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1.
Background
The Berg Balance Scale (BBS) is often used in clinical practice to predict falls in the older adults. However, there is no consensus in research regarding its ability to predict falls.Objective
To verify whether the BBS can predict falls risk in older adults.Data source
Manual and electronic searches (Medline, EMBASE, CINAHL, Ageline, Lilacs, Web of Science, Cochrane Library and PEDro) were conducted using blocks of words (older adults, falls, BBS, study design) and their synonyms, with no language restrictions and published since 1989.Study selection criteria
Prognostic studies or clinical trials were used to assess the BBS and falls history.Data extraction and data synthesis
In this narrative synthesis, two independent assessors extracted data from articles and a third reviewer provided consensus, in case of disagreement. The methodological quality was assessed using the Quality In Prognosis Studies tool.Results
1047 studies were found and 8 studies were included in this review. The mean BBS score was high, regardless of the history of falls. Three studies presented cut-off scores for BBS, ranging from 45 to 51 points. Two studies reported a difference in the BBS score between fallers and non-fallers. Studies presented low to moderate risk of bias.Limitations
Unfeasible to conduct a meta-analysis due the heterogeneity of included studies.Conclusion
The evidence to support the use of BBS to predict falls is insufficient, and should not be used alone to determine the risk of falling in older adults.Systematic review registration number
PROSPERO CRD42016032309. 相似文献2.
Takuya Umehara Ryo Tanaka 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(4):265-275
Background
Various systematic reviews and/or meta-analyses examining the effects of pre- or postoperative exercise on body function or activity in patients undergoing total knee arthroplasty (TKA) have been published. However, the interventional period needed to at least improve outcomes is unknown.Objective
The aim of this systematic review and meta-analysis was to investigate the exercise intervention period needed to effectively improve body function or activity before and after TKA in patients with knee osteoarthritis (OA).Methods
Studies published until July 2017 were included in the review. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to each meta-analysis to determine the quality of the evidence.Results
Twenty-seven randomized controlled trials were identified. A meta-analysis indicated that exercises performed for 8 weeks after discharge in addition to standard postoperative intervention effectively improved body function as assessed using pain level; physical function, and stiffness on the Western Ontario and McMaster Universities Arthritis Index; extension strength; active knee flexion range of motion; timed up and go test; and gait speed.Conclusion
Overall, we found low- to moderate-quality evidence that an 8-week exercise period was needed after discharge to improve body function and activity in patients with knee OA undergoing TKA. 相似文献3.
Gráinne Kelly Aoife Reilly Hannah Moloney Jonathan Moran Caitriona Cunningham Julie Broderick 《Physiotherapy》2018,104(4):359-366
Background
Randomised controlled trials (RCTs) are described as the gold standard of investigative clinical research. Evidence based practice is critical to the physiotherapy profession, and it is therefore important to explore the research underpinning practice by examining published RCTs.Objectives
The main aims of this review were to profile the quantity and quality of RCTs published in the journal Physiotherapy over the past 50 years.Data sources
Physiotherapy journal, hand searched (1967 to 1987) and electronically (1988 to 2017).Study selection or eligibility criteria
Studies identified as RCTs.Study appraisal and synthesis methods
Quality assessed via PEDRO criteria.Results
120 RCTs were identified from January 1967 to January 2017. The frequency of RCTs published has increased steadily and the UK was the most common source of RCTs, but the prevalence of non-UK based trials is increasing. The quality of RCTs improved steadily over the decades, with a mean PEDro score of 6.9 in the most recent decade (2017 to 2008), indicative of ‘high quality’. The mean number of trial participants was 60 and the most commonly evaluated area was musculoskeletal physiotherapy.Limitations
RCTs were not evaluated against CONSORT criteria.Conclusion and implications of key findings
Frequency of publication of RCTs in the journal Physiotherapy has increased over this time, mirroring trends in the wider medical literature. This highlights the predominance of some areas of research such as musculoskeletal and exercise-based research while other prominent areas such as neurology appear to be less researched. 相似文献4.
Objective
The most prominent problem resulting from decreased body function in older adults is declining quality of life. Walking and talking among older adults in peer group may become a nursing therapy to improve their quality of life. The objective of this study was to identify the impact of walking and talking intervention of quality of life among community dwelling older adults in Depok, Indonesia.Method
This study applied quasi-experimental design with 43 and 40 older adults in the intervention and control group, respectively. The participants were selected using multistage random sampling method.Results
Based on t test, the average quality of life score of older adults improved more significantly in the intervention group than that in the control group, with p value of 0.003, its mean p value < α, respectively. An ANCOVA analysis was used to detect confounding factors. The result showed that all characteristics have a p value of > 0.05, which means there were no confounding factors warranting further investigation.Conclusions
It was concluded that walking and talking therapy in peer group significantly increase the quality of life of older adults. 相似文献5.
Objective
This systematic review to aimed to evaluate the effects of orthopaedic manual therapy (OMT) on pain, improving function, and physical performance in patients with knee osteoarthritis (OA).Data sources
Four databases (PubMed, Web of Science, CENTRAL, and CINAHL) were searched.Study selection
Trials were required to compare OMT alone or OMT in combination with exercise therapy, with exercise therapy alone or control.Data extraction
Data extraction and risk assessment were done by two independent reviewers. Outcome measures were visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, WOMAC function score, WOMAC global score, and stairs ascending-descending time.Results
Eleven randomized controlled trials were included (494 subjects), four of which had a PEDro score of 6 or higher, indicating adequate quality. The results of the meta-analysis indicated that reduction of VAS score in OMT compared with the control group was statistically insignificant (SDM: ?0.59; 95% CI: ?1.54 to ?0.36; P = 0.224). The reduction of VAS score in OMT compared with exercise therapy group was statistically significant (SDM: ?0.78; 95% CI: ?1.42 to ?0.17; P = 0.013). The reduction of WOMAC pain score in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.79; 95% CI: ?1.14 to ?0.43; P = 0.001). Similarly, the reduction of WOMAC function score in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.85; 95% CI: ?1.20 to ?0.50; P = 0.001). However, the reduction of WOMAC global score in OMT compared with the exercise therapy group was statistically insignificant (SDM: ?0.23; 95% CI: ?0.54 to ?0.09; P = 0.164). The reduction of stairs ascending-descending time in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.88; 95% CI: ?1.48 to ?0.29; P = 0.004).Conclusions
This review indicated OMT compared with exercise therapy alone provides short-term benefits in reducing pain, improving function, and physical performance in patients with knee OA.Review registration
PROSPERO 2016:CRD42016032799. 相似文献6.
Objective
To investigate the effects of local vibration on muscle strength in healthy adults.Data sources
The electronic databases PubMed, CINAHL, Scopus and Web of Science were searched using a combination of the following keywords: vibration, vibration therapy, power, maximal voluntary contraction, performance, rate of force development and vibratory exercise. In addition, the Medical Subject Headings ‘vibration’, ‘strength’ and ‘exercise’ were used. The bibliographical search was limited to articles published in English.Study selection
Trials that evaluated the effect of localised vibration on muscle strength in healthy humans were included.Data extraction
Two independent evaluators verified the quality of the selected studies using the PEDro Scale and the Cochrane Collaboration’s tool for assessing the risk of bias. Muscle strength was calculated for each intervention.Results
In total, 29 full-text studies were assessed for eligibility. Eighteen studies did not match the inclusion criteria, and were excluded. The 11 studies included in this review had an average PEDro score of 5.36/10. Most of the studies reported significant improvements in muscle strength after the application of local vibration. There was considerable variation in the vibration training parameters and target muscle location.Conclusions
The use of local vibration on the target muscle can enhance muscle strength in healthy adults. Further well-designed controlled studies are required to confirm the effect of local vibration training on muscle strength. 相似文献7.
Marie-Ève Bérubé Stéphane Poitras Marc Bastien Lydie-Anne Laliberté Anyck Lacharité Douglas P. Gross 《Physiotherapy》2018,104(1):1-8
Background
Many physiotherapists underuse evidence-based practice guidelines or recommendations when treating patients with musculoskeletal disorders, yet synthesis of knowledge translation interventions used within the field of physiotherapy fails to offer clear conclusions to guide the implementation of clinical practice guidelines.Objectives
To evaluate the effectiveness of various knowledge translation interventions used to implement changes in the practice of current physiotherapists treating common musculoskeletal issues.Data sources
A computerized literature search of MEDLINE, CINHAL and ProQuest of systematic reviews (from inception until May 2016) and primary research studies (from January 2010 until June 2016).Study selection and eligibility criteria
Eligibility criteria specified articles evaluating interventions for translating knowledge into physiotherapy practice.Data extraction and data synthesis
Two reviewers independently screened the titles and abstracts, reviewed full-text articles, performed data extraction, and performed quality assessment. Of a total of 13 014 articles located and titles and abstracts screened, 34 studies met the inclusion criteria, including three overlapping publications, resulting in 31 individual studies.Results
Knowledge translation interventions appear to have resulted in a positive change in physiotherapist beliefs, attitudes, skills and guideline awareness. However, no consistent improvement in clinical practice, patient and economic outcomes were observed.Limitations
The studies included had small sample sizes and low methodological quality. The heterogeneity of the studies was not conducive to pooling the data.Conclusions and implication of key findings
The intensity and type of knowledge translation intervention seem to have an effect on practice change. More research targeting financial, organizational and regulatory knowledge translation interventions is needed. 相似文献8.
Linden Johnson Karen-Leigh Edward Jo-Ann Giandinoto 《Collegian (Royal College of Nursing, Australia)》2018,25(3):355-361
Background
Care planning is an essential part of nursing practice. Formulating nursing care plans within the framework of standardised nursing language warrants further examination.Aim
The aim of this systematic review was examine the available literature related to nursing documentation and care plans, in relation to the impacts of using standardised nursing language.Methods
The electronic databases of Medline and Cumulative Index to Nursing and Allied Health Literature were searched using predetermined search strategy. A narrative synthesis was undertaken.Findings
Of the 198 articles identified 21 articles were included in the review.Discussion
The examination of the available evidence suggests that a global and Australian difference in use of standardised nursing language in nursing care planning and documentation, including research related to nursing documentation exists.Conclusion
There are major benefits for systematically integrating nursing classification systems and standardised nursing language. Standardised nursing language is essential for the successful integration of nursing documentation into contemporary healthcare where electronic health care records will be the norm. 相似文献9.
Objective
To estimate the effectiveness of a 10-week combined exercise training and home-based walking programme on daily physical activity (PA) compared with standard medical care in patients with moderate chronic obstructive pulmonary disease (COPD).Design
Randomised controlled trial.Setting
Primary care physiotherapy.Participants
Consecutive patients with stable COPD at Gold Stage II with a score of two or more on the Medical Research Council Dyspnoea Scale.Intervention
Ten-week combined exercise training and home-based walking programme compared with standard medical care.Main outcomes
At baseline and after 10 weeks, daily PA was evaluated by accelerometry using three levels of intensity and expressed as metabolic equivalent of task. In addition, daily activities (Physical Activity Scale for the Elderly), functional exercise capacity (6-minute Walk Test), health-related quality of life (Chronic Respiratory Questionnaire) and exercise self-efficacy (Exercise Self-Regulatory Efficacy Scale) were measured.Results
Fifty-two patients {34 females; mean age 70.2 [standard deviation (SD) 9.5] years; mean forced expiratory volume in 1 second 67% (SD 9.2) of predicted} were randomised. PA, adjusted for baseline differences, increased significantly in the intervention group compared with the control group, by 26.1 minutes/day [95% confidence interval (CI) 7.3 to 44.9]. The increase in functional capacity between groups was clinically relevant (34.0 m, 95% CI 2.3 to 65.6) in favour of the intervention group.Conclusions
A combined exercise training and home-based walking programme in primary care physiotherapy improved PA in patients with moderate COPD.Clinical trial registration number NL24766.018.08. 相似文献10.
Donna Wang Bronwyn Everett Tiffany Northall Amy R. Villarosa Yenna Salamonson 《Collegian (Royal College of Nursing, Australia)》2018,25(4):457-465
Background
There is increasing concern regarding autonomy and quality of life for older people living in residential aged care. Failure to provide food choices and suitable dining environments has been reported to negatively impact their nutritional status, undermining their sense of autonomy and quality of life.Aim
This paper presents an integrative review of studies on food choices in residential aged care and explores the relationships between food choices, autonomy and quality of life.Methods
Search of nine databases CINAHL, PubMed, Scopus, PsycINFO, ProQuest, Cochrane, Embase, AMED, and Social Science Citation Index, identified nine primary articles. The Critical Appraisal Skill Program tool was used to examine the quality of these articles.Findings
Three key themes were identified: (1) Prevalence of food choices and catering for residents’ preference; (2) Importance of food choices to nutritional status; (3) Impact of food choices on autonomy and quality of life. The importance of increasing staff awareness and a need to develop aged care regulation to ensure adequate food choices provided.Discussion
The importance of increasing staff awareness regarding the interrelatedness of respecting older people’s food choices, autonomy and quality of life is identified. The needs of determining aged care regulation and accreditation standards were also highlighted.Conclusion
Failure to provide satisfying food choices impacts older people’s quality of life. However, the strength of the relationships between food choices, autonomy and quality of life requires further study. 相似文献11.
Tasneem Islam Alison M. Hutchinson Tracey K. Bucknall 《Collegian (Royal College of Nursing, Australia)》2018,25(4):401-407
Background
Nurse managers enact changes to practice based on information collected from the local ward environment with the aid of electronic risk management and incident reporting systems. Despite being key users of electronic risk management and incident reporting systems, little knowledge exists on nurse managers’ use and communication of information derived from these systems.Aim
This qualitative study aimed to explore nurse manager information requirements, risk management practices, and influences on decision-making when interacting with an electronic risk management and incident reporting system.Methods
Focus groups with eight nurse managers were conducted at a teaching hospital in Melbourne, Australia.Findings
Decision-making and information management approaches varied depending on whether the nurse manager investigated a single incident report or viewed summarised incident reports. Thematic and content analysis produced three themes: navigating the system, relying on data, and communication and feedback.Discussion
Nurse managers faced individual and organisational barriers preventing them from using the risk management and incident reporting system to its full potential.Conclusion
The findings from this study will assist nursing and health care administrators in identifying ineffective practice and meeting nurse manager information requirements. 相似文献12.
Effects of exercise training in water and on land in patients with COPD: a randomised clinical trial
J.M. Felcar V.S. Probst D.R. de Carvalho M.F. Merli R. Mesquita L.S. Vidotto L.R.G. Ribeiro F. Pitta 《Physiotherapy》2018,104(4):408-416
Objectives
To compare the effects of two similar 6-month protocols of high-intensity exercise training, in water and on land, in patients with chronic obstructive pulmonary disease (COPD).Design
Randomised controlled trial.Setting
University-based outpatient clinic.Participants
Thirty-six patients with predominantly moderate-to-severe COPD completed the study.Intervention
Patients were evaluated at baseline, at 3 months and at the end of the programme (i.e. 6 months). For both groups, the 6-month protocol consisted of high-intensity endurance and strength exercises with gradual increase in time and/or workload, totalling 60 sessions.Main outcomes
Objective monitoring of physical activity in daily life (PADL, primary outcome), lung function, peripheral and respiratory muscle strength, body composition, maximal and submaximal exercise capacity, functional status, quality of life, and symptoms of anxiety and depression.Results
After 6 months of training, a significant improvement in PADL was seen for both groups [mean difference (95% confidence interval): land group 993 (358 to 1628) steps/day; water group 1669 (404 to 2934) steps/day]. Significant improvements were also seen in inspiratory, expiratory and peripheral muscle strength; maximal and submaximal exercise capacity; quality of life and functional status for both groups. There were no significant improvements in lung function, body composition, and symptoms of anxiety and depression for either group. No difference was found in the magnitude of improvement between the two types of training for any outcome.Conclusion
High-intensity exercise training in water generates similar effects compared with training on land in patients with moderate-to-severe COPD, rendering it an equally beneficial therapeutic option for this population.Clinical trial registration number
NCT01691131. 相似文献13.
Objective
To identify and explore the feelings and experiences of people living with knee pain as a precursor to exploring how this might contribute to improved care in the future.Design
The qualitative meta-synthesis was undertaken in three parts (1) a systematic search of the literature, (2) a critical appraisal of the relevant studies and (3) meta-aggregation of the findings from the selected studies. A qualitative meta-synthesis is a process that enables researchers to answer a specific research question by combining and summarising a variety of qualitative sources. This was undertaken using a contextualist approach which acknowledges different realities exist but tries to determine an underlying ‘truth’.Setting
The participants from the selected studies were from a range of settings and ethnic groups, and cultural backgrounds.Participants
There were nine articles included in the meta-synthesis. Articles focused on the experiences of surgery, return to sport, or other aspects of care were excluded.Results
No articles were excluded following critical appraisal. Eleven categories were identified from 55 findings which resulted in two synthesised findings being identified: knee pain affects every aspect of life and Searching for the best way forward.Limitations
Articles were largely limited to older adults living with osteoarthritis. Many of the findings did not report demographic data. Only English language studies were included.Conclusion
Many people living with knee pain struggle to adapt to living with knee pain and this is often exacerbated by a lack of knowledge and available information to help them plan for the future.PROSPERO No
CRD42017070227. 相似文献14.
Background
Clinical performance assessment tools (CPATs) used in physiotherapy practice education need to be psychometrically sound and appropriate for use in all clinical settings in order to provide an accurate reflection of a student’s readiness for clinical practice. Current evidence to support the use of existing assessment tools is inconsistent.Objectives
To conduct a systematic review synthesising evidence relating to the psychometric and edumetric properties of CPATS used in physiotherapy practice education.Data sources
An electronic search of Web of Science, SCOPUS, Academic Search Complete, AMED, Biomedical Reference Collection, British Education Index, CINAHL plus, Education Full Text, ERIC, General Science Full Text, Google Scholar, MEDLINE, UK and Ireland Reference Centre databases was conducted identifying English language papers published in this subject area from 1985 to 2015.Study selection
20 papers were identified representing 14 assessment tools.Data extraction and synthesis
Two reviewers evaluated selected papers using a validated framework (Swing et al., 2009).Results
Evidence of psychometric testing was inconsistent and varied in quality. Reporting of edumetric properties was unpredictable in spite of its importance in busy clinical environments. No Class 1 recommendation was made for any of the CPATs, and no CPAT scored higher than Level C evidence.Conclusions
Findings demonstrate poor reporting of psychometric and edumetric properties of CPATs reviewed. A more robust approach is required when designing CPATs. Collaborative endeavour within the physiotherapy profession and interprofessionally may be key to further developments in this area and may help strengthen the rigour of such assessment processes. 相似文献15.
Objective
The aim of this study was to examine prior studies relating to carers’ needs from mental health services for their own wellbeing.Method
A systematic approach was adopted for the literature review. The databases searched included MEDLINE, PSycINFO, EMBASE, and CINAHL, involving the use of search terms such as carers, mental health, and needs. The search was conducted in April 2012 and updated in December 2015. In total, 40 published papers were included in the review and were subsequently assessed for quality. For the data synthesis, a thematic analysis approach was employed to integrate the quantitative and qualitative evidence relating to carers’ needs.Results
Twenty-five of the reviewed studies were qualitative, 12 were quantitative, and 3 were mixed. Four major carer needs emerged from the synthesis: (1) holistic wellbeing of service users, (2) holistic wellbeing of carers, (3) supportive attitudes of professionals, and (4) carer involvement. All four of these needs, in fact, revolved around the carers’ ill relatives.Conclusions
The studies reviewed suggest that while carers of people suffering from mental illness have a range of needs, they generally fail to offer straightforward information about their own needs. 相似文献16.
17.
Toby Raeburn Carol Liston Jarrad Hickmott Michelle Cleary 《Collegian (Royal College of Nursing, Australia)》2018,25(3):347-353
Background
Historical accounts of Australia’s early colonial lunatic asylums often neglect to mention the asylum that operated in Liverpool, NSW between 1826 and 1839.Aim
To find and explore the earliest available evidence of the mental health care provided within Liverpool lunatic asylum.Methods
A literature search was followed by manual searches of primary sources held by the State Records Authority of New South Wales, the State Library of NSW, Liverpool Library and Liverpool Regional Museum. International records available through Ancestry.com were also accessed.Findings
Contrary to previous historical accounts, Liverpool lunatic asylum was located within the parsonage of St Luke’s Church in Liverpool. This building was better suited to mental health care than the disused military barracks previously home to the patients of Australia’s first asylum at Castle Hill.Discussion
Despite the substantial challenges of delivering mental health care in the early colony of NSW, the lunatic asylum at Liverpool retained long term staff who worked there throughout the 13 years of its operation. Payment of wages to a nurse within the Liverpool lunatic asylum indicates a shift in approach to nursing in colonial mental health care that makes an important contribution to the historical identity of nursing in Australia.Conclusion
Clarifying historical information using primary sources that illuminate care within Liverpool lunatic asylum is important because history has the potential to inform and contextualise modern approaches to health care. 相似文献18.
Background
Use of diagnostic thoracic ultrasound (TUS) in medical professions to examine the pleura, lung parenchyma and diaphragm is gaining in popularity, however the ways in which physiotherapists are using TUS is unclear.Objective
The aim of this scoping review is to gain an understanding of the emerging evidence base surrounding physiotherapy use of TUS to inform research and clinical practice.Data sources
A systematic search was conducted of the following databases: Cochrane, EPPI centre, PROSPERO, Medline, CINAHL, AMED, EMBASE, HMIC, and BNI.Study selection
Inclusion criteria: primary research reporting the use of diagnostic TUS; a physiotherapist as part of the study design or as the chief investigator; published in English.Synthesis methods
Data regarding demographics, design, type of conditions and anatomical structures investigated and profession leading the TUS of included papers were compiled in a tabular format.Results
Of the 26 included papers, nine studied healthy participants, four studied COPD and four studied critical care patients. Most papers (n = 23) involved scanning the diaphragm. In eight studies the physiotherapist operated the TUS.Limitations
The paper selection process was performed by one author; with no cross-checking by another individual.Conclusion
Use of TUS by physiotherapists is an emerging area in both diaphragm and lung diagnostics. A wide range of patient populations may benefit from physiotherapists using TUS. Papers in this review are heterogeneous making any generalisability difficult but does show its potential for varied uses. TUS is an innovative skill in the hands of physiotherapists, but more research is needed. 相似文献19.
20.
M.A. van Egmond M. van der Schaaf T. Vredeveld M.M.R. Vollenbroek-Hutten M.I. van Berge Henegouwen J.H.G. Klinkenbijl R.H.H. Engelbert 《Physiotherapy》2018,104(3):277-298
Background
Over the last few years, telerehabilitation services have developed rapidly, and patients value benefits such as reduced travelling barriers, flexible exercise hours, and the possibility to better integrate skills into daily life. However, the effects of physiotherapy with telerehabilitation on postoperative functional outcomes compared with usual care in surgical populations are still inconclusive.Objectives
To study the effectiveness of physiotherapy with telerehabilitation on postoperative functional outcomes and quality of life in surgical patients.Data sources
Relevant studies were obtained from MEDLINE, EMBASE, CINAHL, the Cochrane Library, PEDro, Google Scholar and the World Health Organization International Clinical Trials Registry Platform.Study selection
Randomised controlled trials, controlled clinical trials, quasi-randomised studies and quasi-experimental studies with comparative controls were included with no restrictions in terms of language or date of publication.Data extraction and synthesis
Methodological quality was assessed using the Cochrane risk of bias tool. Twenty-three records were included for qualitative synthesis. Seven studies were eligible for quantitative synthesis on quality of life, and the overall pooled standardised mean difference was 1.01 (95% confidence interval 0.18 to 1.84), indicating an increase in favour of telerehabilitation in surgical patients.Limitations
The variety in contents of intervention and outcome measures restricted the performance of a meta-analysis on all clinical outcome measures.Conclusions
Physiotherapy with telerehabilitation has the potential to increase quality of life, is feasible, and is at least equally effective as usual care in surgical populations. This may be sufficient reason to choose physiotherapy with telerehabilitation for surgical populations, although the overall effectiveness on physical outcomes remains unclear.PROSPERO registration number: CRD42015017744. 相似文献