bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular Responses to Repetitive McKenzie Lumbar Spine Exercises
Authors: Al-Obaidi Saud , Anthony Joseph , Dean Elizabeth , Al-Shuwai Nadia 
Published: February 2017

AbstractBackground and Purpose. Repetitive exercises of the type recommended by McKenzie for the lumbar spine, such as flexion and extension exercises in standing (FIS and EIS) and lying positions (FIL and EIL), have been used in the management of low back pain for over 20 years. The cardiovascular effects of exercises that involve postural stabilization and the arms and of exercises performed in a lying position are well known. Therefore, the purpose of this study was to examine the cardiovascular effects of 4 exercises used in the McKenzie system. Subjects and Methods. One hundred subjects without cardiovascular or cardiopulmonary disease (mean age=31 years, SD=6.1, range=22–44) and who were representative of people susceptible to low back pain were studied. Subjects were randomly assigned to 1 of 4 exercise groups (ie, FIS, EIS, FIL, and EIL). Subjects performed sets of 10, 15, and 20 repetitions of the assigned exercise, with a 15-minute rest between sets. Heart rate, blood pressure, and rate-pressure product (an index of myocardial work) were recorded before and after each set of repetitions. Results. After 10 repetitions, flexion and extension in lying were more hemodynamically demanding than in standing. This trend persisted for 15 and 20 repetitions; however, at 20 repetitions, the hemodynamic demands were different across exercise groups (ie, FIL&gt;EIL&gt;FIS&gt;EIS). Discussion and Conclusion. Repetitive exercises of the type suggested by McKenzie for the lumbar spine can have cardiovascular effects in people with no cardiovascular or cardiopulmonary conditions. These effects may be important with respect to cardiac work, and patients for whom these exercises are indicated should have a cardiac and pulmonary risk factor assessment to determine whether heart rate and blood pressure should be monitored.
The Use of Electrical Stimulation to Increase Quadriceps Femoris Muscle Force in an Elderly Patient Following a Total Knee Arthroplasty
Authors: Lewek Michael , Stevens Jennifer , Snyder-Mackler Lynn 
Published: February 2017

AbstractBackground and Purpose. Persistent residual quadriceps femoris muscle force deficits after total knee arthroplasty (TKA) are commonly reported and can prevent patients from returning quickly and fully to functional activities. Neuromuscular electrical stimulation offers a potentially more effective means of increasing muscle force than current rehabilitation protocols. Case Description. The patient was a 66-year-old man. Neuromuscular electrical stimulation for increasing quadriceps femoris muscle force was initiated 3 weeks after TKA for 11 sessions to supplement stretching exercises and a high-intensity volitional strengthening program. Outcome. The patient's isometric quadriceps femoris muscle force increased from 50% (involved/uninvolved) at 3 weeks after surgery to 86% at 8 weeks after surgery. A concurrent increase in his uninvolved quadriceps femoris muscle force concealed the patient's true increase in his involved quadriceps femoris muscle force in a side-to-side comparison. The patient's final involved quadriceps femoris muscle force (10 weeks after surgery) was 93% of the initial uninvolved quadriceps femoris muscle force. Discussion. Our patient was able to return to independent activities of daily living and recreational activities, with force gains that surpassed those reported in the literature.
A Comparison of Five Low Back Disability Questionnaires: Reliability and Responsiveness
Authors: Davidson Megan , Keating Jennifer L 
Published: February 2017

Abstract
Background and Purpose. The aim of this study was to examine 5 commonly used questionnaires for assessing disability in people with low back pain. The modified Oswestry Disability Questionnaire, the Quebec Back Pain Disability Scale, the Roland-Morris Disability Questionnaire, the Waddell Disability Index, and the physical health scales of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were compared in patients undergoing physical therapy for low back pain. Subjects and Methods. Patients with low back pain completed the questionnaires during initial consultation with a physical therapist and again 6 weeks later (n=106). Test-retest reliability was examined for a group of 47 subjects who were classified as “unchanged” and a subgroup of 16 subjects who were self-rated as “about the same.” Responsiveness was compared using standardized response means, receiver operating characteristic curves, and the proportions of subjects who changed by at least as much as the minimum detectable change (MDC) (90% confidence interval [CI] of the standard error for repeated measures). Scale width was judged as adequate if no more than 15% of the subjects had initial scores at the upper or lower end of the scale that were insufficient to allow change to be reliably detected. Results. Intraclass correlation coefficients (2,1) calculated to measure reliability for the subjects who were classified as “unchanged” and those who were self-rated as “about the same” were greater than .80 for the Oswestry and Quebec questionnaires and the SF-36 Physical Functioning scale and less than .80 for the Waddell and Roland-Morris questionnaires and the SF-36 Role Limitations–Physical and Bodily Pain scales. None of the scales were more responsive than any other. Discussion and Conclusion. Measurements obtained with the modified Oswestry Disability Questionnaire, the SF-36 Physical Functioning scale, and the Quebec Back Pain Disability Scale were the most reliable and had sufficient width scale to reliably detect improvement or worsening in most subjects. The reliability of measurements obtained with the Waddell Disability Index was moderate, but the scale appeared to be insufficient to recommend it for clinical application. The Roland-Morris Disability Questionnaire and the Role Limitations–Physical and Bodily Pain scales of the SF-36 appeared to lack sufficient reliability and scale width for clinical application.
Excessive Pressure in Multichambered Cuffs Used for Sequential Compression Therapy
Authors: Segers Patrick , Belgrado Jean-Paul , Leduc Andre , Leduc Olivier , Verdonck Pascal 
Published: February 2017

Abstract
Background and Purpose. Pneumatic compression devices, used as part of the therapeutic strategy for lymphatic drainage, often have cuffs with multiple chambers that are inflated sequentially. The purpose of this study was to investigate (1) the relationship between cuff chamber pressure (Pchamber) and the pressure on the cuff-skin interface (Pinterface) and (2) the mechanical interaction of cuff chambers and consequences for device control. Subjects and Methods. In this study, we used 3 cylindrical (60-, 80-, and 100-mm-diameter) model limbs and 1 ellipsoidal model of the arm to test a commercially available pressure controller using “target pressures,” indicated by the controller, of 30, 60, 80, and 100 mm Hg. We studied the time course of Pchamber and Pinterface during the inflation sequence and the effect of local curvature on Pinterface. Results. Our data indicated that, overall, Pinterface is of the same order of magnitude as Pchamber. There was some effect of model diameter and shape, with the smaller curvatures yielding the highest Pinterface. Cuff chamber interaction led to Pchamber and Pinterface values in the most distal (first inflated) chamber that were up to 80% higher than the target pressure. For the 80-mm cylindrical model, for instance, pressure in this chamber reached 54, 98, 121, and 141 mm Hg, respectively, instead of the 30, 60, 80, and 100 mm Hg indicated by the controller. Discussion and Conclusion. The discrepancy between the target pressure, indicated by the controller, and the pressure measured inside the cuff chambers undermines the therapeutic control and efficacy of the pneumatic compression devices. Because the measured pressures were far beyond the pressure level indicated by the controller, it is recommended that pneumatic compression devices be used at much lower target pressures (&lt;30 mm Hg) than those applied in clinical practice.
Russian Electrical Stimulation: The Early Experiments
Authors: Ward Alex R , Shkuratova Nataliya 
Published: February 2017

Abstract
Russian forms of electrical stimulation became popular to a large extent as a result of the activities of Kots, who claimed force gains of up to 40% in elite athletes as a result of what was then a new form of stimulation. He did not provide details of his published work, nor did he give references. Russian electrical stimulation became popular despite the lack of research in the English-language literature. No studies published in English examined whether the “10/50/10” treatment regimen (10 seconds of stimulation followed by 50 seconds rest, repeated for 10 minutes) advocated by Kots is optimal, and only one study addressed whether maximum muscle torque was produced at an alternating current frequency of 2.5 kHz. The few studies that compared low-frequency monophasic pulsed current and Russian electrical stimulation are inconclusive. This article reviews and provides details of the original studies by Kots and co-workers. The authors contend that these studies laid the foundations for the use of Russian forms of electrical stimulation in physical therapy. The authors conclude that there are data in the Russian-language literature that support the use of Russian electrical stimulation but that some questions remain unanswered.
Knee Joint Movements in Subjects Without Knee Pathology and Subjects With Injured Anterior Cruciate Ligaments
Authors: Hollman John H , Deusinger Robert H , Dillen Linda R Van , Matava Matthew J 
Published: February 2017

AbstractBackground and Purpose. Although weight-bearing (WB) exercise and increased hamstring muscle activity may contribute to knee joint stability in knees with an injured anterior cruciate ligament (ACL), the relationship among ACL integrity, muscle activity, and joint surface motion is not fully understood. The purpose of this study was to investigate whether knee joint rolling and gliding movements and electromyographic (EMG) activity differed between subjects with injured ACLs and subjects without knee pathology. Subjects. Fifteen subjects with injured ACLs (9 men and 6 women; mean age=26 years, SD=7, range=18–36) and 15 age- and sex-matched subjects without knee pathology (9 men and 6 women; mean age=25 years, SD=6, range=18–36) participated in the study. Methods. Sagittal-plane knee joint rolling and gliding movements and lower-extremity EMG activity were measured during non-weight-bearing (NWB) and WB movements. Mixed-model analyses of variance were conducted to analyze rolling and gliding and EMG data. Results. During NWB knee extension, greater joint surface gliding occurred in knees with injured ACLs at full knee extension. During WB knee extension, greater gliding occurred in knees with injured ACLs throughout the range of motion tested. No differences in EMG activity occurred between groups. Discussion and Conclusion. The results suggest that, in the absence of increased hamstring muscle activity, anterior tibial displacement is not reduced in knees with injured ACLs during WB movement.
Identifying Psychosocial Variables in Patients With Acute Work-Related Low Back Pain: The Importance of Fear-Avoidance Beliefs
Authors: Fritz Julie M , George Steven Z 
Published: February 2017

Abstract
Background and Purpose. Psychosocial factors are known to affect recovery from acute low back pain. The factors with the greatest influence and the optimal methods of measurement and interpretation have not been established. The purpose of this study was to examine baseline psychosocial variables and their ability to predict prolonged work restrictions. Subjects. The subjects were 78 people with work-related low back pain who were participating in a clinical trial (mean age=37.4 years, SD=10.4, range=18–58; mean duration of pain=5.5 days, SD=4.6, range=0–19). Methods. A baseline examination including measures of impairment, disability, and psychosocial variables was performed. All subjects had physical therapy interventions. Work status was assessed after 4 weeks. Sensitivity, specificity, and likelihood ratios were calculated for the prediction of work status by the use of psychosocial variables. Receiver operator characteristic curves and logistic regression were used to identify the variables that were most predictive of work status. Results. Twenty-two subjects (29%) had persistent work restrictions. The work subscale of the Fear-Avoidance Beliefs Questionnaire was the strongest predictor of work status (negative likelihood ratio of 0.08 for scores less than 30, positive likelihood ratio of 3.33 for scores greater than 34). Discussion and Conclusion. Fear-avoidance beliefs about work was the psychosocial factor that could best be used to predict return to work in patients with acute work-related low back pain. Examination of fear-avoidance beliefs may serve as a useful screening tool for identifying patients who are at risk for prolonged work restrictions.
The Relationship of Role-Related Variables to Job Satisfaction and Commitment to the Organization in a Restructured Hospital Environment
Authors: Lopopolo Rosalie B 
Published: February 2017

AbstractBackground and Purpose. Many factors in today's hospitals can influence how physical therapists view their work experience. Changing roles, with the accompanying stress, and professionalism may contribute to a therapist's perception of his or her job and the organization in which he or she works. In this study, the relationship between changes in physical therapist role behaviors following hospital restructuring and 2 work-related outcomes—job satisfaction and commitment to the organization—was studied. The influence of stress and occupational commitment on these outcomes also was examined. Subjects and Methods. Through a survey of 273 hospital-based physical therapists, changes in physical therapist role behaviors, levels of stress, occupational commitment, job satisfaction, and commitment to the organization following restructuring were identified and examined. Results. Six role behavior dimensions reflecting professional and organizational responsibilities were identified from the data. After controlling for sample demographics, the professional role behaviors, specifically those reflecting interaction and integration with other practitioners, appeared to exert a small, but positive, influence on job satisfaction and commitment to the organization. In addition, occupational commitment had a positive influence, whereas stress had a negative influence on job satisfaction and commitment to the organization. Discussion and Conclusion. Multiple aspects of a clinician's role could influence job satisfaction and commitment to the organization following hospital restructuring. The most influential factor was stress, which often accompanies organizational change. However, the positive influence of occupational commitment and the role behaviors that involve increased interaction with other people were noted and reflect professional role characteristics described in the Guide to Physical Therapist Practice.
Examination of and Intervention for a Patient With Chronic Lateral Elbow Pain With Signs of Nerve Entrapment
Authors: Ekstrom Richard A , Holden Kari 
Published: February 2017

AbstractBackground and Purpose. Lateral elbow pain has several causes, which can make diagnosis difficult. The purpose of this case report is to describe the examination of and the intervention for a patient with chronic lateral elbow pain who had signs of nerve entrapment. Case Description. The patient was a 43-year-old woman who had right lateral elbow pain for about 4 months, which she attributed to extensive keyboard work on a computer. She had a reduction in joint passive range of motion during “neural tension testing,” an examination procedure to detect nerve entrapment. This sign, in combination with other findings, suggested that the patient had a mild entrapment of the deep radial nerve (radial tunnel syndrome). The patient was treated 14 times over a 10-week period with “neural mobilization techniques,” which are designed to free nerves for movement; ultrasound; strengthening exercises; and stretching. Outcomes. The patient had minimal symptoms at discharge, was pain-free, and had resumed all activities at a 4-month follow-up visit. Discussion. Neural tension testing may be a useful examination procedure and mobilization may be useful for intervention for patients who have lateral elbow pain.
Use of the ICF Model as a Clinical Problem-Solving Tool in Physical Therapy and Rehabilitation Medicine
Authors: Steiner Werner A , Ryser Liliane , Huber Erika , Uebelhart Daniel , Aeschlimann André , Stucki Gerold 
Published: February 2017

Abstract
The authors developed an instrument called the “Rehabilitation Problem-Solving Form” (RPS-Form), which allows health care professionals analyze patient problems, to focus on specific targets, and to relate the salient disabilities to relevant and modifiable variables. In particular, the RPS-Form was designed to address the patients' perspectives and enhance their participation in the decision-making process. Because the RPS-Form is based on the International Classification of Functioning, Disability, and Health (ICF) Model of Functioning and Disability, it could provide a common language for the description of human functioning and therefore facilitates multidisciplinary responsibility and coordination of interventions. The use of the RPS-Form in clinical practice is demonstrated by presenting an application case of a patient with a chronic pain syndrome.
Treatment of Plantar Verrucae Using 2% Sodium Salicylate Iontophoresis
Authors: Soroko Yolanta T , Repking Mary C , Clemment Julie A , Mitchell Patricia L , Berg Richard L 
Published: February 2017

Abstract
Background and Purpose. Iontophoretic sodium salicylate treatment of plantar warts was studied. Subjects. Twenty patients with 104 plantar verrucae were studied. Methods. Two percent sodium salicylate solution was administered iontophoretically (22.5 mA-minute/electrode, 3 treatments at 6- to 9-day intervals). Results. Nineteen subjects were followed. Verrucae area declined in 15 subjects (78.9%) and increased in 2 subjects (10.5%). One subject (5.3%) no longer had verrucae, and 1 subject (5.3%) exhibited no change. Overall, the number of verrucae and total area decreased. Four of 6 subjects (66.6%) with initial complaints of load-bearing pain reported diminished pain following treatment. Two subjects whose verrucae's size increased reported an increase in pain at the end of the study. Discussion and Conclusion. Sodium salicylate iontophoresis appeared to compare favorably with other office-based interventions in diminishing the size of plantar warts and their associated pain. Application of iontophoresis to weight-bearing surfaces in some subjects appeared to decrease the pain and scarring associated with freezing and electrocautery and the fixation problems associated with medicated patches.
Kinematic Analysis of Kicking Movements in Preterm Infants With Very Low Birth Weight and Full-Term Infants
Authors: Jeng Suh-Fang , Chen Li-Chiou , Yau Kuo-Inn Tsou 
Published: February 2017

AbstractBackground and Purpose. Study of kicking development provides important information to understand how early spontaneous movements change in infants as they acquire voluntary control. Researchers have investigated the kicking movements of preterm infants; however, the movement patterns that they have described were inconsistent. The purpose of this study, therefore, was to examine the development of kicking movements with kinematic analysis in preterm infants with very low birth weight (VLBW) and full-term infants. Subjects and Methods. Twenty-two infants with VLBW who were divided into low gestational age (gestational age of &lt;30 weeks, n=9) and high gestational age (gestational age of ≥30 weeks, n=13) classes and 22 full-term infants were evaluated during kicking movements using 4 synchronized cameras and 3-dimensional kinematic analysis when the infants were 2 and 4 months of corrected age. Results. The infants with VLBW and a high gestational age showed similar kicking movements compared with the full-term infants. In contrast, the infants with VLBW and a low gestational age exhibited a higher kick frequency and a shorter flexion phase at 4 months of corrected age. They also exhibited a higher hip-knee correlation and lower variability in the interlimb coordination pattern at 2 and 4 months of corrected age. Discussion and Conclusion. The findings indicate that infants with VLBW, particularly those with a low gestational age, have age-related differences in movement organization and coordination of kicking compared with full-term infants.
Assessing the Need for Change in Clinical Education Practices
Authors: Strohschein Jennifer , Hagler Paul , May Laura 
Published: February 2017

Abstract
The purposes of this perspective article are to identify areas of need within clinical education, to describe various models and tools that are proposed and utilized in clinical education, and to explore the extent to which these models and tools might meet the identified needs of clinical education. A synthesis of the literature suggests that the clinical education process in physical therapy currently is characterized by 7 primary needs and that 10 models currently exist to guide the general process or to provide specific tools and practices to enhance its effectiveness. Roles and relationships are critical components in successful clinical education. Theory suggests that clinical educators and students should engage in an intentional, structured process of changing roles during the course of the clinical education experience and that nontechnical competencies such as communication, collaboration, and reflection are crucial for effective practice and may be developed in the clinical education setting. Developing a clearer understanding of the current status of physical therapy clinical education can assist clinical educators in the use of the available models and tools or in developing a new model that addresses potentially unique needs.
Relationships Among Lifting Ability, Grip Force, and Return to Work
Authors: Matheson Leonard N , Isernhagen Susan J , Hart Dennis L 
Published: February 2017

Abstract
Background and Purpose. The relationship between functional capacity evaluation (FCE) data and work disability has not been studied. The validity of FCE testing results in terms of subsequent return to work (RTW) was the focus of this exploratory study. Subjects and Methods. Six hundred fifty adults of working age were evaluated as part of a standardized FCE. Clients were contacted by telephone 6 months after the FCE to determine their work status. Predictor variables were gender, age, time off work, maximum safe loads during 3 dynamic lifts, and isometric grip force. Other variables measured were whether or not the client returned to work (RTW-Y/N) and level of return to work (RTW level). Results. A multivariate logistic regression analysis demonstrated that the more time a worker was away from work, the less likely was RTW. Male subjects were less likely to return to work than female subjects. The more weight lifted from floor to waist, the more likely was RTW. The logistic regression equation correctly classified 80.3% of the subjects who returned to work and 56.6% of the subjects who did not return to work. Each of the 3 lift tests was related to RTW level, whereas the grip force tests were not related to either RTW-Y/N or RTW level. Discussion and Conclusion. Time off work and gender were the strongest predictors of RTW, but certain FCE subtests of lifting were related to RTW and RTW level for people with work-related chronic symptoms. Grip force was not related to RTW.