bluuebunny/crossref_metadata_2025_split huggingface dataset:
Head Stability in Walking in Children With Cerebral Palsy and in Children and Adults Without Neurological Impairment
Authors: Holt Kenneth G , Ratcliffe Robert , Jeng Suh-Fang 
Published: February 2017

Abstract
Background and Purpose. The location of several sensory systems in the head implies that maintenance of head stability may be a potentially important part of locomotor activity. A limited amount of research, however, has been conducted to measure stability or to compare head stability among different groups. The purpose of this study was to determine whether a method for measuring head stability during walking could differentiate among 3 groups: (1) children with cerebral palsy, (2) children without neurological impairment, and (3) adults without neurological impairment. Subjects. Eight adults without known neurological impairment, 6 children without known neurological impairment, and 6 children with cerebral palsy and mild spastic hemiplegia were compared. Methods. Subjects walked on a treadmill at their preferred speed at a number of frequencies. Head stability was characterized by fluctuations in period and amplitude of head motion in the sagittal plane across walking cycles. Results. Mean period fluctuation was lower for the adults than for the children, and it was lower for the children without neurological impairments than for the children with cerebral palsy. Conclusion and Discussion. The method can be used to differentiate head stability among different groups during functional activities.
Statistical Inference by Confidence Intervals: Issues of Interpretation and Utilization
Authors: Sim Julius , Reid Norma 
Published: February 2017

Abstract
This article examines the role of the confidence interval (CI) in statistical inference and its advantages over conventional hypothesis testing, particularly when data are applied in the context of clinical practice. A CI provides a range of population values with which a sample statistic is consistent at a given level of confidence (usually 95%). Conventional hypothesis testing serves to either reject or retain a null hypothesis. A CI, while also functioning as a hypothesis test, provides additional information on the variability of an observed sample statistic (ie, its precision) and on its probable relationship to the value of this statistic in the population from which the sample was drawn (ie, its accuracy). Thus, the CI focuses attention on the magnitude and the probability of a treatment or other effect. It thereby assists in determining the clinical usefulness and importance of, as well as the statistical significance of, findings. The CI is appropriate for both parametric and nonparametric analyses and for both individual studies and aggregated data in meta-analyses. It is recommended that, when inferential statistical analysis is performed, CIs should accompany point estimates and conventional hypothesis tests wherever possible.
Toward Sensitive Practice: Issues for Physical Therapists Working With Survivors of Childhood Sexual Abuse
Authors: Schachter Candice L , Stalker Carol A , Teram Eli 
Published: February 2017

Abstract
Background and Purpose. The high rates of prevalence of childhood sexual abuse in the United States and Canada suggest that physical therapists work, often unknowingly, with adult survivors of childhood sexual abuse. The purposes of this qualitative study were to explore the reactions of adult female survivors of childhood sexual abuse to physical therapy and to listen to their ideas about how practitioners could be more sensitive to their needs. The dynamics and long-term sequelae of childhood sexual abuse, as currently understood by mental health researchers and as described by the participants, are summarized to provide a context for the findings of this study. Subjects and Methods. Twenty-seven female survivors (aged 19–62 years) participated in semistructured interviews in which they described their reactions to physical therapy. Results. Survivors' reactions to physical therapy, termed “long-term sequelae of abuse that detract from feeling safe in physical therapy,” are reported. Participant-identified suggestions that could contribute to the sense of safety are shared. Conclusions and Discussion. Although the physical therapist cannot change the survivor's history, an appreciation of issues associated with child sexual abuse theoretically can increase clinicians' understanding of survivors' reactions during treatment. We believe that attention by the physical therapist to the client's sense of safety throughout treatment can maximize the benefits of the physical therapy experience for the client who is a survivor. [Schachter CL, Stalker CA, Teram E. Toward sensitive practice: issues for physical therapists working with survivors of childhood sexual abuse.
Effects of Side Lying on Lung Function in Older Individuals
Authors: Manning Fiona , Dean Elizabeth , Ross Jocelyn , Abboud Raja T 
Published: February 2017

Abstract
Background and Purpose. Body positioning exerts a strong effect on pulmonary function, but its effect on other components of the oxygen transport pathway are less well understood, especially the effects of side-lying positions. This study investigated the interrelationships between side-lying positions and indexes of lung function such as spirometry, alveolar diffusing capacity, and inhomogeneity of ventilation in older individuals. Subjects and Methods. Nineteen nonsmoking subjects (mean age=62.8 years, SD=6.8, range=50–74) with no history of cardiac or pulmonary disease were tested over 2 sessions. The test positions were sitting and left side lying in one session and sitting and right side lying in the other session. In each of the positions, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), single-breath pulmonary diffusing capacity (DLCO/VA), and the slope of phase III (DN2%/L) of the single-breath nitrogen washout test to determine inhomogeneity of ventilation were measured. Results. Compared with measurements obtained in the sitting position, FVC and FEV1 were decreased equally in the side-lying positions, but no change was observed in DLCO/VA or DN2%/L. Conclusion and Discussion. Side-lying positions resulted in decreases in FVC and FEV1, which is consistent with the well-documented effects of the supine position. These findings further support the need for prescriptive rather than routine body positioning of patients with risks of cardiopulmonary compromise and the need to use upright positions in which lung volumes and capacities are maximized.
Health Promotion for People With Disabilities: The Emerging Paradigm Shift From Disability Prevention to Prevention of Secondary Conditions
Authors: Rimmer James H 
Published: February 2017

Abstract
The premise of this article is that, until recently, health promotion for people with disabilities has been a neglected area of interest on the part of the general health community. Today, researchers, funding agencies, and health care providers and consumers are leading an effort to establish higher-quality health care for the millions of Americans with disabilities. The aims of a health promotion program for people with disabilities are to reduce secondary conditions (eg, obesity, hypertension, pressure sores), to maintain functional independence, to provide an opportunity for leisure and enjoyment, and to enhance the overall quality of life by reducing environmental barriers to good health. A greater emphasis must be placed on community-based health promotion initiatives for people with disabilities in order to achieve these objectives.
Accuracy of Digitization Using Automated and Manual Methods
Authors: Wilson Daniel J , Smith Bryan K , Gibson J Kyle , Choe Byung K , Gaba Brenda C , Voelz John T 
Published: February 2017

Abstract
Background and Purpose. Computerized 3-dimensional (3-D) motion measurement systems are used by those interested in human motion. The purposes of this study were (1) to determine the limits of accuracy in determining intersegmental angles during pendular motion at varying speeds and (2) to determine changes in accuracy introduced by autodigitization and digitization by experienced manual raters. Methods. Angular speed of a T-shaped pendulum was systematically increased by releasing the pendulum from 4 angles (0° [no movement], 45°, 90°, and 120°). Twelve reference angles calculated from markers placed on the pendulum were estimated over 20 frames for 10 trials at each release position. Results. Mean errors across trials and frames for intersegmental angles reconstructed by a 3-D motion measurement system were within ±1 degree across all release positions. An analysis of variance and a post hocTukey test revealed that the mean error for the autodigitized trials was larger than that for the manually digitized trials. For the autodigitized trials, the static trials (release position=0°) produced less mean error than the trials with movement produced. The ICCs showed a high degree of consistency among all raters, ranging from .707 to .999. Conclusion and Discussion. Our findings support the conclusion that under carefully controlled conditions, a 3-D motion measurement system can produce clinically acceptable measurements of accuracy across a range of angular speeds. Furthermore, acceptable accuracy is possible regardless of the digitization method.
Effects of Testing Context on Ball Skill Performance in 5-Year-Old Children With and Without Developmental Delay
Authors: Doty Antonette K , McEwen Irene R , Parker Donald , Laskin James 
Published: February 2017

AbstractBackground and Purpose. Physical therapists often test ball-playing skills of children with disabilities using standardized testing, which may not predict performance of ball skills in games with peers. This type of testing is used by physical therapists to determine whether children have delays in ball-handling skills. The purpose of this study was to compare ball skill performance of children with and without developmental delay in a one-to-one testing situation and in a structured game with peers. Subjects. Five-year-old children with developmental delay (n=20) and 5-year-old children without disabilities (n=20) participated in the study. Methods. We used the Peabody Developmental Motor Scales receipt and propulsion scale to test children one-to-one with a therapist and during a structured game with peers. Results. Subjects without developmental delay performed better than subjects with developmental delay under both testing conditions. Children with developmental delay performed better in the one-to-one testing condition than in the game with peers. The performance of children without developmental delay did not differ under the 2 conditions. Boys performed better than girls. Conclusions and Discussion. Physical therapists should consider the potential effect of environment on the ball-handling skills of children with disabilities.
Influence of Age on Length and Passive Elastic Stiffness Characteristics of the Calf Muscle-Tendon Unit of Women
Authors: Gajdosik Richard L , Vander Linden Darl W , Williams Ann K 
Published: February 2017

AbstractBackground and Purpose. Therapeutic stretching of the calf muscle-tendon unit is used to increase its length and to ameliorate decreased dorsiflexion range of motion (ROM), but the influence of age on the passive properties of the calf muscle-tendon unit has not been studied adequately. The purpose of this study was to examine the influence of age on length and passive elastic stiffness (PES) characteristics of the calf muscle-tendon unit when stretched through the full, available dorsiflexion ROM. Subjects. Twenty-four younger women (aged 20–39 years), 24 middle-aged women (aged 40–59 years), and 33 older women (aged 60–84 years) participated. Methods. An isokinetic dynamometer was used to passively stretch the right calf muscle-tendon unit from relaxed plantar flexion to the maximal angle of available dorsiflexion at 5°·s−1. The maximal passive resistive torque was measured, and passive angle-torque curves were constructed for a full ROM from an initial angle of passive resistive torque to the maximal dorsiflexion angle. The full ROM represented length extensibility. The average PES was calculated for this full stretch ROM and for the first half and the last half of this stretch ROM. The maximal passive dorsiflexion angle, maximal passive resistive torque, angular change for the full stretch ROM, and average PES for the full stretch ROM and the first half and the last half of the full stretch ROM were examined for group differences and their relationships with age. Results. The maximal passive dorsiflexion angle, maximal passive resistive torque, angular change for the full stretch ROM, and average PES within the last half of the full stretch ROM were less for the older women than for the younger women. Age was negatively associated with these variables. Conclusion and Discussion. Decreased maximal passive dorsiflexion ROM in older women was associated with decreased maximal passive resistive torque, decreased calf muscle-tendon unit length extensibility, and decreased average PES within the last half of their available passive dorsiflexion ROM.
Bactericidal Effect of 0.95-mW Helium-Neon and 5-mW Indium-Gallium-Aluminum-Phosphate Laser Irradiation at Exposure Times of 30, 60, and 120 Seconds on Photosensitized Staphylococcus aureus and Pseudomonas aeruginosa In Vitro
Authors: DeSimone Noelle A , Christiansen Cory , Dore David 
Published: February 2017

Abstract
Background and Purpose. Studies have demonstrated a bactericidal effect of laser irradiation when lasers with power outputs of ≥6 mW are directed toward pathogenic or opportunistic bacteria previously treated with a photosensitizing agent. The purpose of this study was to determine the bactericidal capabilities of irradiation from lasers with power outputs of less than 6 mW on photosensitized microorganisms. Methods. Two bacteria that commonly infect skin lesions, Staphylococcus aureus and Pseudomonas aeruginosa, were used. The 2 lasers used, the 0.95-mW helium-neon laser and the 5-mW indium-gallium-aluminum-phosphate laser, emit light at a wavelength close to the absorption maxima of the sensitizing agent chosen, toluidine blue O. This agent was used because of its proven effectiveness in sensitizing bacteria. For each bacterial strain, toluidine blue O was added to a 108 cells/mL solution until a 0.01% weight/volume ratio was obtained. These mixtures were spread on agar-coated petri dishes, which were then exposed to 1 of the 2 lasers for 30, 60, and 120 seconds. The cultures were then grown overnight and examined for one or more visible zones of inhibition. The areas surrounding the irradiated zone provided a control for the effects of toluidine blue O alone. To determine the effects of laser irradiation without prior toluidine blue O sensitization, separate plates were established using unsensitized bacteria. Results. Although inconsistencies between plates were noted, both lasers produced at least one zone of inhibition in both bacterial species at all 3 time periods. The 5-mW laser, however, produced a greater number of these zones. Conclusion and Discussion. Laser-induced microbial killing of photosensitized organisms could have clinical applications in the treatment of infected skin lesions, pending in vivo studies.
Use of a Classification System to Guide Nonsurgical Management of a Patient With Chronic Low Back Pain
Authors: Maluf Katrina S , Sahrmann Shirley A , Van Dillen Linda R 
Published: February 2017

Abstract
Background and Purpose. This case report describes the use of a classification system in the evaluation of a patient with chronic low back pain (LBP) and illustrates how this system was used to develop a management program in which the patient was instructed in symptom-reducing strategies for positioning and functional movement. Case Description. The patient was a 55-year-old woman with a medical diagnosis of lumbar degenerative disk and degenerative joint disease from L2 to S1. Rotation with extension of the lumbar spine was found to be consistently associated with an increase in symptoms during the examination. Instruction was provided to restrict lumbar rotation and extension during performance of daily activities. Outcomes. The patient completed 8 physical therapy sessions over a 3-month period. Pretreatment, posttreatment, and 3-month follow-up modified Oswestry Disability Questionnaire scores were 43%, 16%, and 12%, respectively. Discussion. Daily repetition of similar movements and postures may result in preferential movement of the lumbar spine in a specific direction, which then may contribute to the development, persistence, or recurrence of LBP. Research is needed to determine whether patients with LBP would benefit from training in activity modifications that are specific to the symptom-provoking movements and postures of each individual as identified through examination.
Writing Patient-Centered Functional Goals
Authors: Randall Kenneth E , McEwen Irene R 
Published: February 2017

AbstractMotor learning research, health care policies, reimbursement practices, and the standards of accrediting bodies all support writing patient-centered functional goals of physical therapy. This article defines patient-centered functional goals within the context of the Guide to Physical Therapist Practice and provides a rationale for incorporating functional goals into physical therapy for patients in all areas of practice. The article also describes how physical therapists can collaborate with patients to identify functional goals that are meaningful to them and describes a 5-step process for writing functional goals that are measurable.
Alberta Infant Motor Scale: Reliability and Validity When Used on Preterm Infants in Taiwan
Authors: Jeng Suh-Fang , Yau Kuo-Inn Tsou , Chen Li-Chiou , Hsiao Shu-Fang 
Published: February 2017

AbstractBackground and Purpose. The goal of this study was to examine the reliability and validity of measurements obtained with the Alberta Infant Motor Scale (AIMS) for evaluation of preterm infants in Taiwan. Subjects. Two independent groups of preterm infants were used to investigate the reliability (n=45) and validity (n=41) for the AIMS. Methods. In the reliability study, the AIMS was administered to the infants by a physical therapist, and infant performance was videotaped. The performance was then rescored by the same therapist and by 2 other therapists to examine the intrarater and interrater reliability. In the validity study, the AIMS and the Bayley Motor Scale were administered to the infants at 6 and 12 months of age to examine criterion-related validity. Results. Intraclass correlation coefficients (ICCs) for intrarater and interrater reliability of measurements obtained with the AIMS were high (ICC=.97–.99). The AIMS scores correlated with the Bayley Motor Scale scores at 6 and 12 months (r=.78 and .90), although the AIMS scores at 6 months were only moderately predictive of the motor function at 12 months (r=.56). Conclusion and Discussion. The results suggest that measurements obtained with the AIMS have acceptable reliability and concurrent validity but limited predictive value for evaluating preterm Taiwanese infants.
Work-Related Musculoskeletal Disorders in Physical Therapists: Prevalence, Severity, Risks, and Responses
Authors: Cromie Jean E , Robertson Valma J , Best Margaret O 
Published: February 2017

Abstract
Background and Purpose. Physical therapists are at risk for work-related musculoskeletal disorders (WMSDs). Little is known of how therapists respond to injury or of what actions they take to prevent injury. The purpose of this study was to investigate the prevalence and severity of WMSDs in physical therapists, contributing risk factors, and their responses to injury. Subjects. As part of a larger study, a systematic sample of 1 in 4 therapists on a state register (n=824) was surveyed. Methods. An 8-page questionnaire was mailed to each subject. Questions investigated musculoskeletal symptoms, specialty areas, tasks and job-related risk factors, injury prevention strategies, and responses to injury. Results. Lifetime prevalence of WMSDs was 91%, and 1 in 6 physical therapists moved within or left the profession as a result of WMSDs. Younger therapists reported a higher prevalence of WMSDs in most body areas. Use of mobilization and manipulation techniques was related to increased prevalence of thumb symptoms. Risk factors pertaining to workload were related to a higher prevalence of neck and upper-limb symptoms, and postural risk factors were related to a higher prevalence of spinal symptoms. Conclusion and Discussion. Strategies used to reduce work-related injury in industry may also apply to physical therapists. Increased risk of thumb symptoms associated with mobilization techniques suggests that further research is needed to establish recommendations for practice. The issues for therapists who move within or leave the profession are unknown, and further research is needed to better understand their needs and experiences.
Passive Ankle Stiffness in Subjects With Diabetes and Peripheral Neuropathy Versus an Age-Matched Comparison Group
Authors: Salsich Gretchen B , Mueller Michael J , Sahrmann Shirley A 
Published: February 2017

Abstract
Background and Purpose. Patients with diabetes mellitus and peripheral neuropathy (DM and PN) often complain of joint stiffness. Although stiffness may contribute to some of the impairments and functional limitations found in these patients, it has not been quantified in this population. The purpose of this study was to quantify and compare passive ankle stiffness and dorsiflexion (DF) range of motion in subjects with DM and PN versus an age-matched comparison group. Subjects. Thirty-four subjects were tested (17 subjects with DM and PN and 17 subjects in an age-matched comparison group). There were 10 male subjects and 7 female subjects in each group. Methods. A Kin-Com dynamometer was used to measure passive plantar flexor torque as each subject's ankle was moved from plantar flexion into dorsiflexion at 60°/s. The following variables were compared using a Student t test: initial angle (angle of onset of plantar flexor torque), maximal dorsiflexion angle, plantar flexor muscle excursion (difference between initial angle and maximal dorsiflexion angle), slope of the first half of the plantar flexor torque curve (stiffness 1 measurement), and slope of the second half of the plantar flexor torque curve (stiffness 2 measurement). Results. The subjects with DM and PN group had smaller maximal dorsiflexion angles and less plantar flexor muscle excursion than the comparison group. There was no difference in initial angle, stiffness 1 measurement, or stiffness 2 measurement. Conclusion and Discussion. Although the subjects with DM and PN had less dorsiflexion range of motion than did the comparison group, there was no difference in stiffness between the groups. This finding suggests that people with DM and PN have “short” versus “stiff” plantar flexor muscles.