bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motor Learning of a Dynamic Balancing Task After Stroke: Implicit Implications for Stroke Rehabilitation
Authors: Orrell Alison J , Eves Frank F , Masters Rich SW 
Published: February 2017

Abstract
Background and Purpose. After a stroke, people often attempt to consciously control their motor actions, which, paradoxically, disrupts optimal performance. A learning strategy that minimizes the accrual of explicit knowledge may circumvent attempts to consciously control motor actions, thereby resulting in better performance. The purpose of this study was to examine the implicit learning of a dynamic balancing task after stroke by use of 1 of 2 motor learning strategies: learning without errors and discovery learning. Participants and Methods. Ten adults with stroke and 12 older adults practiced a dynamic balancing task on a stabilometer under single-task (balance only) and concurrent-task conditions. Root-mean-square error (in degrees) from horizontal was used to measure balance performance. Results. The balance performance of the discovery (explicit) learners after stroke was impaired by the imposition of a concurrent cognitive task load. In contrast, the performance of the errorless (implicit) learners (stroke and control groups) and the discovery learning control group was not impaired. Discussion and Conclusion. The provision of explicit information during rehabilitation may be detrimental to the learning/relearning and execution of motor skills in some people with stroke. The application of implicit motor learning techniques in the rehabilitation setting may be beneficial. [Orrell AJ, Eves FF, Masters RSW. Motor learning of a dynamic balancing task after stroke: implicit implications for stroke rehabilitation. Phys Ther. 2006;86:369–380.]
High-Level Mobility Assessment Tool (HiMAT): Interrater Reliability, Retest Reliability, and Internal Consistency
Authors: Williams Gavin P , Greenwood Kenneth M , Robertson Val J , Goldie Patricia A , Morris Meg E 
Published: February 2017

Abstract
Background and Purpose. The High-Level Mobility Assessment Tool (HiMAT) assesses high-level mobility in people who have sustained a traumatic brain injury (TBI). The purpose of this study was to investigate the interrater reliability, retest reliability, and internal consistency of data obtained with the HiMAT. Subjects. Three physical therapists and 103 people with TBI were recruited from a rehabilitation hospital. Methods. Three physical therapists concurrently assessed a subset of 17 subjects with TBI to investigate interrater reliability. One physical therapist assessed a different subset of 20 subjects with TBI on 2 occasions, 2 days apart, to investigate retest reliability. Data from the entire sample of 103 subjects were used to investigate the internal consistency of this new scale. Results. Both the interrater reliability (intraclass correlation coefficient [ICC]=.99) and the retest reliability (ICC=.99) of the HiMAT data were very high. For retest reliability, a small systematic change was detected (t=3.82, df=19), indicating a marginal improvement of 1 point at retest. Internal consistency also was very high (Cronbach alpha=.97). Discussion and Conclusion. The HiMAT is a new tool specifically designed to measure high-level mobility, which currently is not a component of existing scales used in TBI. This study demonstrated that the HiMAT is a reliable tool for measuring high-level mobility. [Williams GP, Greenwood KM, Robertson VJ, et al. High-Level Mobility Assessment Tool (HiMAT): interrater reliability, retest reliability, and internal consistency. Phys Ther. 2006;86:395–400.]
A High-Intensity Functional Weight-Bearing Exercise Program for Older People Dependent in Activities of Daily Living and Living in Residential Care Facilities: Evaluation of the Applicability With Focus on Cognitive Function
Authors: Littbrand Håkan , Rosendahl Erik , Lindelöf Nina , Lundin-Olsson Lillemor , Gustafson Yngve , Nyberg Lars 
Published: February 2017

Abstract
Background and Purpose. Knowledge concerning the applicability and the effect of high-intensity exercise programs is very limited for older people with severe cognitive and physical impairments. The primary aim of this study was to evaluate the applicability of a high-intensity functional weight-bearing exercise program among older people who are dependent in activities of daily living and living in residential care facilities. A second aim was to analyze whether cognitive function was associated with the applicability of the program. Subjects. The subjects were 91 older people (mean age=85.3 years, SD=6.1, range=68–100) who were dependent in personal activities of daily living and randomly assigned to participate in an exercise intervention. Their mean score for the Mini-Mental State Examination (MMSE) was 17.5 (SD=5.0, range=10–29). Methods. A high-intensity functional weight-bearing exercise program was performed in groups of 3 to 7 participants who were supervised by physical therapists. There were 29 exercise sessions over 13 weeks. Attendance, intensity of lower-limb strength and balance exercises, and occurrence and seriousness of adverse events were the outcome variables in evaluating the applicability of the program. Results. The median attendance rate was 76%. Lower-limb strength exercises with high intensity were performed in a median of 53% of the attended exercise sessions, and balance exercises with high intensity were performed in a median of 73% of the attended exercise sessions. The median rate of sessions with adverse events was 5%. All except 2 adverse events were assessed as minor and temporary, and none led to manifest injury or disease. No significant differences were observed in applicability when comparing participants with dementia and participants without dementia. In addition, there was no significant correlation between applicability and the MMSE score. Discussion and Conclusion. The results suggest that a high-intensity functional weight-bearing exercise program is applicable for use, regardless of cognitive function, among older people who are dependent in activities of daily living, living in residential care facilities, and have an MMSE score of 10 or higher. [Littbrand H, Rosendahl E, Lindelöf N, et al. A high-intensity functional weight-bearing exercise program for older people dependent in activities of daily living and living in residential care facilities: evaluation of the applicability with focus on cognitive function. Phys Ther. 2006;86:489–498.]
Reporting Ethical Protections in Physical Therapy Research
Authors: Henley Lesley D , Frank Denise M 
Published: February 2017

Abstract
Background and Purpose. Efforts to make physical therapy more evidence based have increased demand for human participants, raising concerns for their safety and welfare. This study examined how often research articles in physical therapy journals report basic ethical protections. Methods. We carried out a retrospective audit of research articles in 6 physical therapy journals between 1996 and 2001. Results. Of 806 articles reviewed, 48% documented both research ethics committee approval and informed consent. Articles reporting clinical interventions had the highest reported rate (64%) of both protections. Articles reporting qualitative methods, chart reviews, and case reports had the lowest rates of documentation of both requirements: 30%, 17%, and 11%, respectively. Reported rates of both requirements in vulnerable populations were 55% for children, 48% for students, and 33% for employees. Twenty-six percent of articles included confidentiality assurances. Case reports were most likely and chart reviews were least likely to mention confidentiality: 88% and 8%, respectively. Discussion and Conclusion. There is no uniform editorial policy among physical therapy journals for reporting basic ethical requirements. Physical therapy journals should standardize ethical protections and make documentation of compliance a prerequisite of publication. [Henley LD, Frank DM. Reporting ethical protections in physical therapy research.
Time Dependency of Walking Classification in Stroke
Authors: Kollen Boudewijn , Kwakkel Gert , Lindeman Eline 
Published: February 2017

Abstract
Background and Purpose. To facilitate optimal stroke rehabilitation, valid interpretation of observed functional recovery is required. The purpose of this study was to examine the longitudinal relationship between comfortable walking speed and Functional Ambulation Categories (FAC) scores for physically independent gait. Subjects. This study was a prospective cohort study with 73 subjects who were severely affected by acute stroke. Methods. Functional Ambulation Categories classification and walking speed were measured between weeks 4 and 26 after stroke. The responsiveness of walking speed measurements for detecting clinically important speed changes was determined, and the longitudinal association between walking speed and FAC scores and its time dependency were established. This relationship subsequently was scrutinized for possible speed changes occurring within specific FAC scores. Responsiveness ratios, random coefficient analysis, paired Student t tests, and the Cohen kappa statistic were used for statistical analyses. Results. Responsiveness ratios exceeded the smallest detectable differences. Random coefficient analysis demonstrated a significant between- and within-subject coefficient and a significant negative interaction between timing of measurements and FAC scores. Paired Student t tests revealed mostly significant pretest-posttest differences in walking speeds, and all kappa values for pretest-posttest FAC scores were significant. Discussion and Conclusion. Walking speed measurements are sensitive for detecting clinically important changes. Functional Ambulation Categories scores are dependent on the timing of comfortable walking speed measurements after stroke. Moreover, there are indications that, in this relationship, repeated FAC appraisals are not only based on steady walking speeds, but that the walking speeds related to a specific FAC appraisal also change and, over time, may shift gradually from higher to lower speeds.
Transcutaneous Electrical Nerve Stimulation for the Management of Neuropathic Pain: The Effects of Frequency and Electrode Position on Prevention of Allodynia in a Rat Model of Complex Regional Pain Syndrome Type II
Authors: Somers David L , Clemente F Richard 
Published: February 2017

AbstractBackground and Purpose. Complex regional pain syndrome type II (CPSII) is a painful condition that develops following a nerve injury. Although transcutaneous electrical nerve stimulation (TENS) relieves the pain of CPSII, the stimulation parameters that would best prevent the development of the condition are not known. The purpose of this study was to compare the ability of several different stimulation strategies to reduce the development of allodynia. Subjects. Sprague-Dawley rats were used in the study. Methods. A chronic constriction injury (CCI) to the right sciatic nerve was used to induce allodynia. Two groups of CCI rats received high-frequency TENS to the lumbar paravertebral region with electrodes positioned on the skin overlying either the right or left paraspinal musculature. Two additional groups of CCI rats received low-frequency TENS to acupuncture points in the right or left hind limbs. A fifth group of CCI rats received no TENS intervention. Thermal and mechanical pain thresholds were assessed in the right hind paw before and 12 days after the CCI surgery. The TENS was delivered 1 hour per day beginning on the day of surgery. Results. Daily high-frequency TENS reduced the development of mechanical allodynia in CCI rats, and low-frequency TENS reduced the development of thermal allodynia, but only when TENS was delivered on the left side. Discussion and Conclusion. The results indicate that TENS delivered contralateral to a nerve injury best reduces allodynia development. Comprehensive reduction of allodynia development would require a combination of high- and low-frequency TENS intervention.
A Systematic Review of the Effectiveness of Physical Therapy Interventions for Temporomandibular Disorders
Authors: McNeely Margaret L , Armijo Olivo Susan , Magee David J 
Published: February 2017

Abstract
Background and Purpose. The purpose of this qualitative systematic review was to assess the evidence concerning the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Methods. A literature search of published and unpublished articles resulted in the retrieval of 36 potential articles. Results. Twelve studies met all selection criteria for inclusion in the review: 4 studies addressed the use of therapeutic exercise interventions, 2 studies examined the use of acupuncture, and 6 studies examined electrophysical modalities. Two studies provided evidence in support of postural exercises to reduce pain and to improve function and oral opening. One study provided evidence for the use of manual therapy in combination with active exercises to reduce pain and to improve oral opening. One study provided evidence in support of acupuncture to reduce pain when compared with no treatment; however, in another study no significant differences in pain outcomes were found between acupuncture and sham acupuncture. Significant improvements in oral opening were found with muscular awareness relaxation therapy, biofeedback training, and low-level laser therapy treatment. Discussion and Conclusion. Most of the studies included in this review were of very poor methodological quality; therefore, the findings should be interpreted with caution.
Contractile Properties and the Force-Frequency Relationship of the Paralyzed Human Quadriceps Femoris Muscle
Authors: Scott Wayne B , Lee Samuel CK , Johnston Therese E , Binkley Jennifer , Binder-Macleod Stuart A 
Published: February 2017

AbstractBackground and Purpose. Following spinal cord injury (SCI), paralyzed muscles undergo physiological changes that alter their force responses to electrical stimulation. The purpose of this study was to investigate the effects of SCI on the contractile properties and force-frequency relationship (FFR) of the paralyzed human quadriceps femoris muscle of adolescents and young adults. Subjects. Thirteen subjects (11 male, 2 female; age range=11–24 years) with motor complete SCIs and 13 matched control subjects (11 male, 2 female; age range=9–23 years) without SCI participated in the study. Methods. Both groups of subjects underwent the same testing protocol using similar equipment. Results. The paralyzed muscles of the subjects with SCI produced 62% of the peak twitch force and had a fatigue ratio that was 65% of that of the control subjects. The paralyzed muscles contracted 14% and 25% faster and relaxed 38% and 46% faster than the nonparalyzed muscles in nonfatigued and fatigued conditions, respectively. Compared with the control subjects, the subjects with SCI had twitch-to-tetanus ratios that were 84% and 127% greater in nonfatigued and fatigued conditions, respectively. Relative to the control subjects, the FFR of the subjects with SCI was shifted to the left in the fatigued condition. Relative to their respective nonfatigued conditions, the FFR of both groups of subjects shifted to the right with fatigue. Discussion and Conclusion. These findings may have important implications for designing stimulation strategies to reduce the rapid fatigue that limits the clinical efficacy of functional electrical stimulation. [Scott WB, Lee SCK, Johnston TE, et al. Contractile properties and the force-frequency relationship of the paralyzed human quadriceps femoris muscle. Phys Ther. 2006;86:788–799.]
Physical Therapist Examination, Evaluation, and Intervention for a Patient With West Nile Virus Paralysis
Authors: Miller Nancy H , Miller David J , Goldberg Joanna L 
Published: February 2017

Abstract
Background and Purpose. The incidence of West Nile virus (WNV) has increased in the United States since 1999. A small percentage of people with WNV develop West Nile neuroinvasive disease (WNND) with encephalitis and flaccid paralysis. The purpose of this report is to describe the physical therapist management and outcomes for a patient with WNND and the therapist’s efforts to use an evidence-based practice approach in the management of a patient with this disease. Case Description. The patient was an active 55-year-old woman in excellent health who became acutely ill with asymmetrical lower-extremity weakness. The physical therapist reviewed the available literature, consulted with medical and physical therapist experts and the patient, and elected to use a poliovirus “period of recovery” approach combining intensive strengthening and monitoring of fatigue. Outcomes. The patient progressed from an initial nonambulatory status to ambulation with a single-point cane at week 18 after onset of symptoms. She began to ambulate without an assistive device by week 20. The patient returned to work part-time by week 22 and full-time by week 43. Discussion. These outcomes demonstrate the recovery of a patient with WNND after an intensive strengthening program.[Miller NH, Miller DJ, Goldberg JL. Physical therapist examination, evaluation, and intervention for a patient with West Nile virus paralysis. Phys Ther. 2006;86:843– 856.]
Effects of a Multimodal Exercise Program for People With Ankylosing Spondylitis
Authors: Ince Gonca , Sarpel Tunay , Durgun Behice , Erdogan Seref 
Published: February 2017

Abstract
Background and Purpose. Few randomized controlled studies have examined the effects of exercise in patients with ankylosing spondylitis (AS). This study investigated the effects of a 12-week, multimodal exercise program in patients with AS. Subjects. A convenience sample of 30 patients with AS (18 male, 12 female), with a mean age of 34.9 years (SD=6.28), participated in the study. Twenty-six subjects were classified as having stage I AS and 4 subjects were classified as having stage II AS according to the modified New York Criteria. Methods. This study was a randomized controlled trial. Subjects were assigned to either a group that received an exercise program or to a control group. The exercise program consisted of 50 minutes of multimodal exercise, including aerobic, stretching, and pulmonary exercises, 3 times a week for 3 months. Subjects in both groups received medical treatment for AS, but the exercise group received the exercise program in addition to the medical treatment. All subjects received a physical examination at baseline and at 12 weeks. The examinations were conducted under the supervision of a physician who specialized in physical medicine and rehabilitation and included the assessment of spinal mobility using 2 methods: clinical measurements (chin-to-chest distance, Modified Schober Flexion Test, occiput-to-wall distance, finger-to-floor distance, and chest expansion) and inclinometer measurements (gross hip flexion, gross lumbar flexion, and gross thoracic flexion). In addition, vital capacity was measured by a physiologist, and physical work capacity was evaluated by a doctorally prepared exercise instructor. Results. The measurements of the exercise group for chest expansion, chin-to-chest distance, Modified Schober Flexion Test, and occiput-to-wall distance were significantly better than those of the control group after the 3-month exercise period. The spinal movements of the exercise group improved significantly at the end of exercise program, but those of the control group showed no significant change. In addition, the results showed that the posttraining value of gross thoracic flexion of the exercise group was significantly higher than that of the control group. Physical work capacity and vital capacity values improved in the exercise group but decreased in the control group. Discussion and Conclusion. In this study, a multimodal exercise program including aerobic, stretching, and pulmonary exercises provided in conjunction with routine medical management yielded greater improvements in spinal mobility, work capacity, and chest expansion.
Clinimetric Properties of the Performance-Oriented Mobility Assessment
Authors: Faber Marjan J , Bosscher Ruud J , van Wieringen Piet CW 
Published: February 2017

Abstract
Background and Purpose. The Performance-Oriented Mobility Assessment (POMA) is a widely used instrument that provides an evaluation of balance and gait. It is used clinically to determine the mobility status of older adults or to evaluate changes over time. To support the use of the POMA for these purposes, the clinimetric properties (in particular, responsiveness) were determined. Subjects. Participants (78% female; mean age=84.9 years) were living in either self-care or nursing-care residences. Concurrent and discriminant validity were assessed with the total group (N=245), whereas reliability and responsiveness were determined with a subsample (n=30). Fall-related predictive validity was assessed with a subsample of 72 participants. Methods. In addition to the POMA, several reference performance tests were administered. The POMA was assessed on 2 consecutive days by 2 raters (observers). The analyses included the calculation of Spearman rank correlation coefficients (R), limits of agreement (LOA) with Bland-Altman plots, minimal detectable changes at the 95% confidence level (MDC95), and sensitivity and specificity with regard to predicting falls. When possible, findings for the total scale (POMA-T) were complemented by findings for its balance subscale (POMA-B) and its gait subscale (POMA-G). Results. The interrater and test-retest reliability for the POMA-T and the POMA-B were good (R=.74–.93), whereas for the POMA-G, the reliability values, although high as well, were systematically slightly lower (R=.72–.89). The Spearman correlations with the reference performance tests (R=|.64|–|.68|) indicated satisfactory concurrent validity for the POMA-T and the POMA-B, but the corresponding findings for the POMA-G (R=|.52|–|.56|) were less convincing. The discriminant validity values of the 3 scales were about the same. The LOA for the POMA-T were on the order of –4.0 to 4.0 for test-retest agreement and –3.0 to 3.0 for interrater agreement. On the basis of the MDC95 values, it was concluded that changes in POMA-T scores at the individual level should be at least 5 points and that those at the group level (n=30) should be at least 0.8 point to be considered reliable. Even when optimal cutoff points were used, sensitivity and specificity values (varying between 62.5% and 66.1%) for the POMA-T as well as for its 2 subscales indicated poor accuracy in predicting falls. Discussion and Conclusion. The POMA-T and its subscale POMA-B have adequate reliability and validity for assessing mobility in older adults. The POMA-T is useful for demonstrating intervention effects at the group level. Changes within subjects, however, should be at least 5 points before being interpreted as reliable changes. The accuracy of the POMA-T in predicting falls is poor.