bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic Resources Used in Ambulation by Children With Spastic Hemiplegic Cerebral Palsy: Relationship to Kinematics, Energetics, and Asymmetries
Authors: Fonseca Sérgio T , Holt Kenneth G , Fetters Linda , Saltzman Elliot 
Published: February 2017

AbstractBackground and Purpose. The atypical walking pattern in children with spastic cerebral palsy is assumed to involve kinematic and morphological adaptations that allow them to move. The purpose of this study was to explore how the requirements of the task and the energy-generating and energy-conserving capabilities of children with cerebral palsy relate to kinematic and mechanical energy patterns of walking. Subjects. Six children with hemiplegic cerebral palsy and a matched group of typically developing children participated in the study. Methods. Kinematic data were collected at 5 different walking speeds. Vertical stiffness, mechanical energy parameters, and landing angle were measured during the stance phase. Results. The affected side of the children with cerebral palsy showed greater vertical stiffness, a greater ratio of kinetic forward energy to potential energy, and a smaller landing angle when compared with those of the nonaffected lower extremity and with those of typically developing children. Discussion and Conclusion. Previous research has shown that children with cerebral palsy assumed a gait similar to an inverted pendulum on the nonaffected limb and a pogo stick on the affected limb. Our results indicate that asymmetries between lower extremities and differences from typically developing children in the landing angle of the lower extremity, vertical lower-extremity stiffness, and kinetic and potential energy profiles support the claim that walking patterns in children with spastic hemiplegic cerebral palsy emerge as a function of the resources available to them.
Individual and Societal Influences on Participation in Physical Activity Following Spinal Cord Injury: A Qualitative Study
Authors: Levins Stephen M , Redenbach Darlene M , Dyck Isabel 
Published: February 2017

Abstract
Background and Purpose. Despite evidence that physical activity, a tool of rehabilitation, affects health and improves functional ability in people following spinal cord injury (SCI), such people are often physically inactive. We used a qualitative method to explore the experiences of individuals with SCI during participation in physical activity. Subjects. The participants were 8 adults (5 male, 3 female), ranging from active to inactive, who were 2 to 27 years post-rehabilitation following SCI (paraplegic). Methods. We used semistructured ethnographic interviews to explore barriers and enablers to participation in physical activity following SCI. Emerging themes were derived from the participants' experiences. Results. Two themes were identified: (1) individual influences, defined as a period of loss of “able identity” and subsequent redefinition of self in which participation in physical activity may be a vehicle or an outcome, and (2) societal influences, which included environmental and attitudinal barriers. Discussion and Conclusion. The participants' experiences offer insight for therapists regarding physical activity following SCI.
Shoulder Function and 3-Dimensional Kinematics in People With Shoulder Impingement Syndrome Before and After a 6-Week Exercise Program
Authors: McClure Philip W , Bialker Jason , Neff Nancy , Williams Gerald , Karduna Andrew 
Published: February 2017

AbstractBackground and Purpose. Shoulder impingement syndrome is a common condition and is often managed with an exercise program. The purpose of this study was to examine an exercise program in patients with shoulder impingement syndrome. Specifically, the purpose was to identify changes that might occur in 3-dimensional scapular kinematics, physical impairments, and functional limitations. Subjects. Fifty-nine patients with impingement syndrome were recruited, and 39 patients successfully completed the 6-week rehabilitation program and follow-up testing. Impingement was defined as having at least 3 of 6 predefined clinical signs or symptoms. Methods. Subjects were assessed before and after a 6-week rehabilitation program and again at 6 months. Pain, satisfaction, and function were measured using the University of Pennsylvania Shoulder Scale. Range of motion, isometric muscle force, and 3-dimensional scapular kinematic data also were collected. Subjects were given a progressive exercise program that included resistive strengthening, stretching, and postural exercises that were done daily at home. Subjects also were given shoulder education related to anatomy, the basic mechanics of impingement, and strategies for reducing load on the shoulder. Each subject attended one physical therapy session per week for a 6-week period, primarily for monitoring and upgrading the exercise program. Pretest and posttest scores were compared using paired t tests and repeated-measures analysis of variance. Results. Passive range of motion increased for both external and internal rotation but not for elevation. Abduction external and internal rotation force all increased. There were no differences in scapular kinematics. Improvements were found for pain, satisfaction, and shoulder function and for Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) scores related to physical function. At 6-month follow-up, improvements made in pain, satisfaction, and function were maintained. Discussion and Conclusion. The use of this exercise protocol in the management of shoulder impingement syndrome may have a positive impact on patients' impairments and functional limitations. Our findings suggest a relatively simple exercise program combined with patient education may be effective and, therefore, merits study in a larger trial using a control group. Changes in scapular kinematics did not appear to be a primary mechanism underlying improvement in symptoms and function.
Effect of Achilles Tendon Lengthening on Ankle Muscle Performance in People With Diabetes Mellitus and a Neuropathic Plantar Ulcer
Authors: Salsich Gretchen B , Mueller Michael J , Hastings Mary Kent , Sinacore David R , Strube Michael J , Johnson Jeffrey E 
Published: February 2017

AbstractBackground and Purpose. The effect of a tendo-Achilles lengthening (TAL) procedure on ankle muscle performance has not been clearly established. The purpose of this study was to compare the effects of TAL and total-contact casting (TCC) with TCC alone on ankle muscle performance in subjects with diabetes mellitus (DM) and a neuropathic plantar ulcer. Subjects. Subjects were randomly assigned to either a TAL group (3 female and 12 male subjects) or a TCC group (4 female and 10 male subjects). Methods. Muscle performance measurements were obtained using an isokinetic dynamometer. Results. Concentric plantar-flexor peak torque decreased 31% after TAL but returned to the baseline level after 8 months. Dorsiflexor peak torque did not change in either group. Plantar-flexor passive torque at 0 degrees of dorsiflexion decreased after TAL but increased to 60% of the baseline level after 8 months. Maximal dorsiflexion angle increased 11 degrees after TAL and remained increased at 8 months. Discussion and Conclusion. The TAL resulted in an increase in ankle dorsiflexion range of motion and a temporary reduction in concentric plantar-flexor peak torque and passive torque at 0 degrees of dorsiflexion. If TAL is being considered for people with DM and a neuropathic forefoot ulcer, the initial compromise in plantar-flexor muscle performance should be addressed.
Effects of Problem-Oriented Willed-Movement Therapy on Motor Abilities for People With Poststroke Cognitive Deficits
Authors: Tang Qing Ping , Yang Qi Dong , Wu Ying Hua , Wang Gai Qing , Huang Zhi Ling , Liu Zun Jing , Huang Xiao Song , Zhou Lin , Yang Pei Ming , Fan Zhen Yong 
Published: February 2017

Abstract
Background and Purpose. Cognitive deficits after stroke are common and interfere with recovery. One purpose of this study was to determine whether the motor abilities of subjects who have poststroke cognitive deficits and who have received problem-oriented willed-movement (POWM) therapy will improve more than the motor abilities of subjects in the reference group who have received neurodevelopmental treatment (NDT). Another purpose of this study was to identify the relationship between cognitive function and motor abilities for both groups. Subjects. The subjects recruited for this study were 36 men and 11 women with various degrees of poststroke cognitive deficits. Methods. A randomized block design was used to assign the subjects to 2 groups. Cognitive function and motor ability were evaluated with the Mini-Mental State Examination and the Stroke Rehabilitation Assessment of Movement (STREAM). Both groups received physical therapy 5 or 6 times per week in 50-minute sessions. Results. The STREAM scores improved after treatment in both groups. Main group effects were found for the lower-extremity (F=4.58, P&lt;.05) and basic mobility (F=27.49, P&lt;.01) subscales of the STREAM. Pretest cognitive function showed a positive relationship with posttest motor ability in the NDT group (r=.446, P&lt;.05). However, the relationship between pretest cognitive function and posttest motor ability had no statistical significance in the POWM group (r=.101, P=.630). Discussion and Conclusion. These findings suggest that, regardless of a person's cognitive function, POWM intervention is effective in improving lower-extremity and basic mobilities and indicates the need to use relatively intact cognitive function or perceptual function, or both, to improve motor rehabilitation for people with cognitive function deficits.
Individually Tailored Treatment Targeting Motor Behavior, Cognition, and Disability: 2 Experimental Single-Case Studies of Patients With Recurrent and Persistent Musculoskeletal Pain in Primary Health Care
Authors: Åsenlöf Pernilla , Denison Eva , Lindberg Per 
Published: February 2017

Abstract
Background and Purpose. This article introduces an individually tailored intervention targeting motor behavior, cognition, and disability in patients managed by physical therapists in primary health care. Effects on self-rated disability, pain intensity, and pain control are described. Subjects. Two women with recurrent or persistent disabling musculoskeletal pain were selected. Methods. Two experimental single-subject A1-B-C-A2 studies with multiple baselines across situations were used. Principal outcome data were collected daily with patient-specific continuous measures for 3 weeks before intervention, continuously during intervention, and for 2 weeks during each of the 1-, 4-, 6-, and 12-month follow-up examinations. Results. Disability and pain intensity decreased, and pain control increased in both subjects. The results were maintained at the follow-up examinations. Discussion and Conclusion. Positive outcomes of the intervention were reported from 2 subjects with recurrent and persistent disabling pain. Procedures for systematic tailoring of treatment to behavioral goals and individual patient characteristics are available as a result of the successful application. The results need to be replicated in future clinical controlled group studies.
Effects of Age and Sex on the Results of an Ankle Plantar-Flexor Manual Muscle Test
Authors: Jan Mei-Hwa , Chai Huei-Ming , Lin Yeong-Fwu , Lin Janice Chien-Ho , Tsai Li-Ying , Ou Yu-Chih , Lin Da-Hon 
Published: February 2017

Abstract
Background and Purpose. The ability to perform 20 or more one-leg heel-rises is considered a “normal” grade for muscle strength (force-generating capacity of muscle) of the ankle plantar flexors, regardless of age and sex. Because muscle strength is closely related to age and sex, the “normal” test criterion was re-evaluated in different groups categorized by age and sex. Subjects and Methods. One hundred eighty sedentary volunteers (21–80 years of age) without lower-limb lesions performed as many repetitions of one-leg heel-rise as possible. Lunsford and Perry criteria were used to determine completion of the test. Results. The age and sex of the participants influenced the maximal repetitions of heel-rise, and the repetitions decreased with age and in female subjects. Discussion and Conclusion. The muscle strength of the ankle plantar flexors, as measured by manual muscle testing, varied with age and sex. Clinicians should consider the variances of age and sex when they perform manual muscle testing of the ankle plantar flexors.
The EdUReP Model for Nonsurgical Management of Tendinopathy
Authors: Davenport Todd E , Kulig Kornelia , Matharu Yogi , Blanco Cesar E 
Published: February 2017

AbstractTendinopathy is a common and substantial source of morbidity worldwide. Various anatomical and functional predispositions combine with abrupt changes in mechanical loading to cause characteristic histological maladaptations in tendons. The nature and latency of cellular changes in tendinopathy makes many common treatments lessthan-optimal options. This Perspective presents the EdUReP model for nonsurgical management of tendinopathy, a model that considers sources of pathology at the cellular, anatomical, and functional levels. The EdUReP model addresses possible sources of symptoms at the levels of pathology, impairment, functional limitation, and disability through Educational interventions, periods of tendon Unloading and controlled Reloading, and implementation of Prevention strategies. The EdUReP model is an evidence-based treatment construct that aims to reduce functional limitation and disability through amelioration of tissue pathology.
Interventions That Increase or Decrease the Likelihood of a Meaningful Improvement in Physical Health in Patients With Sciatica
Authors: Jewell Dianne V , Riddle Daniel L 
Published: February 2017

Abstract
Background and Purpose. The purpose of our study was to determine whether physical therapy interventions predicted meaningful short-term improvement in physical health for patients diagnosed with sciatica. Subjects. We examined data from 1,804 patients (age: X̄=52.1 years, SD=15.6 years; 65.7% female, 34.3% male) who had been diagnosed with sciatica and who had completed an episode of outpatient physical therapy. Methods. Principal components factor analysis was used to define intervention categories from specific treatments applied during the plan of care. A nested-model logistic regression analysis identified intervention categories that predicted meaningful improvement in physical health. Meaningful improvement was defined as a change of 14 or more points on the Physical Component Scale-12 (PCS-12) summary score. Results. Twenty-six percent (n=473) of patients had a meaningful improvement in physical health. Improvement was more likely in patients receiving joint mobility interventions (odds ratio [OR]=2.5, 95% confidence interval [CI]=1.5–4.4) or general exercise (OR=1.5, 95% CI=1.2–2.0). Patients who received spasm reduction interventions were less likely to improve (OR=0.77, 95% CI=0.60–0.98). Discussion and Conclusion. Physical therapists should emphasize the use of joint mobility interventions and exercise when treating patients with sciatica, whereas interventions for spasm reduction should be avoided.
Physical Therapists’ Use of Interventions With High Evidence of Effectiveness in the Management of a Hypothetical Typical Patient With Acute Low Back Pain
Authors: Mikhail Christine , Korner-Bitensky Nicol , Rossignol Michel , Dumas Jean-Pierre 
Published: February 2017

AbstractBackground and Purpose. Evidence-based practice aims to improve patient care and service delivery, particularly in the management of individuals with low back pain (LBP), the largest client group seen by outpatient physical therapists. The purpose of this study was to determine the prevalence of use of interventions with evidence of effectiveness in the management of acute nonspecific LBP by physical therapists. Subjects. A multicenter cross-sectional study was conducted on 100 physical therapists working with patients with LBP. Methods. Using a telephone-administered interview, therapists described their current and desired treatment practices for a typical case of LBP. Each intervention reported was coded according to its evidence of effectiveness (strong, moderate, limited, or none). Information on clinician, workplace, and client characteristics also was obtained. Results. The prevalence of use of interventions with strong or moderate evidence of effectiveness was 68%. However, 90% to 96% of therapists also used interventions for which research evidence was limited or absent. Users of interventions with high evidence of effectiveness, as compared with nonusers, had graduated more recently and had taken a higher number of postgraduate clinical courses. Discussion and Conclusion. Although most therapists use interventions with high evidence of effectiveness, much of their patient time is spent on interventions that are not well reported in the literature. The results indicate the need for improvement in the quality of clinical research as well as its dissemination and implementation in a way that is appealing to therapists, such as through practice-related courses.
Management of Symphysis Pubis Dysfunction During Pregnancy Using Exercise and Pelvic Support Belts
Authors: Depledge Jill , McNair Peter J , Keal-Smith Cheryl , Williams Maynard 
Published: February 2017

Abstract
Background and Purpose. Symphysis pubis pain is a significant problem for some pregnant women. The purpose of this study was to investigate the effects of exercise, advice, and pelvic support belts on the management of symphysis pubis dysfunction during pregnancy. Subjects. Ninety pregnant women with symphysis pubis dysfunction were randomly assigned to 3 treatment groups. Methods. A randomized masked prospective experimental clinical trial was conducted. Specific muscle strengthening exercises and advice concerning appropriate methods for performing activities of daily living were given to the 3 groups, and 2 of the groups were given either a rigid pelvic support belt or a nonrigid pelvic support belt. The dependent variables, which were measured before and after the intervention, were a Roland-Morris Questionnaire score, a Patient-Specific Functional Scale score, and a pain score (101-point numerical rating score). Results. After the intervention, there was a significant reduction in the Roland-Morris Questionnaire score, the Patient-Specific Functional Scale score, and the average and worst pain scores in all groups. With the exception of average pain, there were no significant differences between groups for the other measures. Discussion and Conclusion. The findings indicate that the use of either a rigid or a nonrigid pelvic support belt did not add to the effects provided by exercise and advice.
Physical Therapy Treatment Effectiveness for Osteoarthritis of the Knee: A Randomized Comparison of Supervised Clinical Exercise and Manual Therapy Procedures Versus a Home Exercise Program
Authors: Deyle Gail D , Allison Stephen C , Matekel Robert L , Ryder Michael G , Stang John M , Gohdes David D , Hutton Jeremy P , Henderson Nancy E , Garber Matthew B 
Published: February 2017

AbstractBackground and Purpose Manual therapy and exercise have not previously been compared with a home exercise program for patients with osteo-arthritis (OA) of the knee. The purpose of this study was tocompare outcomes between a home-based physical therapy program and a clinically based physical therapy program. Subjects. One hundred thirty-four subjects with OA of the knee were randomly assigned to a clinictreatment group (n=66; 61% female, 39% male; mean age [±SD]=64±10 years) or a home exercise group (n=68, 71% female, 29% male; mean age [±SD]=62±9 years). Methods. Subjects in the clinic treatment group received supervised exercise, individualized manual therapy, and a home exercise program over a 4-week period. Subjects in the home exercise group received thesame home exercise program initially, reinforced at a clinic visit 2 weeks later. Measured outcomes were the distance walked in 6 minutes and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. Both groups showed clinically and statistically significant improvements in 6-minute walkdistances and WOMAC scores at 4 weeks; improvements were still evident in both groups at 8 weeks. By 4 weeks, WOMAC scores had improved by 52% in the clinic treatment group and by 26% in the home exercise group. Average 6-minute walk distances had improved about 10% in both groups. At 1 year, both groups were substantially and about equally improved over baseline measurements. Subjects in the clinic treatment group were less likely to betaking medications for their arthritis and were more satisfied with the overall outcome of their rehabilitative treatment compared with subjects in the home exercise group. Discussion and Conclusion Although both groups improved by 1 month, subjects in the clinic treatment group achieved about twice as much improvement in WOMAC scores than subjects who performed similar unsupervised exercises at home. Equivalent maintenance of improvements at 1 year was presumably due to both groups continuing the identical home exercise program. The results indicate that a home exercise program for patients with OA of the knee provides important benefit. Adding a small number of additional clinical visits for the application of manual therapy and supervised exercise adds greater symptomatic relief.
Relationship of Physical Examination Findings and Self-Reported Symptom Severity and Physical Function in Patients With Degenerative Lumbar Conditions
Authors: Lyle Mark A , Manes Sarah , McGuinness Michael , Ziaei Sarah , Iversen Maura D 
Published: February 2017

Abstract
Background and Purpose. Limited data are available to assist clinicians in clinical decision making. The purpose of this study was to examine the relationships of symptom provocation during physical examination (PE) procedures and self-report of symptom severity and function in patients with degenerative lumbar conditions. Subjects. Twenty-four men and 50 women with chronic low back pain (CLBP) (&gt;6 months duration) were recruited from a university hospital (median age=64.2 years, X̄=66.8, SD=12.4, range=55.7–97.8). Methods. Demographic information, medical history, PE findings, and data from 2 self-report measures of symptom severity and function (Lumbar Spinal Stenosis [LSS] questionnaire and Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]) were collected. Results. Patients had moderate symptoms of degenerative lumbar conditions (mean LSS symptom score=2.67, SD=0.71) and reported some difficulties with low back function (mean LSS function score=1.99, SD=0.61). The most frequent physical examination findings were a positive quadrant test (70%), followed by lower-extremity muscle weakness (64%), abnormal reflexes (62%), and active lumbar extension (61%). Patients who were symptomatic during the quadrant test, patients who had pain with lateral flexion, and patients who had lower-extremity weakness had higher self-reported LSS symptom severity (t=−3.06, P=.003; t=−2.96, P=.004; and t=−3.2, P=.002, respectively). Pain with lumbar extension was moderately correlated with LSS symptom severity (Spearman rho=.31, P=.007). No lumbar PE procedure was associated with decreased condition-specific function. The quadrant test was the strongest predictor of symptom severity (β=.54, r2=.21, P=.0009). Discussion and Conclusion. The association between PE findings and self-reported symptom severity in this sample is consistent with the pathoanatomy of degenerative spinal conditions and indicates that movement that narrows the foraminal space contributes to symptom severity. The quadrant test distinguished those subjects with clinically meaningful low back symptom severity but was not predictive of impaired function. This study illustrates the potential benefit of identifying clinical PE measures that are reflective of condition severity and back-specific function in patients with similar clinical syndromes.