共查询到20条相似文献，搜索用时 31 毫秒
1.
Objective
To compare clinical pain intensity, exercise performance, pain sensitivity and the effect of aerobic and isometric exercise on local and remote pressure pain thresholds (PPTs) in patients with chronic musculoskeletal pain with high and low levels of kinesiophobia.Design
An experimental pre–post within-subject study.Setting
An exercise laboratory in a multidisciplinary pain clinic.Participants
Fifty-four patients with chronic musculoskeletal pain.Interventions
Acute aerobic and isometric leg exercises.Main outcome measures
Clinical pain intensity (numerical rating scale, range 0 to 10), Tampa Scale of Kinesiophobia, aerobic and isometric exercise performances (intensity and maximal voluntary contraction), and PPTs at local and remote body areas before and after exercise conditions.Results
Patients with a high degree of kinesiophobia demonstrated increased pain intensity compared with patients with a low degree of kinesiophobia [high degree of kinesiophobia: 7.3 (1.6) on NRS; low degree of kinesiophobia: 6.3 (1.6) on NRS; mean difference 1.0 (95% confidence interval 0.08 to 1.9) on NRS]. Aerobic and isometric exercises increased PPTs, but no significant group differences were found in PPTs before and after exercise.Conclusions
Clinical pain intensity was significantly higher in patients with a high degree of kinesiophobia compared with patients with a low degree of kinesiophobia. Despite a difference in isometric exercise performance, the hypoalgesic responses after cycling and isometric knee exercise were comparable between patients with high and low degrees of kinesiophobia. If replicated in larger studies, these findings indicate that although kinesiophobic beliefs influence pain intensity, they do not significantly influence PPTs and exercise-induced hypoalgesia in patients with chronic musculoskeletal pain. 相似文献2.
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3.
4.
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5.
Background
Real time 1:1 videoconferencing (VC) has the potential to play an important role in the management of orthopaedic pathologies. Despite positive reporting of telemedicine studies uptake in clinical practice remains low. Acceptability to patients is an important element of system take-up in telemedicine and a focus towards qualitative methodology may explore the underlying reasons behind its acceptability. In this paper we have systematically reviewed qualitative studies that include evidence about patient responses to VC services in an orthopaedic setting.Objectives
To determine whether real time 1:1 videoconferencing is acceptable to patients in an orthopaedic setting.Data sources
MEDLINE, AMED, PsychINFO, CINAHL, SCOPUS, Cochrane Database, Evidence Search and Open Grey were searched with forwards and backwards reference screening of eligible papers.Eligibility criteria
Qualitative studies exploring the acceptability of VC in an orthopaedic setting were included.Study appraisal and synthesis methods
Studies were appraised using the CASP tool. A Directed Content Framework Analysis was conducted using Normalisation Process Theory.Results
Four studies were included for review. The themes for the four studies did not overlap and did not report clinician acceptability of VC. The Directed Content Analysis of these papers using Normalisation Process Theory highlighted factors which contribute towards its acceptability.Conclusions
All studies concluded that the use of VC was acceptable. Further qualitative research exploring both patient and clinician acceptability is required utilising a theoretical framework to allow for repeatability and generalisability.Systematic Review Registration Number: PROSPERO CRD42015024944. 相似文献
6.
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
7.
The challenges in caring for morbidly obese patients in Intensive Care: A focused ethnographic study
Background
Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges. However little is known about the care of these patients in intensive care.Objective
To explore medical and nursing practices and attitudes in intensive care when caring for critically ill morbidly obese patients.Methods
A focused ethnographic approach was adopted. Participant observation of care practices and interviews with intensive care doctors and nurses were undertaken over a four month period. Qualitative analysis was conducted using constant comparison.Setting
An 18 bedded tertiary intensive care unit in New Zealand.Participants
Sixty-seven intensive care nurses and 13 intensive care doctors involved with the care and management of seven critically ill patients with a body mass index ≥40 kg/m2.Findings
Morbidly obese patients present significant physical and language challenges for intensive care practice. The physical shape of morbidly obese patients did not appropriately fit the different equipment used. Staff used specific knowledge of the patient’s body size and shape to adapt care practices and keep patients safe and comfortable. There were also specific language challenges where staff expressed concern about what words were most appropriate to use to describe body mass when in the presence of morbidly obese patients.Conclusions
Bariatric care pathways need to be developed that use more suitable body measurements to inform the use of bariatric equipment. Intensive care staff need to engage in debate about what is acceptable, respectful, and appropriate language in the delivery of bariatric patient care. 相似文献8.
9.
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10.
11.
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12.
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13.
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14.
15.
Debra E Jackson Lisa A Durrant Marie Hutchinson Charlotte A Ballard Stephen Neville Kim Usher 《Collegian (Royal College of Nursing, Australia)》2018,25(4):409-414
Background
Pressure injury is a common problem. Its prevention and treatment is predominantly focussed on views, perceptions and knowledge of healthcare staff rather than on patient experience, particularly those patients living in their own homes.Aim
This paper reports findings on patients experiences and perceptions of loss associated with PI. These findings are drawn from a larger study of pressure injury patients living and receiving care in the community.Methods
Qualitative interviews with 12 participants with pressure injury and five carers. Data was audio recorded and thematically analysed. The study is reported in accordance with the COREQ guidelines.Findings
Having a pressure injury negatively affected many aspects of life for our participants resulting in multiple losses. These losses included loss of mobility and independence, privacy and dignity, and social engagement and ability to engage in preferred activities.Discussion
Although the effects of a pressure injury may be similar for many people, the most important issues will differ from person-to-person thus treatment and prevention of pressure injury requires a multidisciplinary team having a holistic care approach. Some patients’ pressure injury will never heal and it is increasingly important to involve the patient to find out what matters most to them and how their wound is impacting on them, to jointly develop a holistic, person-centred plan.Conclusion
Policy and practice should recognise and reflect that patients living with a pressure injury at home have different challenges and needs to those in acute or long term care. Pragmatic solutions in the delivery of pressure injury care are needed to compliment the drive to move healthcare from the hospital-to-home. 相似文献16.
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
17.
Tonia Crawford Peter Roger Sally Candlin 《Collegian (Royal College of Nursing, Australia)》2018,25(5):501-507
Background
While patient education has long been an important part of nurses’ roles in patient care, research has found difficulties with providing patient education. Sound subject matter knowledge is not enough to give effective and meaningful instruction; pedagogical knowledge is also needed, with an understanding of different aspects of learning processes to inform our teaching methods Despite the importance of patient education, many nurses do not necessarily have pedagogical knowledge regarding how to teach, how to support patient’s learning and how to consciously implement strategies into patient education.Aim
By understanding theories that explain how people learn better, and awareness of the consequences of different approaches to giving patient education, nurses can be better informed about how to structure their information-giving in ways that will support patient learning.Methods
Discourse analysis from an interactional sociolinguistic perspective is used to examine authentic nurse-patient health information encounters, mapped against cognitive learning theories, schema theory in particular.Findings
The interactional consequences, when elements drawn from learning theories are implemented, are observable in the data.Discussion
Strategies that support patients’ learning include linking information to the patients’ prior experience/knowledge, providing information that is relevant to them, and chunking information into unified themes while encouraging patients’ active involvement through questioning and clarification of information.Conclusion
Awareness of learning theories and strategies outlined in this paper can strengthen communication skills and assist health professionals to structure patient education in ways that support patients’ learning, thereby enhancing patient safety. 相似文献18.
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19.
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20.
Su’e Yuan Yun Qian De’ming Tan Dan Mo Xue’bing Li 《Transfusion and apheresis science》2018,57(2):253-258