Physiotherapy research international : the journal for researchers and clinicians in physical therapy
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Comparative Study
Reliability of detecting 'onset of pain' and 'submaximal pain' during neural provocation testing of the upper quadrant.
Conflicting results have been reported with regard to the reliability of neural tissue provocation tests and it is unclear whether repeated testing affects the test results. In the present study, the stability and reliability of the occurrence of 'onset of pain' and 'submaximal pain' throughout the range of motion during neurodynamic testing was analysed, in both a laboratory and a clinical setting. ⋯ Pain provocation during neurodynamic testing is a stable phenomenon and the range of elbow extension corresponding with the moment of 'pain onset' and 'submaximal pain' may be measured reliably, both in laboratory and clinical conditions.
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The performance of manual hyperinflation by physiotherapists can be improved by the availability of a pressure manometer. The present study aimed to test whether these benefits could be maintained when the manometer is withdrawn and whether the availability of a manometer affects the pressures delivered under changing respiratory compliances. ⋯ The availability of a pressure manometer negates the influence of respiratory compliance on the achievement of target peak airway pressures during manual hyperinflation in the laboratory environment, however these benefits are not retained when feedback is withdrawn. Therefore, it is recommended that a pressure manometer should be routinely available during manual hyperinflation in clinical practice to optimize treatment safety and effectiveness.
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Outcome measures must be repeatable over time to judge changes as a result of treatment. It is unknown whether the presence of neck pain can affect measurement reliability over a time period when some change could be expected as a result of an intervention. The present study investigated the reliability of two measures, active cervical range of movement (AROM) and pressure pain thresholds (PPTs), in symptomatic and asymptomatic subjects. ⋯ The findings of moderate to very high between-week reliability of measures of AROM and PPTs in both asymptomatic and chronic neck pain subjects suggest the presence of symptomatology does not adversely affect reliability of these measures. The results support the use of these measures for monitoring change in chronic neck pain conditions.
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Low abdominal hollowing in four-point kneeling is used clinically to test and rehabilitate transversus abdominis (TrA) but many people find this exercise difficult to perform. Contracting pelvic floor muscles (PF) during low abdominal hollowing may facilitate contraction of TrA. Thickness increase in the abdominal muscles during low abdominal hollowing has been measured with real-time ultrasound scanning and may indicate muscle contraction. The present study investigated the effect of instructing PF contraction on TrA thickness increase during low abdominal hollowing. ⋯ Instructing healthy subjects to co-contract PF results in greater increase in TrA thickness during low abdominal hollowing in four-point kneeling. This may indicate greater contraction of TrA and thus be useful for clinicians training TrA. Further research could investigate the validity of change of thickness as a measure of abdominal muscle contraction, investigate the effect of instructing PF co-contraction on TrA in patients with low back pain and measure PF and TrA activity simultaneously.
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Randomized Controlled Trial Comparative Study Clinical Trial
Reliability and responsiveness of the shuttle walking test in patients with chronic low back pain.
Walking is an important functional activity and the shuttle walking test has been shown to be a useful test for patients with chronic airways obstruction and heart failure. The test has been used in low back pain research over recent years and has increasingly been used as an outcome measure to investigate treatment efficacy in patients with low back pain. The aim of the present study was to determine the reliability and responsiveness of the shuttle walking test within a group of patients with low back pain (with or without sciatica). ⋯ The present study has shown that the shuttle walking test is a reliable and responsive test within a group of patients with low back pain, with or without sciatica. It is simple to administer and provides a quick method of measuring one aspect of a patient's physical function.