bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating Edema Management Into Entry-Level Doctor of Physical Therapy Curriculum: A Case Report
Authors: Sander Antoinette P. , Perdomo Marisa 
Published: July 2018

Background and Purpose:
The Commission on Accreditation in Physical Therapy Education includes criteria for the management of edema. The purpose of this case report is to outline content and instructional guidelines for edema and lymphedema management in 2 entry-level Doctor of Physical Therapy curricula.

Case Description:
Teaching edema management includes both general and specific knowledge of the anatomy and physiology of the lymphatic system, an understanding of the pathophysiology of edema, and competency in traditional and innovative skills of edema management in the context of a patient management model and evidence-based practice. Northwestern University Department of Physical Therapy and Human Movement Science has a required dedicated course that combines clinical management of patients with lymphatic and integumentary dysfunction. The University of Southern California integrates edema management throughout the 3-year curriculum. Both of these programs are presented in detail.

Outcomes:
The Northwestern program has been presented continuously since 2003; the University of Southern California began integrative edema management in 2002 and evolved into the current model in 2005. Mean scores on the Federation of State Boards of Physical Therapy examination consistently indicate that graduates from both schools rank higher than other first-time test takers from US accredited programs in the area of cardiovascular/pulmonary and lymphatic systems.

Discussion and Conclusion:
This report provides objectives, methods, and references to guide an instructional course in edema management in an entry-level Doctor of Physical Therapy curriculum. Two cases of integrating edema content within a current curriculum are presented. An essential element for a successful program is the availability of academic or clinical faculty trained in lymphedema management.
Oncology Section EDGE Task Force on Cancer: A Systematic Review of Clinical Measures for Pain
Authors: Harrington Shana E. , Gilchrist Laura , Lee Jeannette , Westlake Frances L. , Baker Alicia 
Published: July 2018

Background:
Pain is one of the most common complaints in individuals with cancer and can occur at any point during the course of cancer treatment.

Purpose:
To identify outcome measures for assessing pain and to evaluate their psychometric properties and relevance to adults with a diagnosis of cancer.

Methods:
Three electronic databases (CINAHL, MEDLINE, and PsycINFO) were reviewed using specific search terms to locate articles that identify outcome measures assessing pain in adults with a diagnosis of cancer. From the 1164 articles identified, 494 articles were reviewed and 22 outcome measures were selected for analysis. Each outcome measure was independently reviewed and rated by 2 reviewers using the updated Cancer EDGE Task Force Outcome Measure Rating Form. Any discrepancies between reviewers were discussed, and an overall recommendation for each measure was made using the 4-point Cancer EDGE Task Force Rating Scale.

Results:
On the basis of the psychometric properties, clinical utility, and relevance to adults with a diagnosis of cancer, the following 3 measures are highly recommended: McGill Pain Questionnaire–Short Form, Numeric Rating Scale, and Visual Analog Scale. Four measures are recommended: Brief Pain Inventory, Brief Pain Inventory–Short Form, McGill Pain Questionnaire, and Pain Disability Index. Eleven measures are recommended as reasonable to use, and 3 are not recommended.

Conclusions:
Seven of the 22 pain measures demonstrated satisfactory psychometric properties and clinical utility and are thereby recommended for clinical and research use in adults with a diagnosis of cancer.
Identifying Fall Risk of Patients Receiving Hematopoietic Cell Transplant
Authors: Rindflesch Aaron B. , Hake Melissa P. , Meyer Tanya , Murphy Ryan , Olson Morgan L. , Uphoff Kayla , Hollman John H. 
Published: July 2018

Background and Purpose/Objective:
Few studies have examined the efficacy of fall risk assessment tools for patients undergoing hematopoietic cell transplant (HCT). The purpose of this study was to determine whether the Hendrich II Fall Risk Model (HFRM II) can distinguish patients who fell from those who did not fall in the inpatient HCT population.

Methods:
Observational study.

Design:
Retrospective chart review.

Setting:
Academic medical center.

Patients:
Patients undergoing HCT who fell during the first 100 days posttransplant.

Intervention:
None.

Measurements:
Independent-sample t tests were performed to determine differences in HFRM II score, age, pulse, systolic and diastolic blood pressure, platelet count, hemoglobin concentration, and hematocrit for fallers compared with nonfallers. Chi-square tests of independence determined differences regarding sex, assistive device used on the day of fall, transplant type, and physical therapy. Logistic regression analysis detected odds of falling dependent on transplant type, pulse rate, and HFRM II score.

Results:
Forty-seven patients who fell within 100 days after HCT were control matched by transplant date with 2 nonfallers each. Significant differences included HFRM II mean score (5.36 for fallers vs 3.41 for nonfallers; t = 4.510, P < .001) and mean pulse rates (100.09 vs 88.70 bpm; t = 3.398, P = .001). Patients with allogeneic HCT were 3.46 times more likely to have fallen than those with autologous HCT (P = .007).

Limitations:
Potential selection bias of retrospective review.

Conclusions:
HCT patients with higher HFRM II scores, greater pulse rate, or allogeneic transplant were more likely to fall.
Evaluating Hand Grip Strength Prior to Hematopoietic Stem Cell Transplantation as a Predictor of Patient Outcomes
Authors: Bailey Charlotte , Asher Arash , Kim Sungjin , Shinde Arvind , Lill Michael 
Published: July 2018

Background and Purpose:The primary purpose of this study was to determine the predictive capacity of hand grip strength on overall survival among patients undergoing hematopoietic stem cell transplantation (HCT).Design:Retrospective chart review.Setting:Hand grip strength was measured at the time of HCT in an inpatient setting in 2009.Patients:Forty-nine patients with various hematologic malignancies.Intervention:Hand grip strength was performed using the dominant hand. The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) was administered during the same visit. Chart abstraction was performed 5 years postassessment to obtain mortality data, Karnofsky Performance Status (KPS) at HCT, graft type, gender, comorbidity index, and age at HCT.Main Outcome Measure:SurvivalResults:Median follow-up time was 5.62 years. In multivariable analyses, higher hand grip strength was associated with shorter length of stay, higher FACIT-F total score, and higher FACIT-F subscale score in female patients only. Higher hand grip strength was associated with an improved overall survival in all patients with and without adjustment for gender, graft type, and comorbidity index (unadjusted hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.74-0.99;P= .034; adjusted HR: 0.82; 95% CI: 0.69-0.98;P= .033).Limitations:Retrospective design did not allow for assessment of posttransplant complications.Conclusion:Higher hand grip strength was associated with a shorter length of stay, higher quality of life, and lower fatigue for female patients, and better overall survival among men and women. Larger prospective studies are needed to confirm this finding.
Effects of Preoperative Exercise on Physical Fitness and Body Composition in Pancreatic Cancer Survivors Receiving Neoadjuvant Therapy: A Case Series
Authors: Marker Ryan J. , Peters John C. , Purcell W. Thomas , Jankowski Catherine A. 
Published: July 2018

Background and Purpose:
Poor preoperative physical fitness and muscle mass are associated with increased morbidity and mortality in pancreatic cancer survivors. While neoadjuvant therapy improves viability for and effectiveness of a surgical resection in patients with borderline-resectable pancreatic adenocarcinoma, it also reduces preoperative fitness and muscle mass. The purpose of this investigation was to prevent fitness and muscle mass declines in this population with a supervised, preoperative exercise program.

Methods:
Patients recently diagnosed with borderline-resectable pancreatic adenocarcinoma and prescribed neoadjuvant therapy were recruited. Assessments of body composition, physical fitness, and health-related quality of life were assessed at baseline (<4 weeks from diagnosis), preoperatively, and 6 weeks after hospital discharge. Participants attended 2 to 3 supervised exercise sessions per week for the duration of neoadjuvant therapy. Sessions consisted of aerobic, resistance, and flexibility exercises tailored to the individual. Adherence to the exercise program was recorded to assess feasibility.

Results:
Only 3 participants were recruited in an 8-month window, primarily due to location limitations, and are presented as a case series. All participants increased lean muscle mass and physical fitness after the exercise program. Two participants met cancer cachexia diagnostic criteria at baseline but not after the exercise program. One participant developed metastatic disease and did not receive surgery. Neither of the participants who underwent surgery was readmitted to the hospital after discharge.

Conclusion:
This study provides preliminary evidence that a preoperative exercise program during neoadjuvant therapy may be effective at maintaining or improving muscle mass and physical fitness in pancreatic cancer survivors.
Exercise in African American and White Colorectal Cancer Survivors: A Mixed-Methods Approach
Authors: Ray Andrew D. , Masucci Twarozek Annamaria , Williams Brian T. , Erwin Deborah O. , Underwood Willie , Mahoney Martin C. 
Published: July 2018

Background:
African American (AA) colorectal cancer (CRC) survivors tend to be more obese and less physically active than white survivors.

Purpose/Objective:
To test the feasibility of an aerobic exercise program as well as explore perceptions about supervised exercise among AA CRC survivors.

Methods:
A prospective supervised exercise intervention performed on a cycle ergometer 2 d/wk for 12 weeks. Peak (

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2peak) and submaximal exercise (Six-Minute Walk Test [6MWT]) along with questionnaires (36-Item Short Form Health Survey [SF-36], Memorial Sloan Kettering Cancer Center Bowel Function Instrument [BFI], Functional Assessment of Cancer Therapy–Colorectal (FACT-C) and Fatigue (FACIT-F), and Brief Symptom Inventory [BSI]). A second group of survivors participated in an interview evaluating perceptions regarding exercise.

Design:
Prospective case series and qualitative interview.

Setting:
Research university and academic medical center.

Patients:
AA and white CRC survivors.

Results:

Quantitative: A total of 237 letters were mailed to CRC survivors (112 whites, 126 AAs). From the letters, 25 whites and 15 AAs expressed interest; only 5 whites (4.5%) and 4 AAs (3.2%) enrolled. Two AA and 5 white survivors (7/9) finished the program. There was an improvement in peak exercise (P = .011) and quality of life (QOL) (SF-36 total, P = .035) posttraining. Qualitative: 30 CRC survivors (12 AAs and 18 whites) participated in qualitative interviews and selected comorbidity, motivation, and location as primary barriers to exercise.

Limitations:
Small sample size.

Conclusions:
Recruiting CRC survivors (regardless of race) into an exercise program is challenging; however, there are exercise and QOL benefits associated with participation. Barriers to exercise are similar between AA and white CRC survivors.
The Influence of Cognitive Function on Balance, Mobility, and Falls in Older Cancer Survivors
Authors: Blackwood Jennifer 
Published: July 2018

Introduction:
Older cancer survivors fall more often, as disease-associated sequelae such as impaired cognitive function contribute to a higher falls risk. Cognitive dysfunction may contribute to falls and mobility; however, this relationship is not well described. The purpose of this study was to examine associations between cognitive function, gait speed, balance, and falls in older cancer survivors.

Methods:
A cross-sectional analysis of 573 older cancer survivors was conducted from the 2010 Health and Retirement Study wave. Groups were assigned on the basis of falls history: Falls (N = 222) or No Falls (N = 351). Groupwise comparisons on demographic, cognitive, and physical mobility variables were completed. Linear regression analyses were performed to examine associations between cognitive function (recall, orientation, executive function), gait speed, tandem balance, and falls in the sample and by group.

Results:
Significant between-group differences existed in demographic, cognitive function, falls, and mobility variables. Falls were inversely associated with executive function (β = −0.18, P < .05). Delayed recall was linearly associated with tandem stance in the whole sample (β = 0.11, P < .05). Falls history was able to detect differing relationships between gait speed and each of the cognitive processes (β = 0.11-0.17 for fallers; β = 0.11-0.22 for nonfallers), indicating the underlying influence of cognition on mobility in cancer survivors.

Discussion:
Different cognitive processes influence falls, balance, and mobility in the older cancer survivor, especially those with a history of falling. Assessments of balance and falls should include screening more than orientation to detect cognitive impairments that impact mobility and falls.
Computed Tomography–Derived Thoracic Muscle Size as an Indicator of Sarcopenia in People With Advanced Lung Disease
Authors: Mathur Sunita , Rodrigues Nicole , Mendes Polyana , Rozenberg Dmitry , Singer Lianne G. 
Published: July 2018

Purpose:
Computed tomography (CT) of the chest is routinely performed in people with lung disease; however, the utility of measuring thoracic muscle size to assess the presence of sarcopenia (low muscle mass and function) has not been studied. The purpose of this study was to examine the reliability and validity of thoracic muscle size obtained from chest CT as a surrogate of sarcopenia.

Methods:
In this observational study, chest CT was obtained from routine clinical evaluation in 32 individuals with advanced lung disease awaiting lung transplantation. Thoracic muscle area from vertebral levels T4–T6 was manually segmented using Slice-O-Matic software, and average muscle cross-sectional area (CSA) and muscle volume were calculated. Measures of sarcopenia included quadriceps CSA and thickness from ultrasound, quadriceps, and biceps torque and short physical performance battery (SPPB).

Results:
Intrareliability and interrater reliability for muscle CSA were high (intraclass correlation coefficient = 0.96, 0.99; absolute difference = 0.61, 1.7 cm2, respectively). Thoracic muscle CSAs and volume correlated with quadriceps size and limb muscle strength (r = 0.56–0.71, P < .001) but not SPPB. Cross-sectional areas from single slices at T4–T6 were highly correlated with muscle volume (r = 0.89–0.91, P < .001).

Conclusions:
Thoracic muscle size seems to be a reliable and valid technique that can be applied in large studies evaluating the presence of sarcopenia in patients with advanced lung disease.
Reliability of Physical Therapists in Performing Ankle-Brachial Index Measurements
Authors: Clifft Judy K. , Meekins Myra M. , Coleman F. Ann , Bradford Jacque L. , Hatten Marie W. 
Published: July 2018

Purpose:
Reliability of ankle-brachial index (ABI) testing has been assessed in some health care providers, but there is conflicting information on the reliability of physical therapists (PTs). The purpose of this study was to determine the reliability of practicing PTs in performing ABI measurements in an older adult population.

Methods:
Two practicing PTs measured systolic blood pressure in all 4 extremities of 23 subjects (mean age 61.9 yr) using Doppler ultrasound. The measurements were repeated in all subjects and an ABI was calculated for each extremity using the conventional and an alternate method.

Results:
Reliability was assessed with the intraclass correlation coefficient (ICC). The ICC for interrater reliability when using the conventional method for calculating ABI was 0.649 (95% CI [443, 789]). The ICC for intrarater reliability was 0.710 (95% CI [0.530, 0.828]) for rater 1 and 0.586 (95% CI [0.359, 0.748]) for rater 2. The ICCs were generally higher when the alternate method was used to calculate ABI.

Conclusions:
Interrater reliability of PTs was good, and intrarater reliability was fair to excellent when calculating ABI by the conventional and alternate methods. Physical therapists who follow recommended procedures can obtain reliable ABI measurements.
Clinical Predictors of Inspiratory Muscle Strength in Adults With Stable Cystic Fibrosis: A Pilot Study
Authors: Dekerlegand Robert L. , Hadjiliadis Denis , Swisher Anne K. , Parrott James Scott , Heuer Albert J. , Myslinski Mary Jane 
Published: July 2018

Purpose:
Inspiratory muscle strength (IMS) ranges from below normal to supernormal levels in adults with cystic fibrosis (CF). An understanding of disease-related factors contributing to this variability may identify adults with CF at greater risk of respiratory pump dysfunction. The purpose of this study was to explore the ability of clinical measures to predict IMS in adults with CF.

Methods:
Maximal inspiratory pressure (MIP) was assessed in 58 adults with stable CF across a range of disease severity (forced expiratory volume in 1-second [FEV1] = 20% to 130% of the predicted) using a cross-sectional design. The ability of clinical factors to predict IMS was evaluated through multivariable regression analysis.

Results:
The linear combination of percent of predicted FEV1, percent of predicted residual volume (%RV), lean body mass index, and age explained 43% of the variance in MIP expressed in cm H2O. The linear combination of percent of predicted inspiratory capacity, %RV, and body mass index explained 52% of the variance in MIP expressed as percent of the predicted.

Conclusions:
A combination of pulmonary, nutritional, and demographic clinical factors explained approximately half of the variance in IMS in adults with CF. Nutritional status and hyperinflation seem to have the greatest influence on the inspiratory muscles.
The Functional Difficulties Questionnaire: A New Tool for Assessing Physical Function of the Thoracic Region in a Cardiac Surgery Population
Authors: Sturgess Tamica R. , Denehy Linda , Tully Elizabeth A. , McManus Margaret , Katijjahbe Mohd Ali , El-Ansary Doa 
Published: July 2018

Purpose:
There is a paucity of functional outcome measures that specifically target the thoracic region and none that are specific for use in people following cardiac surgery. The aim of this study was to develop a functional questionnaire for this purpose and investigate its psychometric properties.

Methods:
Participants who underwent cardiac surgery were included in this single-site, observational study (part A, n = 38 and part B, n = 25). The investigators developed a 13-item Functional Difficulties Questionnaire (FDQ) informed by the literature, theory, and clinical practice. The questionnaire and measures of physical function, pain, and health-related quality of life (HRQOL) were completed at 4 time points by 38 participants to investigate internal consistency, convergent validity, and responsiveness to change of the FDQ (part A). A different group of 25 participants completed the questionnaire twice within a single day to investigate test–retest reliability, and minimal detectable change (MDC) was calculated (part B).

Results:
The questionnaire showed good internal consistency (Cronbach alpha coefficient = 0.971); moderate to good correlation with assessments for HRQOL 3 months postoperatively (rho = 0.54–0.65 for 5 36-Item Short Form Health Survey subscales) and total pain at all postoperative time points (rho = 0.55–0.69); a responsiveness to change with significant differences in scores across time (Χ2 [3, n = 38] = 41.37, P ≤ 0.0001); and excellent test–retest reliability (intraclass correlation 0.918). The MDC was 16.35 cm out 130 cm.

Conclusions:
The FDQ is an appropriate functional outcome measure specific to the thoracic region for people after cardiac surgery. It may also be suitable for use by clinicians and researchers assessing the thoracic region within other surgical or medical populations, and this warrants further investigation.
Effect of combined circuit exercise on arterial stiffness in hypertensive postmenopausal women: a local public health center-based pilot study
Authors: Jeon Kyoungkyu , Lee Sewon , Hwang Moon-Hyon 
Published: July 2018

Abstract

Objective:
Postmenopausal women have increased arterial stiffness compared with premenopausal women. Regular physical activity including aerobic and resistance exercises are recommended to lower cardiovascular disease risk and to enhance musculoskeletal health in these women. This study examined the effect of combined circuit exercise on arterial stiffness in hypertensive postmenopausal women. Furthermore, it ascertained whether performing this exercise program is feasible in local public health centers with better accessibility than research and commercial facilities.

Methods:
Among 24 hypertensive postmenopausal women, 16 finished this study in either the control (n = 8) or exercise (n = 8) group. Except for one participant who withdrew from the study due to the difficulty of the exercise program, seven participants withdrew due to reasons unrelated to the study. Circuit-type exercise (aerobic- and resistance-combined) program was applied to the exercise group, 60 min/d and 3 d/wk for 12 weeks under supervision. Brachial–ankle pulse wave velocity was measured to assess arterial stiffness.

Results:
In response to the combined exercise, brachial–ankle pulse wave velocity was significantly reduced in the hypertensive women (−0.7 m/s; P < 0.05). Weight, body mass index, and total cholesterol level were also significantly decreased after the exercise program (−2.1 kg, −0.8 kg/m2, and −16 mg/dL, respectively; P < 0.05). In addition, changes in arterial stiffness were related to body adiposity, blood pressure, and blood lipid alterations (r = 0.61-0.70; P < 0.01).

Conclusions:
Circuit combined exercise is an effective intervention to improve arterial stiffness in hypertensive postmenopausal women, and is feasible in local public health centers.