bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physiologic Evidence for the Efficacy of Positive Expiratory Pressure as an Airway Clearance Technique in Patients With Cystic Fibrosis
Authors: Darbee Joan C , Ohtake Patricia J , Grant Brydon JB , Cerny Frank J 
Published: February 2017

AbstractBackground and Purpose. Individuals with cystic fibrosis (CF) have large amounts of infected mucus in their lungs, which causes irreversible lung tissue damage. Although patient-administered positive expiratory pressure (PEP) breathing has been promoted as an effective therapeutic modality for removing mucus and improving ventilation distribution in these patients, the effects of PEP on ventilation distribution and gas mixing have not been documented. Therefore, this preliminary investigation described responses in distribution of ventilation and gas mixing to PEP breathing for patients with moderate to severe CF lung disease. Subjects and Methods. The effects of PEP breathing on ventilation distribution, gas mixing, lung volumes, expiratory airflow, percentage of arterial blood oxyhemoglobin saturation (Spo2), and sputum volume were studied in 5 patients with CF (mean age=18 years, SD=4, range=13–22) after no-PEP, low-PEP (10–20 cm H2O), and high-PEP (&gt;20 cm H2O) breathing conditions. Single-breath inert gas studies and lung function tests were performed before, immediately after, and 45 minutes after intervention. Single-breath tests assess ventilation distribution homogeneity and gas mixing by observing the extent to which an inspired test gas mixes with gas already residing in the lung. Results. Improvements in gas mixing were observed in all PEP conditions. By 45 minutes after intervention, the no-PEP group improved by 5%, the low-PEP group improved by 15%, and the high-PEP group improved by 23%. Slow vital capacity increased by 1% for no PEP, by 9% for low PEP, and by 13% for high PEP 45 minutes after intervention. Residual volume decreased by 13% after no PEP, by 20% after low PEP, and by 30% after high PEP. Immediate improvements in forced expiratory flow during the middle half of the forced vital capacity maneuver (FEF25%–75%) were sustained following high PEP but not following low PEP. Discussion and Conclusion. This study demonstrated the physiologic basis for the efficacy of PEP therapy. The results confirm that low PEP and high PEP improve gas mixing in individuals with CF, and these improvements were associated with increased lung function, sputum expectoration, and SpO2. The authors propose that improvements in gas mixing may lead to increases in oxygenation and thus functional exercise capacity.
Physical Therapist Management of a Patient With Acute Low Back Pain and Elevated Fear-Avoidance Beliefs
Authors: George Steven Z , Bialosky Joel E , Fritz Julie M 
Published: February 2017

Abstract
Background and Purpose. Elevated fear-avoidance beliefs are believed to be a precursor of chronic disability, yet effective intervention options have not been described in the literature. The purpose of this case report is to describe physical therapist management of a patient with acute low back pain and elevated fear-avoidance beliefs. Case Description. The patient was a 42-year-old sales manager with acute low back pain. The patient had no previous history of activity-limiting low back pain and initially had limitations in straight leg raising, limitations in lumbar movement, and elevated fear-avoidance beliefs. Intervention. Treatment-based classification and graded exercise were used. Outcome. Disability, fear-avoidance beliefs, and pain decreased 4 weeks after starting physical therapy. Six months later, disability and fear-avoidance beliefs had increased, but were still improved when compared with the initial measurements. Discussion. Disability and fear-avoidance beliefs improved following a fear-avoidance-based physical therapy intervention. Research is warranted to investigate the effectiveness of this approach.
Factor Analysis as a Tool for Survey Analysis Using a Professional Role Orientation Inventory as an Example
Authors: Swisher Laura L , Beckstead Jason W , Bebeau Muriel J 
Published: February 2017

Abstract
Background and Purpose. The purpose of this article is to illustrate how confirmatory factor analysis can be used to extend and clarify a researcher's insight into a survey instrument beyond that afforded through the typical exploratory factor analytic approach. The authors use as an example a survey instrument developed to measure individual differences in professional role orientation among physical therapists, the Professional Role Orientation Inventory for Physical Therapists (PROI-PT). Sample. Five hundred three physical therapists responded to a mail survey instrument that was sent to a random sample of 2,000 American Physical Therapy Association members. Methods. An adapted version of the Professional Role Orientation Inventory, a 40-item Likert-scale instrument developed to assess professional role orientation on 4 dimensions (authority, responsibility, agency, and autonomy), was used. Exploratory and confirmatory factor analyses were used to examine the factorial validity of the PROI-PT. Results. Exploratory factor analysis served as a starting point for examining the factor structure of the instrument. Confirmatory factor analysis then was used to test the hypothesized factor structure and to suggest refinements to the PROI-PT that would improve a psychometric property (internal consistency). Discussion and Conclusion. Although further refinement of the PROI-PT is needed, an instrument that yields valid and reliable measurements of individual differences in professionalism among physical therapists could further our understanding of the psychosocial aspects of physical therapist practice. Exploratory and confirmatory factor analyses can be used by researchers who study various psychosocial constructs in physical therapy.
The Performance of Infants Born Preterm and Full-term in the Mobile Paradigm: Learning and Memory
Authors: Heathcock Jill C , Bhat Anjana N , Lobo Michele A , Galloway James (Cole) 
Published: February 2017

Abstract
Background and Purpose. By 3 to 4 months of age, infants born full-term and without known disease display associative learning and memory abilities in the mobile paradigm, where an infant's leg is tethered to a mobile such that leg kicks result in proportional mobile movement. The first purpose of this study was to examine the learning and memory abilities of a group of infants born full-term compared with those of a comparison group. Little is known about the learning and memory abilities in infants born preterm, a group at known risk for future impairments in learning and movement. The second purpose of this study was to determine if and when an age-adjusted group of infants born prematurely display associative learning and memory abilities over a 6-week period. Subjects. Ten infants born full-term (38–42 weeks gestational age [GA]) and 10 infants born preterm (&lt;33 weeks GA and &lt;2,500 g) who were tethered and had control over the mobile movement were independently compared with a comparison group of 10 infants born full-term who were tethered and viewed a moving mobile but did not have control over the mobile movement. Infants in all 3 groups were seen at 3 to 4 months of age and were excluded from participation for any known visual or orthopedic diagnoses. Methods. Infants were tested using the mobile conjugate reinforcement paradigm, where one leg is tethered to an overhead mobile such that kicking with that leg results in proportional mobile movement. The kicking rates of the full-term group and the preterm group were compared with their own initial (baseline) kicking rates and with those of the comparison group. Results. After exposure to the conjugate relationship between kicking and mobile movement, the full-term group kicked more frequently compared with their own baseline levels and compared with the comparison group, fulfilling both criteria for learning and memory. In contrast, the preterm group did not increase their kicking rate according to both criteria. Discussion and Conclusion. These results suggest that infants born prematurely differ in their performance in the mobile paradigm as compared with age-matched infants born full-term. The mobile paradigm may provide clinicians with an important early assessment of infants' associative learning and memory abilities. Follow-up studies are needed, however, to further validate this paradigm as a clinical assessment tool.
Physical Therapy Use by Community-Based Older People
Authors: Freburger Janet K , Holmes George M 
Published: February 2017

Abstract
Background and Purpose. Little information is available on factors associated with physical therapy use. Identifying the characteristics of people who use physical therapy and some of the factors associated with its use is a useful first step in determining whether disparities exist in physical therapy use. The purpose of this study was to identify factors associated with physical therapy use by community-based older people. Subjects. The subjects were community-based people 65 years of age or older who participated in the Medicare Current Beneficiary Survey and had at least one physician encounter (N=38,312 person-years across 20,227 individuals). Methods. Logit and ordinary least squares regression analyses were conducted to identify factors associated with physical therapy use. Results. Several measures of health and function were associated with physical therapy use. Several demographic, insurance, and geographic characteristics also were associated with physical therapy use. Income, education, having supplemental private insurance, participating in a managed care plan, and physical therapist supply were positively associated with physical therapy use. Age was negatively associated with physical therapy use. For people who saw a physical therapist, amount of physical therapy received was positively associated with income, having supplemental private insurance, living in a metropolitan area, physical therapist supply, and being African American. Amount of physical therapy received was negatively associated with being in a managed care plan. Discussion and Conclusions. Variation in physical therapy use, explained by factors other than need, suggests potential underuse or overuse of physical therapy by community-based older people.
The Relative Kicking Frequency of Infants Born Full-term and Preterm During Learning and Short-term and Long-term Memory Periods of the Mobile Paradigm
Authors: Heathcock Jill C , Bhat Anjana N , Lobo Michele A , Galloway James (Cole) 
Published: February 2017

Abstract
Background and Purpose. Infants born preterm differ in their spontaneous kicking, as well as their learning and memory abilities in the mobile paradigm, compared with infants born full-term. In the mobile paradigm, a supine infant's ankle is tethered to a mobile so that leg kicks cause a proportional amount of mobile movement. The purpose of this study was to investigate the relative kicking frequency of the tethered (right) and nontethered (left) legs in these 2 groups of infants. Subjects. Ten infants born full-term and 10 infants born preterm (&lt;33 weeks gestational age, &lt;2,500 g) and 10 comparison infants participated in the study. Methods. The relative kicking frequencies of the tethered and nontethered legs were analyzed during learning and short-term and long-term memory periods of the mobile paradigm. Results. Infants born full-term showed an increase in the relative kicking frequency of the tethered leg during the learning period and the short-term memory period but not for the long-term memory period. Infants born preterm did not show a change in kicking pattern for learning or memory periods, and consistently kicked both legs in relatively equal amounts. Discussion and Conclusion. Infants born full-term adapted their baseline kicking frequencies in a task-specific manner to move the mobile and then retained this adaptation for the short-term memory period. In contrast, infants born preterm showed no adaptation, suggesting a lack of purposeful leg control. This lack of control may reflect a general decrease in the ability of infants born preterm to use their limb movements to interact with their environment. As such, the mobile paradigm may be clinically useful in the early assessment and intervention of infants born preterm and at risk for future impairment.
Can Mental Practice Increase Ankle Dorsiflexor Torque?
Authors: Sidaway Ben , Trzaska Amy (Robinson) 
Published: February 2017

Abstract
Background and Purpose. Mental practice has been shown to be effective in increasing the force production of the abductor digiti minimi muscle in the hand. The aim of this study was to determine whether mental practice could produce strength gains in the larger ankle dorsiflexor muscles, which are important during walking. Subjects. Twenty-four subjects were randomly assigned to a physical practice group, a mental practice group, or a control group (8 subjects per group). Methods. In the practice groups, subjects either physically or mentally practiced producing maximal isometric contractions for 3 sets of 10 repetitions, 3 times per week for 4 weeks. Changes in mean peak isometric torque normalized to body weight and the resulting percentage of improvement were analyzed across the 3 groups. Results. Differences in raw torque production after training in the 2 practice groups resulted in significant percentages of improvement for the physical practice group (25.28%) and the mental practice group (17.13%), but not for the control group (−1.77%). The 2 practice groups were not statistically different in their maximal torque-generating capacity after training. Discussion and Conclusion. These findings show that mental practice in people without impairments can lead to an increase in torque production similar to that produced by physical practice. Such a technique may prove to be a useful adjunct to traditional treatment options aimed at increasing muscle strength.
Scapular Muscle Tests in Subjects With Shoulder Pain and Functional Loss: Reliability and Construct Validity
Authors: Michener Lori A , Boardman N Douglas , Pidcoe Peter E , Frith Angela M 
Published: February 2017

Abstract
Background and Purpose. Scapular muscle performance evaluated with a handheld dynamometer (HHD) has been investigated only in people without shoulder dysfunction for test-retest reliability of data obtained with a single scapular muscle test. The purpose of this study was to assess the reliability, error, and validity of data obtained with an HHD for 4 scapular muscle tests in subjects with shoulder pain and functional loss. Subjects and Methods. Subjects (N=40) with shoulder pain and functional loss were tested bymeasuring the kilograms applied with an HHD during 3 trials for muscle tests for the lower trapezius, upper trapezius, middle trapezius, and serratus anterior muscles. Concurrently, surface electromyography (sEMG) data were collected for the 4 muscles. The same procedures were performed 24 to 72 hours after the initial testing by the same tester. Muscle tests were performed 3 times, and the results were averaged for data analysis. Results. Intraclass correlation coefficients for intratester reliability of measurements of isometricforce obtained using an HHD ranged from .89 to .96. The standard error of the measure (90% confidenceinterval [CI]) ranged from 1.3 to 2.7 kg; the minimal detectable change (90% CI) ranged from 1.8 to 3.6 kg. Construct validity assessment, done by comparing the amounts of isometric muscle activity (sEMG) for each muscle across the 4 muscle tests, revealed that the muscle activity of the upper trapezius and lower trapezius muscles washighest during their respective tests. Conversely, the isometric muscle activity of the middle trapezius and serratus anterior muscles was not highest during their respective tests. Discussion and Conclusion. In people with shoulder pain and functional loss, the intrarater reliability and error over 1 to 3 days were established using an HHD for measurement of isometric force for the assessment of scapular muscle performance. Error values can be used to make decisions regarding individual patients. Construct validity was established for the lower and upper trapezius muscle tests; therefore, these tests are advocated for use. However, construct validity was not demonstrated for the serratus anterior and middle trapezius muscle tests as performed in this study. Further investigation of these muscle tests is warranted.
Management of Work-Related Low Back Pain: A Population-Based Survey of Physical Therapists
Authors: Poitras Stéphane , Blais Régis , Swaine Bonnie , Rossignol Michel 
Published: February 2017

Abstract
Background and Purpose. Physical therapy often is used in the management of work-related low back pain (LBP). Little information, however, is known about the types of interventions used by physical therapists in the management of this condition. The objective of this study was to describe the interventions used by physical therapists in the treatment of workers with acute or subacute LBP, with or without radiating pain below the knee. Subjects. Clinical management questionnaires for workers without and with radiating pain were returned by 190 and 139 physical therapists, respectively. Methods. For each treatment session, therapists recorded treatment objectives, interventions, and education provided to 2 workers with LBP, 1 with radiating pain and 1 without radiating pain. Results. The majority of physical therapists used stretching and strengthening exercises, spinal mobilizations, soft tissue mobilizations and massage, manual traction, posture correction, interferential current, ultrasound, heat, and functional activities education. With radiating pain, the majority of the therapists also used cold and the McKenzie approach. Treatment objectives pursued by the majority of the therapists were decrease of pain, increase of range of motion, increase of muscle strength (force-generating capacity of muscle), decrease of muscle tension, and worker education. Discussion and Conclusion. Physical therapists use an array of interventions with workers with LBP. The effectiveness of most interventions reported has not been well studied.
Physiologic Evidence for High-Frequency Chest Wall Oscillation and Positive Expiratory Pressure Breathing in Hospitalized Subjects With Cystic Fibrosis
Authors: Darbee Joan C , Kanga Jamshed F , Ohtake Patricia J 
Published: February 2017

AbstractBackground and Purpose. This investigation identified ventilation distribution, gas mixing, lung function, and arterial blood oxyhemoglobin saturation (Spo2) physiologic responses to 2 independent airway clearance treatments, high-frequency chest wall oscillation (HFCWO) and low positive expiratory pressure (PEP) breathing, for subjects who had cystic fibrosis (CF) and who were hospitalized during acute and subacute phases of a pulmonary exacerbation. Subjects. Fifteen subjects with moderate to severe CF were included in this study. Methods. Subjects performed single-breath inert gas tests and spirometry before and immediately after HFCWO and PEP breathing at admission and discharge. Arterial blood oxyhemoglobin saturation was monitored throughout each treatment. Results. At admission and discharge, PEP breathing increased Spo2 during treatment, whereas HFCWO decreased Spo2 during treatment. Ventilation distribution, gas mixing, and lung function improved after HFCWO or PEP breathing. Discussion and Conclusion. High-frequency chest wall oscillation and PEP breathing are similarly efficacious in improving ventilation distribution, gas mixing, and pulmonary function in hospitalized people with CF. Because Spo2 decreases during HFCWO, people who have moderate to severe CF and who use HFCWO should have Spo2 monitored during an acute exacerbation.
Relationship of Balance and Mobility to Fall Incidence in People With Chronic Stroke
Authors: Harris Jocelyn E , Eng Janice J , Marigold Daniel S , Tokuno Craig D , Louis Cheryl L 
Published: February 2017

Abstract
Background and Purpose. People with stroke are at risk for falls. The purpose of this study was to estimate the strength of the relationship of balance and mobility to falls. Subjects. The participants were 99 community-dwelling people with chronic stroke. Methods. An interview was used to record fall history, and physical performance assessments were used to measure balance (Berg Balance Scale [BBS]) and mobility (gait speed). Results. No differences were found between subjects who fell once and subjects who did not fall or between subjects who fell more than once and subjects who did not fall. Neither balance nor mobility was able to explain falls in people with chronic stroke. Discussion and Conclusion. Clinicians should be cautious when using the BBS or gait speed to determine fall risk in this population. Falls occurred frequently during walking; it may be necessary to focus on reactive balance and environmental interaction when assessing individuals for risk of falls and devising fall prevention programs for individuals with chronic stroke. The authors' observations suggest that the prescription of 4-wheel walkers for individuals with a low BBS score (≤45) may be a mobility aid that could reduce the risk of falls.
Canadian Physical Therapists' Interest in Web-Based and Computer-Assisted Continuing Education
Authors: Mathur Sunita , Stanton Sue , Reid W Darlene 
Published: February 2017

AbstractBackground and Purpose. Distance education via computer-assisted learning (CAL), including Web-based and CD-ROM learning, confers a number of advantages compared with traditional learning methods. The purposes of this study were (1) to determine the interest of Canadian physical therapists in participating in continuing education using CAL methods and (2) to determine whether interest in CAL was related to type of employment, area of practice, education, computer skill and access, and other demographic variables. Subjects and Methods. A random sample of Canadian physical therapists and all members of cardiopulmonary interest groups were surveyed. Results. Of 1,426 survey questionnaires mailed, 69 were returned (58 were unopened and 11 were duplicates). From the remaining 1,357 potential survey responses, 757 responses were received, for an overall response rate of 56%. Seventy-eight percent of the respondents indicated their interest in participating in CAL. Factors associated with interest in CAL included 2 or more hours of Internet access per week, Internet access at both home and work, computer skill, education level, practice area, and belonging to a cardiopulmonary interest group. Discussion and Conclusion. The findings indicate a large positive interest in CAL. Increasing CAL continuing education opportunities could increase options for physical therapists to meet professional expectations for continuing competency.