Physiotherapy theory and practice
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Physiother Theory Pract · May 2012
Randomized Controlled Trial Comparative StudyManual therapy associated with upper limb exercises vs. exercises alone for shoulder rehabilitation in postoperative breast cancer.
Our objective was to evaluate the effectiveness of manual therapy (MT) associated with upper limb (UL) exercises in women with impaired shoulder range of motion (ROM) after axillary lymph node dissection (ALND) for breast cancer. A randomized, prospective, blinded clinical trial with 131 women with a ROM <- 100° for shoulder flexion and/or abduction on the first day postoperatively were evaluated. Sixty-six women were allocated to group exercises and 65 underwent the exercises followed by MT. ⋯ No difference in recovery of shoulder ROM as well as UL function was observed between groups. Improvement in ROM was gradual from the 1st to the 18th month, and the function achieving a good classification at 18th month. MT associated with exercises did not enhance the results obtained with exercises alone for shoulder ROM and ipsilateral UL function.
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Classification systems are available to subgroup patients with acute/nonspecific low back pain (LBP) to determine interventions. The use of classification systems by physical therapists (PT) has little published evidence. The aims of this study were to understand the process PTs use when assessing and determining interventions for patients with acute/nonspecific LBP in outpatient settings and what classification systems, if any, are used in clinical practice. ⋯ Thirteen PTs were included in the study. Four decision-making preferences emerged from the data: (1) identifying the root cause, (2) eclectic approach, (3) experience-based management, and (4) evidence-based management. Experience, education, and other aspects of the PTs' backgrounds influenced their preferred decision-making style, and use of resources, such as classification systems, varied broadly.
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Physiother Theory Pract · Jan 2012
Case ReportsUse of an abbreviated neuroscience education approach in the treatment of chronic low back pain: a case report.
Chronic low back pain (CLBP) remains prevalent in society, and conservative treatment strategies appear to have little effect. It is proposed that patients with CLBP may have altered cognition and increased fear, which impacts their ability to move, perform exercise, and partake in activities of daily living. Neuroscience education (NE) aims to change a patient's cognition regarding their pain state, which may result in decreased fear, ultimately resulting in confrontation of pain barriers and a resumption of normal activities. ⋯ Immediately following the 75-minute evaluation and NE session, the patient reported improvement in all four outcome measures, most notably a reduction in the FABQ-W score to 2/42 and the FABQ-PA to 1/24. At a 7-month follow-up, all outcome measures continued to be improved. NE aimed at decreasing fear associated with movement may be a valuable adjunct to movement-based therapy, such as exercise, for patients with CLBP.
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Physiother Theory Pract · Jan 2012
Pain, balance, self-reported function and physical function in individuals with knee osteoarthritis.
Disability resulting from knee osteoarthritis (OA) is determined by physiological and functional variables though the interactions between the variables remain unclear and deserve further study. This study's major objective was to explore the relationship between pain, body mass index (BMI), balance, self-report function, and physical function in a cohort who had both unilateral and bilateral knee OA. Fifty-two patients (46 female, 6 male) ranging from 31 to 80 years of age (mean ± SD: 59.0 ± 9.8 years) with radiograph-confirmed OA of the knees participated in this study. ⋯ Significant inverse correlation was observed between age and balance (r = -0.58, p = 0.01) in participants with unilateral knee OA. In the regression model for all participants, self-reported function and age accounted for 27.0% of the variance in stair climbing test and 29.0% of the variance in the TUG test. Self-reported function and age are significant predictors of physical function in individuals with knee OA.
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Physiother Theory Pract · Nov 2011
Randomized Controlled Trial Comparative StudyComparison of post-treatment effects of conventional and acupuncture-like transcutaneous electrical nerve stimulation (TENS): A randomised placebo-controlled study using cold-induced pain and healthy human participants.
TENS can be administered in conventional (high frequency, low intensity) or acupuncture-like (AL-TENS: low frequency, high intensity) formats. It is claimed that AL-TENS produces stronger and longer-lasting hypoalgesia than conventional TENS, although evidence is lacking. This randomised controlled parallel group study compared the effects of 30 minutes of AL-TENS, conventional TENS, and placebo (no current) TENS, on cold-pressor pain threshold (CPT), in 43 healthy participants. ⋯ There were no statistically significant differences between conventional TENS vs. placebo or between AL-TENS vs. conventional TENS at 5 or 15 minutes after TENS was switched off. In conclusion, AL-TENS but not conventional TENS prolonged post-stimulation hypoalgesia compared to placebo TENS. However, no differences between AL-TENS and conventional TENS were detected in head-to-head comparisons.