Physiotherapy Practice and Research - Volume 36, 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: Cauda Equina Syndrome (CES) is a well known condition where early detection is paramount. The new onset of bladder and bowel dysfunction, sexual dysfunction and saddle anaesthesia are commonly used as clinical indicators of possible CES. Although the presence of these symptoms alongside LBP should always be taken seriously, the causes of these individual problems are multifactorial. Many of the ‘other’ factors are frequently seen within the general and LBP population and commonly complicate the clinical picture. This review provides a comprehensive overview of the different factors that may lead to the development of bladder and bowel dysfunction, sexual…dysfunction and/or saddle anaesthesia. It is hoped that improved knowledge of these reasons may ensure comprehensive subjective questioning of LBP patients.
Abstract: BACKGROUND PURPOSE: Scapular muscle performance is potentially influenced by arm dominance. The purpose of this study was to investigate the effect of arm dominance on clinical measures of scapulohumeral muscle strength and endurance. METHODS: Thirty-two healthy individuals between the ages of 30 and 65 years were recruited to participate. Scapular muscle strength of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) were recorded with a hand held dynamometer. One scapulohumeral isometric muscle endurance task was performed in prone. The order of testing (strength and endurance) was randomized for each…individual. Dominant to non-dominant strength and endurance measures were compared with paired t -tests. RESULTS: Arm dominance was significantly higher for UT strength (p < 0.001) and endurance (p = 0.015). However, the differences between the dominant and non-dominant limbs were not beyond minimal detectable change values. CONCLUSION: It does not appear that scapulohumeral muscle strength and endurance is clinically different for the dominant and non-dominant limbs in a middle age healthy population.
Keywords: Serratus anterior, trapezius, hand held dynamometer
Abstract: BACKGROUND: At present there is limited literature on leadership within the profession of physiotherapy. Physiotherapy in Ireland faces a period of change and reform due to the issue of graduate unemployment, changes to the traditional career pathway and the impending opening of the physiotherapy register in 2016. PURPOSE: The aim of this study is to explore the beliefs and opinions of physiotherapists in Ireland of the current situation regarding leadership and leadership development within the profession of physiotherapy. METHODS: A web-based questionnaire was sent to members of the Irish Society of Chartered…Physiotherapists (ISCP). This included an open question inviting comment on leadership and/or leadership development. Qualitative analysis of the responses was conducted using a thematic analysis approach. RESULTS: The response rate to the questionnaire was 22% (n = 615). Of these 153 respondents left comments in the open response box. Seven themes were identified in the responses. These were ‘Leadership is important’, ‘Education’, ‘Leadership Qualities’, ‘Leadership Management’, ‘Leadership versus Management’, ‘Role of the ISCP’ and ‘Perceptions of the Physiotherapy Profession’. CONCLUSIONS: Physiotherapists in Ireland recognise the importance of leadership to their profession and would like more opportunities to develop leadership skills. This analysis will form the base on which to guide further research on this topic. The results of this study are both timely and relevant given the impending changes to the profession of physiotherapy with the introduction of the physiotherapy registration.
Keywords: Leadership, physiotherapy profession, Ireland, leadership development
Abstract: BACKGROUND: The Irish Prevention of Falls and Fracture Strategy document emphasises the key role of General Practitioners (GPs) and primary healthcare professionals in prevention of osteoporosis and its associated costs. This study aimed to explore GP awareness and knowledge, management approaches, access to and utilisation of other professional services for osteoporosis in Ireland. METHODS: A random sample (n = 265; 10% ) of registered GPs in Ireland was surveyed and resultant data were analysed using: descriptive statistics; chi square tests for subgroup comparisons (Statistical Package for Social Sciences). RESULTS: A 56% (n = 147)…response rate was achieved. GP awareness of osteoporosis among women was good but less so for osteoporosis among men. Previous low trauma fracture, prolonged corticosteroid use, family history of osteoporosis, early menopause and x-ray evidence were commonly used as clinical indicators of osteoporosis. 97% of respondents reported excellent private availability of DXA scans and 69% reported good public availability. GP-reported practice followed the guidelines regarding osteoporosis medications for the most part. 75% of GP respondents reported only basic to moderate knowledge on advising patients regarding falls prevention and 84% would prefer to refer patients to another health professional but levels of access to appropriate services varied. CONCLUSIONS: GP awareness of osteoporosis among women is good but less so for osteoporosis among men. Bone health medications prescribed are consistent with current evidence but more specifics regarding nature and patterns of prescription are required. Discrepancies in availability and access to private and public Health professional and DXA services were reported. The role of various health professionals, including Physiotherapists, in promoting bone health should be highlighted to GPs.
Keywords: Osteoporosis, bone health, GP, primary care, physiotherapy
Abstract: BACKGROUND: Successful pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD) is dependent on timely and appropriate referral by health professionals, as well as adequate uptake and completion rates by patients. METHODS: A retrospective medical record audit was conducted on 183 in-patients, 133 day-cases and 532 respiratory outpatients (representing 50% of respiratory OPD clinics) in two academic teaching hospitals in Dublin. The audit period covered from 1st October to 31st December 2012. The audit tool was informed by the British Thoracic Society’s audit tool. The inclusion/exclusion criteria of the Health Service Executive (HSE) Model of…Care for Pulmonary Rehabilitation, was applied, in addition to a record of the patient being referred for PR assessment. The aim was to identify referral, uptake and PR completion rates over the 3-month period. RESULTS: From 183 confirmed COPD cases, 98 (54% ) people met the HSE Model of Care criteria for PR, while 39 (21% ) were not functionally limited by the disease. 23 (12% ) were considered not suitable for PR. Approximately half (n = 50) of the eligible population were referred for PR assessment. However, after six months, only 7 people had completed aprogramme. CONCLUSIONS: The results of this audit confirm similar work in that referral to PR was adequate but timely uptake by patients remains poor. Low uptake has implications for the effectiveness of PR at reducing mortality rates and hospital readmission rates.
Abstract: BACKGROUND: Muscle function and functional performance are affected in patients with osteoarthritis (OA). PURPOSE: To assess the relationship between knee OA and ankle proprioception and concentric peak torque of the dorsiflexor and plantar-flexor muscles in older patients. METHODS: Forty participants took part in the study; 20 participants with chronic unilateral knee OA and a control group of 20 healthy participants. Ankle proprioception and concentric peak torque were measured by an isokinetic dynamometer (Biodex). MAIN RESULTS: There was a significantly greater absolute error at the ankle among the knee OA…group (p = 0.0001). The concentric peak torque value of dorsiflexor and plantar-flexor muscles of the control group was significantly higher than the knee OA group (p = 0.003, p = 0.008) respectively. CONCLUSION: Those with OA of the knee displayed deficits in ankle proprioception and concentric peak torque of the dorsiflexor and plantar-flexor muscles.