Physiotherapy Practice and Research - Volume 30, issue 2
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Physiotherapy Practice and Research is the Official Journal of
The Irish Society of Chartered Physiotherapists. It is an international, peer-reviewed journal which aims to advance physiotherapy practice and research through scholarly publication. The journal has a clinical focus and publishes material that will improve the evidence base for physiotherapy and assist physiotherapists in the management of their patients. Contemporary physiotherapy practice incorporates a diverse range of activity and the journal aims to support physiotherapists, and publish material, fromall areas of practice, be that the clinical setting, education, research or management.
Physiotherapy Practice and Research welcomes submissions in the form of original research papers, critical reviews (systematic or state-of-the-art papers), case studies, editorials, expert commentaries and book reviews. Letters to the editor are also welcome. The journal will commission focussed or clinical reviews in areas of interest; those planning such reviews should contact the editor in the first instance. Physiotherapy Practice and Research also aims to foster research capacity within the Profession and as such supports and encourages submission from new researchers.
Physiotherapy Practice and Research is a member of and subscribes to the principles of COPE, the Committee on Publication Ethics.
Abstract: Cystic fibrosis (CF) is the most common inherited disease of the Northern European caucasian population. The carrier rate within the UK is 1:25 and the incidence 1:2500 live births. The disease is caused by a defect of the CF gene, the cystic fibrosis transmembrane conductance regulator (CFTR), the protein of which encodes for a chloride channel in the apical membrane of exocrine epithelial cells. In addition CFTR also modifies the function of other ion transporters (sodium and potassium channels) and has an effect on water permeability, ATP transport and mucus secretion. The main clinical characteristics of the disorder are pancreatic…insufficiency and chronic progressive lung disease. Other problems include male infertility, liver disease and diabetes. Soon after description of the disease by Dorothy Andersen in 1938, chest physiotherapy in the form of postural drainage and percussion became a mainstay of the respiratory management of CF. Airway clearance continues to play an integral role in the care of children and adults with CF but the role of the physiotherapist in caring for CF has changed significantly over the past three decades and has grown to include physical exercise, postural care and the need to address emerging and unique complications which arise as longevity continues to improve.
Abstract: Background: Within Gaelic football, high rates of injury have been reported. The Ladies Gaelic Football Association has 100,000 members; however no injury management research currently exists within this population. The aim of this study was to survey the knowledge of senior level ladies Gaelic football club players of acute soft tissue injury management. Secondary aims were to investigate the treatments employed following injury and player awareness of potentially harmful post injury practices. Methods: A questionnaire exploring demographic, treatment, and PRICE (Protection, Rest, Ice, Compression, Elevation) details was constructed. Results: All six senior County Clare ladies Gaelic football club teams were…sampled, and a response rate of 95% was achieved. 43.9 % of respondents knew four or more of the PRICE letters. Treatments employed by respondents included ice (61.8%), physiotherapy (59.2%) and rest (36.8%). 27.6% of participants would avoid three or more of the following immediately post injury; heat, alcohol, vigorous exercise and vigorous massage. If respondents were to use ice as a form of treatment in the initial stages following injury, 85.7% of them would commence the intervention immediately after injury, and it would be applied by players every one (54.4%) or two (22.2%) hours. Conclusion: The PRICE regime was moderately well known by this population. Poor knowledge of potentially harmful post injury practices and recommended cryotherapy application was reported. As the evidence concerning the PRICE guidelines is not conclusive, further research in this area is required.
Abstract: Objective: The aim of this review is to critically appraise available evidence studying the effects of increased aerobic capacity in persons with Parkinson's disease (PD) and make recommendations for best clinical practice based on the findings. Methods: Eleven databases were systematically searched using keywords relating to PD and aerobic exercise. Selected articles were appraised using the American Academy for Cerebral Palsy and Developmental Medicine scale. Results: Seven articles met the criteria and were selected for review. Three were awarded level II evidence (one strong, one moderate and one weak evidence), two were level IV and two were level V. Improvements…were seen in disease severity, function, mobility, ability to participate in activities of daily living, and quality of life. Conclusions: Current research suggests that increasing aerobic fitness has a number of benefits for people with PD. It is safe to perform and no detriment to neurological status was recorded. There is a need for large, high quality randomised controlled trials with long-term (more than one year) follow-up to confirm findings and assess long-term retention of improvements achieved during intervention. However, aerobic exercise is likely to be a valuable tool in the treatment of people with mild to moderate PD.
Keywords: Parkinson's Disease, Aerobic Exercise, Physiotherapy, Function, Quality of Life
Abstract: Background: Rheumatoid arthritis (RA) is an inflammatory polyarthritis, which affects one percent of the population. Since RA is a progressive chronic disease there is a need for long-term adherence to treatments such as exercise to ensure efficacy and sustained health benefits. Little effort has been devoted to identifying characteristics related to adherence and very few methods for enhancing compliance have been developed. Objectives: The primary aim was to identify barriers to exercise in RA. Secondary aims were to identify facilitators to exercise and methods to increase compliance. These aims were to be achieved by using a qualitative grounded theory research…approach and conducting two focus groups involving people with RA. Methods: Two focus groups were conducted including twelve participants with RA, which were video and audio taped, transcribed and subject to thematic content analysis. Results: The findings revealed that factors which influence RA patients exercise compliance, include disease, environmental and personal factors. The major barriers identified included fatigue, pain, decreased mobility, lack of professional input, inaccessible facilities, surgery, medications, potential embarrassment, fear of falling and the psychological effects of RA. Seven main facilitators were identified and included empathetic specialist professional input, correct exercise instruction, common ground, group therapy, heat, support and having psychological issues addressed. Conclusion: Findings from this study may be useful in the development of exercise interventions for people with RA, which could increase exercise participation. The research regarding exercise compliance is scarce and of poor methodological quality and there is a need for future research in this area.
Abstract: Background: Transversus Abdominis (TrA) has an important role in spinal stability contributing to both intra-abdominal pressure and the formation of a muscular corset around the spine. Transversus Abdominis has been shown to be dysfunctional in patients with low back pain (LBP) and ultrasound (US) imaging is seen to have an increasing role in the assessment and management of these patients. This study assessed the intra-rater reliability of a novice operator to measure the thickness of transversus abdominis when using brightness (B) mode ultrasound imaging. Method: Twenty normal subjects participated in an operator blinded study to assess the intra-rater reliability of…US in measuring the thickness of TrA when contracted using the abdominal hollowing exercise (AHE). Brightness (B) mode US was used to image the TrA at the end of expiration. Subjects were then re-imaged in the standardized position. Results: An intraclass correlation coefficient of 0.96 with 95% confidence intervals of 0.93- 0.98 were obtained indicating excellent reliability. However, limits of agreement were −1.52 mm to +1.35mm (range 2.87mm) suggesting that clinically meaningful measurements may not reliably be measured by a novice operator. Conclusion: This study indicates that additional training is required to achieve clinically meaningful results. It also highlights the importance of using more than one method of establishing reliability.
Abstract: Navicular stress fractures (NSF) are among the most common stress fractures seen in athletes and yet frequently their diagnosis is delayed. These fractures are high risk for non-union due to the poor vascularity of the middle one third of the navicular bone. For effective and efficient management of this condition it is imperative that the diagnosis is made without delay to allow early treatment. This paper reviews clinical aspects of navicular stress fractures bringing to the readers' attention pertinent aspects of the subjective and objective examination, differential diagnosis, investigations, pathophysiology, management, prognosis and complications.
Abstract: The role of physiotherapy in palliative cancer care is a relatively new specialty and has only recently been described. The evidence base for physiotherapy in this setting remains poor. Outcomes of physiotherapy input have been mainly measured in terms of improved functional capacity in trials to date. While the conceptual basis for physiotherapy in this setting includes the model of cancer rehabilitation, and its related outcomes of functional improvement, it also contains a much wider remit, incorporating the wider ethos of palliative care that involves patient support, patient satisfaction and improvements in quality of life. Outcome measures used by physiotherapists…should reflect this variety of input. This paper discusses the theoretical models underpinning physiotherapy input, and relates them to suggested outcome measures in the palliative cancer population. Thus, the paper provides a framework for measuring physiotherapy in palliative cancer care.
Keywords: Palliative Care, Outcome measures, Physiotherapy, Cancer