Physical therapy
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Randomized Controlled Trial Comparative Study
Exercise for people in early- or mid-stage Parkinson disease: a 16-month randomized controlled trial.
Exercise confers short-term benefits for individuals with Parkinson disease (PD). ⋯ Findings demonstrated overall functional benefits at 4 months in the FBF group and improved walking economy (up to 16 months) in the AE group.
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Although clinicians have a number of measures to use to describe walking performance, few, if any, of the measures capture a person's perceived effort in walking. Perceived effort of walking may be a factor in what a person does versus what he or she is able to do. ⋯ The perceived effort of walking was associated with physical activity and confidence in walking. Reducing the perceived effort of walking may be an important target of interventions to slow the decline in function of older adults with mobility limitations.
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Disability in adults with low back pain (LBP) is associated with negative back pain beliefs (BPBs). Adult BPBs can be positively influenced with education, resulting in reduced LBP disability. By late adolescence, the prevalence of LBP reaches adult levels. The relationship among LBP experience, LBP impact, and BPBs has not been investigated in late adolescence. ⋯ Differences in BPBs are associated with different levels of LBP impact at 17 years of age. This finding provides a potential target for intervention early during the life course.
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Few data are available on predictors for a favorable outcome in patients with chronic nonspecific low back pain (CNLBP). ⋯ At short-term follow-up, no association was found for the factors of age and sex with the outcomes of pain intensity and disability. At long-term follow-up, smoking had the same result. At long-term follow-up, pain intensity and fear of movement had no association with disability. At short-term follow-up, conflicting evidence was found for the association between the outcomes pain intensity and disability and the factor of fear of movement. At long-term follow-up, conflicting evidence was found for the factors of age, sex, and physical job demands. At long-term follow-up, conflicting evidence also was found for the association between return to work and age, sex, and activities of daily living. At baseline, there was limited evidence of a positive influence of lower pain intensity and physical job demands on return to work. No high-quality studies were found for the outcomes of quality of life and global perceived effect.
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Classification of patients with extremity problems is commonly based on patho-anatomical diagnoses, but problems exist regarding reliability and validity of the tests and diagnostic criteria used. Alternatively, a classification system based on patient response to repeated loading strategies can be used to classify and direct management. ⋯ This study demonstrates that trained clinicians can classify patients with extremity problems into MDT classifications and that these classifications remain stable during the treatment episode. Further work is needed to test the efficacy of this system compared with other approaches, but if derangements are as common as this survey suggests, the findings have important prognostic implications because this syndrome is defined by its rapid response to repeated movements.