Physiotherapy theory and practice
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Physiother Theory Pract · Jan 2013
Case ReportsT2 radiculopathy: A differential screen for upper extremity radicular pain.
Radicular pain in the upper extremity can have a cervical origin terminating at the cervicothoracic junction (C8, T1). Review of the literature suggests cutaneous representations of T2 nerve root to the axilla, posteromedial arm, and lateral forearm, suggesting yet another source of upper extremity radicular pain. A 53-year-old female experienced insidious right upper thoracic pain radiating into the right axilla, upper arm, and lateral forearm (10/10 numerical pain rating scale (NPRS)) of 1-week duration. ⋯ Reduction of local tenderness, and radiating axillary and right arm pain was observed (2/10 NPRS), with improved cervical extension. The second thoracic intercostal nerve and the adjoining intercostobrachial nerve, medial antebrachial cutaneous nerve, and the posterior brachial cutaneous branch of the radial nerve are speculated to be potential symptom mediators. They have a representation to the axilla, medial and posterior arm, and lateral forearm - a representation supporting the speculation of upper extremity radicular symptoms following mechanical dysfunction of the upper thoracic vertebrae.
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Physiother Theory Pract · Nov 2012
Impact of psychosocial factors, pain, and functional limitations on throwing athletes who return to sport following elbow injuries: a case series.
The purpose of this case series is to explore the possibility that: (1) throwing athletes respond to fear-avoidance model (FAM) measures differently than patients in other orthopedic populations; and (2) there is an association between the FAM measures, pain and function scores. ⋯ Subjects in this case study appeared to respond to the FAM questionnaires differently than patients in other orthopedic populations. The TSK FOI subscale may be the most beneficial to use with throwing athletes.
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In physiotherapy, as with many other health-care practices, therapeutic interventions, based on scientific knowledge, may be at odds with patient experiences. Patients may understand what they need to do to improve their health condition, but feel that these requirements may be emotionally, socially, or culturally incompatible with their lifestyles, social behavior, or personal choices. To work in the best interest of their patients, physiotherapists need to engage with the tensions that exist between scientific reason and social reality to offer a meaningful and relevant service for their patients. ⋯ In this paper, I examine what constitutes physiotherapists' practice knowledge and how Habermas's theory of knowledge, interest, and communication strengthens shared decision-making and can be used as a vehicle toward emancipatory practice. Drawing on data generated in an action research project, I examine how Habermas's ideas can be applied in emancipatory physiotherapy practice. The paper concludes that emancipatory practice is meaningful because it creates opportunities for reflection, evaluation, and choice for future physiotherapy practice.
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Physiother Theory Pract · Jul 2012
Tailored skills training for practitioners to enhance assessment of prognostic factors for persistent and disabling back pain: four quasi-experimental single-subject studies.
The well-known gap between guidelines and behaviour in clinical practice calls for effective behaviour change interventions. One example showing this gap is physiotherapists' insufficient assessment of psychosocial prognostic factors in back pain (i.e., yellow flags). The present study aimed to evaluate an educational model by performing a tailored skills training intervention for caregivers and studying changes over time in physiotherapists' assessment of prognostic factors in telephone consultations. ⋯ Knowledge and biopsychosocial attitudes toward back pain were congruent with guidelines at inclusion and did not change markedly during the intervention. Self-efficacy for assessment of cognitive and emotional prognostic factors increased during the study phases. The results suggest that a tailored skills training intervention using behaviour change techniques, such as individual goal setting, skills training, and feedback on performance, is effective in producing change in specific clinical behaviours in physiotherapists.