How frail elders evaluate their caregiver's role enactment: a scale to measure affection, skill, and attentiveness

In this validity study, using factor analysis, the authors identified three dimensions (affection, skill, and attentiveness) of the Care Receiver View of Caregiver Role Enactment Scale, a self-report measure designed to elicit an elderly care receiver's evaluation of how well their family member carried out the role of caregiver. The scale is a revision of the Satisfaction With Caregiving Scale. This study was a secondary analysis of data from PREP: Family-based Care for Frail Older Persons. Care receiver mutuality was the variable most highly correlated with caregiver role enactment. Other variables related to good quality care were higher care receiver positive affect, better caregiver physical health, and lower caregiver role strain; husband caregivers were rated as giving poorer quality care.     

Retention of Blinding at Follow-Up in a Randomized Clinical Study Using a Sham-Control Cervical Manipulation Procedure for Neck Pain: Secondary Analyses From a Randomized Clinical Study

Objective

Participants in clinical trials of spinal manipulation have not been rigorously blinded to group assignment. This study reports on secondary analyses of the retention of participant blinding beyond the immediate posttreatment time frame following a single-session, randomized clinical study. A novel control cervical manipulation procedure that has previously been shown to be therapeutically inert was contrasted with a typical manipulation procedure.

Methods

A randomized clinical study of a single session of typical vs sham-control manipulation in patients with chronic neck pain was conducted. Findings of self-reported group registration at 24 to 48 hours posttreatment were computed. The Blinding Index (BI) of Bang et al was then applied to both the immediate and post–24- to 48-hour results.

Results

Twenty-four to 48 hours after treatment, 94% and 22% of participants in the typical and control groups, respectively, correctly identified their group assignment. When analyzed with the BI of Bang et al, the immediate posttreatment BI for the group receiving a typical manipulation was 0.22 (95% confidence interval [CI], − 0.03 to 0.47); for the group receiving a control manipulation, it was 0.19 (95% CI, − 0.06 to 0.43). The BI at post-24 hours was as follows: typical = 0.75 (95% CI, 0.59-0.91) and control = − 0.34 (95% CI, − 0.58 to − 0.11).

Conclusions

This study found that the novel sham-control cervical manipulation procedure may be effective in blinding sham group allocation up to 48 hours posttreatment. It appears that, at 48 hours posttreatment, the modified form of the typical cervical manipulation was not. The sham-control procedure appears to be a promising procedure for future clinical trials.     

A narrative review of manual muscle testing and implications for muscle testing research

Objective

Manual muscle testing (MMT) is used for a variety of purposes in health care by medical, osteopathic, chiropractic, physical therapy, rehabilitation, and athletic training professionals. The purpose of this study is to provide a narrative review of variations in techniques, durations, and forces used in MMT putting applied kinesiology (AK) muscle testing in context and highlighting aspects of muscle testing important to report in MMT research.

Method

PubMed, the Collected Papers of the International College of Applied Kinesiology–USA, and related texts were searched on the subjects of MMT, maximum voluntary isometric contraction testing, and make/break testing. Force parameters (magnitude, duration, timing of application), testing variations of MMT, and normative data were collected and evaluated.

Results

“Break” tests aim to evaluate the muscle's ability to resist a gradually increasing pressure and may test different aspects of neuromuscular control than tests against fixed resistances. Applied kinesiologists use submaximal manual break tests and a binary grading scale to test short-term changes in muscle function in response to challenges. Many of the studies reviewed were not consistent in reporting parameters for testing.

Conclusions

To increase the chances for replication, studies using MMT should specify parameters of the tests used, such as exact procedures and instrumentation, duration of test, peak force, and timing of application of force.     

Assessment of Patient Preference for Constant Voltage and Constant Current Spinal Cord Stimulation

Objectives: Spinal cord stimulation devices control energy by generating either constant voltage (CV) pulses or constant current (CC) pulses. This study aimed to investigate: 1) whether patients feel differences between CV and CC stimulation; 2) if patients prefer CV or CC stimulation. Methods: Fourteen patients blinded to the type of pulse generation received 20 randomized pairs of 15‐sec pulse trains (CC‐CV, CV‐CC, CV‐CV, or CC‐CC). Patients identified whether the pairs were the same or different, and if they preferred the first or second train. Results: There was no difference in charge‐per‐pulse input between CV and CC modes. Patients performed at chance level in identifying identical pairs (55.7 ± 24.1% correct, 10 trials), and slightly better in identifying different pairs (67.1 ± 25.2% correct, 10 trials). No patients correctly identified all pairs. Patients were categorized based on their performance in this task. Only three patients fell into a category where preference could be established with some confidence with respect to the group averages. Two of these patients preferred CV, while one patient preferred CC. Conclusion: The lack of patient ability to discriminate in this preliminary investigation suggests that patient preference for a stimulation type should not be the key determining factor in choosing a spinal cord stimulation system.     

Primary failure of tooth eruptionA unique case

Primary failure of tooth eruption rarely occurs. This case represents a rare clinical situation and appears to reflect a generalized disturbance in the eruptive process, inasmuch as (1) deciduous and permanent dentition are affected, (2) incisors, molars, and premolars are involved in all quadrants, (3) skeletal and craniofacial growth are within normal limits, and (4) no systemic/genetic anomalies were detected. This is the first such case reported in the literature; diagnosis and management are discussed.     

Management of Periodontal Tissues for Restorative Dentistry

Proper management of periodontal tissues is required to achieve predictable long-term success with restorative dental procedures. Forced eruption as well as several surgical techniques may be used to achieve and maintain adequate biologic width during restorative and esthetic dental procedures. The technique that will yield optimal results depends on the relationship between the restoration's margins and the surrounding periodontium. A classification system that describes these interrelationships and provides treatment recommendations is included.