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1.
Question
What is the effectiveness and what are the adverse effects.Design
Systematic review with meta-analysis.Participants
Patients with shoulder or upper extremity pain or dysfunction.Intervention
Trigger point dry needling (TDN) compared to control, another intervention or another needling technique.Outcome measures
Primary outcome measures included shoulder or upper limb pain, shoulder or upper limb dysfunction.Results
Eleven randomized trials involving 496 participants were appraised. There was very low evidence that trigger point dry needling of the shoulder region is effective for reducing pain and improving function in the short term. There is some evidence that needling both active and latent trigger points is more effective than needling an active trigger point alone for pain immediately and 1-week after treatment (SMD = ?0.74, 95%CI = ?1.2 to ?0.3; and SMD = ?1.0, 95%CI = ?1.52 to ?0.59).Conclusion
There is very low evidence to support the use of TDN in the shoulder region for treating patients with upper extremity pain or dysfunction. Two studies reported adverse effects to TDN interventions. Most common adverse effects included bruising, bleeding, and pain during or after treatment. Future studies are likely to change the estimates of the effectiveness of TDN for patients with upper extremity pain or dysfunction.PROSPERO: CRD42016045639. 相似文献
2.
Maurício Oliveira Magalhães Josielli Comachio Paulo Henrique Ferreira Evangelos Pappas Amélia Pasqual Marques 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(1):82-91
Background
Low back pain (LBP) is a major health and economic problem worldwide. Graded activity and physiotherapy are commonly used interventions for nonspecific low back pain. However, there is currently little evidence to support the use of one intervention over the other in the medium-term.Objective
To compare the effectiveness of graded activity exercises to physiotherapy-based exercises at mid-term (three and six months’ post intervention) in patients with chronic nonspecific LBP.Methods
Sixty-six patients were randomly allocated to two groups: graded activity group (n = 33) and physiotherapy group (n = 33). These patients received individual sessions twice a week for six weeks. Follow-up measurements were taken at three and six months. The main outcome measurements were intensity pain (Pain Numerical Rating Scale) and disability (Rolland Morris Disability Questionnaire).Results
No significant differences between groups after three and six month-follow ups were observed. Both groups showed similar outcomes for pain intensity at three months [between group differences: ?0.1 (95% confidence interval [CI] = ?1.5 to 1.2)] and six months [0.1 (95% CI = ?1.1 to 1.5)], disability at three months was [-0.6 (95% CI = ?3.4 to 2.2)] and six months [0.0 (95% CI = ?2.9 to 3.0)].Conclusion
The results of this study suggest that graded activity and physiotherapy have similar effects in the medium-term for patients with chronic nonspecific low back pain. 相似文献3.
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4.
C. López-López A. Arranz-Esteban M.V. Martinez-Ureta M.C. Sánchez-Rascón C. Morales-Sánchez M. Chico-Fernández 《Enfermería intensiva / Sociedad Espa?ola de Enfermería Intensiva y Unidades Coronarias》2018,29(2):64-71
Objective
To analyse the influence of psychotropic substance use on the level of pain in patients with severe trauma.Design
Longitudinal analytical study.Scope
Intensive Care Unit (ICU) of Trauma and Emergencies.Patients
severe trauma, non-communicative and mechanical ventilation > 48 hours. Two groups of patients were created: users and non-users of psychotropic substances according to medical records.Interventions
Measurement of pain level at baseline and during mobilization, using the Pain Indicator Behaviour Scale.Variables
demographic characteristics, pain score, sedation level and type and dose of analgesia and sedation.Results
Sample of 84 patients, 42 in each group. The pain level in both groups, during mobilisation, showed significant differences p = 0.011, with a mean of 3.11 (2.40) for the user group and 1.83 (2.14) for the non-user group. A relative risk of 2.5 CI (1,014-6,163) was found to have moderate / severe pain in the user group compared to the non-user group. The mean dose of analgesia and continuous sedation was significantly higher in the user group: P=.032 and P=.004 respectively. There was no difference in bolus dose of analgesia and sedation with P=.624 and P=.690 respectively.Conclusions
Patients with a history of consumption of psychoactive substances show higher levels of pain and experience a higher risk of this being moderate/severe compared to non-users despite receiving higher doses of analgesia and sedation infusion. Key words: pain, multiple trauma, drug users. 相似文献5.
T.O. Smith M. Mansfield J. Dainty G. Hilton C.J.V. Mann C.M. Sackley 《Physiotherapy》2018,104(1):80-90
Objectives
To determine whether physical activity measured using the Physical Activity Scale for the Elderly (PASE), changes during the initial 24 months post-total hip (THR) or knee replacement (TKR), and how this compares to a matched non-arthroplasty cohort.Design
Case-controlled study analysis of a prospectively collected dataset.Setting
USA community-based.Participants
116 people post-THR, 105 people post-TKR compared to 663 people who had not undergone THR or TKR, or had hip or knee osteoarthritis. Cohorts were age-, gender- and BMI-matched.Main outcome measures
Physical activity assessed using the 12-item PASE at 12 and 24 months post operatively.Results
There was no significant difference in total PASE score between pre-operative to 12 months (mean: 136 vs 135 points; p = 0.860) or 24 months following THR (mean: 136 vs 132 points; p = 0.950). Whilst there was no significant difference in total PASE score from pre-operative to 12 months post-TKR (126 vs 121 points; p = 0.930), by 24 months people following TKR reported significantly greater physical activity (126 vs 142 points; p = 0.040). There was no statistically significant difference in physical activity between the normative matched and THR (p ≥ 0.140) or TKR (p ≥ 0.060) cohorts at 12 or 24 months post joint replacement.Conclusions
Physical activity is not appreciably different to pre-operative levels at 12 or 24 months post-THR, but was greater at 24 months following TKR. Health promotion strategies are needed to encourage greater physical activity participation following joint replacement, and particularly targeting those who undergo THR. 相似文献6.
Charlotte Pauwels Alexandra Roren Adrien Gautier Jonathan Linières François Rannou Serge Poiraudeau Christelle Nguyen 《Annals of physical and rehabilitation medicine》2018,61(3):144-150
Background
Lumbar-flexion-based endurance training, namely cycling, could be effective in reducing pain and improving function and health-related quality of life in older people with chronic low back pain.Objectives
To assess barriers and facilitators to home-based cycling in older patients with lumbar spinal stenosis (LSS).Methods
We conducted a retrospective mixed-method study. Patients ≥ 50 years old followed up for LSS from November 2015 to June 2016 in a French tertiary care center were screened. The intervention consisted of a single supervised session followed by home-based sessions of cycling, with dose (number of sessions and duration, distance and power per session) self-determined by patient preference. The primary outcome was assessed by a qualitative approach using semi-structured interviews at baseline and 3 months and was the identification of barriers and facilitators to the intervention. Secondary outcomes were assessed by a quantitative approach and were adherence monitored by a USB stick connected to the bicycle, burden of treatment assessed by the Exercise Therapy Burden Questionnaire (ETBQ) and clinical efficacy assessed by change in lumbar pain, radicular pain, disability, spine-specific activity limitation and maximum walking distance at 3 months.Results
Overall, 15 patients were included and data for 12 were analyzed at 3 months. At baseline, the mean age was 70.9 years (95% CI: 64.9–76.8) and 9/15 patients (60.0%) were women. Barriers to cycling were fear of pain and fatigue, a too large bicycle, burden of hospital follow-up and lack of time and motivation. Facilitators were clinical improvement, surveillance and ease-of-use of the bicycle. Adherence remained stable overtime. The burden of treatment was low [mean ETBQ score: 21.0 (95% confidence interval: 11.5–30.5)]. At 3 months, 7/12 patients (58.3%) self-reported clinical improvement, with reduced radicular pain and disability [mean absolute differences: ?27.5 (?43.3 to ?11.7), P < 0.01 and ?17.5 (?32.1 to ?2.9), P = 0.01, respectively].Conclusions
For people with LSS, home-based cycling is a feasible intervention. 相似文献7.
Objectives
Chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) is a chronic illness which can cause significant fatigue, pain and disability. Activity pacing is frequently advocated as a beneficial coping strategy, however, it is unclear whether pacing is significantly associated with symptoms in people with CFS/ME. The first aim of this study was therefore to explore the cross-sectional associations between pacing and levels of pain, disability and fatigue. The second aim was to explore whether changes in activity pacing following participation in a symptom management programme were related to changes in clinical outcomes.Design
Cross-sectional study exploring the relationships between pacing, pain, disability and fatigue (n = 114) and pre–post treatment longitudinal study of a cohort of patients participating in a symptom management programme (n = 35).Setting
Out-patient physiotherapy CFS/ME service.Participants
One-hundred and fourteen adult patients with CFS/ME.Main outcome measures
Pacing was assessed using the chronic pain coping inventory. Pain was measured using a Numeric Pain Rating Scale, fatigue with the Chalder Fatigue Scale and disability with the Fibromyalgia Impact Questionnaire.Results
No significant associations were observed between activity pacing and levels of pain, disability or fatigue. Likewise, changes in pacing were not significantly associated with changes in pain, disability or fatigue following treatment.Conclusions
Activity pacing does not appear to be a significant determinant of pain, fatigue or disability in people with CFS/ME when measured with the chronic pain coping index. Consequently, the utility and measurement of pacing require further investigation. 相似文献8.
Naoki Akazawa Kazuhiro Harada Naomi Okawa Kimiyuki Tamura Atsushi Hayase Hideki Moriyama 《Physiotherapy》2018,104(4):438-445
Objective
To examine the relationships between muscle mass, intramuscular adipose and fibrous tissues of the quadriceps, and gait independence in chronic stroke survivors.Design
Cross-sectional study.Setting
Hospital-based research.Participants
Seventeen chronic stroke survivors who were unable to walk independently (non-independent walker group) and 11 chronic stroke survivors who were able to walk independently (independent walker group) participated in this study. In addition, 25 healthy older adults (healthy group) were enrolled.Interventions
None.Main outcome measures
The muscle mass and intramuscular adipose and fibrous tissues of the rectus femoris and vastus intermedius were assessed based on muscle thickness and echo intensity of ultrasound images, respectively.Results
The thicknesses of the rectus femoris and vastus intermedius on the paretic and non-paretic sides in the non-independent walker group were significantly lower than those in the healthy group (mean difference ?0.5 to ?0.2 cm; P < 0.001–0.037). The paretic side in the non-independent walker group had significantly higher rectus femoris and vastus intermedius echo intensity compared with the healthy group (mean difference 15.8–17.4; P = 0.007–0.025). The thickness of the rectus femoris on the non-paretic side was significantly lower in the independent walker group than in the healthy group (mean difference ?0.3 cm; P = 0.001).Conclusions
These results suggest that chronic stroke survivors who are unable to walk independently are likely to experience secondary changes in skeletal muscle on both the paretic and non-paretic sides. 相似文献9.
Objectives
To pilot the methods for a randomized controlled trial (RCT) to investigate whether the treatment effect of Mechanical Diagnosis and Therapy (MDT) is enhanced with the LUMOback.Design
Assessor blinded RCT with 3 and 6-week follow-ups.Setting
An outpatient clinic.Participants
Primary eligibility criteria were: a directional preference of lumbar extension, ≥18 years of age, and non-specific low back pain lasting for ≥1 month.Interventions
The MDT group undertook extension exercises (10 reps/3 hour) and postural correction using a lumbar roll at home. The MDT + LUMOback group also wore the LUMOback daily, providing a vibration alert in a slouched posture.Main outcome measures
The Global Rating of Change Scale (GRCS) (0–6), recruitment rate per month, treatment sessions, compliance rate of wearing the LUMOback, participants’ adherence with treatment, dropout rate and the stage of the MDT program at six weeks.Results
Twenty-two participants were included for 20 months (a recruitment rate of 1.1 patient/month). Dropout rate was 9%. The mean (SD) of the GRCS of the MDT and MDT + LUMOback groups were 4.7 (0.8) and 4.7 (0.5) at the 3-week follow-up and were both 4.9 (0.5) at the 6-week follow-up. The patients undertook a mean of 6.7 sessions for six weeks and exercises with mean of 3.7 set/day in each group. The mean compliance rate of wearing the LUMOback was 88%. Nobody was discharged from the intervention with full recovery within six weeks.Conclusions
Data indicated a promising method for the full RCT, but a rationale for the full RCT was not justified.Clinical Trial Registration number: UMIN000018380. 相似文献
10.
Background
Pain and sedation protocols are suggested to improve the outcomes of patients within paediatric intensive care. However, it is not clear how protocols will influence practice within individual units.Objectives
Evaluate a nurse led pain and sedation protocols impact on pain scoring and analgesic and sedative administration for post-operative cardiac patients within a paediatric intensive care unit.Methods
A retrospective chart review was performed on 100 patients admitted to a tertiary paediatric intensive care unit pre and post introduction of an analgesic and sedative protocol. Stata12 was used to perform Chi-squared or Student’s t-test to compare data between the groups.Results
Post protocol introduction documentation of pain assessments increased (pre protocol 3/24 h vs post protocol 5/24 h, p = 0.006). Along with a reduction in administration of midazolam (57.6 mcg/kg/min pre protocol vs 24.5 mcg/kg/min post protocol, p = 0.0001). Children’s pain scores remained unchanged despite this change, with a trend towards more scores in the optimal range in the post protocol group (5 pre protocol vs 12 post protocol, p = 0.06).Conclusions
Introducing a pain and sedation protocol changed bedside nurse practice in pain and sedation management. The protocol has enabled nurses to provide pain and sedation management in a consistent and timely manner and reduced the dose of midazolam required to maintain comfort according to the patients COMFORT B scores. Individual evaluation of practice change is recommended to units who implement nurse led analgesic and sedative protocols to monitor changes in practice. 相似文献11.
Katherinne Ferro Moura Franco Yuri Rafael dos Santos Franco Naiane Teixeira Bastos de Oliveira Rosimeire Simprini Padula Cristina Maria Nunes Cabral 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(6):512-518
Background
The progression through the difficulty levels of Pilates exercises is a subjective criterion, that depends on the therapist's experience and ability to identify the best moment to progress to the next level.Objective
To identify the factors that interfere in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain.Methods
Data from 139 patients with chronic nonspecific low back pain from a randomized controlled trial were used for statistical analysis using binary logistic regression. The dependent variable was the progression through the difficulty levels, and the independent variables were age, gender, educational level, low back pain duration, pain intensity, general disability, kinesiophobia, previous physical activity, and number of absences.Results
The factors that interfered in the progression through the difficulty levels were previous physical inactivity (odds ratio [OR] = 5.14, 95% confidence interval [CI]: 1.53–17.31), low educational level (OR = 2.62, 95% CI: 1.12–6.10), more advanced age (OR = 0.95, 95% CI: 0.92–0.98) and more absences (OR = 0.63, 95% CI: 0.50–0.79). These variables explain 41% of the non-progression through the difficulty level of the exercises.Conclusion
Physical inactivity, low educational level, more advanced age and greater number of absences can be interfering factors in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain. 相似文献12.
Objectives
To investigate how a virtual cultural simulation experience and guided reflection influenced physiotherapy students’ intrapersonal and interpersonal cultural empathy, and to explore students’ satisfaction with the learning experience.Design
Three research arms within a single cohort: 1) pre-test post-test investigation of intrapersonal cultural empathy; 2) quasi-experimental investigation of interpersonal cultural empathy; 3) post-test measurement of satisfaction.Setting
An Australian university.Participants
Bachelor and Master physiotherapy students, response rate 98% (162/165).Interventions
A self-directed online virtual simulation in which the student assumed the role of a patient who has been hospitalised in a developing country. Students were then guided to reflect on the experience via online questions.Main outcome measures
The primary measure was the Comprehensive State Empathy Scale (CSES) of intrapersonal cultural empathy. Secondary measures were the Theory of Planned Behaviour:Cultural Competence Questionnaire (TPB:CCQ) of interpersonal cultural empathy; and the Satisfaction with Cultural Simulation Experience Scale (SCSES).Results
Intrapersonal cultural empathy improved after the virtual simulation, shown in overall CSES scores [pre-test: 95 (81–109) vs post-test: 106 (89–117); median difference 11; P = <0.001]. For the TPB:CCQ, the post-simulation (‘intervention’) group demonstrated greater ‘Perceived Behavioural Control’ interpersonal empathy compared to the presimulation (‘control’) group [4.41 (0.54) vs 4.59 (0.53); mean difference = 0.19; 95% confidence interval = 0.01 to 0.36; P = 0.020]. Satisfaction with the experience was high (mean SCSES score = 40/56 (71%)).Conclusions
A virtual cultural simulation experience and guided reflection led to significant increases in students’ intrapersonal cultural empathy, with some influence on interpersonal cultural empathy. Students were highly satisfied with this learning experience. 相似文献13.
J. Broderick C. Mc Grath K. Cullen D. Talbot J. Gilmor M. Baily-Scanlan T. O’Dwyer 《Physiotherapy》2018,104(2):248-250
Objectives
To explore the influence of obesity on outcomes of exercise capacity and disease impact in patients with chronic obstructive pulmonary disease (COPD) in response to pulmonary rehabilitation (PR) and to compare outcomes to those of normal weight and overweight counterparts.Design
Secondary data analysis of clinical database.Setting
St. James’s Hospital, Dublin, Ireland.Participants
155 participants with a primary diagnosis of COPD who completed a PR programme between 2012 and 2014.Main Outcome Measures
Exercise capacity evaluated using the Six Minute Walk Test (6MWT) and the COPD Assessment Test (CAT) evaluated disease impact.Results
Walking distance in the 6MWT improved significantly [mean difference of 55 m (95% CI: 42 to 68; p < 0.001)] and similarly [F(2, 92) = 1.434, p = 0.24] across all BMI categories, although the level of improvement reached clinical significance in the normal/underweight and overweight categories only. Disease impact on the CAT score improved across all body mass index (BMI) classifications by 2.3 points (95% CI: 0.9 to 3.6; p < 0.050) which reached clinical significance and did not vary across BMI categories [F(2, 80) = 0.534, p = 0.58].Conclusion
Exercise capacity and self-report disease impact of individuals with COPD improved similarly in response to PR irrespective of BMI. 相似文献14.
Ardalan Shariat Joshua A. Cleland Mahmoud Danaee Mehdi Kargarfard Bahram Sangelaji Shamsul Bahri Mohd Tamrin 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(2):144-153
Objective
To evaluate the effectiveness of exercise, ergonomic modification, and a combination of training exercise and ergonomic modification on the scores of pain in office workers with neck, shoulders, and lower back pain.Methods
Participants (N = 142) in this randomized controlled trial were office workers aged 20–50 years old with neck, shoulders, and lower back pain. They were randomly assigned to either the ergonomic modification group, the exercise group, the combined exercise and ergonomic modification group, or the control group (no-treatment). The exercise training group performed a series of stretching exercises, while the ergonomic group received some modification in the working place. Outcome measures were assessed by the Cornell Musculoskeletal Disorders Questionnaire at baseline, after 2, 4, and 6 months of intervention.Results
There was significant differences in pain scores for neck (MD ?10.55; 95%CI ?14.36 to ?6.74), right shoulder (MD ?12.17; 95%CI ?16.87 to ?7.47), left shoulder (MD ?11.1; 95%CI ?15.1 to ?7.09) and lower back (MD ?7.8; 95%CI ?11.08 to ?4.53) between the exercise and control groups. Also, significant differences were seen in pain scores for neck (MD ?9.99; 95%CI ?13.63 to ?6.36), right shoulder (MD ?11.12; 95%CI ?15.59 to ?6.65), left shoulder (MD ?10.67; 95%CI ?14.49 to ?6.85) and lower back (MD ?6.87; 95%CI ?10 to ?3.74) between the combined exercise and ergonomic modification and control groups. The significant improvement from month 4 to 6, was only seen in exercise group (p < 0.05).Conclusion
To have a long term effective on MSDs, physical therapists and occupational therapists should use stretching exercises in their treatment programs rather than solely rely on ergonomic modification.15.
Valdecira Rodrigues de Jesus Pricila Mara Novais de Oliveira Vivian Mara Gonçalves de Oliveira Azevedo 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(4):304-309
Background
The hammock positioning within the incubators simulates the intrauterine environment, however, there is little evidence of its benefits and possible risks.Objectives
The aim of this study was to assess the effects of hammock positioning on behavioral status, vital signs, and pain in very low birth weight preterm newborns.Methods
This is a quasi-experimental/case series study in which premature infants (<1500 g) were positioned in supine for one hour in a hammock. The preterm newborns were assessed 10 min before, during (2, 20, 40, and 60 min), and 10 min after hammock positioning with the Brazelton Neonatal Behavioral Assessment Scale, vital signs and pain by the Neonatal Facial Coding System.Results
28 preterm infants between 28 and 36 weeks of gestational age were evaluated. Regarding the behavioral state, the preterm newborns progressively evolved to light or deep sleep during hammock positioning. There was a statistically significant reduction of the heart and respiratory rate from 2 to 60th minute in a hammock, which was maintained after the positioning. The oxygen saturation remained within normal values. No changes in pain scores were observed.Conclusion
The hammock positioning can be considered a safe method of positioning that can be used to reduce the stress levels in very low birth weight preterm newborns. We did not observe worsening in either pain or vital signs. 相似文献16.
Objective
To investigate the prognostic importance of a number of sensorimotor and psychological factors for global perceived effect (GPE) after physiotherapy in patients with neck pain. In addition to baseline values, change scores were used as independent variables to identify treatment-modifiable factors.Design
Clinical cohort study.Setting
Primary and secondary healthcare physiotherapy clinics.Participants
Patients (n = 70) with non-specific neck pain.Intervention
Usual care physiotherapy.Methods
A three-dimensional motion tracking system was used to measure neck motion and sensorimotor variables, in addition to self-reported outcomes covering personal, somatic and psychological factors at baseline (before treatment) and at 2 months. Logistic regression was used to analyse associations between the prognostic variables and the primary outcome (GPE) at 2 months.Results
At baseline, neck motion and motor control, pain duration and functioning were the strongest predictors for GPE, with no effect of psychological factors. Among the change variables, reduced pain intensity [odds ratio (OR) 1.86; 95% confidence interval (CI) 1.31 to 2.62], increased functioning (OR 1.46; 95% CI 1.11 to 1.92), reduced disability (OR 1.12; 95% CI 1.05 to 1.20), reduced kinesiophobia (OR 1.21; 95% CI 1.07 to 1.37), reduced catastrophising (OR 1.09; 95% CI 1.09 to 1.18) and increased self-efficacy (OR 1.12; 95% CI 1.03 to 1.21) were significantly associated with GPE.Conclusions
Both baseline values and change in pain intensity and functioning predicted GPE at 2 months. Psychological factors such as kinesiophobia, catastrophising and self-efficacy were only able to predict outcome by their change scores, indicating that these factors are modifiable by common physiotherapy practice and are important for GPE. 相似文献17.
Background
The unipedal balance test (UBT) is widely used with older adults, but interpreting performance on the test requires the availability of normative values.Objective
To use meta-analysis to provide normative values for the UBT for adults ≥ 60 years.Data sources
Electronic searches of PubMed, CINAHL, and Scopus as well as hand searches.Study selection
Inclusion required that articles provided means and standard deviations for UBT time for strata including at least 30 participants without pathology.Study appraisal and synthesis
The two authors independently abstracted information on UBT procedures and performance. The Comprehensive Meta Analysis (3.0) program (random effects model) was used to consolidate UBT data from 23 articles. A custom six component (14 point) checklist was used to rate article quality.Results
Meta-analysis showed the mean UBT time for 13,454 tested individuals to be 26.9 seconds. Times were longer for individuals who were younger, male, and allowed longer test durations (e.g. ≥ 120 seconds vs 30 seconds).Limitations
Although the UBT norms presented herein provide a better estimate of normal performance than individual studies, differences between studies in age and gender strata and test durations limit the generalizability of some of the normative values generated using meta-analysis. 相似文献18.
Fereshteh Pourkazemi Claire E. Hiller Jacqueline Raymond Deborah Black Elizabeth J. Nightingale Kathryn M. Refshauge 《Physiotherapy》2018,104(4):430-437
Objective
To explore and identify the predictors of ankle sprain after an index (first) lateral ankle sprain.Design
Prospective cohort study, Level of evidence II.Setting
Musculoskeletal research laboratory at the University of Sydney.Participants
A sample of convenience (70 controls, 30 with an index sprain) was recruited.Methods
Potential predictors of ankle sprain were measured including: demographic measures, perceived ankle instability, ankle joint ligamentous laxity, passive range of ankle motion, balance, proprioception, motor planning and control, and inversion/eversion peak power. Participants were followed up monthly and the number of ankle sprains was recorded over 12 months.Results
Ninety-six participants completed the study; 10 participants sustained an ankle sprain. A combination of 10 predictors including: a recent index sprain, younger age, greater height and weight, perceived instability, increased laxity, impaired balance, and greater inversion/eversion peak power explained 27 to 56% of the variance in occurrence of ankle sprain (χ211,95 = 30.67, p = 0.001). The regression model correctly classified 90% of cases. The strongest independent predictors were history of an index sprain (odds ratio (OR) = 8.23, 95% confidence interval (CI) = 1.66 to 40.72) and younger age (OR = 8.41, 95%CI = 1.48 to 47.96).Conclusion
A recent index ankle sprain and younger age were the only independent predictors of ankle sprain. The combination of greater height or weight, feeling of instability, peak power and impaired balance predicted the occurrence of ankle sprain in almost 90% of participants. These findings could form the basis for intervention targeted at reducing recurrence of sprain after an index sprain. 相似文献19.
Swati Jha Stephen J. Walters Oscar Bortolami Simon Dixon Abualbishr Alshreef 《Physiotherapy》2018,104(1):91-97
Aims
To evaluate the clinical and cost-effectiveness of electric stimulation plus standard pelvic floor muscle training compared to standard pelvic floor muscle training alone in women with urinary incontinence and sexual dysfunction.Methods
Single centre two arm parallel group randomised controlled trial conducted in a Teaching hospital in England. Participants were women presenting with urinary incontinence and sexual dysfunction. The interventions compared were electric stimulation versus standard pelvic floor muscle training.Outcome measures
included Prolapse and Incontinence Sexual function Questionnaire (PISQ) physical function dimension at post-treatment (primary); other dimensions of PISQ, SF-36; EQ-5D, EPAQ, resource use, adverse events and cost-effectiveness (secondary outcomes).Results
114 women were randomised (Intervention n = 57; Control group n = 57). 64/114 (56%).Participants
had valid primary outcome data at follow-up (Intervention 30; Control 34). The mean PISQ-PF dimension scores at follow-up were 33.1 (SD 5.5) and 32.3 (SD 5.2) for the Intervention and Control groups respectively; with the Control group having a higher (better) score. After adjusting for baseline score, BMI, menopausal status, time from randomisation and baseline oxford scale score the mean difference was ?1.0 (95% CI: ?4.0 to 1.9; P = 0.474).There was no differences between the groups in any of the secondary outcomes at follow-up. Within this study, the use of electrical stimulation was cost-effective with very small incremental costs and quality adjusted life years (QALYs).Conclusions
In women presenting with urinary incontinence in conjunction with sexual dysfunction, physiotherapy is beneficial to improve overall sexual function. However no specific form of physiotherapy is beneficial over another.Trial registration ISRCTN09586238. 相似文献20.
Jeong-Oh Yoon Min-Hyeok Kang Jun-Seok Kim Jae-Seop Oh 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(2):161-167