotherapists. Physiotherapists play a pivotal role in treatment of those with SMI but are reported to lack skills and confidence with this patient group. Furthermore, disparities in accessing healthcare are evidenced for those with SMI.
Purpose
This study explored experiences of physiotherapeutic care for those with co-morbid physical and mental health complaints to identify barriers and facilitators to care.
Methods
A qualitative study using Interpretive Phenomenological Analysis was undertaken. Semi-structured interviews were completed with service users (n = 8) with longstanding physiotherapeutic and psychiatric complaints. Focus groups were completed with physiotherapists working in mental health. Verbatim transcripts of interviews were analysed using Interpretive Phenomenological Analysis to obtain in depth insight into participant experiences. Study quality was enhanced through use of methodological and investigator triangulation, negative case analysis, reflexivity and secondary coding.
Analysis
Data was analysed systematically following the structure: individual case analysis, emergence of themes, cross case analysis, validation of themes and ideas.
Results
This analysis produced five master themes: Communication [1], holistic care [2], benefit of physiotherapy [3], healthcare politics and service interaction [4], patient activation [5].
Results identified current service provision did not always meet the complexities of service user needs.
Conclusion and Implications
Improved physiotherapist awareness of mental health and how to communicate and treat this population was identified. The importance of better integration between services was also highlighted. A positive experience of physiotherapy is vital for patient activation and engagement with physiotherapy.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261715
in Physiotherapy > Vol. 109 (2020) . - p. 94-101[article]
Titre : Patient and family experience of physical rehabilitation on the intensive care unit: a qualitative exploration Type de document : Article Auteurs : Zoé van Willigen ; Chantel Ostler ; Debbie Thackray ; Rebecca Cusack Année de publication : 2020 Article en page(s) : p. 102-110 Note générale : https://doi.org/10.1016/j.physio.2020.01.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Kinésithérapie (spécialité) ; Réadaptation ; Unités de soins intensifsRésumé : Objectives
To explore the experience of physical rehabilitation in the intensive care unit (ICU), from the perspective of patients and relatives.
Design
Exploratory, qualitative study.
Participants
Five former ICU patients and five family members of former ICU patients recruited from ICU support groups across the UK.
Interventions
Semi-structured interviews.
Main outcome measures
Participants’ experiences of physical rehabilitation in the ICU. Data were analysed using an iterative thematic approach.
Results
Four main themes were identified: Trust and Rapport, Necessity (of treatment), Psychological Benefit, and Goal Setting: Whose goal is it anyway? Despite a lack of enjoyment, patients tend to comply with physical rehabilitation, due in part to a positive patient–therapist relationship. There was agreement across participants that physical rehabilitation should be started as soon as possible after admission to ICU and exhaustion was highlighted as the biggest challenge to participation. In addition to aiding physical recovery, physical rehabilitation in the ICU may also provide psychological support for both patients and relatives. Finally, participants described a desire for therapists to direct goal setting in the early stages of recovery as they felt unable to engage in the process due to other priorities.
Conclusions
The experience of physical rehabilitation on ICU may be influenced by key aspects of person-centred care. This study suggests that patients and relatives are keen for physical rehabilitation to start as soon as possible, which is a crucial new finding to support the practice of early rehabilitation in the ICU.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261716
in Physiotherapy > Vol. 109 (2020) . - p. 102-110[article]
Titre : Physiotherapy management of greater trochanteric pain syndrome (GTPS): an international survey of current physiotherapy practice Type de document : Article Auteurs : H.P. French ; S.J. Woodley ; A. Fearon ; L. O'Connor ; A. Grimaldi Année de publication : 2020 Article en page(s) : p. 111-120 Note générale : https://doi.org/10.1016/j.physio.2019.05.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Femur ; Pratique factuelle ; Syndrome fémoropatellaire ; Tendinopathie ; Traitement par les exercices physiquesRésumé : Objectives
This study aimed to establish and compare current physiotherapy management of GTPS in Australia, New Zealand (NZ) and Ireland.
Design
Cross-sectional observational survey of physiotherapists.
Methods
An online survey was distributed to registered musculoskeletal physiotherapists in Australia, NZ and Ireland. Ordinal and nominal data were analysed using frequency counts or mean ranks; median and interquartile ranges were calculated for numerical data. Inter-country comparisons were made using Chi-squared analyses for nominal/ordinal data and Kruskal–Wallis tests for numerical data. Statistical significance was set at P
Results/findings
Valid responses were received from 361 physiotherapists, 61% were female and 80% worked in private practice. Overall, consistency in treatment of GTPS was observed across the three countries. All physiotherapists used education and exercise (most commonly strengthening and neuromuscular control) primarily targeting the gluteal muscles. Other interventions included massage (90%), stretching (53%), range of motion (40%), thermal modalities (50%), taping (38%) and electrotherapy (25%), whilst 40% commonly recommended up to 2 to 3 corticosteroid injections per patient/per annum. Physiotherapists used pain severity scales as their primary outcome measure (79%). Single leg stance was the most common physical measure used (68%), and global rating scores or standardised physical measures were less commonly used.
Conclusion
This international survey established the physiotherapy management of GTPS. Education used in conjunction with exercise is in line with current evidence, but a proportion of clinicians use adjunct treatments without clear rationale or supporting evidence. Results indicate the need to further define optimal management of GTPS using robust methodologies such as randomised controlled trials.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=261717
in Physiotherapy > Vol. 109 (2020) . - p. 111-120[article]
Paru le : 01/09/2020
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Titre : Core competencies for physiotherapists working with refugees: a scoping review Type de document : Article Auteurs : Emer McGowan ; Nicole Beamish ; Emma Stokes ; Rachael Lowe Année de publication : 2020 Article en page(s) : p. 10-21 Note générale : https://doi.org/10.1016/j.physio.2020.04.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Compétence clinique ; Kinésithérapie (spécialité) ; Réadaptation ; RéfugiésRésumé : Objective
To summarise the existing knowledge base that can inform the development of a core competency profile for physiotherapists to support and deliver rehabilitation services to refugees.
Method
In this scoping review, a comprehensive search of peer-reviewed and grey literature was conducted. The search parameters included studies relevant to the physiotherapy profession and published between 2000 and 2019. MEDLINE, EMBASE, CINAHL, PEDro, and Ovid PsycINFO databases were searched. Grey literature was accessed through website searches, Google Scholar, and direct requests.
Findings
Three themes were identified in the literature. The first theme encompassed the physical and mental health of refugees. The second theme explored the cultural competence physiotherapists need to work with refugees. This theme included the cultural influences on health and healthcare and communication strategies that could be used to optimise healthcare for refugees. The last theme described refugees and the healthcare system which encompassed the challenges that refugees face in accessing healthcare and navigating the healthcare system. The main physiotherapy competencies detected in the literature were an understanding of refugee health, the administration of culturally competent care and knowledge of healthcare systems as they relate to refugees.
Conclusion
This comprehensive search identified three themes that can be used to inform the development of a competency profile for physiotherapists working with refugees. These themes are, however, rather vague and non-specific and signal the need for research to further examine the physiotherapy competencies necessary to provide the highest quality of care for this growing population.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260386
in Physiotherapy > Vol. 108 (2020) . - p. 10-21[article]
Titre : Patients’ perceptions of rehabilitation in the community following hip fracture surgery. A qualitative thematic synthesis Type de document : Article Auteurs : J. Blackburn ; G. Yeowell Année de publication : 2020 Article en page(s) : p. 63-75 Note générale : https://doi.org/10.1016/j.physio.2020.02.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Fractures de la hanche ; Perception ; RéadaptationRésumé : Background
Hip fracture is one of the most common injuries in adults and can be a life changing experience for most. Many patients are ill-prepared for the changes in their normal daily activity that often occur in the following months after surgery. Community rehabilitation services vary, as management often focuses on acute over community services. This can impact on the patient’s experience post hip fracture.
Objectives
The aim of this review was to understand and examine patients’ perspective, views and experiences of physiotherapy rehabilitation in the community after hip fracture surgery, to improve future clinical practice for this population.
Design
A qualitative thematic synthesis was undertaken to investigate the aim. A content thematic analysis approach was used to analyse the qualitative data.
Data sources
A systematic search was carried out of the following databases: CINAHL, PEDro, PubMed, Whiley Online, AMED & CINAHL. Further searches were performed in Google Scholar and backwards citation was used to search within included studies.
Study selection
A review of qualitative studies was performed using the SPIDER tool for identification of suitable studies and the CASP tool for analysis of quality. Studies were included if they were qualitative or part qualitative and involved patients’ perceptions of rehabilitation after hip fracture following hospital discharge.
Results
Full text review was performed on 35 studies of which, 10 were identified as suitable. Three key themes were identified regarding experiences of rehabilitation within the community after hip fracture: Engaging in physical activity; Maintaining a positive perspective, and Support.
Conclusion
Findings support the need for the patient perspective and experience to be considered in the improvement of hip fracture care pathways regarding rehabilitation in the community setting after hip fracture. This can help identify key areas of improvement in rehabilitation to enhance and improve the patient journey after hip fracture.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260388
in Physiotherapy > Vol. 108 (2020) . - p. 63-75[article]
Titre : Effect of exercise interventions in the early phase to improve physical function after hip fracture – A systematic review and meta-analysis Type de document : Article Auteurs : Monica Beckmann ; Vigdis Bruun-olsen ; Are Hugo Pripp ; Astrid Bergland ; Toby Smith ; Kristi E. Heiberg Année de publication : 2020 Article en page(s) : p. 90-97 Note générale : https://doi.org/10.1016/j.physio.2020.04.009 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Fractures de la hanche ; Méta-analyse ; Récupération fonctionnelle ; Revue systématiqueRésumé : Background
The efficacy of exercise interventions in the early recovery phase, i.e. started within the first three months after hip fracture, has been poorly studied compared to prolonged exercise interventions.
Objective
To examine the effect of exercise interventions to improve physical function in the early phase after hip fracture.
Data sources
Seven databases including MEDLINE via Ovid, The Cochrane Library, Embase, Cinahl, Pedro, AMED and Web of Science were comprehensively searched till December 2019.
Eligibility criteria
Randomised controlled trials (RCTs) of exercise interventions initiated within the first three months after hip fracture to improve physical function, were eligible for inclusion. Primary outcome was physical function assessed using walking ability, walking speed, balance, muscle strength, mobility, and endurance.
Data extraction and data synthesis
We conducted subgroup analyses specifically to investigate outcomes of these individual measurements. A meta-analysis was conducted to examine the overall effect of early exercise interventions. A meta-regression was conducted to examine the impact of study characteristic on exercise interventions. We used the PEDro score to determine quality of the included studies.
Results
Nine studies (669 patients) were included. Despite high statistical heterogeneity, there was high to moderate quality evidence that exercise provided benefit in improving physical function (standardised mean difference (SMD) 1.07; 95% CI: 0.44 to 1.70; p 0.05). Meta-regression demonstrated no statistically significant association between study characteristics and exercise interventions (p > 0.05).
Conclusion
Exercise in the early phase of hip fracture rehabilitation can improve physical function. It remains unclear what type of exercise is superior in the early phase after hip fracture.
Limitations
This conclusion should be interpreted with caution given the high statistical heterogeneity reported and non-significant subgroup analyses of specific physical function measures, which were underpowered.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260394
in Physiotherapy > Vol. 108 (2020) . - p. 90-97[article]
Titre : Cost-effectiveness of physiotherapeutic interventions for low back pain: a systematic review Type de document : Article Auteurs : F. Fatoye ; J.M. Wright ; T. Gebrye Année de publication : 2020 Article en page(s) : p. 98-107 Note générale : https://doi.org/10.1016/j.physio.2020.04.010 Langues : Anglais (eng) Descripteurs : HE Vinci
Analyse coût-bénéfice ; Kinésithérapie (spécialité) ; Lombalgie ; Revue systématiqueRésumé : Background
Due to the rapid increase in healthcare costs of low back pain (LBP), it is important to provide clinically effective and cost-effective interventions to individuals with the condition.
Objective
To evaluate all recent economic evaluations of physiotherapeutic interventions for patients with LBP.
Data sources
A literature search of Cumulative Index to Nursing and Allied Health Literature, MEDLINE, the National Health Service Economic Evaluation Database, Health Technology Assessment and Database of Abstracts of Review of Effects (January 2008 to October 2018) was undertaken.
Study selection
Randomised controlled trials and cohort studies that assessed the cost- effectiveness of physiotherapeutic interventions on patients with LBP compared with a control group were included in this review. A Consolidated Health Economic Evaluation Reporting Standards checklist was used to assess the quality of studies.
Data extraction/data synthesis
Two authors extracted data independently. A descriptive synthesis was conducted to summarise the data.
Results
In total, 1531 articles were identified and 11 studies met the inclusion criteria for this review. The total number of study participants in this review was 2633 and their ages ranged from 18 to 80 years. The duration of LBP in these patients ranged from 3 weeks to 1 year. Excluding one study, all studies reported that the physiotherapeutic intervention was cost-effective compared with the control arm. Meta-analysis was not possible due to heterogeneity of the studies.
Conclusion
Although most studies in this review suggested that physiotherapeutic interventions were cost-effective, it is difficult to pool their results for conclusive evidence.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260397
in Physiotherapy > Vol. 108 (2020) . - p. 98-107[article]
Titre : Effect of extended scope physiotherapists assessments in orthopaedic diagnostic setting: a systematic review Type de document : Article Auteurs : J. Trøstrup ; C.B. Juhl ; L.R. Mikkelsen Année de publication : 2020 Article en page(s) : p. 120-128 Note générale : https://doi.org/10.1016/j.physio.2017.08.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Kinésithérapeutes ; Maladies ostéomusculaires ; Orthopédie ; Prise de décision clinique ; Revue systématique ; Satisfaction des patientsRésumé : Background
Patients with musculoskeletal diseases can potentially be assessed by an extended scope physiotherapist (ESP) instead of by an orthopaedic surgeon (OS).
Objectives
To evaluate the effectiveness of the diagnostic musculoskeletal assessment performed by ESP compared to OS.
Data sources
MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, PEDro and reference lists of included studies and previous reviews were searched in November 2015.
Eligibility criteria
Studies were included if they evaluated adults with a musculoskeletal disease referred to an outpatient orthopaedic clinic where a diagnostic assessment had been conducted by an ESP.
Data extraction
Data were extracted using a customised data extraction sheet. Two reviewers using checklists evaluated methodological independently.
Results
We included one randomised controlled trial and 31 observational studies. Diagnostic agreement between ESPs and OSs was 65 to 100% across studies. Health care cost savings for diagnostic assessments performed by ESPs were 27 to 49% compared to OSs. Overall, 77 to 100% of the patients were satisfied with the ESP assessment. Results were comparable on diagnostic agreement, cost and satisfaction in studies with high, moderate and low risk of bias.
Limitations
Risk of bias in the included studies.
Conclusion and implication of key findings
Diagnostic assessments performed by ESP may be as beneficial as or even better than assessment performed by OSs in terms diagnostic agreement, costs and satisfaction. However, the methodological quality was generally too low to determine the clear effectiveness of ESP assessment, and more high quality studies are needed.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260401
in Physiotherapy > Vol. 108 (2020) . - p. 120-128[article]
Titre : Provision of first contact physiotherapy in primary care across the UK: a survey of the service Type de document : Article Auteurs : Serena Halls ; Rachel Thomas ; Hannah Stott ; Margaret E. Cupples ; Paula Kersten ; Fiona Cramp ; Dave Foster ; Nicola Walsh Année de publication : 2020 Article en page(s) : p. 2-9 Note générale : https://doi.org/10.1016/j.physio.2020.04.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Kinésithérapie (spécialité) ; Maladies ostéomusculaires ; Médecine générale ; Soins de santé primairesRésumé : Background
First Contact Physiotherapy (FCP) is an emerging model of care whereby a specialist physiotherapist located within general practice undertakes the first patient assessment, diagnosis and management without a prior GP consultation. Despite institutional and professional body support for this model and NHS commitment to its implementation, data regarding current FCP provision are limited.
Objectives
To identify current FCP service provision across the UK, including models of provision and key professional capabilities.
Design
Cross-sectional online survey, targeting physiotherapists and service managers involved in FCP.
Methods
Recruitment involved non-probability sampling targeting those involved in FCP service provision through emails to members of known clinical networks, snowballing and social media. The survey gathered data about respondents, FCP services and the role and scope of physiotherapists providing FCP.
Results
The authors received 102 responses; 32 from service managers and 70 working in FCP practice from England (n = 60), Scotland (n = 22), Wales (n = 14), and Northern Ireland (n = 2). Most practitioners were NHS band 7 or 8a (91%, n = 63), with additional skills (e.g. requesting investigations, prescribing). 17% (12/70) worked 37.5 hours/week; 37% (26/70) ≤10 hours; most (71%, 50/70) used 20-minute appointments (range 10–30 minutes); varying arrangements were reported for administration and follow-up. Services covered populations of 1200 to 600,000 (75% Conclusions
This survey provides new evidence regarding variation in FCP practice across the UK, indicating that evidence-informed, context specific guidance on optimal models of provision is required.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260404
in Physiotherapy > Vol. 108 (2020) . - p. 2-9[article]
Titre : Can a brief behavioural change intervention encourage hospital patients with low physical activity levels to engage and initiate a change in physical activity behaviour? Type de document : Article Auteurs : I. Waite ; D. Grant ; J. Mayes ; S. Greenwood Année de publication : 2020 Article en page(s) : p. 22-28 Note générale : https://doi.org/10.1016/j.physio.2020.04.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Comportement ; Entretien motivationnel ; Exercice physiqueRésumé : Background
Regular physical activity (PA) reduces risk factors for chronic disease. This novel study evaluates self-reported engagement with PA in recently discharged patients, identified as having low PA levels, who agreed to participate in an in-patient behaviour change intervention.
Method
This exploratory study invited hospital in-patients, who were classified as ‘moderately inactive’ or ‘inactive’, to participate in a brief individual physiotherapy-led motivational interviewing (MI) behavioural change intervention. Patients were encouraged to set individual exercise and activity goals, and an appropriate programme referral was identified and agreed upon.
Results
Three hundred and forty-two of 526 patients, who were screened between January 2017 and March 2018, were classified ‘inactive’ or ‘moderately inactive’. Seventy-seven percent of patients consented to participate in the brief MI intervention (n = 58 ‘moderately active’, n = 206 ‘inactive’). One hundred percent participants who received the brief intervention agreed to attend a PA programme. At telephone follow-up, 66% self-reported engagement in community exercise or independent PA initiatives.
Conclusion
This exploratory study demonstrates that a brief, MI-facilitated, behaviour change intervention is feasible and has the potential to aid PA engagement for hospital patients with low PA levels upon discharge from hospital. Considering that the ‘first-step’ with engagement in PA is often the biggest challenge for patients, this initiative has promise to improve PA behaviour and could be rolled out across the National Health Service (NHS).Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260408
in Physiotherapy > Vol. 108 (2020) . - p. 22-28[article]
Titre : First point of contact physiotherapy; a qualitative study Type de document : Article Auteurs : Rob Goodwin ; Fiona Moffatt ; Paul Hendrick ; Stephen Timmons ; Neil Chadborn ; Pip Logan Année de publication : 2020 Article en page(s) : p. 29-36 Note générale : https://doi.org/10.1016/j.physio.2020.02.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Kinésithérapeutes ; Manipulations de l'appareil locomoteur ; Recherche qualitativeRésumé : Objectives
First point of contact physiotherapy (FPCP) provides patients direct access to a physiotherapist. Literature demonstrates efficacy of FPCP. Evidence has highlighted the need for cultural shifts from both patient and professional perspectives to optimise FPCP. This study explored stakeholder perceptions of patient awareness and understanding of FPCP to better inform FPCP implementation.
Design, setting, participants
A qualitative methodology utilised semi-structured interviews and focus groups. Findings from a previous realist review were used to generate a priori topic guides. Participants included patients, physiotherapists, GPs, administration staff, and commissioners. A thematic analysis was undertaken.
Results
Four themes emerged that are described: level of patient awareness of the FPCP role situated against the GP as first contact practitioner, patients attain an awareness of FPCP from a variety of sources, patient understanding of physiotherapy arises from several sources and is poorly aligned with the FPCP model, characteristics and behaviours of patients influence access to FPCP services. Patient awareness and understanding was poor. Patients tended to view the GP as the default first contact practitioner. Traditional advertising approaches appeared on the whole invisible to patients and there was a reliance on signposting to facilitate patient access.
Conclusion
Findings from this study can inform implementation of FPCP. Several obstacles to the optimisation of FPCP were highlighted. Improved marketing of physiotherapy generally and FPCP specifically may increase patient awareness and understanding. However, it is likely further time will be required to bring about the cultural shift in public perception required to optimise the potential of FPCP.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260410
in Physiotherapy > Vol. 108 (2020) . - p. 29-36[article]
Titre : Effect of an abdominal hypopressive technique programme on pelvic floor muscle tone and urinary incontinence in women: a randomised crossover trial Type de document : Article Auteurs : L. Soriano ; C. González-Millán ; M.M. Álvarez Sáez ; R. Curbelo ; L. Carmona Année de publication : 2020 Article en page(s) : p. 37-44 Note générale : https://doi.org/10.1016/j.physio.2020.02.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Plancher pelvien ; Service de santé pour les femmes ; Technique abdominale hypopressive ; Troubles du plancher pelvienRésumé : Objectives
To test the effect of a structured abdominal hypopressive technique (AHT) programme on pelvic floor muscle (PFM) tone and urinary incontinence (UI) in women.
Design
Crossover trial with random assignment of women to one of two groups: Group 1 (AHT followed by rest) and Group 2 (rest followed by AHT).
Setting
Two cultural centres in Madrid, Spain.
Participants
Women aged 20–65 years.
Interventions
Two months of supervised AHT exercises compared with 2 months of rest.
Main outcome measures
Variation in PFM tone and score on the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF)].
Results
Forty-two women were randomised to two groups (both n = 21). No sequence or period effect was noted. The mean difference in PFM tone after the 2-month AHT programme was 59 g/cm² [95% confidence interval (CI) 37 to 82]; the between-group difference was 83 g/cm² (95% CI 50 to 116; P Conclusions
A structured 2-month AHT programme for women showed short-term benefits in PFM tone and UI. In addition, study participants reported improved body image and sense of well-being, and programme satisfaction, as demonstrated by questionnaire at the end of the intervention period. Further research is needed to test the long-term effects and effectiveness of AHT compared with other PFM exercises.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260412
in Physiotherapy > Vol. 108 (2020) . - p. 37-44[article]
Titre : Investigating physiotherapy stakeholders’ preferences for the development of performance-based assessment in practice education Type de document : Article Auteurs : A. O'Connor ; N. Krucien ; P. Cantillon ; M. Parker ; A. McCurtin Année de publication : 2020 Article en page(s) : p. 46-54 Note générale : https://doi.org/10.1016/j.physio.2020.04.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Étudiants ; Etudiants en kinésithérapie ; Evaluation ; Kinésithérapie (spécialité) ; Pratique professionnelleMots-clés : Méthode des choix discrets Résumé : Objectives
Discrete choice experiments (DCEs) are used in healthcare to measure the relative importance that stakeholders give to different features (or attributes) of medical treatments or services. They may also help to address research questions in health professional education. Several challenges exist regarding the performance-based assessment process (PBA) employed in physiotherapy practice-based education, a process which determines students’ readiness for independent practice. Evidence highlights many commonalities among these challenges, but it is unknown which factors are the most important to stakeholders. The use of DCE methodology may provide answers and help to prioritise areas for development. Thus, this study employed DCE to identify clinical educators’, practice tutors and physiotherapy students’ preferences for developing the PBA process in physiotherapy.
Design
Attributes (aspects of the PBA process known to be important to stakeholders) were derived from focus group interviews conducted with three groups; physiotherapy students, clinical educators (practising clinicians) and practice tutors (dedicated educational roles in the workplace). These attributes included the PBA tool, grading mechanisms, assessors involved, and, feedback mechanisms. Preferences for each group were calculated using a logistic regression model.
Results
Seventy-two students, 124 clinical educators and 49 practice tutors (n = 245) participated. Priorities identified centred primarily on the mandatory inclusion of two assessors in the PBA process and on refinement of the PBA tool.
Conclusion
Employment of DCE enabled the prioritisation of stakeholder-informed challenges related to PBA in physiotherapy practice-based education. This corroborates findings from previous qualitative work and facilitates a prioritised pathway for development of this process.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260413
in Physiotherapy > Vol. 108 (2020) . - p. 46-54[article]
Titre : Hot and cold knees: exploring differences in patella skin temperature in patients with patellofemoral pain Type de document : Article Auteurs : Jessie Janssen ; James Selfe ; Phillip Gichuru ; Jim Richards ; Hayri Baran Yosmaoglu ; Sonmezer Emel ; Renuka Erande ; Peter Resteghini ; Paola Dey Année de publication : 2020 Article en page(s) : p. 55-62 Note générale : https://doi.org/10.1016/j.physio.2020.04.007 Langues : Anglais (eng) Descripteurs : HE Vinci
Courbe ROC ; Syndrome fémoropatellaire ; Température cutanéeRésumé : Objectives
To investigate the distribution of patella skin temperature (Tsk) measurements and to explore the presence of temperature subgroups in patellofemoral pain (PFP) patients.
Design
Cross-sectional observational study design.
Participants
One dataset of 58 healthy participants and 232 PFP patients from three different datasets.
Main outcome measures
Patella skin temperature, measured by physiotherapists using a low cost hand held digital thermometer. The distribution of patella skin temperature was assessed and compared across datasets. To objectively determine the clinically meaningful number of subgroups, we used the average silhouette method. Finite mixture models were then used to examine the presence of PFP temperature subgroups. Receiver operating characteristic curves were used to estimate optimal patella Tsk thresholds for allocation of participants into the identified subgroups.
Results
In contrast to healthy participants, the patella skin temperature had an obvious bimodal distribution with wide dispersion present across all three PFP datasets. The fitted finite mixture model suggested three temperature subgroups (cold, normal and hot) that had been recommended by the average silhouette method with discrimination cut-off thresholds for subgroup membership based on receiver operating curve analysis of Cold = Conclusion
A low cost hand held digital thermometer appears to be a useful clinical tool to identify three PFP temperature subgroups. Further research is recommended to deepen understanding of these clinical findings and to explore the implications to different treatments.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260442
in Physiotherapy > Vol. 108 (2020) . - p. 55-62[article]
Titre : Airway clearance techniques and use of mucoactive agents for adult critically ill patients with acute respiratory failure: a qualitative study exploring UK physiotherapy practice Type de document : Article Auteurs : Bronwen Connolly ; Matthew Barclay ; Bronagh Blackwood ; Judy Bradley ; Rohan Anand ; Mark Borthwick ; Marc Chikhani ; Paul Dark ; Murali Shyamsundar ; John Warburton ; Daniel F. McAuley ; Brenda O'Neill Année de publication : 2020 Article en page(s) : p. 78-87 Note générale : https://doi.org/10.1016/j.physio.2020.06.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Insuffisance respiratoire ; Kinésithérapie respiratoire ; Prise en charge des voies aériennes ; Techniques de physiothérapieRésumé : Objectives
To explore and describe current UK physiotherapy practice relating to airway clearance techniques and mucoactive agents in critically ill adult patients with acute respiratory failure in the intensive care unit.
Design
A descriptive, qualitative study using focus group interviews. Focus groups were audio-recorded, independently transcribed, and data analysed thematically. Participants Senior, experienced physiotherapists, clinically active in critical care.
Results
Fifteen physiotherapists participated in four interview sessions. Five themes emerged describing airway clearance techniques: 'Repertoire of airway clearance techniques', 'Staffing and skillset', 'Commencing respiratory physiotherapy', 'Technique selection', and 'Determining effectiveness' were themes related to airway clearance techniques. Five themes were also identified in relation to mucoactive agents: 'Use in clinical practice', 'Decision to commence', 'Selection of agent', 'Stopping mucoactive agents', and 'Determining effectiveness'. A summary of key features of standard practice was developed.
Conclusions
Standard UK physiotherapy practice of airway clearance techniques is variable, but patient-centred and targeted to individual need, with adjunctive use of mucoactive agents to enhance and optimise patient management if required. Based on this study, key features of airway clearance techniques have been summarised to help capture standard care, which could be used in future trials involving ACT as part of usual care.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260443
in Physiotherapy > Vol. 108 (2020) . - p. 78-87[article]
Titre : Characteristics of patients with knee and ankle symptoms accessing physiotherapy: self-referral vs general practitioner’s referral Type de document : Article Auteurs : N.E. Lankhorst ; J.A. Barten ; R. Meerhof ; S.M.A. Bierma-Zeinstra ; M. Van middelkoop Année de publication : 2020 Article en page(s) : p. 112-119 Note générale : https://doi.org/10.1016/j.physio.2017.03.008 Langues : Anglais (eng) Descripteurs : HE Vinci
Cheville ; Genou ; Kinésithérapie (spécialité) ; Médecins de premier recoursRésumé : Objectives
To determine patient characteristics, frequency of use, type of symptoms and treatment outcomes in patients with knee or ankle symptoms, separately, for patients referred by their general practitioner (GP) and patients who self-referred.
Design
Longitudinal study.
Setting
Dutch primary care physical therapy practices.
Participants
All patients who visited a physiotherapist with knee or ankle symptoms between 2006 and 2012.
Method
Data were collected from the NIVEL Primary Care Database. The mode of access (self-referred or GP-referred) was determined for all patients. For analyses, descriptive statistics, unpaired t-tests, Chi-square test and logistic regression analyses were applied.
Results
The study included 6179 patients with knee or ankle symptoms. The use of self-referral increased from 26% in 2006 to 56% in 2012, and stabilised between 2010 and 2012. Self-referred patients were younger, had a higher education level and had a shorter duration of symptoms compared with GP-referred patients. Self-referred patients had fewer treatment sessions than GP-referred patients.
Conclusions
Among patients with knee or ankle symptoms, younger patients, and those with a higher education level, a shorter duration of symptoms and recurrent symptoms were more likely to self-refer than other patients. Self-referred patients had fewer treatment sessions. After 2009, the frequency of self-referrals to physical therapists stabilised. Future studies should examine the effectiveness of physical therapy for patients who self-refer with acute knee and ankle symptoms.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260445
in Physiotherapy > Vol. 108 (2020) . - p. 112-119[article]
Titre : Outcomes of physical activity for people living with dementia: qualitative study to inform a Core Outcome Set Type de document : Article Auteurs : Ana-Carolina Gonçalves ; Alda Marques ; Dinesh Samuel ; Sara Demain Année de publication : 2020 Article en page(s) : p. 129-139 Note générale : https://doi.org/10.1016/j.physio.2019.05.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Démence ; Exercice physique ; Recherche qualitativeRésumé : Background
The need for a Core Outcome Set to evaluate physical activity interventions for people living with dementia, across stages of disease and intervention settings has been established. This qualitative study precedes the consensus phase of developing this Core Outcome Set and aims to: (i) compare the outcomes identified by patients, carers and professionals to those previously reported in the literature; (ii) and understand why certain outcomes are considered important.
Design and methods
In-depth semi-structured interviews were conducted with people living with dementia, family carers and professionals (n = 29). The outcomes identified in the interviews were mapped to a list of outcomes reported in a recent literature review. An in-depth thematic analysis was conducted to understand the importance of physical activity in dementia care.
Results
A comprehensive, inductively derived list of 77 outcomes, common across stages of dementia and intervention setting, was put together for the consensus phase of this Core Outcome Set: ten of these were new outcomes generated by this qualitative study. Five themes explained why stakeholders perceived physical activity outcomes as important for people living with dementia: “being well and staying well”, “having a role towards others”, “maintaining identity”, “being connected to the present” and “delivering good quality care”.
Conclusion
Ten new outcomes of physical activity, not previously reported in recent literature, were identified. Physical activity is considered important to people living with dementia due to its positive impact on multiple health outcomes for both patients and carers.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=260446
in Physiotherapy > Vol. 108 (2020) . - p. 129-139[article]
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Titre : Early rehabilitation reduces the likelihood of developing intensive care unit-acquired weakness: a systematic review and meta-analysis Type de document : Article Auteurs : David E. Anekwe ; Sharmistha Biswas ; André Bussières ; Jadranka Spahija Année de publication : 2020 Article en page(s) : p. 1-10 Note générale : https://doi.org/10.1016/j.physio.2019.12.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Lever précoce ; Mortalité ; Neurostimulation électrique transcutanée (TENS) ; Unités de soins intensifs ; Ventilation artificielleRésumé : Background
Intensive care unit-acquired weakness (ICUAW) is associated with significant impairments in body structure and function, activity limitation, and participation restriction. The etiology and management of ICUAW remain uncertain.
Objective
To estimate the extent to which early rehabilitation interventions (early mobilization [EM] and/or neuromuscular electrical stimulation [NMES]) compared to usual care reduce the incidence of ICUAW in critically ill patients.
Data sources
We searched MEDLINE, EMBASE, CINAHL, Cochrane Central and Physiotherapy Evidence Database databases from inception to May 1st, 2017.
Eligibility criteria
Randomized controlled trials of EM and/or NMES interventions in critically ill adults.
Data extraction and data synthesis
Data on the incidence of ICUAW and secondary outcomes were extracted. Both odds and risk ratios for ICUAW were pooled using the random-effects model.
Results
We identified 1421 reports after duplicate removal. Nine studies including 841 patients (419 intervention and 422 usual care) were included in the final analysis. The interventions involved EM in five trials, NMES in three trials, and both EM and NMES in one trial. Early rehabilitation decreased the likelihood of developing ICUAW: odds ratio of 0.63 (95% CI: 0.43 to 0.92) in the screened population, and 0.71 (95% CI: 0.53 to 0.95) in the randomized population.
Conclusion, implications of key findings
Early rehabilitation was associated with a decreased likelihood of developing ICUAW. Our findings support early rehabilitation in the ICU. While results were consistent in both the screened and randomized populations, the wide confidence intervals suggest that well-conducted trials are needed to validate our findings.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258844
in Physiotherapy > Vol. 107 (2020) . - p. 1-10[article]
Titre : ‘Mind the gap’ — a scoping review of long term, physical, self-management in Parkinson’s Type de document : Article Auteurs : Sophia M. Hulbert ; Victoria A. Goodwin Année de publication : 2020 Article en page(s) : p. 88-99 Note générale : https://doi.org/10.1016/j.physio.2019.12.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Gestion de soi ; Maladie de Parkinson ; Revue systématiqueRésumé : Background
Parkinson’s is a common progressive neurological condition characterised by impairments of movement and balance; and non-motor deficits. It is now accepted that physical activity is a fundamental for people with Parkinson’s (PwP), despite this PwP remain inactive. There is a social and financial drive to increase physical activity for PwP through physical self-management, however little is known about this concept.
Objective
This scoping review provides an overview of the literature concerning physical self-management for PwP and its provision, participation and uptake by PwP.
Design and sources of evidence
Systematic search of the databases; Medline, EMBASE, HMIC, CDSR, Cochrane Methods Studies, DARE, CINAHL, PEDro, PsycINFO and Cochrane Library using the search terms ‘Parkinson*’ and ‘self-manag*’ was undertaken alongside citation and grey literature searching and a consultation exercise.
Charting methods
A narrative summary was undertaken to describe the current state of the literature.
Results
1959 studies were identified with nineteen papers from seventeen studies meeting the inclusion criteria - Three reviews, four experimental studies, three pre–post-test designs, six cross-sectional designs, one qualitative interview design and two mixed method designs.
Conclusion
The findings of this scoping review suggest a need for clarity on what ‘physical self-management’ means and involves, with a gap between what the evidence promotes and what is being achieved by PwP. Further research should focus on the amount, type, intensity and duration of physical self-management models including behavioural change approaches and how, where and by whom this should be implemented.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258845
in Physiotherapy > Vol. 107 (2020) . - p. 88-99[article]
Titre : Water-based exercises for improving walking speed, balance, and strength after stroke: a systematic review with meta-analyses of randomized trials Type de document : Article Auteurs : Lucas R. Nascimento ; Louise C. Flores ; Kênia K.P. de Menezes ; Luci F. Teixeira-Salmela Année de publication : 2020 Article en page(s) : p. 100-110 Note générale : https://doi.org/10.1016/j.physio.2019.10.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Démarche ; Équilibre postural ; Hydrothérapie ; RéadaptationRésumé : Background
Water-based exercises have the potential to reduce impairments and walking limitations after stroke.
Objective
To examine the effects of water-based exercises on walking speed, balance, and strength after stroke.
Data sources
Eletronic searches on MEDLINE, CINAHL, EMBASE, Cochrane, PsycINFO, and PEDro databases.
Eligibility criteria
The review included randomized trials. Participants in the reviewed studies were ambulatory adults, who have had a stroke. The experimental intervention was comprised of water-based exercises.
Data synthesis
Outcome data related to walking speed, balance, and strength were extracted from the eligible trials and combined in meta-analyses. The quality of the included trials was assessed by the PEDro scores and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system.
Results
Thirteen trials involving 464 participants were included. Random-effects meta-analyses provided moderate-quality evidence that water-based exercises significantly increase walking speed by 0.06 m/second (95% CI 0.01 to 0.10) and balance by 4.5 points on the Berg Balance scale (95% CI 2.2 to 6.8), compared with land-based exercises, without concurrent changes in strength (MD 5.2 Nm/kg; 95% CI −1.4 to 11.9).
Conclusions
This systematic review provided low-quality evidence regarding the efficacy of water-based exercises, compared with no intervention. However, there is moderate quality evidence, which suggested significant benefits of water-based exercises in walking speed and balance, compared with land-based exercises. Differences appear small to be considered clinically relevant, and, therefore, water-based exercises can be prescribed as alternative interventions, based upon individuals’ exercise preferences.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258846
in Physiotherapy > Vol. 107 (2020) . - p. 100-110[article]
Titre : Effects of joint mobilisation on clinical manifestations of sympathetic nervous system activity: a systematic review and meta-analysis Type de document : Article Auteurs : Marcos J. Navarro-Santana ; Guido F. Gómez-Chiguano ; Mihai D. Somkereki ; César Fernández-de-las-Peñas ; Joshua A. Cleland ; Gustavo Plaza-Manzano Année de publication : 2020 Article en page(s) : p. 118-132 Note générale : https://doi.org/10.1016/j.physio.2019.07.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Lever et mobilisation de patient ; Maladies du système nerveux autonome ; Pratique factuelle ; Température cutanéeRésumé : Background
A potential mechanism of action of manual therapy is the activation of a sympathetic-excitatory response.
Objective
To evaluate the effects of joint mobilisation on changes in clinical manifestations of sympathetic nervous system activity.
Data sources
MEDLINE, EMBASE, AMED, CINAHL, EBSCO, PubMed, PEDro, Cochrane Collaboration Trials Register, Cochrane Database of Systematic Reviews and SCOPUS databases.
Study selection
Randomised controlled trials that compared a mobilisation technique applied to the spine or the extremities with a control or placebo.
Data extraction and data synthesis
Human studies collecting data on skin conductance or skin temperature were used. Data were extracted by two reviewers. Risk of bias was assessed using the Cochrane guidelines, and quality of evidence was assessed using the GRADE approach. Standardised mean differences (SMD) and random effects were calculated.
Results
Eighteen studies were included in the review and 17 were included in the meta-analysis. The meta-analysis found a significant increase in skin conductance [SMD 1.21, 95% confidence interval (CI) 0.88 to 1.53, n = 269] and a decrease in temperature (SMD 0.92, 95% CI −1.47 to −0.37, n = 128) after mobilisation compared with the control group. An increase in skin conductance (SMD 0.73, 95% CI 0.51 to 0.96, n = 293) and a decrease in temperature (SMD −0.50, 95% CI −0.82 to −0.18, n = 134) were seen after mobilisation compared with placebo. The risk of bias was generally low, but the heterogenicity of the results downgraded the level of evidence.
Limitations
Most trials (14/18) were conducted on asymptomatic healthy subjects.
Conclusion
There is moderate evidence suggesting a sympatho-excitatory effect of joint mobilisation.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258858
in Physiotherapy > Vol. 107 (2020) . - p. 118-132[article]
Titre : Efficacy of kinesio taping in treatment of shoulder pain and disability: a systematic review and meta-analysis of randomised controlled trials Type de document : Article Auteurs : Sherief Ghozy ; Nguyen Minh Dung ; Mostafa Ebraheem Morra ; Sara Morsy ; Ghadeer Gamal Elsayed ; Linh Tran ; Le Huu Nhat Minh ; Alzhraa Salah Abbas ; Tran Thai Huu Loc ; Truong Hong Hieu ; Truong Cong Dung ; Nguyen Tien Huy Année de publication : 2020 Article en page(s) : p. 176-188 Note générale : https://doi.org/10.1016/j.physio.2019.12.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Bande adhésive de contention ; Essais cliniques comme sujet ; Méta-analyse ; Revue systématique ; ScapulalgieRésumé : Background
Kinesio tape is an elastic therapeutic tape used for treating sports injuries and various other disorders. A systematic review and network meta-analysis approach was used to synthesise all related evidence on the clinical effectiveness of kinesio taping for the treatment of shoulder pain.
Methods
A literature search was performed using 10 major databases. Randomised clinical trials reporting usage of kinesio taping for shoulder pain have been included. Quality and risk of bias were assessed using the Cochrane Collaboration's quality assessment tool. Meta-analysis was conducted to calculate standardised mean differences and corresponding 95% confidence intervals (CI). The corresponding 95% CI of pooled effect size were calculated using a fixed-effects or random-effects model based on the level of heterogeneity. In addition, meta-regression was used to assess the influence of underlying shoulder disease on the efficacy of kinesio taping.
Results
This systematic review and meta-analysis included 12 studies, with a total of 555 participants. Pairwise comparisons inferred that kinesio taping only showed significant improvement of shoulder pain and disability when combined with exercise. However, kinesio taping did not produce better results than placebo or treatment with steroids. The duration of treatment and underlying shoulder pathology did not influence the efficacy of kinesio taping.
Conclusion
There is insufficient evidence to support the use of kinesio taping in clinical practice as a treatment for shoulder pain. However, there is limited evidence of its benefit as a complementary treatment in shoulder pain syndromes.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258863
in Physiotherapy > Vol. 107 (2020) . - p. 176-188[article]
Titre : Patient and public beliefs about the role of imaging in the management of non-specific low back pain: a scoping review Type de document : Article Auteurs : Stéphanie Taylor ; Annette Bishop Année de publication : 2020 Article en page(s) : p. 224-233 Note générale : https://doi.org/10.1016/j.physio.2019.08.014 Langues : Anglais (eng) Descripteurs : HE Vinci
Imagerie par résonance magnétique ; Lombalgie ; Opinion publiqueRésumé : Background or context
Routine imaging for non-specific low back pain is advised against in guidelines yet imaging continues to occur. Patient and public beliefs regarding imaging may be a driving factor contributing to this.
Objectives
To review the current evidence in relation to patient and public beliefs regarding imaging for low back pain.
Data sources
A systematic scoping review was conducted in databases Medline, Embase, Cinahl, Psyc info (inception - Jan 2018).
Study selection
Any method of study including beliefs of adults about imaging for non-specific low back pain.
Data extraction and data synthesis
Descriptive data was extracted and patient and public beliefs about imaging for low back pain was analysed using conventional qualitative content analysis.
Results
12 studies from an initial search finding of 1135 were analysed. 3 main themes emerged; (1) The Desire for imaging; (2) Influences on patient desire for imaging including (a) clinical presentation, (b) past experience and (c)relationships with care professionals and (3) Negative consequences of imaging.
Limitations
Few qualitative studies were found, all studies were in English language, the majority of studies were older than 2003.
Conclusion and implications of key findings
There is little available evidence on patient and public beliefs about imaging but what evidence there is suggests that imaging is seen as positive in the management of low back pain and patient desire for a diagnosis is a big driver of this. There is also a suggestion that these beliefs may still be being influenced by health care professionals.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258869
in Physiotherapy > Vol. 107 (2020) . - p. 224-233[article]
Titre : Sociocultural factors influencing physiotherapy management in culturally and linguistically diverse people with persistent pain: a scoping review Type de document : Article Auteurs : Koji Yoshikawa ; Bernadette Brady ; Meredith Perry ; Hemakumar Devan Année de publication : 2020 Article en page(s) : p. 292-305 Note générale : https://doi.org/10.1016/j.physio.2019.08.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Adhésion et observance thérapeutiques ; Compétence culturelle ; Ethnies ; Facteurs socioéconomiques ; Kinésithérapie (spécialité) ; Relations médecin-patientRésumé : Background
People with persistent pain from culturally and linguistically diverse (CALD) communities experience significant health inequities.
Objective
To synthesise the sociocultural factors influencing pain management between CALD patients with persistent pain and physiotherapists treating CALD patients.
Data sources
Major electronic databases MEDLINE, AMED, Scopus, Web of Science, PsycINFO and Google Scholar were searched until July 2018.
Study selection
Studies were included if they explored clinical interactions between physiotherapists and patients with persistent pain from diverse ethnocultural backgrounds.
Study appraisal
The methodological quality of qualitative and quantitative studies were assessed using the Critical Appraisal Skills Programme (CASP) Checklist and Mixed Methods Appraisal Tool (MMAT) respectively.
Synthesis method
A thematic synthesis approach was used to extract the common themes.
Results
Sixteen articles from 16 studies were included. Eleven studies were qualitative and five studies were quantitative. Ten explored patients’ perspectives, four explored physiotherapists’ perspectives, and two explored both. Key factors included: (a) language competence; (b) active vs passive coping strategies; (c) gendered influences; (d) cultural-spiritual beliefs, illness perceptions and expression of pain; (e) treatment satisfaction and; (f) barriers to access.
Conclusion
Discordant perspectives on causation, pain management approaches, and patient autonomy in management are evident between CALD patients and physiotherapists. Such discordance potentially create stress in the therapeutic alliance and undermines the efficacy of pain management interventions. To mitigate such barriers, it is crucial to foster cultural competence in physiotherapy and equip physiotherapists with opportunities to maximise their sociocultural awareness, knowledge and skill practising physiotherapy in cultural plural societies.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258873
in Physiotherapy > Vol. 107 (2020) . - p. 292-305[article]
Titre : The experience of fatigue in neurological patients with Multiple Sclerosis: a thematic synthesis Type de document : Article Auteurs : Georgina Newton ; Amy Griffith ; Andy Soundy Année de publication : 2020 Article en page(s) : p. 306-316 Note générale : https://doi.org/10.1016/j.physio.2016.11.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Fatigue ; Recherche qualitative ; Sclérose en plaquesRésumé : Objectives
To identify the experiences that result from MS-related fatigue (MSRF) through a systematic review and thematic synthesis of qualitative literature.
Design
The thematic synthesis was undertaken in three stages: (1) a systematic review of the literature, searching relevant databases from their inception to March 2016. (2) A critical appraisal of included studies, and (3) a double blind 2-phase synthesis of results was undertaken.
Setting
Participants were included from articles using primary and secondary care settings.
Participants
The synthesis included nine articles that incorporated a total of one hundred and fifty two participants (103 females and 49 males) in the review.
Results
No articles were excluded following critical appraisal. Two major themes were synthesised: (1) biopsychosocial experiences of fatigue, which illustrated the physical, cognitive and social challenges patients experience and (2) experiences that alter the impact of fatigue including the strategies individual employ to help manage fatigue. These major themes were further split into five subthemes.
Limitations
Only the most common experiences of MSRF were identified. Findings did not break down results by key demographics e.g. disease type. Only English language studies were included.
Conclusion
Physiotherapists are able to support the management by: (a) having a greater understanding of MSRF and (b) being able to help patients manage the factors that influence it.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258878
in Physiotherapy > Vol. 107 (2020) . - p. 306-316[article]
Titre : Shared decision making should be an integral part of physiotherapy practice Type de document : Article Auteurs : Tammy Hoffmann ; Jeremy Lewis ; Chris Maher Année de publication : 2020 Article en page(s) : p. 43-49 Note générale : https://doi.org/10.1016/j.physio.2019.08.012 Langues : Anglais (eng) Descripteurs : HE Vinci
Pratique factuelle ; Prise de décision ; Soins aux patients ; Soins centrés sur le patientRésumé : Shared decision making is integral to high-quality, evidence-based, and patient-centred physiotherapy practice. It involves therapists and patients collaboratively making a health-related decision after having discussed the options, the likely benefits and harms of each option, and considered the patient's values, preferences and circumstances. Despite being a crucial part of the final step in evidence-based practice, the skills needed to facilitate shared decision making are rarely taught to physiotherapists. This Debate article explores the reasons for the importance of shared decision making to physiotherapy practice; its fundamental role in improving therapist-patient communication, informed decision-making, and evidence-based care; and illustrates some of the processes involved using clinical scenarios. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258879
in Physiotherapy > Vol. 107 (2020) . - p. 43-49[article]
Titre : Precision health: a primer for physiotherapists Type de document : Article Auteurs : Cameron Dickson ; Elina Hyppönen Année de publication : 2020 Article en page(s) : p. 66-70 Note générale : https://doi.org/10.1016/j.physio.2019.08.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Génétique ; Guide de bonnes pratiques ; Kinésithérapie (spécialité) ; Médecine de précisionRésumé : Health care provision is changing, and so is the information we use to guide decisions related to patient care. Increasingly, health practitioners will need to deal with genetics and ‘big data’ in the context of clinical practice. Indeed, commercial packages for consumer genetic testing are already widely available, and devices enabling self-monitoring of health are in daily use by many of our patients. “Precision health” (distinct from “precision medicine”) provides a model, which allows us to bring our genome together with our external environment (lifestyles, societal influences etc.) and eventually, our transient internal environment (reflected by ‘omics’), to optimise disease prevention and care. Such advancements have given rise to a need for primary health care clinicians to understand basic genetic and precision health concepts. This editorial meets this need, serving as a primer by providing the following: an introduction to current primary health challenges; description of the key elements of the precision health model; an overview of basic genetic, and associated research concepts; a snapshot of some clinically pertinent research in the context of precision health; and a brief discussion of challenges and future directions. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258881
in Physiotherapy > Vol. 107 (2020) . - p. 66-70[article]
Titre : The effect of five isometric exercises on glenohumeral translations in healthy subjects and patients with the hypermobility type of the ehlers-danlos syndrome (heds) or hypermobility spectrum disorder (hsd) with multidirectional shoulder instability: an observational study Type de document : Article Auteurs : Valentien Spanhove ; Inge De Wandele ; Birgitte Hougs Kjær ; Fransiska Malfait ; Fran Vanderstukken ; Ann Cools Année de publication : 2020 Article en page(s) : p. 11-18 Note générale : https://doi.org/10.1016/j.physio.2019.06.010 Langues : Anglais (eng) Descripteurs : HE Vinci
Échographie ; Epaule ; Instabilité articulaire ; Syndrome d'Ehlers-DanlosRésumé : Objectives
To examine whether patients, diagnosed with the hypermobility type of the Ehlers-Danlos syndrome (hEDS) or Hypermobility Spectrum Disorder (HSD), with multidirectional shoulder instability (MDI) have increased humeral head translations compared to healthy controls and to describe the direction of the humeral translations during five exercises.
Design
Observational study.
Setting
Ghent University Hospital.
Participants
Twenty-seven female patients (aged mean (SD) 35 (13) years) with hEDS/HSD and MDI and 20 female healthy controls (aged 34 (11) years) participated in this study.
Interventions
The acromiohumeral (AHD) and humeralglenoid distance (HGD) were measured using ultrasound during five isometric exercises: shoulder external rotation, shoulder extension, shoulder flexion, elbow extension and holding a 2 kg dumbbell.
Main outcome measures
Ultrasound measures of the AHD and HGD.
Results
During isometric shoulder extension, elbow extension and dumbbell loading, patients had a significantly larger change in AHD compared to controls. In patients, the AHD was significantly smaller during isometric shoulder flexion, extension and elbow extension compared to the AHD measured in rest. By contrast, the AHD was significantly larger during isometric external rotation and dumbbell loading compared to the AHD measured in rest. Regarding the HGD, no significant differences between patients and controls were observed. However, significantly smaller HGD values were found in patients during isometric shoulder flexion compared to the HGD in rest.
Conclusions
Isometric external rotation and holding a 2 kg dumbbell caused an inferior translation in patients with hEDS/HSD and MDI, whereas isometric shoulder flexion and shoulder/elbow extension respectively led to an anterior-superior and superior translation.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=258890
in Physiotherapy > Vol. 107 (2020) . - p. 11-18[article]
Titre : Telerehabilitation is non-inferior to usual care following total hip replacement — a randomized controlled non-inferiority trial Type de document : Article Auteurs : M. Nelson ; M. Bourke ; K. Crossley ; T. Russell Année de publication : 2020 Article en page(s) : p. 19-27 Note générale : https://doi.org/10.1016/j.physio.2019.06.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Arthroplastie prothétique de hanche ; Essai contrôlé randomisé ; Kinésithérapie (spécialité) ; TélémédecineRésumé : Objectives
Determine if outpatient physiotherapy care via telerehabilitation is as effective as in-person physiotherapy care after total hip replacement.
Design
Randomised, single-blind, controlled, non-inferiority clinical trial.
Setting
QEII Jubilee Hospital, Brisbane, Australia.
Participants
Seventy patients receiving a total hip replacement entered the study, sixty-nine completed the study.
Interventions
The control group (n = 35;
age 67; female 60%) received in-person outpatient physiotherapy and a paper-based home exercise programme. The intervention group (n = 35;
age 62; female 66%) received remotely delivered telerehabilitation directly into their homes and a technology-based home exercise program using an iPad application.
Main outcome measures
The primary outcome was the quality of life subscale of the Hip disability and Osteoarthritis Outcome Score measured at six weeks post-operatively. Secondary outcomes included objective strength and balance outcomes, self-reported function and satisfaction outcomes, and home exercise program compliance.
Results
No between group difference was detected in the Hip disability and Osteoarthritis Outcome Score quality of life subscale at the primary end point of six weeks (P = 0.970). Strength, balance and self-reported function showed no between group differences. Overall satisfaction was high across both groups, with the intervention group scoring higher for ease of attending appointments (intervention 95 (10), control 86 (18), mean difference 9 (95% CI 2 to 16), P = 0.017. The intervention group were more compliant with their home exercise programme (intervention 86% (20%), control 74% (26%), mean difference 12% (95% CI 1% to 23%), P = 0.048).
Conclusions
Telerehabilitation programmes can be delivered to total hip replacement patients in their own homes, using readily available technology while maintaining high levels of satisfaction. More importantly, telerehabilitation patients appear to achieve non-inferior physical and functional outcomes as those receiving in-person rehabilitation programmes.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259047
in Physiotherapy > Vol. 107 (2020) . - p. 19-27[article]
Titre : Minimal important difference for London Chest Activity of Daily Living scale in patients with chronic obstructive pulmonary disease Type de document : Article Auteurs : Aline Almeida Gulart ; Cintia Laura Pereira de Araujo ; Anelise Bauer Munari ; Barbara Ferreira Schneider ; Pedro Dal Lago ; Anamaria Fleig Mayer Année de publication : 2020 Article en page(s) : p. 28-35 Note générale : https://doi.org/10.1016/j.physio.2019.08.007 Langues : Anglais (eng) Descripteurs : HE Vinci
Activités de la vie quotidienne ; Broncho-pneumopathie chronique obstructive ; Différence minimale cliniquement importante ; Évaluation des résultats des patients ; RéadaptationRésumé : Objectives
To determine the minimal important difference (MID) for the London Chest Activity of Daily Living scale (LCADL) in patients with chronic obstructive pulmonary disease (COPD), focusing on the percentage of the total score (LCADL%total), using an anchor-based method in addition to distribution-based methods.
Design
Non-controlled before-and-after study.
Setting
Two outpatient centres.
Participants
Seventy-seven patients with COPD (GOLD II–IV, 47 males, forced expiratory volume in 1 second mean 37 (SD 14) % predicted).
Interventions
Aerobic training and localised training for upper and lower limbs was conducted for 24 sessions, three times per week.
Main outcome measures
The main outcome was LCADL score pre- and post-exercise training. The MID was established using distribution and anchor-based methods. The modified Saint George Respiratory Questionnaire was the anchor for the analysis of sensitivity and specificity of the MID.
Results
The established MIDs ranged from −2.1 to −5.9 points for LCADLtotal and from −2 to −6 points for LCADL%total. The receiver operating characteristic curve indicated a cut-off point of −3 points for LCADLtotal (sensitivity 51%, specificity 82%; P = 0.01) and −4 points for LCADL%total (sensitivity 56%, specificity 82%; P = 0.04).
Conclusions
The present findings suggest −3 points and −4 points as the MIDs for LCADLtotal and LCADL%total, respectively.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259049
in Physiotherapy > Vol. 107 (2020) . - p. 28-35[article]
Titre : Stroke survivors’ recommendations for the visual representation of movement analysis measures: a technical report Type de document : Article Auteurs : Kathleen Lane ; Elizabeth Chandler ; David Payne ; Valérie M. Pomeroy Année de publication : 2020 Article en page(s) : p. 36-42 Note générale : https://doi.org/10.1016/j.physio.2019.08.008 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Cinésiologie appliquée ; Electromyographie ; Mouvement du corps ; Réadaptation ; RétroactionRésumé : Background
Stroke survivors do not have routine access to objective feedback on their movement performance.
Objective
To devise visual representation of objective measures of movement performance that are understandable by and meaningful to stroke survivors.
Design
Co-production through interviews and generative discussion.
Participants
Eight people, mean age 65 years, who were at least one year after stroke with low, medium or high functional ability. All provided informed consent.
Data collection
Participants performed standardised upper and lower limb functional tasks. Their movement was measured using the Vicon motion analysis system and surface electromyography. Participants returned six months later when they were shown anonymised visual representations of the movement tasks. Nobody saw their own data. Visual representations were provided of people with low, medium and high functional ability. A generative discussion elicited participants’ views on how the measures should be presented visually to maximise understandability and meaningfulness.
Findings
Participants’ understanding of the visual presentation of movement analysis was enhanced with the addition of everyday symbols such as a stick-figure and a brief explanation from a physiotherapist/researcher. Meaningfulness was seen in terms of motivation to participate in and ownership of their rehabilitation.
Implications
These findings justify further development of objective measures of movement performance for use in routine clinical practice.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259059
in Physiotherapy > Vol. 107 (2020) . - p. 36-42[article]
Titre : The feasibility of increasing physical activity in care home residents: Active Residents in Care Homes (ARCH) programme Type de document : Article Auteurs : Michael V. Hurley ; Julia Wood ; Raymond Smith ; Robert Grant ; Jake Jordan ; Heather Gage ; Liezl West Anderson ; Bernadette Kennedy ; Fiona Jones Année de publication : 2020 Article en page(s) : p. 50-57 Note générale : https://doi.org/10.1016/j.physio.2019.06.007 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Qualité de vie ; Services de soins à domicile ; Sujet âgéRésumé : Objectives
Maintaining physical activity for older residents in care homes maximises their physical and mental health and wellbeing, independence, dignity and quality of life. Unfortunately, most residents do not participate in regular physical activity. Active Residents in Care Homes, ARCH, was designed to increase physical activity by facilitating whole-system change in a care home. We evaluated whether ARCH can be delivered, its effects on resident’s physical activity, wellbeing and costs.
Design
Feasibility study.
Setting
Three residential care homes.
Participants
Care home residents and staff.
Intervention
Occupational and physiotherapists implemented ARCH over 4 months with an 8-month follow-up.
Main outcome measures
Assessment of Physical Activity, Pool Activity Level, EQ5D-5L, Dementia Care Mapping, cost of implementing ARCH, health and social care utilisation.
Results
After implementing ARCH, residents displayed more positive behaviours, better mood and engagement and higher physical activity levels, but these improvements were not sustained at 8-month follow-up. The cost (2016 prices) of implementing ARCH was £61,037, which equates to £1,650/resident. Healthcare utilisation was £295/resident (SD 320) in the 4 months prior to ARCH, £308/resident (SD 406) during the 4-month implementation and £676/resident (SD 438) in the 8-month follow-up.
Conclusions
The ARCH programme can be delivered, it may have some short-term benefits and is affordable. Rather than have unrealistic increases in the health and longevity of older care home residents, ARCH may slow the decline in physical, mental and emotional well-being usually seen in older people in care homes, return some dignity and improve their quality of life in their last months or years.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259072
in Physiotherapy > Vol. 107 (2020) . - p. 50-57[article]
Titre : Effects of land- and water-based exercise programmes on postural balance in individuals with COPD: additional results from a randomised clinical trial Type de document : Article Auteurs : Larissa A. de Castro ; Josiane M. Felcar ; Débora R. de Carvalho ; Laís S. Vidotto ; Rubens A. Da Silva ; Fabio Pitta ; Vanessa S. Probst Année de publication : 2020 Article en page(s) : p. 58-65 Note générale : https://doi.org/10.1016/j.physio.2019.08.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Broncho-pneumopathie chronique obstructive ; Chutes accidentelles ; Équilibre postural ; Hydrothérapie ; Traitement par les exercices physiquesRésumé : Objective
To investigate the effects of water-based exercise training on postural balance in individuals with chronic obstructive pulmonary disease (COPD), and compare the effects of two similar protocols of land- and water-based exercise programmes on postural balance in this population.
Design
Randomised clinical trial.
Setting
University-based, outpatient, physical therapy clinic.
Subjects
Fifty individuals with COPD.
Interventions
Participants were assigned at random to the land group (LG; n = 27) or the water group (WG; n = 23), and underwent high-intensity endurance and strength training three times per week for 3 months.
Main outcome measures
Functional balance was assessed by the timed up and go test (TUG), and static balance was assessed with a force platform in the following conditions: standing with feet hip-width apart and eyes open; standing with feet hip-width apart and eyes closed; standing on a short base; and one-legged stance.
Results
Seventeen subjects completed the intervention in the LG {nine males, mean age 64 [standard deviation (SD) 8] years, mean forced expiratory volume in 1 second (FEV1) 48 (SD 17) %predicted} compared with 14 subjects in the WG [nine males, mean age 65 (SD 8) years, FEV1 51 (SD 15) %predicted]. Water-based exercise training had a positive effect on functional balance [TUG: mean difference −1.17 (−1.93 to −0.41 95% confidence interval) seconds; P = 0.006], whereas static balance remained unaltered for both groups. There was no between-group difference in postural balance after exercise training; however, a higher proportion of participants who had a clinically relevant improvement in the TUG were in the WG (LG 35%, WG 64%; P Conclusion
Functional balance improved after 3 months of high-intensity exercise training performed in water. Despite the environment, non-specific training seems to be insufficient to improve static balance.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259124
in Physiotherapy > Vol. 107 (2020) . - p. 58-65[article]
Titre : Effectiveness of spinal manipulation and myofascial release compared with spinal manipulation alone on health-related outcomes in individuals with non-specific low back pain: randomized controlled trial Type de document : Article Auteurs : Taise Angeli Boff ; Fernanda Pasinato ; Ângela Jornada Ben ; Judith E. Bosmans ; Rodrigo Luiz Carregaro Année de publication : 2020 Article en page(s) : p. 71-80 Note générale : https://doi.org/10.1016/j.physio.2019.11.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Équilibre postural ; Lombalgie ; Manipulations de l'appareil locomoteur ; Personnes handicapées ; Qualité de vie ; Résultat thérapeutiqueRésumé : Objective
To investigate the effectiveness of spinal manipulation combined with myofascial release compared with spinal manipulation alone, in individuals with chronic non-specific low back pain (CNLBP).
Design
Randomized controlled trial with three months follow-up.
Setting
Rehabilitation clinic.
Participants
Seventy-two individuals (between 18 and 50 years of age; CNLBP ≥12 consecutive weeks) were enrolled and randomly allocated to one of two groups: (1) Spinal manipulation and myofascial release – SMMRG; n = 36) or (2) Spinal manipulation alone (SMG; n = 36).
Interventions
Combined spinal manipulation (characterized by high velocity/low amplitude thrusts) of the sacroiliac and lumbar spine and myofascial release of lumbar and sacroiliac muscles vs manipulation of the sacroiliac and lumbar spine alone, twice a week, for three weeks.
Main outcome measures
Assessments were performed at baseline, three weeks post intervention and three months follow-up. Primary outcomes were pain intensity and disability. Secondary outcomes were quality of life, pressure pain-threshold and dynamic balance.
Results
No significant differences were found between SMMRG vs SMG in pain intensity and disability post intervention and at follow-up. We found an overall significant difference between-groups for CNLBP disability (SMG-SMMRG: mean difference of 5.0; 95% confidence interval of difference 9.9; −0.1), though this effect was not clinically important and was not sustained at follow-up.
Conclusions
We demonstrated that spinal manipulation combined with myofascial release was not more effective compared to spinal manipulation alone for patients with CNLBP.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259137
in Physiotherapy > Vol. 107 (2020) . - p. 71-80[article]
Titre : Volume of water added to crushed ice affects the efficacy of cryotherapy: a randomised, single-blind, crossover trial Type de document : Article Auteurs : Daniela de Estéfani ; Caroline Ruschel ; Inaihá Laureano Benincá ; Daniela Pacheco dos Santos Haupenthal ; Núbia Carelli Pereirade Avelar ; Alessandro Haupenthal Année de publication : 2020 Article en page(s) : p. 81-87 Note générale : https://doi.org/10.1016/j.physio.2019.12.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Techniques de physiothérapie ; Température cutanée ; Thermographie ; Utilisations thérapeutiquesRésumé : Objective
To compare the effects of different cryotherapeutic preparations.
Design
Randomised, single-blind, crossover trial.
Setting
University laboratory.
Participants
Sixteen healthy women.
Interventions
Participants were randomised to receive three cryotherapeutic preparations: pure ice (500 g), watered ice (500 g of ice in 500 ml of water) and wetted ice (500 g of ice in 50 ml of water).
Main outcome measures
The primary outcome was skin surface temperature after cryotherapy, measured at the central point of application, and the minimum temperature of the region of interest (ROI). The secondary outcome was the surface area cooled to Results
After application of ice, mean skin surface temperature at the central point was 4.6 [standard deviation (SD) 1.9] °C for the pure ice preparation, 4.9 (SD 2.5) °C for the wetted ice preparation, and 9.6 (SD 1.8) °C for the watered ice preparation. When compared with the watered ice preparation, this represented a mean difference (MD) of 5.0 °C for the pure ice preparation [95% confidence interval (CI) 4.0 to 6.0; P Conclusions
Application of pure ice or wetted ice led to a greater decrease in skin surface temperature compared with watered ice. For clinical purposes, combining equal parts of water and ice could decrease this effect.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259144
in Physiotherapy > Vol. 107 (2020) . - p. 81-87[article]
Titre : Do therapist effects determine outcome in patients with shoulder pain in a primary care physiotherapy setting? Type de document : Article Auteurs : Margit K. Kooijman ; Elisah M. Buining ; Ilse C.S. Swinkels ; Bart W. Koes ; Cindy Veenhof Année de publication : 2020 Article en page(s) : p. 111-117 Note générale : https://doi.org/10.1016/j.physio.2019.08.009 Langues : Anglais (eng) Descripteurs : HE Vinci
Kinésithérapeutes ; Personnalité ; ScapulalgieRésumé : Objectives
To explore whether a therapist effect exists in physiotherapists treating patients with shoulder pain and to identify if personality traits of the physiotherapist influences patients outcome.
Design
Observational cohort study.
Setting
Primary care physiotherapy practices.
Participants
Data on patients with shoulder complaints that started and finished treatment between 2009 and 2012 were derived from the NIVEL Primary Care Database. Personality traits of the physiotherapist were identified using the Big Five Inventory. Data of 2814 patients and 56 physiotherapists were analysed using multi level linear regression.
Main outcome measure
Severity of complaint was measured on a 10-point Likert scale at the start and end of treatment. Change score is used as outcome.
Results
A therapist effect exists in the rehabilitation of patients with shoulder complaints in a physiotherapy setting; the physiotherapist explained 12% of variance and the personality trait extraversion showed a significant association (P = 0.03) with change in treatment outcome.
Conclusion
Current explorative study suggests that patients who were treated by therapists that tend to be more outgoing and energetic achieved better treatment results. Additional studies are needed to unravel the interplay between personality traits and other variables of importance, like patients’ personality traits or psychological factors, in treating patients with shoulder complaints.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259146
in Physiotherapy > Vol. 107 (2020) . - p. 111-117[article]
Titre : Relevance of medical comorbidities for functional mobility in people with limb loss: retrospective explanatory models for a clinical walking measure and a patient-reported functional outcome Type de document : Article Auteurs : Christopher Kevin Wong ; Stanford T. Chihuri ; Elizabeth G. Santo ; Ryan A. White Année de publication : 2020 Article en page(s) : p. 133-141 Note générale : https://doi.org/10.1016/j.physio.2020.01.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Amputation ; Équilibre postural ; Évaluation de résultat (soins) ; Membres ; Prothèses et implantsRésumé : Objectives
Various modifiable and non-modifiable factors affect functional mobility, but subjective patient-reported and objective performance-based measures are rarely combined in explanatory analyses of functional mobility in people with limb loss. This study determined separate explanatory models for patient-reported function using the Prosthetic Evaluation Questionnaire Mobility Subscale (PEQ-MS), and performance-based 2-Minute Walk Test (2MWT).
Design
Retrospective cross-sectional observational analysis.
Setting
Wellness-walking program.
Participants
Three hundred five volunteers with lower limb loss participated. Sixty nine percent were men, mean age 56 (15) years. Fifty two percent had vascular amputation causes, 42% had surgical levels above the knee, and 82% had medical comorbidities. Walking levels included limited-household (21%), limited-community (30%), and independent-community (49%). Outcome measures included patient-reported PEQ-MS, Activities-specific Balance Confidence (ABC) and Houghton scales; and performance-based balance and walking.
Main outcomes
Separate PEQ-MS and 2MWT multiple regression models fit using backward deletion.
Results
Modifiable (balance ability, ABC, Houghton score; P Conclusions
Both modifiable and non-modifiable factors explained prosthetic functional mobility. Performance-based walking was explained by modifiable factors including balance ability and confidence, prosthesis and walking aid use. Patient-reported function was also explained by prosthesis and walking aid use, walking speed and medical comorbidities. Modifiable factors for objective and subjective prosthetic mobility may provide a clinical roadmap for rehabilitation.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259154
in Physiotherapy > Vol. 107 (2020) . - p. 133-141[article]
Titre : Shoulder pain after recent stroke (SPARS): hemiplegic shoulder pain incidence within 72 hours post-stroke and 8–10 week follow-up Type de document : Article Auteurs : Martine Nadler ; Mathilde Pauls ; Gillian Cluckie ; Barry Moynihan ; Anthony C. Pereira Année de publication : 2020 Article en page(s) : p. 142-149 Note générale : https://doi.org/10.1016/j.physio.2019.08.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Hémiplégie ; Luxation de l'épaule ; Réadaptation ; ScapulalgieRésumé : Objectives
This study aimed to identify very early incidence of hemiplegic shoulder pain within 72 hours (HSP), how clinical assessment was related to pain at 8–10 week follow-up and explore current standard therapy/management.
Design
Observational, prospective.
Setting
Teaching hospital hyper-acute and follow-up stroke services.
Participants
121 consecutive patients with confirmed cerebral infarct/haemorrhage recruited within 72 hours of stroke onset.
Interventions
N/A.
Main outcome measures
Subjective report of pain severity and aggravating factors: using numerical rating scales and pain questionnaire (ShoulderQ), shoulder abductor and flexor muscle strength (Oxford MRC Scale), Neer’s Test of sub-acromial pain, shoulder subluxation and soft tissue shoulder palpation.
Results
At initial assessment ( Conclusion
This study reports HSP at an earlier time point after stroke than previous publications. Patients with severe arm weakness and/or shoulder subluxation within 72 hours are at significantly higher risk of HSP at 8–10 weeks. These data highlight the high incidence of HSP, the non-standardized therapy approach, and can inform sample size calculations for future intervention studies.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259165
in Physiotherapy > Vol. 107 (2020) . - p. 142-149[article]
Titre : Identifying Priorities for Physiotherapy Research in the UK: the James Lind Alliance Physiotherapy Priority Setting Partnership Type de document : Article Auteurs : Gabrielle Rankin ; Rachael Summers ; Katherine Cowan ; Karen Barker ; Kate Button ; Sean Paul Carroll ; Billy Fashanu ; Fidelma Moran ; Brenda O'Neill ; Ruth ten Hove ; Jackie Waterfield ; Sarah Westwater-Wood ; Ian Wellwood Année de publication : 2020 Article en page(s) : p. 161-168 Note générale : https://doi.org/10.1016/j.physio.2019.07.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Consensus ; Kinésithérapie (spécialité) ; RechercheRésumé : Objectives
To identify unanswered questions for physiotherapy research and help set and prioritise the top 10 generic research priorities for the UK physiotherapy profession; updating previous clinical condition- specific priorities to include patient and carer perspectives, and reflect changes in physiotherapy practice, service provision and new technologies.
Design
The James Lind Alliance (JLA) Priority Setting Partnership (PSP) methodology was adopted, utilising evidence review, survey and consensus methods.
Participants
Anyone with experience and/or an interest in UK physiotherapy: patients, carers, members of the public, physiotherapists, student physiotherapists, other healthcare professionals, researchers, educators, service providers, commissioners and policy makers.
Results
Five hundred and ten respondents (50% patients, carers or members of the public) identified 2152 questions (termed “uncertainties”). Sixty-five indicative questions were developed from the uncertainties using peer reviewed thematic analysis. These were ranked in a second national survey (1,020 responses (62% were complete)). The top 25 questions were reviewed in a final prioritisation workshop using an adapted nominal group technique. The top 10 research priorities focused on optimisation (top priority); access; effectiveness; patient and carer knowledge, experiences, needs and expectations; supporting patient engagement and self-management; diagnosis and prediction.
Conclusions
This study is currently the UK’s most inclusive consultation exercise to identify patients‘and healthcare professionals‘priorities for physiotherapy research. The exercise deliberately sought to capture generic issues relevant to all specialisms within physiotherapy. The research priorities identified a range of gaps in existing evidence to inform physiotherapy policy and practice. The results will assist research commissioning bodies and inform funding decisions and strategy.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259170
in Physiotherapy > Vol. 107 (2020) . - p. 161-168[article]
Titre : The oxygen cost of rehabilitation interventions in mechanically ventilated patients: an observational study Type de document : Article Auteurs : Claire Black ; Micheal Grocott ; Mervyn Singer Année de publication : 2020 Article en page(s) : p. 169-175 Note générale : https://doi.org/10.1016/j.physio.2019.06.008 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Maladie grave ; Réadaptation ; Ventilation artificielleRésumé : Objective
Early rehabilitation is assumed to be a crucial intervention to facilitate weaning from mechanical ventilation in critically ill patients and to limit their long-term functional dependence. However, little is known about the physiological load imposed on patients during such interventions. Without the ability to quantify the exercise intensity of rehabilitation interventions it is impossible to establish a clear separation between usual care and intervention groups in randomised controlled trials. This may explain the lack of definitive benefit of rehabilitation in published trials. We sought to characterise the physiological load, measured as oxygen consumption (
), of the physical activities carried out during rehabilitation interventions in mechanically ventilated participants.
Design
Observational study.
Setting
Single centre medical-surgical university hospital ICU.
Participants
26 mechanically ventilated participants ventilated >7 days, able to participate in a rehabilitation program.
Intervention
Oxygen consumption (measured by the Medgraphics Ultima breath-by-breath gas exchange analysis system) and heart rate were measured continuously pre-, during and post-standard rehabilitation sessions.
Results
52 sessions were recorded in 26 participants. There was considerable variation in the oxygen cost of the physical activities between participants. The recovery time for 1 in 4 rehabilitation sessions was longer than the rehabilitation activity time.
Conclusions
Absolute exercise intensity in mechanically ventilated ICU participants, as measured by oxygen consumption, is not activity-dependent.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259214
in Physiotherapy > Vol. 107 (2020) . - p. 169-175[article]
Titre : Construct validity of the 9-Hole Peg Test and Purdue Pegboard Test in people with mild to moderately severe Parkinson’s disease Type de document : Article Auteurs : Elizabeth L. Proud ; Kimberly J. Miller ; Belinda Bilney ; Meg E. Morris ; Jennifer L. McGinley Année de publication : 2020 Article en page(s) : p. 2020-208 Note générale : https://doi.org/10.1016/j.physio.2019.12.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Activités de la vie quotidienne ; Ergothérapie ; Évaluation des résultats des patients ; Kinésithérapie (spécialité) ; Main ; Maladie de ParkinsonRésumé : Objectives
To evaluate the construct validity of two dexterity measures, the 9-Hole Peg Test (9HPT) and Purdue Pegboard Test (PPT) in people with Parkinson’s disease (PD).
Design
Cross-sectional observational study.
Setting
Testing was conducted at the university or in participants’ homes.
Participants
Thirty community dwelling people with mild to moderately severe PD and no major upper limb comorbidities or cognitive impairments.
Interventions
Pegboard tests were administered in the ‘on’ and ‘end-of-dose’ phases of participants’ PD medication cycles. Participants rated hand function with two self-report questionnaires – the Manual Ability Measure-36 (MAM-36) and a subset of upper limb items from the MDS-UPDRS. To explore construct validity, we compared ‘on’ phase pegboard scores with normative values for unimpaired men and women and investigated relationships between pegboard scores and hand function questionnaires.
Results
In the ‘on’ phase, pegboard scores were poorer than normative values. Differences in individual subtest scores ranged between 10 and 41%. Correlations between self-reported hand function and pegboard scores were weak to moderately strong in the ‘on’ phase (r = 0.21–0.51), and weak at ‘end-of-dose’ (r = 0.13–0.22). Higher correlation coefficients were observed between hand function and PPT subtest scores than with hand function and 9HPT scores. Most participants reported difficulty with daily hand tasks.
Conclusions
We found evidence for construct validity supporting the use of the 9HPT and PPT to evaluate people with mild to moderately severe PD when ‘on’, but not at the ‘end-of-dose’. Results also suggest that the PPT may be more sensitive to PD-related changes in dexterity than the 9HPT.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259218
in Physiotherapy > Vol. 107 (2020) . - p. 2020-208[article]
Titre : Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy: A cross-sectional study Type de document : Article Auteurs : Grace Lavelle ; Marika Noorkoiv ; Nicola Theis ; Thomas Korff ; Cherry Kilbride ; Vasilios Baltzopoulos ; Adam Shortland ; Wendy Levin ; Jennifer M. Ryan Année de publication : 2020 Article en page(s) : p. 209-215 Note générale : https://doi.org/10.1016/j.physio.2019.08.013 Langues : Anglais (eng) Descripteurs : HE Vinci
Accélérométrie ; Autorapport ; Exercice physique ; Paralysie cérébrale ; Reproductibilité des résultatsRésumé : Objectives
The aim of this study was to examine the validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy (CP).
Design
Cross-sectional.
Setting
Participants were recruited through 8 National Health Service (NHS) trusts, one school, one university and through organisations that provide services for people with disabilities in England.
Participants
Sixty-four, ambulatory young people aged 10–19 years with CP [Gross Motor Function Classification System (GMFCS) levels I–III] participated in this study.
Main outcome measure
The IPAQ-SF was administered to participants. Participants were then asked to wear a wGT3X-BT triaxial accelerometer (ActiGraph, Pensacola, FL) for 7 days to objectively assess PA. Time spent in sedentary behaviour, in moderate to vigorous PA (MVPA) and in total PA (TPA) was compared between measures.
Results
Young people with CP self-reported less time in sedentary behaviour and underestimated the time spent in TPA, when compared to accelerometer measurements. Bland–Altman plots demonstrated poor agreement between the measures for MVPA, with upper and lower 95% limits of agreement of −147 to 148.9 minute. After adjusting for gender and GMFCS level, age was a predictor of the difference between measures for MVPA (P Conclusions
These findings suggest that the IPAQ-SF is not a valid method of measuring TPA or sedentary behaviour in young people with CP and it is not appropriate for use when assessing an individual’s time in MVPA. Therefore, where feasible, an objective measure of PA should be used.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259220
in Physiotherapy > Vol. 107 (2020) . - p. 209-215[article]
Titre : Recovery of upper limb function is greatest early after stroke but does continue to improve during the chronic phase: a two-year, observational study Type de document : Article Auteurs : Karen N. Borschmann ; Kathryn S. Hayward Année de publication : 2020 Article en page(s) : p. 216-223 Note générale : https://doi.org/10.1016/j.physio.2019.10.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Médecine physique et de réadaptation ; Membre supérieur ; Récupération fonctionnelleRésumé : Objectives
Investigate upper limb (UL) capacity and performance from Design
Longitudinal study of participants with acute stroke, assessed ≤14-days, 6-weeks, 3-, 6-, 12-, 18-, and 24-months post stroke.
Setting
Two acute stroke units.
Main outcome measures
Examination of UL capacity using Chedoke McMaster Stroke Assessment (combined arm and hand scores, 0–14), performance using Motor Activity Log (amount of movement and quality of movement, scored 0–5), and grip strength (kg) using Jamar dynamometer. Random effects regression models were performed to explore the change in outcomes at each time point. Routine clinical imaging was used to describe stroke location as cortical, subcortical or mixed.
Results
Thirty-four participants were enrolled: median age 67.7 years (IQR 60.7–76.2), NIHSS 11.5 (IQR 8.5–16), female n = 10 (36%). The monthly rate of change for all measures was consistently greatest in the 6-weeks post baseline. On average, significant improvements were observed to 12-months in amount of use (median improvement 1.81, 95% CI 1.35 to 2.27) and strength (median improvement 8.29, 95% CI 5.90 to 10.67); while motor capacity (median improvement 4.70, 95% CI 3.8 to 5.6) and quality of movement (median improvement 1.83, 95% CI 1.37 to 2.3) improved to 18-months post stroke. Some individuals were still demonstrating gains at 24-months post stroke within each stroke location group.
Conclusion
This study highlights that the greatest rate of improvement of UL capacity and performance occurs early post stroke. At the group level, improvements were evident at 12- to 18-months post stroke, but at the individual level improvements were observed at 24-months.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259226
in Physiotherapy > Vol. 107 (2020) . - p. 216-223[article]
Titre : Does cardiac rehabilitation for people with stroke in the sub-acute phase of recovery lead to physical behaviour change? Results from compositional analysis of accelerometry-derived data Type de document : Article Auteurs : Mark W. Orme ; Nicola J. Clague-Baker ; Matthew Richardson ; Sophie Drewry ; Thompson Robinson ; Sally J. Singh Année de publication : 2020 Article en page(s) : p. 234-242 Note générale : https://doi.org/10.1016/j.physio.2019.10.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Exercice physique ; Mode de vie sédentaire ; Réadaptation cardiaqueRésumé : Objectives
Does adapted cardiac rehabilitation (CR) improve the physical behaviours of people with mild-to-moderate stroke in the sub-acute recovery phase using a compositional data analysis (CoDA) approach?
Design
Before-after.
Setting
University Hospitals of Leicester, Glenfield Hospital, UK.
Participants
24 individuals completed CR and provided valid physical activity (PA) data (mean (SD) 63.1 (14.6) years, 58% male (14/24)).
Intervention
6-week adapted CR program within 6-months of stroke.
Main outcome measures
Physical behaviours were assessed using waist-worn accelerometry. Step count, stationary time (ST), light PA (LPA), and moderate-to-vigorous PA (MVPA) were compared pre post CR using conventional analyses and CoDA. Analysed compositions were: Waking day (ST, LPA, MVPA); ST (1–9-minutes, 10–29-minutes, ≥30-minutes bouts); and MVPA (1–4-minutes, 5–9-minutes, ≥10-minutes bouts).
Results
Following CR, patients took significantly more steps (mean (SD) 3255 (2864) vs 3908 (3399) steps/day, P = 0.004) and engaged in more bouts of MVPA lasting ≥5 and ≥10-minutes (≥5-minutes: mean (SD) 0.7 (1.4) vs 1.2 (1.8) bouts/day, P = 0.008). Using CoDA, no changes in waking day or ST compositions occurred. For waking day, 42% (10/24) increased their LPA and MVPA at the expense of ST. For ST, 33% (8/24) increased their short bouts at the expense of medium and long bouts. For MVPA, 13% (3/24) increased their medium and long bouts at the expense of short bouts.
Conclusion
People with stroke in the sub-acute stage of recovery exhibited low levels of PA. CR appears to be an effective intervention to increase step count but did not alter the overall proportion of time individuals spent being sedentary, or engaging in LPA or in MVPA.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259236
in Physiotherapy > Vol. 107 (2020) . - p. 234-242[article]
Titre : Impact of hypertonic saline nebulisation combined with oscillatory positive expiratory pressure on sputum expectoration and related symptoms in cystic fibrosis: a randomised crossover trial Type de document : Article Auteurs : Marta San Miguel-Pagola ; Grégory Reychler ; María A. Cebrià i Iranzo ; Marta Gómez-Romero ; Fernando Díaz-Gutiérrez ; Beatriz Herrero-Cortina Année de publication : 2020 Article en page(s) : p. 243-251 Note générale : https://doi.org/10.1016/j.physio.2019.11.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Acide hyaluronique ; Expectoration ; Mucoviscidose ; Solution saline hypertoniqueRésumé : Objective
To evaluate the impact of combining nebulised hyaluronic acid plus hypertonic saline (HA + HS) with oscillatory positive expiratory pressure (oscillatory-PEP) on sputum expectoration and related symptoms in adults with cystic fibrosis (CF).
Design
Randomised crossover trial.
Setting
Seven centres.
Participants
Twenty-two outpatients with CF.
Interventions
Usual care (HA + HS followed by autogenic drainage) and combined therapy (HA + HS with oscillatory-PEP followed by autogenic drainage]. Each treatment was performed for 5 days.
Main outcome measures
Sputum expectoration was measured during the nebulisation period (primary outcome), during autogenic drainage and for 24 hours post intervention. The Cough and Sputum Assessment Questionnaire (CASA-Q) and its domains (cough symptoms, cough impact, sputum symptoms and sputum impact), the Leicester Cough Questionnaire (LCQ) and lung function tests were used. Tolerance and patient preference were registered.
Results
Twenty-two participants [mean age 25 (standard deviation 8) years, percentage predicted forced expiratory volume in 1 second 67 (22)] were recruited. Combined therapy promoted greater sputum expectoration than usual care during the nebulisation period {median difference 1.8 ml [95% confidence interval (CI) 0.2–6.2]}. Both treatments led to similar expectoration during autogenic drainage and for 24 hours post intervention. Combined therapy led to a greater improvement in the sputum symptoms domain [6.7 points (95% CI 3.3–13.3] and total CASA-Q score [2.4 points (95% CI 0.1–9.3)] compared with usual care. No differences in LCQ score or lung function were observed. Fewer adverse events were reported using combined therapy, which was selected as the preferred intervention.
Conclusions
Combined nebulisation increased immediate sputum expectoration, improved sputum symptoms and reduced adverse events compared with usual care in patients with CF.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259248
in Physiotherapy > Vol. 107 (2020) . - p. 243-251[article]
Titre : Development and implementation of the physiotherapy-led exercise interventions for the treatment of rotator cuff disorders for the ‘Getting it Right: Addressing Shoulder Pain’ (GRASP) trial Type de document : Article Auteurs : David J. Keene ; Hessam Soutakbar ; Sally Hopewell ; Peter Heine ; Anju Jaggi ; Chris Littlewood ; Zara Hansen ; Karen Barker ; Willie Hamilton ; Andrew J. Carr ; Sarah E. Lamb Année de publication : 2020 Article en page(s) : p. 252-266 Note générale : https://doi.org/10.1016/j.physio.2019.07.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Essai clinique ; Exercice physique ; ScapulalgieRésumé : Objectives
The Getting it Right: Addressing Shoulder Pain (GRASP) trial is a large-scale, multicentre, 2 × 2 factorial randomised controlled trial investigating clinical and cost-effectiveness of a progressive exercise programme versus best-practice advice, with or without corticosteroid injection, for treating people with rotator cuff disorders. Here we describe the development, implementation and details of the physiotherapy-led interventions.
Methods
Medical Research Council guidance for developing complex interventions were used, taking into account clinical guidelines, expert and patient opinion, research evidence, current practice variation, and deliverability. A stakeholder meeting of 26 experts, clinicians, researchers, and patient representatives was used to design key components of the interventions. Stakeholders prioritised strengthening posterior rotator cuff muscles and using practical, easy-to-do exercises. The interventions were designed to be deliverable across the UK National Health Service.
Results
Progressive exercise consists of up to six sessions with a physiotherapist over 16 weeks. The best-practice advice consists of one face-to-face session with a physiotherapist with substantially greater reliance on self-management. Both interventions include self-management advice, home-exercise instruction, and behaviour-change strategies to target exercise adherence. All participants receive a Participant Information Booklet. The best-practice advice intervention is a self-guided system of progressively challenging exercises, with demonstration videos and written materials. The progressive exercise intervention has a wider range of exercise options, and greater flexibility for tailoring, progression, supervised practice and feedback.
Conclusion
GRASP has recruited 708 participants and will provide high quality evidence to inform management of people with shoulder pain due to a rotator cuff disorder. Results are anticipated in 2020.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259262
in Physiotherapy > Vol. 107 (2020) . - p. 252-266[article]
Titre : A qualitative study of the dementia-care experiences and educational needs of physiotherapists in the Republic of Ireland Type de document : Article Auteurs : Tony Foley ; Cormac Sheehan ; Aisling A. Jennings ; Trish O'Sullivan Année de publication : 2020 Article en page(s) : p. 267-274 Note générale : https://doi.org/10.1016/j.physio.2019.08.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Démence ; Education ; Groupes de discussion ; Kinésithérapie (spécialité) ; Recherche qualitativeRésumé : Objectives
Gait disturbance and impaired balance lead to a greater risk of falls and hip fractures for people with dementia. Physiotherapists play an important role in multidisciplinary dementia care. This study aimed to explore physiotherapists’ experiences of dementia care and sought to identify their dementia-specific educational needs.
Design
Qualitative design, using focus group interviews.
Setting
Primary care and secondary care physiotherapy services in the Republic of Ireland.
Participants
Six focus groups with thirty-two physiotherapists, working in community care and hospital settings.
Results
Physiotherapists described a significant dementia-related workload. Challenges to care included absence of a formal diagnosis, clinical uncertainty, scarcity of resources, physical working environment and the assessment of rehabilitation potential. Dementia care was enhanced by the involvement of family members and by collaboration with other allied healthcare professionals. Participants expressed a wish to receive further dementia training and clear evidence-based physiotherapy guidelines. Identified areas of educational need included enhanced communication techniques, use and interpretation of cognitive screening tools, sub-typing of dementia, and ethical issues in dementia care.
Conclusions
Our findings indicate that physiotherapists remain challenged by complex aspects of dementia care. Tailored dementia training for physiotherapists should be developed, focusing on their educational needs. Delivery of training should incorporate interactive case-based activities and interprofessional education with other allied healthcare professionals.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259265
in Physiotherapy > Vol. 107 (2020) . - p. 267-274[article]
Titre : “WALK30X5”: a feasibility study of a physiotherapy walking programme for people with mild to moderate musculoskeletal conditions Type de document : Article Auteurs : Catherine J. Minns Lowe ; Paul Kelly ; Karen Milton ; Charlie Foster ; Karen Barker Année de publication : 2020 Article en page(s) : p. 275-285 Note générale : https://doi.org/10.1016/j.physio.2019.08.010 Langues : Anglais (eng) Descripteurs : HE Vinci
Appareil locomoteur ; Douleur musculosquelettique ; Etudes de faisabilité ; Exercice physique ; Maladies ostéomusculaires ; Marche à piedRésumé : Objectives
To explore the feasibility of delivering and evaluating a web-based walking intervention for people with long term musculoskeletal conditions (LTMCs), to determine its acceptability and the feasibility of conducting a definitive trial.
Design
Prospective randomised feasibility study, with blind outcome assessment at baseline, 3 and 6 months.
Setting
Hospital based physiotherapy service.
Participants
Forty one adults referred for assessment and advice for any mild/moderate LTMCs. doing Interventions
Participants randomised to: 1. Usual care: one usual physiotherapy advice and assessment session, including setting a physical activity goal and one follow up session (8 weeks). 2. “Walk30 × 5”: session one, usual care plus intervention of walking programme. Participants were shown the website and podcasts and practiced how to use them. One follow up session (8 weeks).
Outcome measures
Primary: timed six minute walk test (T6MWT). Secondary: step count, self-reported pain, fatigue, mood, self-efficacy, happiness, objective blood pressure, peak expiratory flow rate, and self-report and accelerometer measured physical activity.
Results
Recruitment target achieved. No adverse events occurred. Adherence was high and the intervention acceptable. Loss to follow up n = 3 (7%) at 3 months, n = 8 (20%) at 6 months. T6MWT and step count proved suitable outcomes, unlike accelerometry. Estimated sample size for a definitive trial is 216.
Conclusions
“Walk30 × 5” is ready for evaluation in a future, appropriately powered (n = 216), phase III trial. If effective, the intervention will provide a cheap, highly accessible intervention to enable people with mild/moderate LTMCs to achieve UK physical activity guidelines.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259268
in Physiotherapy > Vol. 107 (2020) . - p. 275-285[article]
Titre : Elicitation interview study to identify salient beliefs about exercise participation in adults with cystic fibrosis Type de document : Article Auteurs : Tiffany J. Dwyer ; Barbara N. Griffin ; Peter T.P. Bye ; Jennifer A. Alison Année de publication : 2020 Article en page(s) : p. 286-291 Note générale : https://doi.org/10.1016/j.physio.2019.10.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Comportement ; Comportement social ; Exercice physique ; Mucoviscidose ; PsychosociologieRésumé : Objectives
Conduct an elicitation study, using the Theory of Planned Behaviour framework, to identify salient beliefs about exercise participation in adults with cystic fibrosis (CF). Specifically, identify attitudes on advantages and disadvantages of exercise (behavioural beliefs); individuals and groups who apply social pressure to exercise (normative beliefs); and perceived control over facilitators and barriers to exercise (control beliefs) for adults with CF.
Design
Qualitative interviews using open-ended, structured questions.
Setting
Adult CF clinic in a large Australian hospital.
Participants
Sixteen adults with CF, three relatives/friends of adults with CF and six CF clinic staff.
Results
The most common positive attitudes about exercise were to keep fit and healthy (68%) and feel better and happier (60%), and negative attitude was to feel breathless (36%). Social pressure to exercise mainly came from parents/family (72%) and friends (52%), and 60% of participants reported that no-one discourages exercise. Having someone to exercise with (44%) and be encouraged (36%) were the most common facilitators of perceived control to exercise, whereas being unwell (96%) and not having sufficient time (56%) were the most common barriers.
Conclusions
Attitudes, social pressure and perceived control to exercise for adults with CF were similar to beliefs previously reported by the general population and some patient groups. A number of CF-specific exercise beliefs, mainly related to pulmonary function, were also reported. These findings can help develop questionnaires for larger groups of adults with CF, interpret relationships between exercise beliefs and participation, and inform clinicians to target interventions to increase exercise participation.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259272
in Physiotherapy > Vol. 107 (2020) . - p. 286-291[article]
Titre : Experience of an upper limb training program with a non-immersive virtual reality system in patients after stroke: a qualitative study Type de document : Article Auteurs : Isabelle Lehmann ; Gillian Baer ; Corina Schuster-Amft Année de publication : 2020 Article en page(s) : p. 317-326 Note générale : https://doi.org/10.1016/j.physio.2017.03.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Membre supérieur ; Phénoménologie ; Récupération fonctionnelle ; Thérapie par réalité virtuelleRésumé : Objectives
The YouGrabber (YG) is a new virtual reality training system that focuses on unilateral and bimanual activities. This nested study was part of a larger multicenter randomized controlled trial and explored experiences of people with chronic stroke during a 4 weeks intensive upper limb training with YG.
Design
A qualitative design using semi-structured, face-to-face interviews. A phenomenological descriptive approach was used, with data coded, categorized and summarized using a thematic analysis. Topics investigated included: the experience of YG training, perceived impact of YG training on arm function, and the role of the treating therapist.
Results
Five people were interviewed (one female, age range 55 to 75 years, 1 to 6 years poststroke). Seven main themes were identified: (1) general experience, (2) expectations, (3) feedback, (4) arm function, (5) physiotherapist’s role, (6) fatigue, (7) motivation. Key experiences reported included feelings of motivation and satisfaction, with positive factors identified as challenge, competition, fun and effort. The YG training appeared to trigger greater effort, however fatigue was experienced at the end of the training. Overall, patients described positive changes in upper limb motor function and activity level, e.g. automatic arm use. While the opportunity for self-practice was appreciated, input from the therapist at the start of the intervention was deemed important for safety and confidence.
Conclusions
Reported experiences were mostly positive and the participants were motivated to practice intensively. They enjoyed the challenging component of the games.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259273
in Physiotherapy > Vol. 107 (2020) . - p. 317-326[article]
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Paru le : 01/03/2020
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Titre : Low-level laser therapy for carpal tunnel syndrome : systematic review and network meta-analysis Type de document : Article Auteurs : William K. W. Cheung ; Irene X.Y. Wu ; Regina W.S. Sit ; Robin S. T Ho ; Charlene Hoi Lam Wong ; Samuel Y. S. Wong ; Vincent C.H. Chung Année de publication : 2020 Article en page(s) : p. 24-35 Note générale : https://doi.org/10.1016/j.physio.2019.06.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Méta-analyse en réseau ; Photothérapie de faible intensité ; Revue de la littérature ; Revue systématique ; Syndrome du canal carpienRésumé : Background
Splinting is recommended by various organisations as a non-surgical first-line treatment for carpal tunnel syndrome (CTS), despite the limited evidence supporting its effectiveness. Previous studies on the effectiveness of low-level laser therapy (LLLT) have reported mixed results, and this systematic review aimed to resolve this controversy.
Objective
To perform a network meta-analysis (NMA) for evaluating the effectiveness of LLLT compared with other conservative treatments for CTS.
Methods
Eighteen electronic databases were searched for potential randomised controlled trials (RCTs). RCTs evaluating LLLT or other non-surgical treatments as an add-on to splinting were included. Included RCTs measured at least one of the following three outcomes with validated instruments: pain, symptom severity and functional status.
Results
Six RCTs (418 patients) were included. NMA suggested that LLLT plus splinting has the highest probability (75%) of pain reduction, compared with sham laser plus splinting (61%), ultrasound plus splinting (57%) and splinting alone (8%). However, while LLLT plus splinting is significantly more effective than sham laser plus splinting for pain reduction, the magnitude is not clinically significant (Visual Analogue Scale mean difference −0.53 cm, 95% confidence interval −1.01 to −0.05 cm; P = 0.03, I2 = 25%). The effect of LLLT plus splinting on symptom severity and functional status was not superior to splinting alone.
Conclusion
The use of LLLT in addition to splinting for the management of CTS is not recommended, as LLLT offers limited additional benefits over splining alone in terms of pain reduction, reduction of symptom severity or improved functional status.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254081
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 24-35[article]
Titre : Effectiveness of expiratory muscle strength training on expiratory strength, pulmonary function and cough in the adult population : a systematic review Type de document : Article Auteurs : Lucy Templeman ; Fiona Roberts Année de publication : 2020 Article en page(s) : p. 43-51 Note générale : https://doi.org/10.1016/j.physio.2019.06.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercices respiratoires ; Expiration ; Force musculaire ; Pneumopathie de déglutition ; Pressions respiratoires maximales ; Revue de la littératureMots-clés : Entraînement à la force musculaire expiratoire Résumé : Background
Respiratory muscle strength declines in certain disease states, leading to impaired cough, reduced airway clearance and an increased risk of aspiration pneumonia. Respiratory muscle training may therefore reduce this risk.
Objectives
To assess current evidence of expiratory muscle strength training (EMST) on maximum expiratory pressure, cough flow and spirometry.
Data sources
Databases including CINAHL, Medline, Science Direct and PEDRo were searched.
Eligibility criteria
Randomised controlled trials investigating expiratory muscle strength training on maximum expiratory pressure, pulmonary function or cough in any adult population, published before December 2017.
Study appraisal
Data were extracted to a trial description form and study quality evaluated by two reviewers. Meta-analysis was performed with calculation of mean differences and 95% confidence intervals.
Results
Nine studies met inclusion criteria and ranged in size from 12 to 42 participants. Trials investigated EMST in healthy adults (2), multiple sclerosis (3), COPD (2), acute stroke (1) and spinal cord injury (1). Overall, EMST improved maximum expiratory pressure (15.95 cmH2O; 95% CI: 7.77 to 24.12; P
Conclusions
Meta-analysis indicated a small significant increase in maximum expiratory pressure following EMST. Improvements in maximum expiratory pressure did not lead to improvements in cough or pulmonary function.
Limitations
Variations in protocol design and population limited the overall effect size.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254110
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 43-51[article]
Titre : Is pelvic floor muscle training effective for symptoms of overactive bladder in women? A systematic review Type de document : Article Auteurs : K. Bo ; Ana Carolina Nociti Lopes A. C. N. L. Fernandes ; Thaiana Bezerra T. B. Duarte ; Luiz Gustavo Oliveira L. G. O. Brito ; Cristine H. J. Ferreira Année de publication : 2020 Article en page(s) : p. 65-76 Note générale : https://doi.org/10.1016/j.physio.2019.08.011 Langues : Anglais (eng) Descripteurs : HE Vinci
Femmes ; Plancher pelvien ; Revue de la littérature ; Techniques de physiothérapie ; Vessie hyperactiveMots-clés : Entraînement des muscles du plancher pelvien Résumé : Background
Overactive bladder (OAB) syndrome can be very bothersome and is associated with impaired quality of life and work productivity.
Objective
To evaluate the effect of pelvic floor muscle training (PFMT) on OAB symptoms in women. Furthermore, to assess the influence of PFMT on pelvic floor muscle (PFM) function, satisfaction with treatment, side effects, adherence and the quality of exercise reporting.
Data sources
Systematic review of randomized controlled trials (RCTs). Electronic search was conducted on MEDLINE/PubMed, Embase, CINAHL, SciELO, SCOPUS, Web of Science and Physiotherapy Evidence Database (PEDro). The risk of bias was assessed using the PEDro scale. The Consensus on Exercise Reporting Template (CERT) was used to assess the quality of exercise reporting.
Study selection
Full text RCTs including non-pregnant female participants, investigating PFMT vs inactive control or usual care, other life style modifications or other interventions.
Synthesis methods
Descriptive analysis.
Results
Eleven RCTs were included. There was considerable heterogeneity of PFMT protocols, outcome measures and follow-up periods. Hence, a qualitative analysis was undertaken. PFMT provided a significant reduction of OAB symptoms in five studies with a reduction in urinary frequency (n = 1), and urgency urinary incontinence (n = 4). PFM function was assessed in three studies, and two studies found improvement in favor of PFMT.
Limitations
A meta-analysis was not possible due to huge heterogeneity of included studies.
Conclusion
PFMT might reduce OAB symptoms, however, due to many limitations of the published studies it is not possible to clearly determine the effect of PFMT on OAB symptoms and PFM function.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254111
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 65-76[article]
Titre : The effect of exercise on high-level mobility in individuals with neurodegenerative disease : a systematic literature review Type de document : Article Auteurs : Moira Smith ; Ruth N. Barker ; Gavin Williams ; Jennifer Carr ; Ronny Gunnarsson Année de publication : 2020 Article en page(s) : p. 174-193 Note générale : https://doi.org/10.1016/j.physio.2019.04.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Maladie de Parkinson ; Maladies neurodégénératives ; Mobilité ; Revue de la littérature ; Sclérose en plaquesMots-clés : Mobilité de haut niveau Résumé : Objective
To investigate the effect of exercise on high-level mobility (i.e. mobility more advanced than independent level walking) in individuals with neurodegenerative disease.
Data sources
A systematic literature search was conducted in Medline, CINAHL, Scopus, SportDiscus and PEDro.
Study selection
Randomised controlled trials of exercise interventions for individuals with neurodegenerative disease, with an outcome measure that contained high-level mobility items were included. High-level mobility items included running, jumping, bounding, stair climbing and backward walking. Outcome measures with high-level mobility items include the High Level Mobility Assessment Tool (HiMAT); Dynamic Gait Index; Rivermead Mobility Index (RMI) or modified RMI; Functional Gait Assessment and the Functional Ambulation Category.
Study appraisal
Quality was evaluated with the Cochrane Risk of Bias Tool.
Results
Twenty-four studies with predominantly moderate to low risk of bias met the review criteria. High-level mobility items were included within primary outcome measures for only two studies and secondary outcome measures for 22 studies. Eight types of exercise interventions were investigated within which high-level mobility tasks were not commonly included. In the absence of outcome measures or interventions focused on high-level mobility, findings suggest some benefit from treadmill training for individuals with multiple sclerosis or Parkinson’s disease. Progressive resistance training for individuals with multiple sclerosis may also be beneficial. With few studies on other neurodegenerative diseases, further inferences cannot be made.
Conclusion
Future studies need to specifically target high-level mobility in the early stages of neurodegenerative disease and determine the impact of high-level mobility interventions on community participation and maintenance of an active lifestyle.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254113
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 174-193[article]
Titre : Evaluation instruments for physical therapy using virtual reality in stroke patients : a systematic review Type de document : Article Auteurs : Fernanda Araújo Felipe ; Fernanda Oliveira de Carvalho ; Érika Ramos Silva ; Nayara Gomes Lima Santos ; Patrícia Almeida Fontes ; Akeline Santos de Almeida ; Diogo Costa Garção ; Paula Santos Nunes ; Adriano Antunes de Souza Araújo Année de publication : 2020 Article en page(s) : p. 194-210 Note générale : https://doi.org/10.1016/j.physio.2019.05.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Jeu sérieux ; Jeu vidéo ; Médecine physique et de réadaptation ; Réadaptation ; Réalité de synthèse ; Revue de la littératureMots-clés : Exergame Résumé : Background
Physiotherapeutic rehabilitation is essential to improve functional mobility, muscular strength, balance and quality of life of stroke patients, but conventional techniques using repeated physical activities can soon become monotonous. The use of virtual reality (VR) in rehabilitation offers a possible alternative to the traditional methods of promoting improvements in muscle strength and balance. However, there is not yet consensus about which instruments should be used to assess the effectiveness of VR in stroke rehabilitation.
Objective
To conduct a systematic review to identify the types of evaluation tools used for different VR interventions to rehabilitate stroke patients, considering balance, strength, function, quality of life, cognition and motivation.
Data sources
A comprehensive literature search using MEDLINE-PubMed, Web of Science, Scopus, Lilacs and IEEE Xplore was undertaken.
Study selection
Studies on stroke patients who had undergone VR therapy and an assessment of its effectiveness using evaluative instruments.
Study appraisal and synthesis methods
Data were extracted by a single reviewer using standardised forms, and were checked by a second reviewer. The extracted information included study design, number of participants, type of stroke, items that were evaluated (balance, muscle strength, functional evaluation), console used, number of rehabilitation sessions, results and conclusions.
Results
In total, 1836 articles were identified; of these, 29 were included in this review after consideration of the inclusion and exclusion criteria. The selected articles rated one or more of the following factors: balance (n = 12), grip strength (with or without devices for direct measurement) (n = 8), functionality (n = 12) and quality of life (n = 12).
Limitations
The full text of one article was not available, despite a request to the authors to send it via email.
Conclusion and implications of key findings
The Berg Balance Scale, the Fugl–Meyer Assessment and the Stroke Impact Scale were the instruments used most frequently to assess balance, function and quality of life, respectively, in stroke patients who underwent rehabilitation using VR.Disponible en ligne : Oui En ligne : https://www.sciencedirect.com/science/article/pii/S0031940619300744#! Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254114
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 194-210[article]
Titre : Demographic and geographical variability in physiotherapy provision following hip and knee replacement. An analysis from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man Type de document : Article Auteurs : Toby O. Smith ; Jack R. Dainty ; Emma M. Clark ; Michael R. Whitehouse ; Andrew J. Price ; Alex J. MacGregor Année de publication : 2020 Article en page(s) : p. 1-11 Note générale : https://doi.org/10.1016/j.physio.2019.11.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Arthroplastie ; Études de cohortes ; Grande-Bretagne ; Médecine physique et de réadaptation ; Membre inférieur ; Mesures des résultats rapportés par les patients (PROM) ; RéadaptationRésumé : Background
Total hip (THR) and knee replacement (TKR) are two of the most common elective orthopaedic procedures worldwide. Physiotherapy is core to the recovery of people following joint replacement. However, there remains uncertainty as to physiotherapy provision at a national level.
Objectives
To examine the relationship between patient impairment and geographical variation on the provision of physiotherapy among patients who undergo primary total hip or knee replacement (THR/TKR).
Design
Population-based observational cohort study.
Methods
Patients undergoing THR (n = 17,338) or TKR (n = 20,260) recorded in the National Joint Registry for England (NJR) between 2009 and 2010 and completed Patient Reported Outcome Measures (PROMs) questionnaires at Baseline and 12 months postoperatively. Data were analysed on the frequency of physiotherapy over the first postoperative year across England’s Strategic Health Authorities (SHAs). Logistic regression analyses examined the relationship between a range of patient and geographical characteristics and physiotherapy provision.
Results
Following THR, patients were less likely to receive physiotherapy than following TKR patients (‘some’ treatment by a physiotherapist within 1st post operative year: 53% vs 79%). People with worse functional outcomes 12 months postoperatively, received more physiotherapy after THR and TKR. There was substantial variation in provision of physiotherapy according to age (younger people received more physiotherapy), gender (females received more physiotherapy) ethnicity (non-whites received more physiotherapy) and geographical location (40% of patients from South West received some physiotherapy compared to 40 73% in London after THR).
Conclusions
There is substantial variation in the provision of physiotherapy nationally. This variation is not explained by differences in the patient’s clinical presentation.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254117
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 1-11[article]
Titre : Towards more homogenous and rigorous methods in sham-controlled dry needling trials : two Delphi surveys Type de document : Article Auteurs : Felicity A. Braithwaite ; Julie Lynette Walters ; Lorimer G. Moseley ; Marie T. Williams ; Maureen McEvoy Année de publication : 2020 Article en page(s) : p. 12-23 Note générale : https://doi.org/10.1016/j.physio.2019.11.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Méthode Delphi ; PlaceboMots-clés : Dry needling Essais contrôlés fictivement Blinding Method Résumé : Objectives
Sham-controlled trials of dry needling, a popular treatment for pain, use a range of methods and theoretical frameworks and most have high risk of bias. Critically, patient blinding is often unsuccessful and therapist blinding has not been attempted. The specific effects of dry needling on pain therefore remain unclear. Our objectives were to identify (1) important elements of active dry needling; (2) important elements of shams for dry needling.
Design and participants
Two Delphi surveys (to quantify levels of consensus) were undertaken with three expert groups: experts in (1) dry needling, (2) research methodology, and (3) deceptive/hypnotic techniques including magic. Experts in dry needling participated in Delphi 1 and all three groups participated in Delphi 2. Each survey commenced with an open-ended question. Responses were converted to single ‘items’ suitable for rating on 9-point Likert scales [categorised as ‘Not important’ (0–3), Depends (4–6), and Essential (7–9)], which participants rated in the following two rounds. Consensus was pre-defined as ≥80% agreement within a 3-point category.
Results
In Delphi 1 (n = 20 experts), of 80 items, 35 reached consensus in the ‘Essential’ category, which related to explanations, therapist knowledge/skills, intervention rationale, the setting, and safety. In Delphi 2 (n = 53 experts), of 97 items, 15 items reached consensus in the ‘Essential’ category in all three groups, which related to standardisation/indistinguishability, therapist attributes, expectations/beliefs, vision, protocol, and environment.
Conclusions
Experts placed high importance on the entire intervention experience for active and sham protocols. Cognitive influences that extend beyond mimicking of tactile sensations should be used to create a believable simulation of active dry needling.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254125
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 12-23[article]
Titre : Comparison of virtual reality rehabilitation and conventional rehabilitation in Parkinson’s disease : a randomised controlled trial Type de document : Article Auteurs : Costanza Pazzaglia ; Isabella Imbimbo ; Eliana Tranchita ; Carlo Minganti ; Diego Ricciardi ; R. Lo Monaco ; A. Parisi ; Luca Padua Année de publication : 2020 Article en page(s) : p. 36-42 Note générale : https://doi.org/10.1016/j.physio.2019.12.007 Langues : Anglais (eng) Descripteurs : HE Vinci
Maladie de Parkinson ; Médecine physique et de réadaptation ; Réadaptation ; Réalité de synthèse ; Résultat thérapeutique ; ThérapeutiqueMots-clés : Thérapeutique conventionnelle Résumé : Objective
To compare a 6-week virtual reality (VR) rehabilitation programme with a conventional rehabilitation programme in patients with Parkinson’s disease.
Design
Prospective, single-blinded, randomised controlled trial.
Setting
Outpatients.
Participants
Fifty-one patients with Parkinson’s disease were assigned at random to a VR rehabilitation programme or a conventional rehabilitation programme.
Interventions
Both programmes ran for 6 consecutive weeks, with a 40-minute session three times per week.
Main outcome measures
The Balance Berg Scale (BBS) was used to measure balance. Secondary outcome measures were: Dynamic Gait Index (DGI) to evaluate ability to adapt gait to complex walking tasks; Disabilities of the Arm, Shoulder and Hand (DASH) scale to measure performance of the upper limb; and Short Form 36 (SF-36) to evaluate quality of life.
Results
The VR rehabilitation programme led to an increase in BBS score {45.6 [standard deviation (SD) 7.9] vs 49.2 (SD 8.1), mean difference 3.6, 95% confidence interval (CI) 1.3 to 5.9; P = 0.003}, DGI score [18.7 (SD 4.7) vs 20.2 (SD 4.2), mean difference 1.6, 95% CI 0.6 to 2.5; P = 0.003] and SF-36 mental composite score [37.7 (SD 11.4) vs 43.5 (SD 9.2), mean difference 5.8, 95% CI 0.4 to 11.3; P = 0.037], and a decrease in DASH scale score [29.6 (SD 17.5) vs 21.6 (SD 15.1), mean difference −7.9, 95% CI −13.7 to −2.2; P = 0.009]. In contrast, the conventional rehabilitation programme only led to a decrease in DASH scale score [30.3 (SD 18.1) vs 25.1 (SD 15.8), mean difference −5.2, 95% CI −8.8 to −1.5; P = 0.007].
Conclusion
These findings suggest that rehabilitation is useful in Parkinson’s disease, and the VR rehabilitation programme was more effective in determining overall improvement than the conventional rehabilitation programme.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254126
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 36-42[article]
Titre : Development of a functional rehabilitation intervention for post knee arthroplasty patients : community based rehabilitation post knee arthroplasty (CORKA) trial Type de document : Article Auteurs : Jonathan Room ; Martha Batting ; Karen L. Barker Année de publication : 2020 Article en page(s) : p. 52-64 Note générale : https://doi.org/10.1016/j.physio.2019.06.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Arthroplastie prothétique de genou ; Essai contrôlé randomisé ; Médecine physique et de réadaptation ; Réadaptation ; ThérapeutiqueMots-clés : Développement de l'intervention Réadaptation à base communautaire Résumé : Knee osteoarthritis is a common cause of disability in older people and knee arthroplasty surgery in the UK is increasing. The CORKA trial is a randomised controlled trial of rehabilitation targeted at patients identified as being at risk of a poor outcome after knee arthroplasty. This paper describes the development and delivery of the CORKA intervention. It was informed by current evidence, relevant guidelines, expert and patient opinion, practical considerations and a pilot study. The intervention is a multicomponent rehabilitation programme with the main component being an exercise programme delivered to participants in their own home. It includes functional task practice, strategies to improve adherence and where appropriate the provision of appropriate aids and equipment. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254127
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 52-64[article]
Titre : Physiotherapist administered, non-invasive ventilation to reduce postoperative pulmonary complications in high-risk patients following elective upper abdominal surgery; a before-and-after cohort implementation study Type de document : Article Auteurs : Jane Lockstone ; Selina M. Parry ; Linda Denehy ; Iain Kilpatrick I. K. Robertson ; David Story ; Scott Parkes ; Ianthe Boden Année de publication : 2020 Article en page(s) : p. 77-86 Note générale : https://doi.org/10.1016/j.physio.2018.12.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Australie ; Chirurgie générale ; Complications postopératoires ; Soins postopératoires ; Ventilation non effractiveRésumé : Objectives
To (1) determine whether short, 30-minute sessions of non-invasive ventilation (NIV) is associated with fewer postoperative pulmonary complications (PPC) following elective high-risk upper abdominal surgery and (2) measure feasibility and safety of this intervention when delivered by physiotherapists.
Design
Prospective, pre post cohort, observational, single-centre study.
Setting
Primary referral hospital in Australia.
Participants
A total of 182 consecutive high-risk elective upper abdominal surgery patients consisting of 101 pre cohort participants compared to 81 post cohort participants.
Interventions
Both groups received standardised preoperative physiotherapy and early postoperative mobilisation. The post cohort group received five additional 30-minute NIV sessions in the first two postoperative days.
Main outcome measure
Primary outcome measure was PPC incidence within the first seven postoperative days. Secondary outcomes included feasibility and safety of physiotherapy-led NIV.
Results
Incidence of PPC (7% vs 18%, adjusted relative risk 0.24; 95% CI 0.10 to 0.59, p = 0.002) was less in the NIV group compared to those who received no NIV. Mean time to first NIV session was 18.6 (SD 11.0) hours with 74% of participants receiving NIV within 24-hours of surgery. There were no major adverse events.
Conclusion
These findings suggest PPC reduction may be possible with postoperative NIV following high-risk elective upper abdominal surgery. Results should be seen as hypothesis-generating associations only considering the significant limitations to this study. Physiotherapy-led NIV was delivered safely to ICU and ward patients. However, the planned protocol was not feasible and appropriate physiotherapy staffing and/or a multidisciplinary approach may be required to provide this service successfully.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254128
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 77-86[article]
Titre : Video-assisted thoracoscopic lobectomy : which patients require postoperative physiotherapy? Type de document : Article Auteurs : P. Agostini ; Sebastian Thomas Lugg ; Kerry Adams ; T. Smith ; Maninder Singh Kalkat ; Pala Babu Rajesh ; Richard S. Steyn ; B. Naidu ; Alison Rushton ; Ehab S. Bishay Année de publication : 2020 Article en page(s) : p. 87-93 Note générale : https://doi.org/10.1016/j.physio.2019.01.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Atélectasie pulmonaire ; Chirurgie thoracique vidéoassistée ; Facteurs de risque ; Médecine physique et de réadaptation ; Pneumonie ; Réadaptation ; Techniques de physiothérapieRésumé : Objectives
Following major thoracic surgery physiotherapy is recommended to improve reduced lung volume, aid secretion clearance, and improve mobility, however, in many centres physiotherapy provision is variable following minimally invasive video-assisted thoracoscopic surgery (VATS). The objective of this study was to observe frequency of problems potentially amenable to physiotherapy following VATS lobectomy, and to identify associated baseline factors of patients in whom physiotherapy may be beneficial.
Methods
A prospective observational study was performed including all consecutive cancer patients undergoing VATS lobectomy in a regional centre over 4 years (2012–2016). Standard postoperative care included early mobilisation by nursing staff from postoperative day one (POD1). Physiotherapy assessment of all patients on POD1 determined presence of issues potentially amenable to physiotherapy intervention, and treatment was commenced. Outcome measures included postoperative pulmonary complication (PPC) development, hospital and high dependency unit (HDU) length of stay (LOS).
Results
Of 285 patients, 209 (73%) received physiotherapy to assist/improve reduced mobility, of these 23 (8%) also received sputum clearance therapies and 65 (23%) specific therapy for lung volume loss. The remaining 76 (27%) patients had significantly lower hospital/HDU LOS (P
Conclusion
Following VATS lobectomy a large proportion of patients demonstrated issues potentially amenable to physiotherapy. The authors recommend that patients receive routine physiotherapy assessment following this type of surgery to ensure that all issues are identified early. Screening of COPD, BMI, preoperative mobility and age will allow early identification of patients who may benefit most from postoperative physiotherapy and preoperative optimisation, however, these factors cannot predict the need for physiotherapy.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254129
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 87-93[article]
Titre : Cognitive factors are associated with disability and pain, but not fatigue among physiotherapy attendees with persistent pain and fatigue Type de document : Article Auteurs : Dave P. Thompson ; Deborah Antcliff ; Steve R. Woby Année de publication : 2020 Article en page(s) : p. 94-100 Note générale : https://doi.org/10.1016/j.physio.2019.01.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Auto-efficacité ; Catastrophisation ; Douleur chronique ; Fatigue ; Grande-Bretagne ; Médecine physique et de réadaptation ; RéadaptationMots-clés : Fibromyalgia Impact Questionnaire Questionnaire de mesure de l'impact de la fibromyalgie Chalder Fatigue Scale Echelle de fatigue de Chalder Résumé : Objectives
Most research exploring the relationship between cognitive factors and pain, disability and fatigue in patients with persistent pain/fatigue has been performed in multi disciplinary environments. It is unclear whether these associations are consistent in other contexts. This study therefore aimed to establish the relationships between these factors in patients with persistent pain/fatigue referred for physiotherapy treatment.
Design
Cross-sectional observational study assessing the association between cognitive factors (self-efficacy and catastrophizing) and levels of pain, disability, mental fatigue and physical fatigue in patients with persistent pain/fatigue disorders. Data were analysed using regression analyses.
Setting
Two out-patient physiotherapy departments, Manchester, UK.
Participants
166 patients with persistent pain and fatigue disorders chronic widespread pain, fibromyalgia and chronic fatigue syndrome/myalgic encephalopathy).
Main outcome measures
Disability was assessed using the Fibromyalgia Impact Questionnaire, whilst mental and physical fatigue were assessed with the sub-scales of the Chalder Fatigue Scale. Pain intensity was measured with a Numeric Pain Rating Scale, self-efficacy with the Chronic Pain Self-efficacy Questionnaire and catastrophizing with the Pain Catastrophizing Scale.
Results
Cognitive factors were significantly associated with pain (self-efficacy beliefs β = −0.30, P
Conclusions
Similar associations were observed in patients referred to physiotherapy as to those observed in patients treated in multi disciplinary clinical environments. Self-efficacy beliefs appear to be particularly strong determinants of disability, but exert a lesser influence over pain or fatigue. Targeting self-efficacy may be an effective method to reduce disability in patients with persistent pain and fatigue disorders.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254130
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 94-100[article]
Titre : Is a model of stratified exercise therapy by physical therapists in primary care feasible in patients with knee osteoarthritis? : a mixed methods study Type de document : Article Auteurs : J. Knoop ; Marike van der Leeden ; Martin van der Esch ; Mariëtte de Rooij ; Wilfred F. H. Peter ; Kim Bennell ; M.P.M. Steultjens ; Arja H. Hakkinen ; Leo D. Roorda ; Willems F. Lems ; Joost Dekker Année de publication : 2020 Article en page(s) : p. 101-110 Note générale : https://doi.org/10.1016/j.physio.2019.01.013 Langues : Anglais (eng) Descripteurs : HE Vinci
Gonarthrose ; Phénotype ; Soins de santé primaires ; Techniques de physiothérapie ; Traitement par les exercices physiquesRésumé : Objectives
To explore the feasibility of a newly developed model of stratified exercise therapy in primary care for patients with knee osteoarthritis (OA).
Design
Mixed method design (process, outcome and qualitative evaluation).
Setting
Six physical therapy practices in primary care around Amsterdam.
Participants
Fifty eligible patients with knee OA, visiting one of the participating physical therapists (PTs).
Intervention
Patients were allocated to a subgroup based on a simple stratification tool and received subgroup-specific, protocolized, 4-month, exercise therapy.
Main outcome measures
Feasibility of this model of stratified exercise therapy was explored by multiple process parameters, outcome measures (physical functioning and knee pain; at baseline and 4-months follow-up) and experiences from patients and PTs.
Results
From 97 potentially eligible patients, fifty patients were included and allocated to the ‘high muscle strength subgroup’ (n = 17), ‘depression subgroup’ (n = 4), ‘obesity subgroup’ (n = 6) or ‘low muscle strength subgroup’ (n = 23). Three patients dropped out during the study period. PTs provided relatively low numbers of sessions (on average 10 sessions), although exceedance of the recommended maximum number of sessions did occur frequently. We found clinically relevant improvements on physical functioning and knee pain (P
Conclusions
Our model of stratified exercise therapy seems to be feasible in primary care, although a number of limitations were reported. Future research should determine the (cost-)effectiveness of an adapted model, compared to usual, non-stratified exercise therapy.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254131
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 101-110[article]
Titre : Promotion of physical activity for adolescents with cystic fibrosis : a qualitative study of UK multi disciplinary cystic fibrosis teams Type de document : Article Auteurs : Sarah Denford ; Kelly Mackintosh ; Melitta McNarry ; A. R. Barker ; Craig Anthony Williams Année de publication : 2020 Article en page(s) : p. 111-118 Note générale : https://doi.org/10.1016/j.physio.2019.01.012 Langues : Anglais (eng) Descripteurs : HE Vinci
Adolescent ; Equipe soignante ; Exercice physique ; Fréquence respiratoire ; MucoviscidoseRésumé : Background
The Cystic Fibrosis Trust recently published a standards of care document which stated that patients should be given a physical activity (PA) programme based on their motivations, fitness, and willingness to be active. However, there remains much debate regarding the roles and responsibilities for PA promotion, as well as “optimal” recommendations and advice. This study aimed to qualitatively explore cystic fibrosis (CF) multidisciplinary teams (MDTs) advice, recommendations and practices relating to PA promotion for adolescents with CF.
Method
Semi-structured interviews were conducted with fifteen members of CF MDTs (11 physiotherapists, two dieticians and two paediatricians). Thematic analysis was used to analyse the data.
Results
Major themes identified were: (1) structure of MDTs, (2) recommendations relating to intensities, durations and types of PA, and (3) use of exercise testing. Participants reported variation between MDTs in terms of who is responsible for promoting and supporting PA, the nature of advice given to patients, and the use of exercise testing. Participants consistently lacked confidence in their own or others’ knowledge to provide standardised recommendations to patients and highlighted that PA promotion and support was often overlooked during busy periods.
Conclusions
Despite its importance, PA support and promotion is not always prioritised. MDTs lack confidence in their ability to promote PA. Standardised advice and training relating to optimal intensities, durations and types of PA would provide a baseline from which to individualise advice to each patient and could increase confidence in PA promotion among MDTs.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254132
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 111-118[article]
Titre : Attributes of physiotherapy continence clinicians : a qualitative perspective Type de document : Article Auteurs : Susan C. Slade ; Jean E. Hay-Smith ; Sally Mastwyk ; Meg E. Morris ; Helena C. Frawley Année de publication : 2020 Article en page(s) : p. 119-127 Note générale : https://doi.org/10.1016/j.physio.2019.01.018 Langues : Anglais (eng) Descripteurs : HE Vinci
Australie ; Incontinence urinaire ; Mise en condition physique de l'homme ; Personnel de santé ; Plancher pelvien ; Recherche qualitative ; StéréotypesMots-clés : Croyances des cliniciens Résumé : Objectives
To understand the attributes of expert physiotherapy continence clinicians and how they compare to novices in relation to experience, knowledge, capability and skills in pelvic floor rehabilitation.
Design
Qualitative methods were used for thematic analysis of data collected from clinician focus groups.
Participants
Registered physiotherapists in Melbourne, Australia. Recruitment was through purposive, and “snowball” sampling, and continued until attainment of data adequacy.
Intervention
Audio recorded focus groups.
Results
Twenty-eight physiotherapists participated in seven focus groups. A key finding was that continence rehabilitation is an area of expert physiotherapy practice. Proficiency is often attained through postgraduate education, mentoring by experienced colleagues, clinical experience and research participation. The ‘continence clinician as expert’ was identified in three main themes (i) attributes that are important for competent continence practice; (ii) research literacy and the ability to generate and translate research into practice; and (iii) patient-centred care, including managing consumer expectations. Knowledge translation was assisted by research literacy, access to evidence and the use of comprehensively reported research. Proficient clinicians prioritised evidence-informed practice, consumer engagement, peer networks and collaboration.
Conclusions
The main attributes of proficient physiotherapy continence clinicians were high levels of skill, training and experience, enabling an extended scope of practice. Research capability and research co-partnerships were also seen to support implementation of contemporary, evidence-based practice. Therapists new to this field were thought to benefit from structured mentoring, further training and clear career pathways embedded within healthcare systems. Consumer-focussed care was seen as a core skill across all levels of physiotherapy practice.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254154
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 119-127[article]
Titre : Matching the perceived benefits of Transcutaneous Electrical Nerve Stimulation (TENS) for chronic musculoskeletal pain against Patient Reported Outcome Measures using the International Classification of Functioning, Disability and Health (ICF) Type de document : Article Auteurs : Peter W. Gladwell ; Fiona Cramp ; Shea Palmer Année de publication : 2020 Article en page(s) : p. 128-135 Note générale : https://doi.org/10.1016/j.physio.2019.01.017 Langues : Anglais (eng) Descripteurs : HE Vinci
Centres antidouleur ; Douleur musculosquelettique ; Lombalgie ; Mesures des résultats rapportés par les patients (PROM) ; Neurostimulation électrique transcutanée (TENS) ; Recherche qualitativeRésumé : Background
There is no consensus regarding the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) for chronic musculoskeletal or low back pain. A review of previous trial methodology identified problems with treatment fidelity. Qualitative research with experienced TENS users identified specific contexts for TENS use, leading to individualised outcomes. There is little information available to guide the selection of Patient Reported Outcome Measures (PROMs) appropriate for TENS evaluation.
Objective
To determine the capability of previously used PROMs to capture the perceived benefits of TENS reported by secondary care Pain Clinic patients who successfully used TENS to manage chronic musculoskeletal pain.
Design
The World Health Organisation International Classification of Functioning, Disability and Health (ICF) was used to match the perceived benefits of TENS against previously used PROMS.
Methods
Semi-structured interviews conducted with nine patients (6 women) as well as three other qualitative datasets (88 patients in total) generated patient-reported benefits which were matched against previously used PROMs using the ICF.
Findings
There were 18 items in the final list of benefits, and none of the four functional outcome measures used in previous RCTs captured more than 8 of these 18 items. The data analysis complemented the inductive thematic analysis but could not replace it, indicating the value of both forms of analysis.
Conclusions
This study highlights a low level of match between outcome measures used in previous TENS studies, and the benefits perceived by experienced TENS users. This suggests that further work is required if the patient-reported benefits of TENS are to be evaluated.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254158
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 128-135[article]
Titre : Is strength training feasible for young people with Prader-Willi syndrome? A phase I randomised controlled trial Type de document : Article Auteurs : Nora Shields ; Kim Bennell ; Jessica Radcliffe ; Nicholas F. Taylor Année de publication : 2020 Article en page(s) : p. 136-144 Note générale : https://doi.org/10.1016/j.physio.2019.01.016 Langues : Anglais (eng) Descripteurs : HE Vinci
Entraînement en résistance ; Etude clinique ; Force musculaire ; Mise en condition physique de l'homme ; Personnes handicapées ; Syndrome de Prader-WilliRésumé : Objective
To investigate the feasibility of progressive resistance training for people with Prader-Willi syndrome (PWS), who have muscle weakness and very low muscle mass.
Design
Randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis.
Setting
Community gymnasium.
Participants
Sixteen participants with PWS (eight female; mean age 25 years) were randomly assigned with 1:1 allocation to an experimental (n = 8) or control group (n = 8).
Intervention
Progressive resistance training was performed twice a week for 10 weeks. The training was supervised one-to-one by a physiotherapist and comprised seven exercises. The control group continued their usual activities and were offered the training after follow-up assessment.
Main outcome measures
Three domains of feasibility were evaluated: implementation (attendance and adherence), practicality (safety) and limited efficacy testing. Muscle strength (one repetition maximum for chest and leg press), physical function (box stacking test, timed stairs climb), muscle composition (US) and body composition (whole-body DXA scan) were measured before and after the intervention.
Results
Participants attended 92% of scheduled sessions and adhered by progressing their training resistance by 82% (range 60–140%). There was one unexpected serious adverse event unrelated to the intervention and several non-serious expected adverse events related to the intervention. Estimates of standardised mean differences indicated moderate to large effects in favour of the experimental group for arm (0.92, 95%CI −0.11 to 1.95) and leg strength (0.78, 95%CI −0.27 to 1.83). The effect was uncertain for secondary outcomes.
Conclusions
There is preliminary evidence showing progressive resistance training is feasible for people with Prader-Willi syndrome and may increase muscle strength.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254179
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 136-144[article]
Titre : Effects of ventilation mode and manual chest compression on flow bias during the positive end- and zero end-expiratory pressure manoeuvre in mechanically ventilated patients : a randomised crossover trial Type de document : Article Auteurs : Bianca Lorrane Reges Amaral ; A. B de Figueiredo ; Daiane Menezes Lorena ; Ana Carolina Otoni Oliveira ; Nadja C. Carvalho ; Marcia S. Volpe Année de publication : 2020 Article en page(s) : p. 145-153 Note générale : https://doi.org/10.1016/j.physio.2018.12.007 Langues : Anglais (eng) Descripteurs : HE Vinci
Etude clinique ; Massage cardiaque ; Thérapie respiratoire ; Ventilation artificielleMots-clés : Dégagement des voies aériennes Manoeuvre pression expiratoire finale positive - pression expiratoire nulle Essai croisé randomisé Résumé : Objectives
To investigate the effects of ventilation mode and manual chest compression (MCC) application on the flow bias generated during positive end-expiratory pressure–zero end-expiratory pressure (PEEP-ZEEP) in mechanically ventilated patients. PEEP-ZEEP is an airway clearance manoeuvre with the potential to exceed the flow bias required to remove secretions. However, the ventilation mode applied during the manoeuvre has not been standardised.
Design
Randomised crossover trial.
Participants
Nineteen mechanically ventilated patients.
Interventions
Patients were randomised to receive PEEP-ZEEP in volume-controlled and pressure-controlled modes, and with or without MCC.
Main outcome measures
The difference in flow bias – assessed by the peak expiratory flow (PEF) and peak inspiratory flow (PIF) ratio and difference – between PEEP-ZEEP applied in both ventilation modes, and with and without MCC.
Results
The expiratory flow bias was significantly higher in the volume-controlled mode than the pressure-controlled mode. This result was caused by a lower PIF in the volume-controlled mode. PEEP-ZEEP applied in the pressure-controlled mode did not achieve the PEF-PIF difference threshold to clear mucus. Moreover, in the majority of cycles of PEEP-ZEEP applied in the pressure-controlled mode, an inspiratory flow bias was generated, which might embed mucus. PEF was 8 l/minute higher with MCC compared with without MCC, which increased the PEF-PIF difference by the same amount. No haemodynamic or respiratory adverse effects were found.
Conclusions
If applied in the volume-controlled mode, PEEP-ZEEP can achieve the flow bias needed to expel pulmonary secretions. However, this is not the case in the pressure-controlled mode. MCC can augment the flow bias generated by PEEP-ZEEP, but its application may be dispensable.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254180
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 145-153[article]
Titre : PALS: peer support for community dwelling older people with chronic low back pain : a feasibility and acceptability study Type de document : Article Auteurs : Kay Cooper ; Patricia Schofield ; Blair H. Smith ; Susan Klein Année de publication : 2020 Article en page(s) : p. 154-162 Note générale : https://doi.org/10.1016/j.physio.2019.01.015 Langues : Anglais (eng) Descripteurs : HE Vinci
Adulte (19-44 ans) ; Autosoins ; Douleur chronique ; Gestion de soi ; Lombalgie ; Soutien socialRésumé : Objectives
(i) Examine the feasibility and acceptability of a peer support intervention (PALS) to facilitate self-management in community dwelling older adults with Chronic Low Back Pain (CLBP), and (ii) examine the feasibility of study methods in order to inform the design of a future randomised controlled trial.
Design
Mixed methods feasibility and acceptability study.
Setting
Community.
Participants
18 older adults (aged 65 to 79) with CLBP and 6 peer support volunteers (PSVs) aged 34 to 65.
Intervention
Six sessions of 1 to 3 hours duration, approximately 2 weeks apart, delivered in mutually convenient public places, or by telephone. Each session had a suggested topic and each participant and PSV had a PALS manual detailing aims and target outcomes for each session.
Outcome measures
Recruitment, retention, integrity, acceptability and feasibility of the PALS intervention, feasibility of study processes, appropriateness and usefulness of outcome measures.
Results
We recruited to target and retained 2/3 of participants. PALS was delivered as intended and acceptable to people with CLBP and PSVs. Most participants were satisfied with PALS and would recommend it to someone else with CLBP. Study processes worked well, but recruitment procedures need to be refined. Outcome measures were returned and were mostly complete, but further work on the most appropriate measures is required.
Conclusions
PALS was feasible to deliver and acceptable to the older people and PSVs who took part in this study. We identified amendments to PALS and the study processes that, once implemented, will allow the effectiveness of PALS to be tested in a large-scale study.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=254206
in Physiotherapy > Vol. 106, n° 1 (Mars 2020) . - p. 154-162[article]