bluuebunny/crossref_metadata_2025_split huggingface dataset:
Work-Related Musculoskeletal Disorders and the Culture of Physical Therapy
Authors: Cromie Jean E , Robertson Valma J , Best Margaret O 
Published: February 2017

Abstract
Background and Purpose. Knowledge, skills, relationships, and attitudes of caring and working hard are all thought to be valued by physical therapists. This article explores how physical therapists see themselves, in light of some of these values, when they experience work-related musculoskeletal disorders (WMSDs). The article also explores the ways in which these values may compete with each other, and it suggests how this may contribute to the onset of WMSDs and to therapists' behavior following a WMSD. Subjects and Methods. Eighteen therapists who had made a career change after a WMSD participated in interviews that were designed to gain insight into the attitudes and beliefs of therapists who had had a WMSD. Results. Participants did not anticipate WMSDs, and they typically believed their physical therapy knowledge and skills would have prevented WMSDs from occurring. They saw themselves as knowledgeable and caring and indicated that these characteristics were highly valued by the profession. Their need to demonstrate these attributes sometimes resulted in behaviors that contributed to the development of their WMSDs and made them worse after their onset. Discussion and Conclusion. The cultural values of physical therapists may make it difficult for them to do their jobs in a way that minimizes the risk of WMSDs. The study identified a potential conflict between the therapists' need to (1) demonstrate their ability to work hard and care for their patients and (2) appear knowledgeable and skilled by remaining injury free.
Supported Treadmill Training for Gait and Balance in a Patient With Progressive Supranuclear Palsy
Authors: Suteerawattananon Monthaporn , MacNeill Betty , Protas Elizabeth J 
Published: February 2017

Abstract
Background and Purpose. Impaired balance, gait disturbances, and frequent falls are common problems in people with progressive supranuclear palsy (PSP). This case report describes the use of a modified body weight support treadmill training program to reduce falls and improve the balance and gait of a patient with PSP. Case Description. The patient was a 62-year-old man diagnosed with PSP. His major problems were impaired balance and frequent, abrupt falls. Methods. Physical therapy included walk training, balance perturbation, and step training using body weight support with a treadmill. Training sessions lasted 11/2 hours and occurred 3 days a week for 8 weeks. Fall incidence, balance, and gait were assessed before, during, and after the program. Outcomes. The patient reported fewer falls during and after training. Balance and gait improved after training. Discussion. This case report is the first to report fall reduction, improved gait, and improved balance following physical therapy for a person with PSP.
Neurogenic Bladder, Neurogenic Bowel, and Sexual Dysfunction in People With Spinal Cord Injury
Authors: Benevento Barbara T , Sipski Marca L 
Published: February 2017

AbstractThe purpose of this article is to review the literature related to the effects of spinal cord injuries on genitourinary, gastrointestinal, and sexual function. These important areas of function are profoundly affected by spinal cord injuries, with the effects of injury being dependent on the specific level and degree of neurologic dysfunction. Our ability to manage neurogenic bladder dysfunctions and neurogenic bowel dysfunctions has improved over the past few years; however, in general the techniques used have not significantly changed. In contrast, a significant amount of new information has been made available regarding the effects of specific neurologic injuries on sexual response, particularly female sexual response. Moreover, techniques to remediate erectile dysfunction and infertility in the male have vastly improved the fertility potential of men with spinal cord injuries. Further research is warranted in all of these areas.
Effect of Passive Range of Motion Exercises on Lower-Extremity Goniometric Measurements of Adults With Cerebral Palsy: A Single-Subject Design
Authors: Cadenhead Sherri L , McEwen Irene R , Thompson David M 
Published: February 2017

AbstractBackground and Purpose. People with spastic cerebral palsy often receive passive stretching that is intended to maintain or increase joint passive range of motion (PROM) even though the effectiveness of these exercises has not been definitively demonstrated. The purpose of this study was to determine the effect of PROM exercises on 6 adults with spastic quadriplegia and contractures. Participants. Four men and 2 women (X̄=31 years of age, range=20–44 years) who lived in an institution for people with mental retardation participated in the study. Methods. The authors used 2 multiple baseline designs. Three participants (group 1) received lower-extremity PROM exercises during phase A; PROM exercises were discontinued during phase B. Three participants (group 2) did not receive PROM exercises during phase A; PROM exercises were initiated during phase B. Data were analyzed using visual analysis and the C statistic. Results. Results varied with the method of analysis; however, phase A and phase B measurements, overall, did not differ for either group. Discussion and Conclusion. This study demonstrated use of a single-subject design to measure the effect of PROM exercises on adults with cerebral palsy. The authors concluded that the PROM exercise protocol did not have an effect on the lower-extremity goniometric measurements of the participants.
Scale to Measure Patient Satisfaction With Physical Therapy
Authors: Monnin Dominique , Perneger Thomas V 
Published: February 2017

Abstract
Background and Purpose. Patient satisfaction can be one indicator of quality of care. In this study, a patient satisfaction questionnaire for physical therapy was developed. Subjects. The subjects were a consecutive sample of 1,024 patients who received physical therapy between January and March 1999 at a teaching hospital in Geneva, Switzerland. Methods. A cross-sectional mail survey was conducted in which a structured questionnaire measuring patient satisfaction with various aspects of physical therapy followed by open-ended questions was sent to the subjects. Results. Overall, 528 of 1,024 patients (52%) responded (patient demographics for 501 respondents who provided demographic data: mean years of age=58.6, SD=18.9, range=15–95; 258 men, 243 women). Factor analysis was used to identify main domains of satisfaction, and a scale was constructed to measure satisfaction with each dimension: treatment subscale (5 items), admission subscale (3 items), logistics subscale (4 items), and a global assessment subscale (2 items). All subscales had good acceptability and small floor and ceiling effects. Internal consistency coefficients varied between .77 and .90, indicating good reliability for all subscales. Scale validity was supported by a logical grouping of items into subscales, according to their content, and by correlations of satisfaction scores with the patient's intention to recommend the facility and with the number of positive and negative comments to open-ended questions. Younger patients were less satisfied than older patients for 2 of the subscales (admission and logistics). Discussion and Conclusion. The 14-item instrument is a promising tool for the evaluation of patient satisfaction with physical therapy in both inpatients and outpatients.
Predictive Validity of the Test of Infant Motor Performance as Measured by the Bruininks-Oseretsky Test of Motor Proficiency at School Age
Authors: Flegel Judy , HA Kolobe Thubi 
Published: February 2017

AbstractBackground and Purpose. As the survival rate of infants who are born prematurely increases, the need for accuracy in early identification and prediction of developmental outcome in these infants is imperative. This study examined the predictive validity of the Test of Infant Motor Performance (TIMP) and the relationship between perinatal risk and motor performance in children who are of school age. Subjects and Methods. A stratified, random sample of 35 children was selected from subjects who had been examined using the TIMP and the Problem-Oriented Perinatal Risk Assessment System (POPRAS). The subjects were between 32 weeks gestational age and 4 months postterm (mean age=10 days postterm). The stratification was based on age at the time of TIMP administration (AGE) and on POPRAS scores. The Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) was administered to the children at a mean age of 5.75 years. Predictive values were calculated and correlation and regression analyses were conducted to examine the relationship between the TIMP and POPRAS scores and the BOTMP score. Results. Using the receiver operating characteristic curve and a cutoff z score of −1.6, the TIMP's sensitivity, specificity, and positive and negative predictive values were .50, 1.00, 1.00, and .87, respectively. The correlation between TIMP and BOTMP scores, with AGE controlled, was .36, and the correlation between POPRAS and BOTMP scores was −.55. Thirty-seven percent of BOTMP variance was accounted for collectively by POPRAS scores, TIMP scores, and AGE. Discussion and Conclusion. The TIMP and POPRAS may be viable instruments that can be used together to identify infants who are at risk for poor long-term motor performance.
Impairment-Based Examination and Disability Management of an Elderly Woman With Sacroiliac Region Pain
Authors: Godges Joseph J , Varnum Denisa R , Sanders Kelly M 
Published: February 2017

Abstract
Background and Purpose. The purpose of this case report is to describe the use of a cluster of sacroiliac tests in conjunction with an impairment-based model of examination, diagnosis, and management of sacroiliac region pain. Case Description. The patient was a 74-year-old woman with an 18-month history of low back, left buttock, and groin pain following a misstep. The initial symptoms were intermittent. The symptoms became constant and limited her walking tolerance to 5 minutes, which affected her ability to care for her grandchildren. She was examined using a cluster of sacroiliac tests that examined: (1) innominate active mobility, (2) innominate positional symmetry, and (3) sacroiliac ligament tenderness. Outcomes. Following 4 treatments for identified impairments, the patient had unlimited walking tolerance and she resumed an active caregiving role for her grandchildren. Discussion. This case illustrates the use of an impairment-based model for examination and management of an elderly patient with what appeared to be sacroiliac joint dysfunction.
Dual Task Interference During Gait in People With Parkinson Disease: Effects of Motor Versus Cognitive Secondary Tasks
Authors: O'Shea Simone , Morris Meg E , Iansek Robert 
Published: February 2017

Abstract
Background and Purpose. Exacerbation of movement disorders while doing 2 tasks (dual task performance) is a characteristic feature of Parkinson disease (PD). The aim of this investigation was to identify whether the type of secondary task (motor or cognitive) determined the severity of dual task interference. Subjects and Methods. Footstep patterns for 15 people with PD and 15 comparison subjects without PD were compared when they walked: (1) at a self-selected speed, (2) while simultaneously performing a motor task (coin transference), and (3) while simultaneously performing a cognitive task (digit subtraction). Gait speed, stride length, cadence, and the percentage of the gait cycle in double-limb stance (DS) were examined with a computerized stride analyzer. Results. When there was no second task, the mean stride length was less in the group with PD (1.29 m) than in the comparison group (1.51 m), and the mean gait speed was less in the group with PD (71.47 m/min) than in the comparison group (87.29 m/min). The mean cadence was less in the group with PD (110.79 steps/min) than in the comparison group (115.81 steps/min). The percentage of the gait cycle in DS was greater in the group with PD (33.38%) than in the comparison group (31.21%). Both groups reduced their stride length and speed when they had to change from unitask performance to dual task performance and DS increased. For the group with PD, cadence also decreased. For both groups, the type of secondary task had a negligible effect on the performance decrement. Discussion and Conclusion. Although the performance of simultaneous motor or cognitive tasks compromised gait in people with PD, the type of secondary task was not a major determinant of the severity of dual task interference.
Use of Anabolic Steroids to Attenuate the Effects Glucocorticoids on the Rat Diaphragm
Authors: Eason Jane M , Dodd Stephen L , Powers Scott K 
Published: February 2017

Abstract
Background and Purpose. Administration of glucocorticoids results in atrophy and contractile dysfunction in the rat diaphragm. Anabolic steroids may be useful in preventing atrophy and contractile dysfunction. The purpose of this study was to assess the effects of simultaneous administration of testosterone and glucocorticoids on morphological and contractile properties of the rat diaphragm. Subjects. Eighty-eight adult female Sprague-Dawley rats were divided into 1 of 4 groups: a control group that was given sham injections for 13 days (CONT group, n=23), a group that was given prednisolone injections (0.5 mg/100 g) for 10 days (PRED group, n=23), a group that was given testosterone injections (0.5 mg/100 g) for 13 days (TEST group, n=18), and a group that was given a combination of prednisolone and testosterone injections (0.5 mg/100 g) for 10 and 13 days, respectively (COMBO group, n=23). Methods. The animals were weighed daily, and drug doses were adjusted to changes in body mass. Twenty-four hours following the final injection, animals were weighed and sacrificed and the diaphragm was removed and weighed. A small strip of diaphragm was attached to a force transducer to determine normalized maximal isometric tetanic tension (PO). Results. Body weights in the PRED group were decreased by 26% as compared with body weights in the CONT group, and body weights in the COMBO group were decreased by 11% as compared with body weights in the CONT group. Diaphragm weights in the PRED and COMBO groups were decreased by 22% and 12%, respectively, as compared with diaphragm weights in the CONT group. Normalized maximal isometric tetanic tension was decreased by 11% in the PRED group as compared with PO in both the CONT and TEST groups and was decreased by 13% as compared with PO in the COMBO group. There was no difference in PO among the CONT, TEST, and COMBO groups. Discussion and Conclusion. The results support the hypothesis that simultaneous administration of testosterone with glucocorticoids would prevent a decrease in PO. The results indicate that simultaneous administration of testosterone with glucocorticoids prevented the loss in body weight and partially attenuated the loss in diaphragm weight that is commonly observed when glucocorticoids are given alone. These data support the notion that testosterone may be useful in the prevention of glucocorticoid-induced atrophy.
Maximal Voluntary and Functional Performance Needed for Independence in Adults Aged 65 to 97 Years
Authors: Cress M Elaine , Meyer Mary 
Published: February 2017

Abstract
Background and Purpose. Age-related loss of muscle mass and cardiovascular endurance can lead to impairments in muscle force production and cardiac function that, in turn, limit performance in activities essential to everyday living. The purposes of this study were: (1) to identify the “breakpoint” or threshold of maximal voluntary performance and performance in ordinary daily function (2) to evaluate the predictive validity of the threshold to identify the ability independently without self-reported functional limitation. Subjects and Methods. Men and women (N=192; mean age=76 years, SD=7 were recruited from single-family community dwellings or retiremet communities with multiple levels of care. Physical function was measured with the Continuous-Scale Physical Functional Performance Test (CS-PFP). Maximal voluntary performance measures included peak oxygen consumption (V̇) and isokinetic knee extensor torque (KET). Segmented linear regression models of the CS-PFP on the physical performance measures were used to determine the threshold values and their confidence intervals. A logistic regression model was used to evaluate the ability of the CS-PFP scores to identify those living independently and to further illustrate the concepts of threshold and physical reserve. Results. Threshold values identified for V̇O2peak (20 mL·kg−1·min−1) and KET (2.5 N·m/[kgom-1]) were associated with an average of CS-PFP scoe of 57 units. The threshold accurately predicted individuals reporting functional limitations. Discussion and Conclusion. The thresholds provide a mechanism for easily estimating an individual's physical reserve, predicting dependency in living status, and providing unbiased guidance for intervention in late-life independence.
An Electromyographic Analysis of the Deep Cervical Flexor Muscles in Performance of Craniocervical Flexion
Authors: Falla Deborah , Jull Gwendolen , Dall'Alba Paul , Rainoldi Alberto , Merletti Roberto 
Published: February 2017

Abstract
Background and Purpose. This study evaluated an electromyographic technique for the measurement of muscle activity of the deep cervical flexor (DCF) muscles. Electromyographic signals were detected from the DCF, sternocleidomastoid (SCM), and anterior scalene (AS) muscles during performance of the craniocervical flexion (CCF) test, which involves performing 5 stages of increasing craniocervical flexion range of motion—the anatomical action of the DCF muscles. Subjects. Ten volunteers without known pathology or impairment participated in this study. Methods. Root-mean-square (RMS) values were calculated for the DCF, SCM, and AS muscles during performance of the CCF test. Myoelectric signals were recorded from the DCF muscles using bipolar electrodes placed over the posterior oropharyngeal wall. Reliability estimates of normalized RMS values were obtained by evaluating intraclass correlation coefficients and the normalized standard error of the mean (SEM). Results. A linear relationship was evident between the amplitude of DCF muscle activity and the incremental stages of the CCF test (F=239.04, df=36, P&lt;.0001). Normalized SEMs in the range 6.7% to 10.3% were obtained for the normalized RMS values for the DCF muscles, providing evidence of reliability for these variables. Discussion and Conclusion. This approach for obtaining a direct measure of the DCF muscles, which differs from those previously used, may be useful for the examination of these muscles in future electromyographic applications.
Dermatomyositis: Evolution of a Diagnosis
Authors: Cleland Joshua A , Venzke Jane Walter 
Published: February 2017

AbstractBackground and Purpose. As direct access evolves, physical therapists will increasingly encounter patients with pathology that might have an underlying systemic origin. The purpose of this case report is to describe the diagnostic process that led a patient's physical therapist to recognize signs and symptoms of dermatomyositis. Case Description. The patient was an 18-year-old woman who was referred for physical therapy by her primary care physician on 3 occasions with 3 separate musculoskeletal diagnoses. During the third episode, the physical therapist recognized signs and symptoms that could be indicative of dermatologic disease and referred the patient to a dermatologist. Outcomes. A rheumatologist diagnosed the patient's condition as dermatomyositis and referred her for physical therapy. The physical therapy plan of care focused on strengthening and stretching, with an emphasis on a home exercise program. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) indicated that the patient continually made functional improvements over an 18-month period. Discussion. Although diagnosis of diseases such as inflammatory myopathies is not within a physical therapist's scope of practice, this case demonstrates the role a physical therapist can play in recognition of underlying systemic pathology by using the diagnostic process.
Using Clinical Outcomes to Identify Expert Physical Therapists
Authors: Resnik Linda , Hart Dennis L 
Published: February 2017

Abstract
Background and Purpose. Previous studies of expert physical therapists have sampled therapists based on years of clinical experience or reputation, not on their patients' clinical outcomes. The purposes of this study were to identify expert physical therapists by using patient self-reported outcomes and to describe the characteristics of clinicians whose patients with lumbar spine syndromes reported higher health-related quality of life (HRQL) following rehabilitation. Methods. Retrospective data were analyzed on 24,276 patients (mean age=47.8 years, SD=16, range=14–97) with lumbar spine syndromes treated by 930 physical therapists participating in the Focus On Therapeutic Outcomes database in 1999–2000. Physical therapists and staff answered questions concerning years of experience and practice setting when starting their participation in the outcomes system. Patient self-report HRQL data were collected at intake and discharge from outpatient rehabilitation. Discharge HRQL data were risk adjusted using patient characteristics. Data were aggregated by physical therapist. Risk-adjusted discharge HRQL scores were used to classify physical therapists whose patients reported mean HRQL improvement above the 90th percentile as experts and physical therapists whose patients reported mean HRQL improvement between the 45th and 55th percentiles as average. Results. Therapists classified as expert had fewer patients in the database than did therapists classified as average (X̄±SD) (19±17 versus 29±22). Mean treatment duration was different between groups (32±11 days for the expert group versus 31±8 days for the average group). Discussion and Conclusion. The results challenge assumptions that extensive clinical experience is necessary to achieve superior patient outcomes, and they provide information about the relationship between therapist characteristics and patient outcomes.