How accurate are visual assessments by physical therapists of lumbo-pelvic movements during the squat and deadlift?

ObjectivesTo investigate the accuracy of visual assessments made by physical therapists of lumbo-pelvic movements during the squat and deadlift and how much movement is considered injurious.DesignQuantitative Cross-sectional.Participants14 powerlifters, 10 Olympic weightlifters and six physical therapists.SettingThe lifters were recorded simultaneously by video and an inertial measurement unit (IMU) system while performing squats and deadlifts. The physical therapists assessed the videos and rated whether specific lumbo-pelvic movements were visible during the lifts and whether the movement amplitude was considered injurious.Main outcome measuresThe nominal visual assessments, if there was a movement and if it was considered injurious, were compared to the degrees of movement attained from the IMU system.ResultsDuring the squat, a posterior pelvic tilt of ≥34° was required to visually detect the movement. For other lumbo-pelvic movements, there was no significant difference in the amount of movement between those who were assessed as moving or not moving their lumbo-pelvic area, nor was there a difference in movement amplitude between those who were assessed as having an increased risk of injury or not.ConclusionsPhysical therapists did not consistently detect lumbo-pelvic movements during squats and deadlifts when performed by competitive lifters.     

Evaluation of the Force Sensing Application pressure mapping system

Abstract

Pressure mapping techniques are used in wheelchair and seating services to assess posture and assist in the prevention and treatment of pressure ulcers. The Force Sensitive Application (FSA) pressure mapping systems in Wales have a high clinical use and frequent calibration is required. This project aimed to assess the performance of the systems and develop a calibration strategy. Testing of the systems was spilt into three stages. The pilot stage compared different calibration techniques (manual, automated and with new software) to determine the optimal calibration frequency. The second stage, longer term, was like the pilot stage with the best calibration method tested over 10 weeks. The third test was a simple before-and-after calibration test, conducted to determine the effect of calibration. It was concluded that the calibration process is essential to maintain the reliability of the mats and it was decided that the systems in Wales should be calibrated every 2 months to provide a more consistent output.     

Early CPAP protocol in preterm infants with gestational age between 28 and 32 weeks: experience of a public hospital

BackgroundThe use of continuous positive airway pressure (CPAP) applied early after birth improves several outcomes when compared with intubation and invasive mechanical ventilation. “Early CPAP” protocols vary in relation to the pressure level, type of interface used, and studied sample.ObjectiveThis study compared intubation rate, exogenous surfactant use, and hospitalization length (among other variables) prior to and after adopting an “early CPAP” protocol in preterm infants with gestational age between 28 and 32 weeks, using intermediate pressures and short binasal prongs.MethodsThis was a retrospective study conducted in a public university hospital in Brazil. All preterm infants with gestational age between 28 and 32 weeks were included in the study. The newborns born between January 2011 and December 2012, prior to the protocol being implemented, were considered the historical control group, and those born after implementation, between February 2013 and August 2014 were considered the intervention group.ResultsThe participants in both groups had similar baseline characteristics (p > 0.05). There were significant reductions in intubation rate (89% versus 73%, p = 0.02), exogenous surfactant use (86% versus 67%, p = 0.02), and median (Q1 - Q3) days of invasive mechanical ventilation [4 (2 - 14) versus 1 (0.15–9), p = 0.01] and length of hospital stay in days [56 (42–77) versus 42 (35–71), p = 0.02].ConclusionsThe findings demonstrate positive outcomes of the early CPAP protocol. This protocol used simple and affordable equipment available in the hospital which could easily be reproduced in other centers, generating better outcomes for preterm infants and reducing hospital expenses.     

Blood pressure measurement in special populations and circumstances

According to the established validation protocols, a typical validation study of a blood pressure (BP) monitor includes general population adults with normal or elevated BP. It is recognized, however, that the automated (oscillometric) BP monitors may have different accuracy or uses in some special populations compared with adults in the general population. Thus, an automated BP monitor with proven accuracy in a general population of adults may not be accurate in a special population, and therefore separate validation is needed. Recognized special populations deserving separate validation are those for which there is theoretical, and also clinical evidence, that the accuracy of BP monitors in these groups differs from that in the general population. Young children, pregnant women (including those with preeclampsia), individuals with arm circumference >42 cm, and patients with atrial fibrillation are regarded as special populations. Adolescents, individuals older than 80 years, and patients with end‐stage renal disease or diabetes mellitus have also been considered as possible special groups, but there is still inadequate evidence of altered accuracy of BP monitors in these subjects. Validation studies should be performed in special populations and evaluated separately after the BP‐measuring device has successfully undergone a validation study in a general population (unless the test device is intended only for a special population). This article discusses issues relating to the measurement of BP and the diagnosis of hypertension in selected special populations, as well as in low‐resource settings, where a simplified yet efficient evaluation strategy is necessary.     

Validation of the Chinese version of the Canadian Haemophilia Outcomes‐Kids' Life Assessment Tool (the CHO‐KLAT)

It is important to assess the health‐related quality of life outcomes of boys in China, but there are no tools validated for this purpose. The objective of the study was to assess the validity of the Simplified Chinese version of the CHO‐KLAT_2.0. We recruited 60 boys with either haemophilia A (HA) or haemophilia B (HB) and their parents from four regions in China, and assessed the validity of CHO‐KLAT compared to the PedsQL. All participants complete the CHO‐KLAT a second time 1–2 weeks later to assess reliability. The boys ranged in age from 7 to 18 (mean = 12.4; SD = 3.03) years. The severity distribution was: mild (9), moderate (10) and severe (41). On‐demand therapy was received by 26 boys, while 18 received low‐dose prophylaxis (HA: 10 IU kg^?1 2–3 times week^?1, and HB: 20 IU kg^?1 1 time week^?1). The mean CHO‐KLAT scores were 63.7 (SD = 10.6) for child‐report and 58.3 (SD = 11.4) for parent‐report. Validity was supported by a correlation of 0.67 (P < 0.0001) with the PedsQL for child‐report and 0.64 (P < 0.0001) for parent‐report. The test–retest reliability was 0.88 (95% CI: 0.82–0.94) for child‐report, and 0.90 (95% CI: 0.86–0.95) for parent‐report. Inter‐rater reliability was 0.46 (95% CI: 0.26–0.66). CHO‐KLAT scores were 11 points higher among patients who had been on prophylaxis 3 times per week for ≥24 weeks. These results confirm the reliability and validity of the Chinese version of the CHO‐KLAT. This measure is suitable for use in prospective clinical trials in boys with haemophilia in China.