Readings Flashcards
Week 1
Exercise compliance in acute low back pain patients
Schneiders
written reinforcement used as an educational strategy to improve compliance to home-based exercises is an effective and clinically viable strategy. It is recommended that exercise is prescribed with accompanying written and illustrated instructions to increase compliance in prospective clinically randomized trials on therapeutic exercise.
Week 2
How reliable are Functional Movement Screening scores? A systematic review of rater reliability
Schneiders
‘moderate’ evidence that raters can achieve acceptable levels of inter-rater and intra-rater reliability of composite FMS scores when using live ratings
Week 2
FUNCTIONAL MOVEMENT SCREENTM NORMATIVE VALUES IN A YOUNG, ACTIVE POPULATION Dr. Anthony G. Schneiders1 Åsa Davidsson2 Elvira Hörman2 Prof. S. John Sullivan1
No difference between males and females
No difference between those who reported a previous injury and those who did not
Week 2Can Serious Injury in Professional Football be Predicted by a Preseason Functional Movement Screen?
Kyle Kiesel, PT, PhD, ATC, CSCS,aPhillip J. Plisky, PT, DSc, OCS, ATC,aandMichael L. Voight, PT, DHSc, OCS, SCS, ATCb
A score of 14 or less on the FMS was positive to predict serious injury with specificity of 0.91 and sensitivity of 0.54
Fundamental movement as measured by the FMS is an identifiable risk factor for injury in professional football players.
The study suggests that professional players with dysfunctional fundamental movement patterns as measured by the FMS are more likely to suffer an injury than those scoring higher on the FMS
Week 3
Conservative management for postprostatectomy urinary incontinence (Review) Anderson CA, Omar MI, Campbell SE, Hunter KF, Cody JD, Glazener CMA
information from one large trial suggested that men do not benefit from seeing a therapist to receive pelvic floor muscle training after transurethral resection (TURP) for benign prostatic enlargement. Overall, there was insufficient evidence to demonstrate a beneficial effect from pelvic floor muscle training.
Week 3
Interventions for preventing and treating pelvic and back pain in pregnancy (Review) Pennick V, Liddle SD
Moderate-quality evidence showed that acupuncture or exercise, tailored to the stage of pregnancy, significantly reduced evening pelvic or lumbo-pelvic pain. Acupuncture was significantly more effective than exercise for reducing evening pelvic pain. A 16- to 20-week training program was no more successful than usual care in preventing pelvic or LBP. Low-quality evidence suggested that exercise reduced pain and disability from LBP. Reported adverse effects were minor and transient. Further research is likely to change the estimates of effect of these interventions. An agreed classification system for categorising women is overdue. LBP: there was low-quality evidence that exercise significantly reduced pain (six RCTs) and disability (two RCTs). From single trials; exercise in water significantly reduced LBP-related sick leave; pain and physical function were similar when wearing pelvic support belts or having osteo-manipulative therapy (OMT) compared with usual care or sham ultrasound. Very low-quality evidence suggested that a specially-designed pillow may relieve night pain better than a regular pillow. Pelvic pain: there was moderate-quality evidence that acupuncture reduced evening pain better than exercise; both were better than usual care (one RCT). From single trials: exercise plus a rigid belt improved average pain but not function; acupuncture was better than sham acupuncture for evening pain and function, but not average pain. There was no difference in evening pain after either deep or superficial acupuncture. Lumbo-pelvic pain: there was moderate-quality evidence that an eight- to 20-week exercise program reduced the risk of lumbopelvic pain; but a 16- to 20-week training program was no better than usual care for preventing pain (four RCTs). From single trials: exercise significantly reduced lumbo-pelvic-related sick leave and improved function; OMT significantly improved pain and function; a combination of manual therapy, exercise and education improved pain and function; acupuncture improved these outcomes more than usual care or physiotherapy; pain and function improved more when acupuncture was started at 26- rather than 20-weeks’ gestation. Ear acupuncture significantly improved these outcomes more than sham acupuncture.
Week 3
Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women (Review) Dumoulin C, Hay-Smith EJC, Mac Habée-Séguin G
Pelvic floor muscle training versus no treatment for urinary incontinence in women Stress incontinence is the involuntary leakage of urine with a physical activity such as coughing or sneezing. Urgency leakage occurs with a strong need to urinate, but the person cannot make it to the toilet in time. A combination of stress and urgency leakage is called mixed incontinence. The review of trials found that pelvic floor muscle training (muscle-clenching exercises) helps women cure and improve stress urinary incontinence in particular, and all types of incontinence.
Week 3
Effects of a 15-Month Supervised Exercise Program on Physical and Psychological Outcomes in Prostate Cancer Patients Following Prostatectomy: The ProRehab Study Eva M. Zopf, Dr Sport Science1 , Wilhelm Bloch, Prof Dr Med1 , Stefan Machtens, Dr Med2 , Jürgen Zumbé,
The presented data hint at the potential of rehabilitative sports groups for prostate cancer patients. However, according to the current state of the art, exercise intensity and volume may need to be increased to enhance the effects.
Week 4
Prosthetic rehabilitation for older dysvascular people following a unilateral transfemoral amputation (Review) Cumming J, Barr S, Howe TE
Problems with inadequate circulation in the legs (dysvascularity), particularly in people over the age of 60 years, can be so severe that they need a leg amputated. This may be as high as at or above the knee. Accompanying medical conditions (co-morbidities) such as diabetes, cardiovascular or heart disease can affect a person’s rehabilitation. When an above or through knee artificial limb (prosthesis) is fitted, it is hard to regain mobility and function and some people choose to use a wheelchair. Motivation, comfort, cosmetic appearance, functionality, reliability, ease of use, previous mobility and the extra exertion needed to use an artificial leg are all potentially important factors that affect a person’s independence and their use of the prosthesis. Fear of falling, number of falls, social circumstances, help and support from other people are also important influences. The review authors searched for trials comparing different types of rehabilitation that may benefit the mobility or function in older people using an artificial limb. Only one controlled trial was found. This had a crossover design and each of the 10 participants had three seemingly identical prosthetic weights added to the prosthesis below the knee in a random order. The participants, nine men and one woman, were over 50 years of age and eight were over 60 years. Over the few hours of the trial, four participants preferred the lightest weight (150 g), five preferred the medium weight (770 g) and one preferred the heaviest weight (1625 g). Seven of the 10 people successfully ranked the weights from lightest to heaviest. The weights did not alter the participant’s walking speed in a two-minute walk test. The small number of participants, short exposure to the different weights in a laboratory setting and the fact that there were differences in weight between people and also their prosthesis limits the usefulness of these findings. The artificial limbs were all modular style prostheses
Week 4
Physiotherapy Rehabilitation for Individuals with Lower Limb Amputation: A 15-Year Clinical Series Brenton Hordacre1,2*, Vicki Birks2 , Stephen Quinn1 , Christopher Barr1 , Benjamin L. Patritti2 & Maria Crotty1
Results. Mean age was 68 years (standard deviation [SD]: 15), with 69% male, 80% dysvascular and 68% transtibial. The overall median inpatient rehabilitation length of stay (RLOS) was 39 days (interquartile range [IQR]: 26–57). Individuals with amputation entering rehabilitation each year had a higher number of co-morbidities (b: 0.08; 95% confidence interval: 0.05–0.11). Introduction of the IPP was associated with a significant reduction in time to initial prosthetic casting, independent walking and inpatient RLOS. Introduction of RRDs was associated with a significant reduction in time to wound healing, initial prosthetic casting and independent walking. Conclusions. Individuals with amputation were typically elderly dysvascular men with transtibial amputations. Introduction of the IPP and RRDs successfully reduced time to rehabilitation outcomes including independent walking, an outcome that is rarely reported but is of significance to patients and physiotherapists. C
Week 4
PREDICTING WALKING ABILITY FOLLOWING LOWER LIMB AMPUTATION: A SYSTEMATIC REVIEW OF THE LITERATURE Kate Sansam, MRCP, Vera Neumann, MD, FRCP, Rory O’Connor, MD, MRCP and Bipin Bhakta, MD, FRCP
Results: A total of 57 studies were selected. Predictors of good walking ability following lower limb amputation include cognition, fitness, ability to stand on one leg, independence in activities of daily living and pre-operative mobility. Longer time from surgery to rehabilitation and stump problems are predictors of poor outcome. The impact of the cause of amputation on walking varies between studies. In general, unilateral and distal amputation levels, and younger age were predictive of better walking ability. Sex probably does not have a significant influence on walking ability. Conclusion: The heterogeneity of methods and outcome measures used in the identified studies make comparison difficult and, in part, explains conflicting conclusions in relation to predictive factors. Further investigation of predictive factors is needed to estimate walking potential more accurately and guide targeting of modifiable factors to optimize outcome after lower limb amputation.
