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1.
Stephen May Ken Chance-Larsen Chris Littlewood Dave Lomas Mahmoud Saad 《Physiotherapy》2010,96(3):179-613
Background
Shoulder pain is a common clinical problem, and numerous tests are used to diagnose structural pathology.Objectives
To systematically review the reliability of physical examination procedures used in the clinical examination of patients with shoulder pain.Data sources
MEDLINE, PEDro, AMED, PsychInfo, Cochrane Library (2009) and CINAHL were searched from the earliest record on the database to June 2009.Study eligibility criteria
Reliability studies that included any patients with shoulder pain were analysed for their quality and reliability results.Study appraisal and synthesis methods
Pre-established criteria were used to judge the quality of the studies (high quality >60% methods score) and satisfactory levels of reliability (kappa or intraclass correlation coefficient ≥0.85, sensitivity analysis 0.70). A qualitative synthesis was performed based on levels of evidence.Results
Thirty-six studies were included with a mean methods score of 57%. Seventeen studies were deemed to be of high quality; high-quality studies were less likely to meet the pre-agreed level of reliability. The majority of studies indicated poor reliability for all procedures investigated.Limitations
Overall, the evidence regarding reliability was contradictory.Conclusions and implications
There is no consistent evidence that any examination procedure used in shoulder assessments has acceptable levels of reliability. Alternate methods of classification which are reliable should be used to classify patients with shoulder problems. 相似文献2.
Marla K. Beauchamp Sachi O'Hoski Roger S. Goldstein Dina Brooks 《Archives of physical medicine and rehabilitation》2010,91(9):1460-1465
Beauchamp MK, O'Hoski S, Goldstein RS, Brooks D. Effect of pulmonary rehabilitation on balance in persons with chronic obstructive pulmonary disease.
Objectives
To describe within-subject effects of pulmonary rehabilitation (PR) on balance in persons with chronic obstructive pulmonary disease (COPD) and to determine whether any observed changes in balance were associated with change in exercise tolerance or health-related quality of life.Design
Single-arm longitudinal study.Setting
Inpatient PR center.Participants
Subjects with COPD (N=29; mean ± SD age, 69.8±10.3y; forced expiratory volume in 1 second, 46.3%±22.3% predicted; 59% men [n=17]).Interventions
A standardized 6-week multidisciplinary PR program (exercise training, breathing exercises, education, and psychologic support).Main Outcome Measures
Balance was assessed using the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and the Activities-Specific Balance Confidence (ABC) scale. Exercise tolerance was determined from the 6-minute walk test (6MWT), and health-related quality of life from the Chronic Respiratory Questionnaire (CRQ).Results
Subjects showed small improvements in BBS (2.8±2.8 points; P<.001) and TUG (−1.5±2.4s; P=.003) scores, but not in ABC scores (4.8±15.4 points; P>.05). There was a weak relationship between change in BBS and change in CRQ scores (r=.40; P=.045) and no relationship with change in 6MWT.Conclusions
PR contributed to minor improvements in balance and had no effect on balance confidence in subjects with COPD. Further work is warranted to determine the optimal intervention for improving balance in this population. 相似文献3.
Won Hyuk Chang Sang Hee Im Jeong Ah Ryu Sang Chul Lee Ji Sung Kim 《Archives of physical medicine and rehabilitation》2009,90(2):279-284
Chang WH, Im SH, Ryu JA, Lee SC, Kim JS. The effects of scapulothoracic bursa injections in patients with scapular pain: a pilot study.
Objective
To assess the effects of steroid plus hyaluronate injections for scapulothoracic bursitis in patients with scapular pain.Design
Prospective open-label unicenter trial with a 3-month follow-up.Setting
University rehabilitation hospital.Participants
Twenty-two cases of suspected scapulothoracic bursitis.Intervention
Injections into scapulothoracic bursa were performed with steroid plus hyaluronate. Injections were administered once a week for 3 weeks.Main Outcome Measures
Visual analog scale (VAS), Rubin scale, adverse events, and injection-associated complications.Results
Mean outcome scores at 3-month follow-up visits showed significant improvements versus baseline (mean VAS increased from 7.8 to 2.2) (P<.05). Furthermore, mean VAS scores at 1, 2, and 3 weeks after treatment commencement showed significant improvements versus baseline (P<.05). No serious complication occurred during the study.Conclusions
Scapulothoracic bursitis should be considered when treating patients with perimarginal scapular pain or subscapular pain. Our findings show that steroid plus hyaluronate injections into the scapulothoracic bursa provide an effective means of treating patients with scapulothoracic bursitis. 相似文献4.
Thierry Lelard Pierre-Louis Doutrellot Pascal David Said Ahmaidi 《Archives of physical medicine and rehabilitation》2010,91(1):9-14
Lelard T, Doutrellot P-L, David P, Ahmaidi S. Effects of a 12-week Tai Chi Chuan program versus a balance training program on postural control and walking ability in older people.
Objective
To compare the respective effects of 2 balance training programs: a Tai Chi (TC) program and a balance training program on static postural control and walking ability.Design
Randomized controlled trial.Setting
General community.Participants
Older subjects (N=28) participated in the study.Interventions
The TC group (n=14; mean age ± SD, 76.8±5.1y) and the balance training group (n=14; 77.0±4.5y) were both trained for 12 weeks.Main Outcome Measures
Static postural control was assessed via measurement of center of pressure sway under eyes open (EO) and eyes closed (EC) conditions. Walking speed over a 10-meter course was also assessed.Results
After the 12-week training period, there were no significant differences in walking speed or postural parameters in either the EO or EC conditions for the TC and balance training groups. Performance in the EC condition was lower than in the EO condition in pretest and posttest for the balance training and TC groups. The Romberg quotient (EO/EC ratio) was significantly higher after the balance training program than the TC program (P<.05).Conclusions
We cannot conclude that the balance training program has better effects than the TC program on postural control or walking ability. None of the outcome measures showed significant change posttraining in either the TC or the balance training groups. However, the differences described in the Romberg quotient after the training period between the TC and the balance training groups suggest that TC should be helpful to limit the deleterious effects of eye closure on postural balance. 相似文献5.
Svetlana Knorr Brenda Brouwer S. Jayne Garland 《Archives of physical medicine and rehabilitation》2010,91(6):890-896
Knorr S, Brouwer B, Garland SJ. Validity of the Community Balance and Mobility Scale in community-dwelling persons after stroke.
Objectives
To examine the convergent validity, sensitivity to change, floor and ceiling effects of the Community Balance and Mobility Scale (CB&M) in community-dwelling stroke survivors. The secondary objective was to determine the correlations between the CB&M and lower-limb motor recovery and strength.Design
Validity study.Setting
Two university-based research centers.Participants
Community-dwelling persons after stroke (N=44; 24 men, 20 women; mean age, 62.6±12.6y). Baseline measures were taken 3 months after the onset of stroke (98.6±52.6d); participants were reassessed 8 months poststroke (246.8±57.2d).Interventions
Not applicable.Main Outcome Measures
CB&M, Berg Balance Scale (BBS), Timed Up & Go (TUG), Chedoke McMaster Stroke Assessment (CMSA) Impairment Inventory for leg and foot, concentric bilateral isokinetic strength of the lower-limb flexor and extensor muscle groups using a dynamometer. The magnitude of the associations and the standardized response means (SRMs) among the CB&M, BBS, and TUG were used to examine the convergent validity and sensitivity to change, respectively.Results
Moderate to high convergent validities (ρ=.70 to .83, P<.001) were observed among the CB&M, BBS, and TUG. The CB&M was moderately correlated with the CMSA leg and foot scores (ρ=.61 and .63, respectively, P<.001) and the paretic limb strength (ρ=.67, P<.001). The CB&M demonstrated the greatest ability to detect change between the baseline and follow-up assessments (SRM=.83).Conclusions
The CB&M is valid and sensitive to change in assessing functional balance and mobility in ambulatory stroke survivors with moderate to mild neurologic impairments. 相似文献6.
Jennifer M. Srygley Talia Herman Nir Giladi Jeffrey M. Hausdorff 《Archives of physical medicine and rehabilitation》2009,90(5):786-792
Srygley JM, Herman T, Giladi N, Hausdorff JM. Self-report of missteps in older adults: a valid proxy of fall risk?
Objective
To evaluate the relationship between missteps and falls and to identify factors associated with missteps, potentially to generate a broader picture of fall risk.Design
Prospective, observational cohort.Setting
General community.Participants
A sample of healthy, community-living older adults (N=266; age, 70-90y) who were cognitively intact and walked independently.Interventions
Not applicable.Main Outcome Measures
Baseline testing of gait, motor function, cognitive function, affect, and balance confidence was followed by a 12-month period in which subjects completed a daily log documenting the number of falls and missteps (defined as a trip, slip, or other loss of balance in which recovery occurred to prevent a fall).Results
Mean ± SD participant age was 76.4±4.3 years. Of all the participants, 20.7% reported at least 1 misstep, and 25.6% of the participants reported at least 1 fall during the 12 months. Among subjects who had multiple falls, missteps were more common than falls by a ratio of 3:1 (P<.001). Subjects who reported multiple missteps were more likely to fall prospectively (relative risk=3.89). Missteps were associated with higher scores on the Geriatric Depression Scale (P=.009) and increased anxiety (P=.014), but were not associated with other known risk factors for falls, including gait and cognitive function.Conclusions
The self-report of missteps may be a valuable tool in the research of falls and fall risk and may provide a way to identify patients at risk for falls before they fall. 相似文献7.
8.
Morten T. Kristensen Charlotte Ekdahl Henrik Kehlet Thomas Bandholm 《Archives of physical medicine and rehabilitation》2010,91(6):885-889
Kristensen MT, Ekdahl C, Kehlet H, Bandholm T. How many trials are needed to achieve performance stability of the Timed Up & Go test in patients with hip fracture?
Objective
To examine the number of trials needed to achieve performance stability of the Timed Up & Go (TUG) test using a standardized walking aid in patients with hip fracture who are allowed full weight bearing (FWB).Design
Prospective methodologic study.Setting
An acute 14-bed orthopedic hip fracture unit.Participants
Patients (N=122; 89 women, 33 men) with hip fracture with a median age (25%-75%, quartiles) of 80 (67-85) years performed the TUG on hospital discharge to their own home (n=115) or further inpatient rehabilitation (n=7).Interventions
Not applicable.Main Outcome Measures
After a demonstration by a physical therapist how to perform the TUG with a standardized walking aid (a 4-wheeled rollator), the patients performed 6 timed TUG trials with up to 1-minute seated rest intervals. The participants were given a few minutes to familiarize with the rollator before commencing the timed trials. Repeated-measures analysis of variance (ANOVA) with Bonferroni corrections were used to examine the number of trials needed to ensure statistically stable TUG scores.Results
A total of 106 (87%) patients performed all 6 TUG trials, while 120 patients performed a minimum of 3 timed trials. Repeated-measures ANOVAs of both groups showed that TUG scores improved significantly (P≤.007) up to and including the third TUG trial.Conclusions
These results suggest that the original TUG manual, described as 1 practice trial followed by 1 timed trial, needs modification when used in patients with hip fracture who are allowed FWB. The best (fastest) of 3 timed TUG trials performed with a standardized walking aid is recommended. 相似文献9.
Helene L. Soberg Erik Bautz-Holter Olav Roise Arnstein Finset 《Archives of physical medicine and rehabilitation》2010,91(3):481-488
Soberg HL, Bautz-Holter E, Roise O, Finset A. Mental health and posttraumatic stress symptoms 2 years after severe multiple trauma: self-reported disability and psychosocial functioning.
Objectives
To describe mental health and posttraumatic stress symptoms (PTSS) for patients with severe multiple trauma at 2 years postinjury. Further, objectives were to examine relationships between PTSS and factors related to the person, injury, and postinjury physical and psychosocial functioning from the time of return home to 2 years after injury. The final aim was to identify predictors of PTSS and mental health at 2 years.Design
Prospective cohort study with a 2-year follow-up.Setting
Hospital and community setting.Participants
Patients (N=99) age 18 to 67 years with multiple trauma and a New Injury Severity Score (NISS) greater than 15 treated at a regional trauma referral center. Mean age ± SD was 35.3±14.2 years; 83% were men. Mean NISS ± SD was 34.9±12.7.Intervention
Not applicable.Main Outcome Measures
Postinjury psychologic distress associated with depression on the Medical Outcomes Study 36-Item Short-Form Health Survey Mental Health scale and PTSS on the Post-Traumatic Symptom Scale 10 (PTSS-10) at 2 years post injury. Self-reported physical, mental, and cognitive functioning at the return home and 1 and 2 years, and coping strategies.Results
Mean PTSS-10 score ± SD at 2 years was 25.6±12.2. Twenty percent had a PTSS-High score, indicating posttraumatic stress disorder (PTSD). Twenty-seven percent had Mental Health scores indicating depression. Predictors of PTSS were sex (female), younger age, avoidant coping, pain, mental health, and cognitive functioning on the return home, which explained 70% of the variance in PTSS-10 score.Conclusions
Twenty percent had a PTSS-High score indicating PTSD at 2 years postinjury. The personal factors sex (female), younger age, and avoidant coping and the functional factors pain, mental health, and cognitive functioning predicted PTSS at 2 years. 相似文献10.
Chen KM Chen MH Chao HC Hung HM Lin HS Li CH 《International journal of nursing studies》2009,46(2):154-163
Background
Sleep disturbances, depression, and low perception of health status are commonly seen in elderly population; however, clinicians tend to underestimate or overlook the presence of these symptoms and assume them to be a part of normal aging. Non-pharmacological methods that promote a mind-body interaction should be tested to enhance the mental health of older adults.Objective
To test the effects of 6 months of silver yoga exercises in promoting the mental health of older adults in senior activity centers, especially their sleep quality, depression, and self-perception of health status.Design
Cluster randomized trial.Settings
Eight senior activity centers, southern Taiwan.Participants
A sample of 139 participants was recruited, and 128 of them completed the study. Inclusion criteria: (1) community-dwelling older adults ages 60 and over, (2) no previous training in yoga, (3) able to walk without assistance, (4) cognitively alert based on the Short Portable Mental Status Questionnaire (SPMSQ) score of eight or higher, and (5) independent or mildly dependent in self-care based on a Barthel Index (BI) score of 91 or higher. The mean age of the participants was 69.20 ± 6.23 years, and the average number of chronic illness was 0.83 ± 0.90. The average BI score of the participants was 99.92 ± 0.62, and the mean SPMSQ score was 9.90 ± 0.30.Methods
Participants were randomly assigned into either the experimental (n = 62) or the control (n = 66) group based on attendance at selected senior activity centers. A 70-min silver yoga exercise program was implemented three times per week for 6 months as the intervention for the participants in the experimental group.Results
Most of the mental health indicators of the participants in the experimental group had significantly improved after the silver yoga interventions, and many of the indicators improved after 3 months of intervention and were maintained throughout the 6 months study. The mental health indicators of the participants in the experimental group were all better than the participants in the control group (all p < .05).Conclusions
After 6 months of silver yoga exercises, the sleep quality, depression, and health status of older adults were all improved. 相似文献11.
Objectives
To identify the extent to which an adapted pain management programme is successful in modifying pain beliefs, psychological distress, locus of control and self-efficacy using both qualitative and quantitative approaches.Design
Prospective, observational study with questionnaires at baseline and following completion of a pain management programme.Setting
Outpatient pain management programme in a district general hospital.Participants
Fifteen participants experiencing chronic pain, referred from pain and rheumatology clinics within the hospital.Outcome measures
Pain beliefs, self-efficacy, locus of control and psychological distress.Results
Wilcoxon signed ranks tests demonstrated significant improvements in pain beliefs, self-efficacy and psychological distress. However, changes in locus of control were not found to be significant. The qualitative data supported these findings.Conclusions
The pilot study suggested that the pain management programme successfully modified three out of four of the psychosocial risk factors (Yellow Flags) in a population with established pain and disability. A larger scale project replicating this pilot study including a comparison group, and further research to assess the extent to which modifying Yellow Flags generalises to affect quality of life and disability, are underway. 相似文献12.
Gagnon C Mathieu J Jean S Laberge L Perron M Veillette S Richer L Noreau L 《Archives of physical medicine and rehabilitation》2008,89(7):1246-1255
Gagnon C, Mathieu J, Jean S, Laberge L, Perron M, Veillette S, Richer L, Noreau L. Predictors of disrupted social participation in myotonic dystrophy type 1.
Objective
To identify personal and environmental predictors of the most disrupted participation domains in people with myotonic dystrophy type 1 (DM1).Design
Cross-sectional study.Setting
Outpatient neuromuscular clinic.Participants
Adults (n=200; 121 women), age 18 years or older (mean age, 47y), with a confirmed diagnosis of DM1 were selected from the registry of a neuromuscular clinic (N=416). Fifty-two participants had the mild phenotype and 148 the adult phenotype.Interventions
Not applicable.Main Outcome Measures
Social participation in mobility, housing, employment, and recreation was assessed with the Life Habits Measure. Disrupted participation was based on whether help was needed in performing most life habits because of incapacities or environmental barriers. Environmental factors were assessed by using the Measure of the Quality of the Environment. Personal factors were assessed with standardized instruments including the Berg Balance Scale, the Krupp Fatigue Severity Scale, and manual muscle testing.Results
A large proportion of participants (45%-61%) reported disrupted participation in all 4 domains. Lower-extremity strength (odd ratios [OR], 15.0-5.5; P<.050) and higher fatigue (OR, 6.0-2.6; P<.05) were present in participants with disrupted participation. With regard to environmental factors, family support (OR, 3.6-2.5; P<.05) and public services (OR, 2.8-2.2; P<.05) were perceived as barriers for participants with disrupted participation in most domains.Conclusions
This study identified personal and environmental factors that may influence the trajectory toward disrupted participation in individuals with DM1. Fatigue, strength, family support, and public services were found to be independent predictors of disrupted participation. 相似文献13.
Ortqvist M Gutierrez-Farewik EM Farewik M Jansson A Bartonek A Broström E 《Archives of physical medicine and rehabilitation》2007,88(9):1164-1170
Örtqvist M, Gutierrez-Farewik EM, Farewik M, Jansson A, Bartonek Å, Broström E. Reliability of a new instrument for measuring plantarflexor muscle strength.
Objectives
To test the reliability of a new muscle strength testing instrument (the Strength Measuring Chair [SMC]) designed to quantify isometric strength in the lower extremities, and to determine the agreement between the SMC and an isokinetic dynamometer (Biodex).Design
Isometric strength tests were performed in plantarflexors with 2 different knee positions (60°, 30°). Measurements were taken at 3 different sessions.Setting
Strength testing laboratory.Participants
Twenty-three able-bodied adults and 15 able-bodied children.Interventions
Not applicable.Main Outcome Measure
Isometric plantarflexor strength.Results
The reliability of isometric strength measurements of plantarflexors taken in the SMC was excellent for both the adult and children groups (intraclass correlation coefficient range, .84−.87). A Bland-Altman 95% limit of agreement test showed no systematic variation in 3 of the 4 SMC test observations; systematic variation was only observed in the adult group at a knee position of 30°. There was no systematic difference in the adult group between the SMC and the isokinetic dynamometer, but there was a systematic variation in the children’s group.Conclusions
The SMC reliably measured isometric plantarflexor strength in the tested populations. 相似文献14.
Altman IM Swick S Parrot D Malec JF 《Archives of physical medicine and rehabilitation》2010,91(11):1697-1704
Altman IM, Swick S, Parrot D, Malec JF. Effectiveness of community-based rehabilitation after traumatic brain injury for 489 program completers compared with those precipitously discharged.
Objective
To evaluate outcomes of home- and community-based postacute brain injury rehabilitation (PABIR).Design
Retrospective analysis of program evaluation data for treatment completers and noncompleters.Setting
Home- and community-based PABIR conducted in 7 geographically distinct U.S. cities.Participants
Patients (N=489) with traumatic brain injury who completed the prescribed course of rehabilitation (completed-course-of-treatment [CCT] group) compared with 114 who were discharged precipitously before program completion (precipitous-discharge [PD] group).Intervention
PABIR delivered in home and community settings by certified professional staff on an individualized basis.Main Outcome Measures
Mayo-Portland Adaptability Inventory (MPAI-4) completed by means of professional consensus on admission and at discharge; MPAI-4 Participation Index at 3- and 12-month follow-up through telephone contact.Results
Analysis of covariance (CCT vs PD group as between-subjects variable, admission MPAI-4 score as covariate) showed significant differences between groups at discharge on the full MPAI-4 (F=82.25; P<.001), Ability Index (F=50.24; P<.001), Adjustment Index (F=81.20; P<.001), and Participation Index (F=59.48; P<.001). A large portion of the sample was lost to follow-up; however, available data showed that group differences remained statistically significant at follow-up.Conclusions
Results provided evidence of the effectiveness of home- and community-based PABIR and that treatment effects were maintained at follow-up. 相似文献15.
Susan B. Williams Caroline A. Brand Keith D. Hill Susan B. Hunt Helen Moran 《Archives of physical medicine and rehabilitation》2010,91(1):106-114
Williams SB, Brand CA, Hill KD, Hunt SB, Moran H. Feasibility and outcomes of a home-based exercise program on improving balance and gait stability in women with lower-limb osteoarthritis or rheumatoid arthritis: a pilot study.
Objective
To evaluate the feasibility and gait stability and balance outcomes of a 4-month individualized home exercise program for women with arthritis.Design
Pre-post interventional study.Setting
General community.Participants
Women (N=49) (volunteers) with lower-limb osteoarthritis or lower-limb rheumatoid arthritis were enrolled. Only 39 subjects were eligible and completed the study.Intervention
After completion of the initial assessment, all participants received home balance exercises from an experienced physiotherapist based on assessment findings and exercises available from commercially available kits. All measures were repeated 4 months later.Main Outcome Measures
Falls risk (Falls Risk of Older People—Community Setting) and balance measures.Results
Thirty-nine women (mean age, 69.3y; 95% confidence interval, 65.7-72.9) completed the 4-month program. At baseline, 64% of participants reported falling in the preceding 12 months, and the average falls risk (Falls Risk of Older People—Community Setting) score was 14.5, with 42% rated as moderate risk (16-23). Participants achieved improved performance on most balance and related measures after the exercise program, including falls risk (P=.01), activity levels (P=.015), fear of falling (P=.022), functional reach test (P=.001), rising index for sit to stand (P=.001), step width in walking (P=.001), and body mass index (P=.006).Conclusions
An individualized balance training home exercise program is feasible for older women with osteoarthritis or rheumatoid arthritis and may improve stability during walking and other functional activities. 相似文献16.
Cory L. Christiansen Jennifer E. Stevens-Lapsley PT PhD 《Archives of physical medicine and rehabilitation》2010,91(10):1524-1528
Christiansen CL, Stevens-Lapsley JE. Weight-bearing asymmetry in relation to measures of impairment and functional mobility for people with knee osteoarthritis.
Objectives
To compare weight-bearing asymmetry (WBA) for people with unilateral knee osteoarthritis (OA) with that for healthy adults of similar age. In addition, associations between WBA and clinical measures of knee impairment and functional mobility were evaluated.Design
Cross-sectional design with age-matched control (CTL) group.Setting
Clinical research laboratory.Participants
People with end-stage unilateral knee OA (n=50) (OA group) and healthy people (n=17) (CTL group) were enrolled in the study (N=67).Interventions
Not applicable.Main Outcome Measures
WBA during a Five Times Sit-to-Stand Test (FTSST) based on average vertical ground reaction force under each foot, self-reported knee pain assessed using a Numerical Pain Rating Scale, knee extensor strength asymmetry based on peak isometric knee extension torque, knee motion asymmetry based on maximum passive knee extension and flexion angles, FTSST time, six-minute walk test distance, and Stair Climbing Test time.Results
The OA group demonstrated greater WBA than the CTL group during transitions between sitting and standing as measured by an absolute symmetry index (P=.015). No correlation was found between WBA and knee motion asymmetry, but comparisons of WBA with all the other outcome variables indicated fair relationships (range, r=.29-.44).Conclusions
Weight-bearing asymmetry during transitions between sitting and standing can serve as a clinically relevant measure related to both knee impairment and functional mobility for people with unilateral knee OA. 相似文献17.
Susan Jedeloo AnneLoes van Staa Jos M. Latour 《International journal of nursing studies》2010,47(5):593-603
Background
Adolescents with chronic conditions have to learn to self-manage their health in preparation for transitioning to adult care. Nurses often struggle with how to approach youth with chronic conditions successfully. Little is known about the preferences and attitudes of these young people themselves.Objective
To uncover preferences for self-management and hospital care of adolescents with various chronic conditions.Design and method
A Q-methodological study was conducted. Semi-structured interviews were held with adolescents who rank-ordered 37 opinion statements on preferences for care delivery and self-management. They were asked to motivate their ranking. By-person factor analysis was conducted to uncover patterns in the rankings of statements. The factors were described as preference profiles.Participants and setting
A purposive sample of 66 adolescents (12-19 years) treated in a university children's hospital in the Netherlands was invited to participate. Thirty-one adolescents, 16 boys and 15 girls with various chronic conditions eventually participated (response 47%). Eight participants (26%) had a recently acquired chronic condition, while the rest (74%) had been diagnosed at birth or in the first 5 years of life.Results
Four distinct preference profiles for health care delivery and self-management were identified: ‘Conscious & Compliant’; ‘Backseat Patient’; ‘Self-confident & Autonomous’; and ‘Worried & Insecure’. Profiles differ in the level of independence, involvement with self-management, adherence to therapeutic regimen, and appreciation of the parents’ and health care providers’ role. The desire to participate in treatment-related decisions is important to all preference profiles. The profiles are recognizable to adolescents and nurses alike. As Q-methodology allows no inferences with respect to the relative distribution of these profiles in a given population, only tentative hypotheses were formulated about associations between profiles and patient characteristics.Conclusion
This study increases our understanding of different subjectivities of adolescents living with a chronic condition related to their treatment and health. There is no “one size fits all” approach to adolescent health care, but rather a limited number of distinct preference profiles. This study demonstrates the value of a non-disease-specific approach in that adolescents with various chronic conditions were found to have much in common. The profiles seem a promising tool for nurses to actively seek adolescents’ opinion and participation in health care and will be further explored. 相似文献18.
Sally D. Lark Sowjanya Pasupuleti MSc 《Archives of physical medicine and rehabilitation》2009,90(3):470-474
Lark SD, Pasupuleti S. Validity of a functional dynamic walking test for the elderly.
Objective
To determine the validity of a safe, quick, and simple method of measuring dynamic balance in the elderly during gait called the parallel walk test.Design
Control study.Setting
Outpatient clinic, community.Participants
Twenty-seven elderly fallers (age 82±6y) registered at a falls clinic and 34 elderly nonfallers (age 76±7y) were recruited to this study based on Mini Mental State Examination and Barthel Index scores.Interventions
Subjects were timed as they walked 6m between 2 parallel lines on the floor at 3 different widths (20, 30.5, 38cm) in their own footwear. They were scored for foot placement on the line (1 point) or outside the lines (2 points). Participants also performed a timed 6-m tandem walk test, a 30-second tandem stance, and a 30-second parallel stance.Main Outcome Measures
Scores and time to complete the parallel walk test and tandem walk test along with the time of standing for tandem and parallel stance. Validity coefficients were calculated for the sensitivity and specificity of the parallel walk test.Results
All subjects completed the parallel walk test, but few attempted and completed the tandem walk test. The fallers had significantly greater scores at 20 and 30.5cm and took significantly longer to complete the 6m at all widths. The 20-cm width was most discriminatory. The parallel walk test showed a significant correlation with the tandem stance.Conclusions
All subjects attempted and completed the parallel walk test but not the tandem walk test. The time to completion and scoring accurately measures dynamic balance during gait in elderly fallers. The parallel walk test could be a useful tool in the clinical setting for assessing balance in gait pre- and postintervention. 相似文献19.
Hanneke Bouwsema Corry K. van der Sluis Raoul M. Bongers 《Archives of physical medicine and rehabilitation》2010,91(9):1442-1446
Bouwsema H, van der Sluis CK, Bongers RM. Learning to control opening and closing a myoelectric hand.
Objective
To compare 3 different types of myoelectric signal training.Design
A cohort analytic study.Setting
University laboratory.Participants
Able-bodied right-handed participants (N=34) randomly assigned to 1 of 3 groups.Interventions
Participants trained hand opening and closing on 3 consecutive days. One group trained with a virtual myoelectric hand presented on a computer screen, 1 group trained with an isolated prosthetic hand, and 1 group trained with a prosthetic simulator. One half of the participants trained with their dominant side, and the other half trained with their nondominant side. Before and after the training period, a test was administered to determine the improvement in skill. Participants were asked to open and close the hand on 3 different velocities at command.Main Outcome Measures
Peak velocity, mean velocity, and number of peaks in the myoelectric signal of hand opening and closing.Results
No differences were found for the different types of training; all participants learned to control the myoelectric hand. However, differences in learning abilities were revealed. After learning, a subgroup of the participants could produce clearly distinct myoelectric signals, which resulted in the ability to open and close the hand at 3 different speeds, whereas others could not produce distinct myoelectric signals.Conclusions
Acquired control of a myoelectric hand is irrespective of the type of training. Prosthetic users may differ in learning capacity; this should be taken into account when choosing the appropriate type of control for each patient. 相似文献20.
Marshall PW, Murphy BA. Muscle activation changes after exercise rehabilitation for chronic low back pain.