bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence for Electronic Health Record Systems in Physical Therapy
Authors: Vreeman Daniel J , Taggard Samuel L , Rhine Michael D , Worrell Teddy W 
Published: February 2017

Abstract
With increasing pressures to better manage clinical information, we investigated the role of electronic health record (EHR) systems in physical therapist practice through a critical review of the literature. We reviewed studies that met our predefined criteria after independent review by 3 authors. The investigators in all of the reviewed studies reported benefits, including improved reporting, operational efficiency, interdepartmental communication, data accuracy, and capability for future research. In 7 studies, the investigators reported barriers, including challenges with behavior modification, equipment inadequacy, and training. The investigators in all studies reported key success factors, including end-user participation, adequate training, workflow analysis, and data standardization. This review suggests that EHRs have potential benefits for physical therapists. The authors formed the following recommendations based on the studies’ themes: (1) incorporate workflow analysis into system design and implementation; (2) include end users, especially clinicians, in system development; (3) devote significant resources for training; (4) plan and test carefully to ensure adequate software and hardware performance; and (5) commit to data standards. [Vreeman DJ, Taggard SL, Rhine MD, Worrell TW. Evidence for electronic health record systems in physical therapy.
Factors Affecting Physical Activity Behavior in Urban Adults With Arthritis Who Are Predominantly African-American and Female
Authors: Greene Brenda L , Haldeman Gina F , Kaminski Ashley , Neal Kerryn , Lim S Sam , Conn Doyt L 
Published: February 2017

Abstract
Background and Purpose. Physical activity and exercise play a critical role in the management of arthritis. Understanding the factors affecting physical activity and exercise behavior is a necessary first step toward identifying the needs of, and intervention strategies for, people with arthritis. The purpose of this study was to identify factors affecting physical activity and exercise behavior in urban subjects with osteoarthritis (OA) and rheumatoid arthritis (RA). Subjects. Seventy-two consecutive subjects were recruited from the rheumatology clinic at a large urban public hospital. The sample was predominantly African American (92%), female (87%), and not working (90%). The subjects’ average age was 60.9 years (SD=13.9, range=30–90). Methods. Time per day spent sitting or lying down and time per week spent in exercise, leisure, and household activities were determined by individual interview. Self-efficacy, outcome expectations, disability, pain, body mass index, and social support were measured as possible explanatory factors. Results. The average daily total activity time was 3.1 hours. Household and leisure activities accounted for 85% of that time. Explanatory factors for physical activity behavior were not the same for subjects with OA and RA, despite similar between-group characteristics. Self-efficacy was present in all of the significant explanatory models. Discussion and Conclusion. The results indicate that factors that affect physical activity behavior among urban and predominantly African-American adults are dependent upon the type of physical activity and are different for people with OA and RA. Self-efficacy was the most consistent explanatory factor. [Greene BL, Haldeman GF, Kaminski A, et al. Factors affecting physical activity behavior in urban adults with arthritis who are predominantly African-American and female.
Effect of Therapeutic Exercise on Gait Speed in Community-Dwelling Elderly People: A Meta-analysis
Authors: Lopopolo Rosalie B , Greco Melissa , Sullivan Dorianne , Craik Rebecca L , Mangione Kathleen K 
Published: February 2017

Abstract
Background and Purpose. Inconsistent research findings make it unclear whether therapeutic exercise improves gait speed in community-dwelling elderly people. Using meta-analytical procedures, we examined the effect of therapeutic exercise on changing gait speed in community-dwelling older adults and the effect of type, intensity, and dose of therapeutic exercise on gait speed. Method. Studies were retrieved using a comprehensive database search. Two independent reviewers determined study eligibility based on inclusion criteria, rated study quality, and extracted information on study methods, design, intervention, and results. Data were combined to obtain an overall effect size, its 95% confidence interval, and a measure of significance. In addition, analyses to characterize the clinical relevance of the findings were performed. Results. One hundred seventeen studies were evaluated, with 24 studies (n=1,302 subjects) meeting the inclusion criteria for habitual gait speed and 18 studies (n=752 subjects) meeting the inclusion criteria for fast gait speed. Therapeutic exercise—or, more specifically, strength training and combination training (aerobic plus other exercise)—had significant effects (r=.145, P=.017; r=.176, P=.002, respectively) on habitual gait speed. High-intensity (effort expended by subjects) exercise and high-dosage (frequency and duration of exercise sessions) intervention also had a significant effect (r=.184, P=.001; r=.190, P=.001, respectively) on gait speed, whereas there was no effect for moderate- and low-intensity exercise or for low-dosage exercise. No exercise intervention affected fast gait speed in this analysis. Discussion and Conclusion. The results provide support for the belief that therapeutic exercise can improve gait speed in community-dwelling elderly people and that intensity and dosage are important contributing factors. The relatively weak correlation found between therapeutic exercise and gait speed merits further study. [Lopopolo RB, Greco M, Sullivan DH, et al. Effect of therapeutic exercise on gait speed in community-dwelling elderly people: a meta-analysis. Phys Ther. 2006;86:520–540.]
Use of the Physical Performance Test to Assess Preclinical Disability in Subjects With Asymptomatic Carotid Artery Disease
Authors: Landgraff Nancy C , Whitney Susan L , Rubinstein Elaine N , Yonas Howard 
Published: February 2017

Abstract
Background and Purpose. The purpose of this study was to determine whether subjects with asymptomatic carotid artery stenosis and occlusion demonstrate deficits in physical performance compared with a comparison group. These deficits may indicate that a person is demonstrating preclinical disability. Subjects. Seventy-one subjects with no known disease and 39 subjects with asymptomatic carotid artery stenosis of moderate and severe degrees or with occlusion were included. Methods. Physical performance was assessed with the 9-item and 7-item versions of the Physical Performance Test (PPT). Individual tasks also were timed for the subjects with disease. Results. There were significant differences between the comparison group and the subjects with carotid artery stenosis on the 9-item PPT (P&lt;.00) and on the 7-item PPT (P&lt;.03). Subjects with asymptomatic carotid artery stenosis and occlusion demonstrated less than optimal performance on the PPT (9-item PPT, X̅=27 of 36; 7-item PPT, X̅=21 of 28). Subjects with moderate stenosis were the slowest in performing the task of simulated eating. Discussion and Conclusion. Subjects with asymptomatic carotid artery stenosis and occlusion exhibited changes in function, as indicated by their performance on the PPT relative to that of a comparison group. This finding may be indicative of preclinical disability, indicating that these people are symptomatic. This indication may affect the medical and surgical options that can be considered for their care. [Landgraff NC, Whitney SL, Rubinstein EN, Yonas H. Use of the Physical Performance Test to assess preclinical disability in subjects with asymptomatic carotid artery disease. Phys Ther. 2006;86:541–548.]
Early Rehabilitation Following Surgical Fixation of a Femoral Shaft Fracture
Authors: Paterno Mark V , Archdeacon Michael T , Ford Kevin R , Galvin Doug , Hewett Timothy E 
Published: February 2017

AbstractBackground and Purpose. The purpose of this case report is to describe the outcome of a patient following fixation of a midshaft femur fracture and an evaluation-based, immediate-weight-bearing approach to rehabilitation. Case Description. The patient was a 28-year-old male manual laborer whose left femur was fractured in a head-on motor vehicle accident. The patient was treated with internal fixation of the left femur by use of an antegrade intramedullary nail. Following surgery, impairments in range of motion, knee extensor and hip abductor strength, and gait were observed. Intervention focused on immediate weight bearing and early progression of strengthening to address the observed impairments. Outcomes. All of the patient’s impairments improved, and he was able to return to work as a manual laborer within 6 months. Discussion. Immediate weight bearing with early strengthening activities following surgical correction of a midshaft femur fracture may result in early resolution of impairments and functional limitations and decreased disability.
Timed “Up & Go” Test: Reliability in Older People Dependent in Activities of Daily Living— Focus on Cognitive State
Authors: Nordin Ellinor , Rosendahl Erik , Lundin-Olsson Lillemor 
Published: February 2017

Abstract
Background and Purpose. It is unknown how cognitive impairment affects the reliability of Timed “Up & Go” Test (TUG) scores. The aim of the present study was to investigate the expected variability of TUG scores in older subjects dependent in activities of daily living (ADL) and with different levels of cognitive state. The hypothesis was that cognitive impairment would increase the variability of TUG scores. Subjects. Seventy-eight subjects with multiple impairments, dependent in ADL, and living in residential care facilities were included in this study. The subjects were 84.8±5.7 (mean±SD) years of age, and their Mini-Mental State Examination score was 18.7±5.6. Methods. The TUG assessments were performed on 3 different days. Intrarater and interrater analyses were carried out. Results. Cognitive impairment was not related to the size of the variability of TUG scores. There was a significant relationship between the variability and the time taken to perform the TUG. The intraclass correlations were greater than .90 and were similar within and between raters. In repeated measurements at the individual level, an observed value of 10 seconds was expected to vary from 7 to 15 seconds and an observed value of 40 seconds was expected to vary from 26 to 61 seconds for 95% of the observations. Discussion and Conclusion. The measurement error of a TUG assessment is substantial for a frail older person dependent in ADL, regardless of the level of cognitive function, when verbal cuing is permitted during testing. The variability increases with the time to perform the TUG. Despite high intraclass correlation coefficients, the ranges of expected variability can be wide and are similar within and between raters. Physical therapists should be aware of this variability before they interpret the TUG score for a particular individual.
Neuromuscular Activation in Conventional Therapeutic Exercises and Heavy Resistance Exercises: Implications for Rehabilitation
Authors: Andersen Lars L , Magnusson S Peter , Nielsen Michael , Haleem John , Poulsen Kenn , Aagaard Per 
Published: February 2017

AbstractBackground and Purpose. Central activation failure and muscular atrophy are common after knee joint injury. Thus, exercises that aim to stimulate muscular hypertrophy and increase neural drive to the muscle fibers should be used during rehabilitation. This study examined the level of knee joint neuromuscular activation during 4 conventional therapeutic exercises (quadriceps femoris muscle setting, manual lateralization of the patella, rhythmic stabilization, and the pelvic bridging exercise) and 4 heavy resistance exercises (free-weight squat with a barbell, horizontal seated leg press, isolated knee extension with a cam mechanism, and isolated hamstring muscle curl) in young, untrained men who were healthy. Subjects. Thirteen male subjects (mean age=25.3 years, SD=3.0) with no previous history of knee injury participated in the study. Methods. Neuromuscular activation during the exercises was defined as the root-mean-square (RMS) electromyographic (EMG) signal normalized to the peak RMS EMG signal of a maximal isometric muscle contraction. Results. Low levels of neuromuscular activation were found during all conventional exercises (&lt;35%). A limitation may be that only a few of many different conventional exercises were investigated. The highest level of neuromuscular activation (67%–79%) was observed during the open kinetic chain resistance exercises (isolated knee extension and hamstring muscle curl). None of the conventional exercises or heavy resistance exercises were found to preferentially activate the vastus medialis muscle over the vastus lateralis muscle. Discussion and Conclusion. The results indicate that heavy resistance exercises should be included in rehabilitation programs to induce sufficient levels of neuromuscular activation to stimulate muscle growth and strength.
Interferential Therapy Produces Antinociception During Application in Various Models of Inflammatory Pain
Authors: Jorge Sérgio , Parada Carlos A , Ferreira Sérgio H , Tambeli Cláudia H 
Published: February 2017

Abstract
Background and Purpose. Although interferential therapy (IFT) is used widely in the management of many painful conditions, the effectiveness and the mechanism of action of IFT in animal models of inflammatory pain have not been evaluated. The aim of this study was to evaluate the effectiveness of IFT in reducing inflammatory pain and edema in rats. Subjects. Sixty-nine male Wistar rats were used in the study. Methods. The effect of IFT application (4,000-Hz carrier frequency, 140-Hz amplitude-modulated beat frequency, pulse duration=125 milliseconds, current intensity=5 mA) for 1 hour on the formalin-induced nociceptive response and edema and on carrageenan-induced mechanical hyperalgesia and edema was evaluated. Results. Interferential therapy significantly reduced the formalin-evoked nociceptive response when applied to the paw immediately after but not before the formalin injection. Interferential therapy application at 2 hours after the carrageenan injection significantly prevented a further increase in carrageenan-induced mechanical hyperalgesia only immediately after discontinuation of the electrical current application. The antinociception induced by IFT was not attributable to a reduction in inflammation because IFT did not significantly reduce the edema induced by either formalin or carrageenan. Discussion and Conclusion. The results suggest that, despite its short-duration effect, IFT is effective in reducing inflammatory pain and should be considered primarily for use in the control of acute inflammatory pain. [Jorge S, Parada CA, Ferreira SH, Tambeli CH. Interferential therapy produces antinociception during application in various models of inflammatory pain. Phys Ther. 2006;86:800–808.]
Determining Meaningful Changes in Gait Speed After Hip Fracture
Authors: Palombaro Kerstin M , Craik Rebecca L , Mangione Kathleen K , Tomlinson James D 
Published: February 2017

AbstractBackground and Purpose. Older subjects after hip fracture walk more slowly than age-matched peers. The extent to which they walk more slowly is difficult to define because the standard error of the measure (SEM), sensitivity to change, and clinically important change have not been reported for gait speed. The purposes of this study were to quantify the SEM for habitual and fast gait speeds among older subjects after hip fracture, to define the minimal detectable change (MDC), and to estimate the minimal clinically important difference (MCID) for habitual gait speed. Subjects. A sample of 92 subjects after hip fracture was drawn from 3 studies that collected gait speed data. Methods. An estimate of the MDC was determined by use of the SEM. The MCID was determined from expert opinion and from a receiver operating characteristic (ROC) curve. Results. The SEM and the MDC were 0.08 m/s and 0.10 m/s for habitual speed and fast speed, respectively. Both methods of MCID estimation identified 0.10 m/s as a meaningful change in habitual gait speed. Discussion and Conclusion. The estimated MCID for gait speed of 0.10 m/s was supported by clinical expert opinion and the cutoff point of the ROC curve. [Palombaro KM, Craik RL, Mangione KK, Tomlinson JD. Determining meaningful changes in gait speed after hip fracture.Phys Ther. 2006; 86:809–816.]
Descriptive Characteristics as Potential Predictors of Outcomes Following Constraint-Induced Movement Therapy for People After Stroke
Authors: Fritz Stacy L , Light Kathye E , Clifford Shannon N , Patterson Tara S , Behrman Andrea L , Davis Sandra B 
Published: February 2017

Abstract
Background and Purpose. Limited evidence exists regarding the characteristics of people who benefit most from constraint-induced movement therapy (CIMT). This study’s purpose was to investigate 6 potential descriptors in predicting CIMT outcomes. Subjects. The participants were a convenience sample (N=55) of people who were more than 6 months poststroke. Methods. The Wolf Motor Function Test (WMFT) and the Motor Activity Log amount scale (MALa) were used to assess outcomes for CIMT. The potential predictors (side of stroke, time since stroke, hand dominance, age, sex, and ambulatory status) were entered into a linear regression model using stepwise entry, with simultaneous entry of the dependent variables’ pretest scores as the covariate. Results. Age was the only significant predictor of the 6 potential predictors in the model and was predictive only of MALa scores. None of the independent variables showed a predictive relationship with the WMFT. Discussion and Conclusion. Although age was the only significant predictor, an equally strong finding in this study was that side of stroke, chronicity, hand dominance, sex, and ambulatory status were not found to be predictors at the follow-up session. This finding emphasizes the importance of not excluding people from CIMT based on these predictors. [Fritz SL, Light KE, Clifford SN, et al. Descriptive characteristics as potential predictors of outcomes following constraint-induced movement therapy for people after stroke.Phys Ther. 2006;86:825– 832.]
Physical Therapist Examination, Evaluation, and Intervention Following the Surgical Reconstruction of a Grade III Acromioclavicular Joint Separation
Authors: Culp Lisa B , Romani William A 
Published: February 2017

AbstractBackground and Purpose. This case report describes the examination, intervention, and outcome of a patient following the surgical reconstruction of a grade III acromioclavicular (AC) joint separation. Detailed postoperative interventions have not previously been described in the literature. Case Description. The patient was a 34-year-old male college professor with a left grade III AC joint separation and no prior restrictions of upper-extremity function. After 12 weeks of presurgical treatment, the patient’s complaints included crepitus and the inability to push open heavy doors. Intervention. Surgical reconstruction of the AC joint and a 4-month graded exercise program were used. Outcome. The patient returned to preinjury levels of function 5 months after surgery with scores of 3.33/100 and 0/100 on the Disabilities of the Arm, Shoulder and Hand questionnaire and optional Sport/Music or Work Module, respectively. Discussion. An intervention focusing on restoring shoulder strength, range of motion, flexibility, and neuromuscular control of the shoulder following a surgical reconstruction of the AC joint can lead to a successful functional outcome. [Culp LB, Romani WA. Physical therapist examination, evaluation, and intervention following the surgical reconstruction of a grade III acromioclavicular joint separation.Phys Ther.2006;86:857 – 869.]
Are Models of Disability Useful in Real Cases? Pediatric Case Examples Realized in Research, Clinical Practice, and Education
Authors: Campbell Suzann K 
Published: February 2017

Abstract
Conceptual models are useful devices for organizing complex material and examining interrelationships among variables. For example, speakers at the 1990 II STEP Conference presented a systems model of motor control, the dynamical systems model as used in studying infant motor development, and the World Health Organization model as a systematic approach to the description of impairments, functional limitations, and disability. The purpose of this perspective is to provide examples of the usefulness of models of disability in organizing research, educational materials, and measurement in clinical practice. The disability model of the National Center for Medical Rehabilitation Research was used: (1) to design a measurement strategy for assessing effects of spasticity reduction in a child with cerebral palsy, (2) to develop a new assessment of functional motor performance in infants, and (3) as the conceptual framework for a comprehensive reference book for the practice of pediatric physical therapy (the current edition has been reformatted to conform to the International Classification of Function, Disability and Health). Similar models of the dimensions of disability have guided extensive development of tests designed by physical therapists for assessing function and quality of life in children with neurologic conditions. [Campbell SK. Are models of disability useful in real cases? Pediatric case examples realized in research, clinical practice, and education.Phys Ther. 2006;86:881 – 887.]
Effects of Two 4-Week Proprioceptive Neuromuscular Facilitation Programs on Muscle Endurance, Flexibility, and Functional Performance in Women With Chronic Low Back Pain
Authors: Kofotolis Nick , Kellis Eleftherios 
Published: February 2017

Abstract
Background and Purpose. Improving functional performance in patients with chronic low back pain is of primary importance. The purpose of this study was to examine the effects of 2 proprioceptive neuromuscular facilitation (PNF) programs on trunk muscle endurance, flexibility, and functional performance in subjects with chronic low back pain (CLBP). Subjects. Eighty-six women (40.2±11.9 [X̅±SD] years of age) who had complaints of CLBP were randomly assigned to 3 groups: rhythmic stabilization training, combination of isotonic exercises, and control. Methods. Subjects trained with each program for 4 weeks with the aim of improving trunk stability and strength. Static and dynamic trunk muscle endurance and lumbar mobility were measured before, at the end of, and 4 and 8 weeks after training. Disability and back pain intensity also were measured with the Oswestry Index. Results. Multivariate analysis of variance indicated that both training groups demonstrated significant improvements in lumbar mobility (8.6%–24.1%), static and dynamic muscle endurance (23.6%–81%), and Oswestry Index (29.3%–31.8%) measurements. Discussion and Conclusion. Static and dynamic PNF programs may be appropriate for improving short-term trunk muscle endurance and trunk mobility in people with CLBP. [Kofotolis N, Kellis E. Effects of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional performance in women with chronic low back pain. Phys Ther. 2006;86:1001–1012.]