Physical therapy
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Scarring after surgery can lead to a wide range of disorders. At present, the degree of scar adhesion is assessed manually and by ordinal scales. This article describes a new device (the Adheremeter) to measure scar adhesion and assesses its validity, reliability, and sensitivity to change. ⋯ The Adheremeter showed a good level of reliability, validity, and sensitivity to change. Further studies are needed to confirm these results in larger cohorts and to assess the device's validity for other types of scars.
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Present literature and clinical practice provide strong support for the use of aerobic exercise in reducing pain and improving function for individuals with chronic musculoskeletal pain syndromes. However, the molecular basis for the positive actions of exercise remains poorly understood. Recent studies suggest that neurotrophin-3 (NT-3) may act in an analgesic fashion in various pain states. ⋯ This is the first study demonstrating the effect of exercise on deep tissue mechanical hyperalgesia in a rodent model of pain and providing a possible molecular basis for exercise training in reducing muscular pain.
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Case Reports
Development of a therapeutic exercise program for patients with osteoarthritis of the hip.
No detailed exercise programs specifically for patients with hip osteoarthritis (OA) have been described in the literature. This lack of data creates a gap between the recommendation that people with OA should exercise and the type and dose of exercises that they should perform. The purpose of this case report is to describe and demonstrate the use of a therapeutic exercise program for a patient with hip OA. ⋯ The patient experienced less pain and improved physical function and physical test outcomes after intervention and at the 6-month follow-up. The main challenges when prescribing an exercise program for a patient with hip OA are monitoring the exercises to provide improvements without provoking persistent pain and motivating the patient to achieve long-term adherence to exercising. Randomized clinical trials are needed to evaluate the efficacy of this TEP in patients with hip OA.
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Rehabilitation of elderly patients with sit-to-stand (STS) dysfunction includes retraining coordinated movement among participating body segments. Although trunk position is considered important, spinal movement has not been measured. ⋯ The revised model for image-based analysis demonstrated concurrent hip and thoracolumbar movement during the STS task. Close to full available hip flexion and thoracic extension were needed for optimal STS performance.
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The American Physical Therapy Association's Vision 2020 advocates that physical therapists be integral members of health care teams responsible for diagnosing and managing movement and functional disorders. This report details the design and early implementation of a physical therapist service in the emergency department (ED) of a large, urban hospital and presents recommendations for assessing the effectiveness of physical therapists in this setting. ⋯ Practice in the hospital ED enables physical therapists to fully use their knowledge, diagnostic skills, and ability to manage acute pain and musculoskeletal injury. Recommendations for future action are made to encourage more institutions across the country to incorporate physical therapy in EDs to enhance the process and outcome of nonemergent care.