Physiotherapy Practice and Research - Volume 34, issue 1
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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: The understanding that the human brain is capable of structural and functional change throughout life has significant implications for the future of physical therapy. Cortical plasticity impacts on many areas of physical therapy including clinical practice, research and education. Although the principles of plasticity underpin developments in neurological physical therapy, relevance to musculoskeletal physical therapy is still emerging. How will key areas of musculoskeletal physical therapy change as our understanding of plasticity advances? If cortical plasticity can be harnessed, new plasticity-based therapies, that enhance performance in healthy individuals and improve pain and function in patient populations, have the potential to…become the cornerstone of musculoskeletal physical therapy. In addition, common physical therapy techniques, such as electrical stimulation, require reconsideration of their clinical efficacy and application in light of new discoveries in neuroscience. The aim of this appraisal is to provide an update on brain plasticity for physical therapists in relation to clinical practice, research and education.
Abstract: Background and purpose: Pre-operative physical therapy (PT) has been used in clinical practice to improve post-surgical outcomes after a total hip and/or knee replacement. The purpose of this systematic literature review was to investigate the ability of pre-operative physical therapy to improve post-surgical outcomes of patients undergoing a total knee and/or total hip arthroplasty. Methods: This review used the search engines PubMed, CINAHL, Cochrane library and the PEDro database and investigated all articles that studied the influence of pre-operative therapy on post-surgical results in patients that underwent a total knee and/or total hip arthroplasty. The studies included were randomized controlled…trials (RCTs), English written, and compared pre-surgical outcomes to post-surgical outcomes in physical therapy interventions. Quality scoring was assessed using the PEDro scale for RCTs. Results: Ten articles met the inclusion criteria. The quality score ranged from 4–7 on the PEDro scale. Results found pre-operative PT in both total knee and total hip arthroplasty reduced the risk of discharge to a rehabilitation facility. Pain reduction (p < 0.05) was found with pool interventions versus land interventions immediately following an exercise session. Discussion: The results indicate there were benefits in the use of pre-operative PT on improving patient satisfaction, pain reduction, and discharge to a lower cost of care setting. The use of pre-operative physical therapy resulted in mixed findings in functional outcomes however. Conclusions: This updated systematic review suggests the current literature on pre-operative physical therapy is inconclusive regarding impact of improving post-surgical outcomes on patients receiving total knee and/or hip arthroplasty.
Keywords: Arthroplasty, outcome assessment, PEDro scale, post-surgical, pre-surgical, systematic review, total knee, total hip
Abstract: Background: A growing emphasis is being placed on the role of health promotion in tackling chronic conditions faced by the health services. This research study sought to investigate the health promotion knowledge, attitudes and practices of chartered physiotherapists in Ireland, as it has been suggested that physiotherapists are particularly well positioned to engage in health promotion strategies in the 21st century. Methods: An online self-administered questionnaire, which had been modified from a previously established tool, was emailed to 2753 registered members of the Irish Society of Chartered Physiotherapists on two occasions. 526 completed surveys were returned giving a response rate…of 19.1%. Data was analysed using PASW Statistics 18. Results: Physiotherapists hold a traditional view of health promotion relating it primarily to the provision of information and advice to bring about individual behaviour change. Self reported knowledge of the wider determinants of health and key action areas of health promotion was low. Physiotherapists displayed positive attitudes to their role in health promotion but identified significant barriers to its implementation in the form of time constraints, lack of health promotion training and patient attitudes. Conclusions: Collaboration must take place between the disciplines of health promotion and physiotherapy to ensure that clarity in both roles and terminology is established. Interventions to improve health are complex. Pre- and post-registration physiotherapy education should be reviewed to ensure that physiotherapists have the knowledge base and skill set required to successfully engage in health promotion action.
Keywords: Health promotion, physiotherapy, physical therapy, knowledge, attitudes
Abstract: Background: The purpose of the study is to measure the relationship of findings of the Goutallier classification, a qualitative measure of fat content within a designated muscle group, and a dichotomous measure of fatty infiltration (presence or not present) toward delayed or poor recovery after physiotherapy intervention. Methods: The retrospective predictive validity study involved 35 adolescent patients diagnosed with spondylolysis, who received magnetic resonance imaging (MRI) prior to physiotherapy care. Scoring of presence of fatty infiltration and Goutallier classifications from the MRI were compared to success or delayed or poor outcomes with physiotherapy, upon patient discharge from formal care. Results:…Although agreement among the physicians who were responsible for scoring was poor, consensus findings of fatty infiltration on both measurement mechanisms were related to delayed or poor physiotherapy outcomes (correlation = 0.28, and the sensitivity of presence of fatty infiltration was 76.2% [95% CI = 61%, 87%], the specificity was 69% [95% CI 44%, 87%], the LR + was 2.5 [95% CI 1.1, 6.8], and the LR– was 0.3 [95% CI 0.1, 0.8] for delayed or poor outcome). Discussion: To our knowledge, this is the first study that has looked at whether fatty infiltration of the multifidus muscle in adolescents was associated with poor or delayed recovery in physiotherapy treatment. Conclusions: The results indirectly support the importance of the multifidus muscles in recovery of low back pain and suggest the significance of future, further research.
Keywords: Adolescent, fatty infiltration, low back pain, magnetic resonance imagery, multifidus muscles, outcomes
Abstract: Background: Negative low back pain (LBP) beliefs have been associated with greater disability among patients with LBP. The LBP beliefs of health care professionals (HCPs) are associated with the LBP beliefs of their patients. Intensive (8-day) education improves both the LBP beliefs of HCPs, and their stated management of LBP. However, it is unclear if shorter (2–3 day) educational workshops can effectively change the LBP beliefs of HCPs. This study examined whether educational, biopsychosocial workshops improve the LBP beliefs of physiotherapists. In addition, the study aimed to identify which LBP beliefs are modified, which factors facilitate these changes, and to…compare LBP beliefs between countries. Methods: 150 physiotherapists attending a LBP workshop in one of three countries (Ireland, England or Germany) participated. LBP beliefs were evaluated using the Back Beliefs Questionnaire (BBQ) before and after the workshops. A small sample (n = 12) of participating physiotherapists identified the key perceived mediators of change in their LBP beliefs, and this data were analysed using thematic analysis. Results: Significant differences in LBP beliefs existed between countries, both at baseline and follow-up. BBQ scores across all three countries were significantly increased (p < 0.001), after the workshop. Combining the scientific evidence with live patient presentations were identified as important mediators of changing LBP beliefs. Conclusions: Biopsychosocially-orientated educational workshops improved the LBP beliefs of physiotherapists. Future studies should examine if LBP management changes after such educational workshops.
Keywords: Low back pain, education, beliefs, biopsychosocial, physiotherapy