bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Back and Neck Pain: Who Seeks Care From Physical Therapists?
Authors: Freburger Janet K , Carey Timothy S , Holmes George M 
Published: February 2017

Abstract
Background and Purpose Little information is available on factors associated with physical therapist use by people with back or neck pain. Identifying the characteristics of people who seek care from physical therapists is a useful first step in determining whether there is appropriate use of physical therapy services. The purpose of this study was to identify factors associated with physical therapist use by people with back or neck pain. Subjects The subjects were 29,049 people who had back pain or neck pain, or both, and who were seen for an initial evaluation at 1 of 21 US spine care centers. Each subject and evaluating physician completed a written survey at the time of the initial evaluation. Methods Multiple logistic regression analyses were conducted to identify factors associated with physical therapist use. Results Several measures of health and illness severity were associated with physical therapist use. Age and being male were negatively associated with physical therapist use. Education level, having workers' compensation coverage, and being in litigation were positively associated with physical therapist use. Physical therapist use also varied by previous physician use and census region. Discussion and Conclusion The results suggest that variations in physical therapist use are associated with factors other than health and illness severity. The results also suggest that people who would benefit from physical therapy may not be receiving it or that people who would not benefit from physical therapy are receiving it, or both.
Identifiers Suggestive of Clinical Cervical Spine Instability: A Delphi Study of Physical Therapists
Authors: Cook Chad , Brismée Jean-Michel , Fleming Robert , Sizer Phillip S 
Published: February 2017

AbstractBackground and Purpose Clinical cervical spine instability (CCSI) is controversial and difficult to diagnose. Within the literature, no clinical or diagnostic tests that yield valid and reliable results have been described to differentially diagnose this condition. The purpose of this study was to attempt to obtain consensus on symptoms and physical examination findings that are associated with CCSI. Subjects One hundred seventy-two physical therapists who were Orthopaedic Certified Specialists (OCS) or Fellows of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT) participated in the survey. Methods This study was a 3-round Delphi survey designed to obtain consensual symptoms and physical examination findings for CCSI. Results The symptoms that reached the highest consensus among respondents were “intolerance to prolonged static postures,” “fatigue and inability to hold head up,” “better with external support, including hands or collar,” “frequent need for self-manipulation,” “feeling of instability, shaking, or lack of control,” “frequent episodes of acute attacks,” and “sharp pain, possibly with sudden movements.” The physical examination findings related to cervical instability that reached the highest consensus among respondents included “poor coordination/neuromuscular control, including poor recruitment and dissociation of cervical segments with movement,” “abnormal joint play,” “motion that is not smooth throughout range (of motion), including segmental hinging, pivoting, or fulcruming,” and “aberrant movement.” Discussion and Conclusion The Delphi method is useful in situations where clinical judgments are encountered but empirical evidence to provide evidence-based decision making does not exist. Findings of this study may provide beneficial clinical information, specifically when the identifiers are clustered together, because no set of clinical examination and symptom standards for CCSI currently exists. Diagnosis of CCSI is challenging; therefore, appropriate clinical reasoning is required for distinctive physical therapy assessment using pertinent symptoms and physical examination findings.
Silent Waves: Theory and Practice of Lymph Drainage Therapy, ed 2
Authors: Hoppenrath Terri 
Published: February 2017

Abstract
The focus of this book is to provide a comprehensive management approach to lymphedema, integrating lymphatic anatomy and physiology of the human body with drainage techniques and interventions. The book is organized into 6 parts. Some chapters are quite brief, whereas others are extensive. The book reflects the author's view of fluid movement within the human body, appreciating the successful effects of decongestion along available lymphatic channels or pathways.
Periodic Direct Current Does Not Promote Wound Closure in an In Vitro Dynamic Model of Cell Migration
Authors: Godbout Charles , Frenette Jérôme 
Published: February 2017

AbstractBackground and Purpose. A prevailing paradigm is that electrical fields can promote cell migration and tissue healing. To further validate this paradigm, we tested the hypothesis that periodic direct current (DC) can enhance wound closure using an in vitro dynamic model of cell migration. Methods and Results. Layers of primary fibroblasts were wounded and treated with DC under various voltages. Repair area, cell velocity, and directionality as well as lamellipodium area were evaluated at different times. Direct current had no beneficial effect on cell migration. Moreover, prolonged stimulation under the highest voltage led to significant reduction in wound closure and cell velocity. The reduction of membrane protusions in stimulated cells may be associated with the deleterious effect of DC. Discussion and Conclusion. Contrary to the authors’ expectations, they found that periodic DC did not promote wound closure, a finding that emphasizes the need to clarify the complex effects of electrical fields on migrating cells. [Godbout C, Frenette J. Periodic direct current does not promote wound closure in an in vitro dynamic model of cell migration. Phys Ther. 2006;86:50–65.]
Reliability and Validity of Trunk Assessment for People With Multiple Sclerosis
Authors: Verheyden Geert , Nuyens Godelieve , Nieuwboer Alice , Van Asch Pol , Ketelaer Piet , De Weerdt Willy 
Published: February 2017

Abstract
Background and Purpose. Standardized scales are a prerequisite for rehabilitation and research. This study was designed to determine the reliability and validity of scores on items of the trunk assessment of the Melsbroek Disability Scoring Test (MDST) and Trunk Impairment Scale (TIS) in people with multiple sclerosis (MS). Subjects. Thirty people with MS participated in the study. Methods. Interrater and test-retest reliability and construct validity were assessed. Results. Kappa and weighted kappa values for the items of the trunk assessment of the MDST ranged from .74 to .95, and the kappa and weighted kappa values for the TIS items ranged from .46 to 1.00. Intraclass correlation coefficients for interrater and test-retest agreement were .93 and .92, respectively, for the trunk assessment of the MDST and .97 and .95, respectively, for the TIS. Bland-Altman analysis showed consistency of scores without observer bias. Construct validity was established. Discussion and Conclusion. The MDST and TIS provide reliable assessments of the trunk and are valid scales for measuring trunk performance in people with MS. [Verheyden G, Nuyens G, Nieuwboer A, et al. Reliability and validity of trunk assessment for people with multiple sclerosis.
Bone Biology and the Clinical Implications for Osteoporosis
Authors: Downey Patricia A , Siegel Michael I 
Published: February 2017

AbstractBone biology is a complex and vastly growing area of study. It brings together the traditional fields of anatomy, physiology, and biomechanics with the increasingly complex fields of developmental biology and molecular genetics. For clinicians who treat bone disorders such as osteoporosis, developing a working knowledge of this topic is essential. This article discusses bone from a structural, anatomical, and functional perspective. It reviews skeletogenesis as a developmental process and from a regulatory perspective and presents biomechanical principles and theories. Osteoporosis is reviewed, including recent literature related to the role of exercise in prevention and treatment of this disease. [Downey PA, Siegel MI. Bone biology and the clinical implications for osteoporosis.]
Structure and Biomechanics of Peripheral Nerves: Nerve Responses to Physical Stresses and Implications for Physical Therapist Practice
Authors: Topp Kimberly S , Boyd Benjamin S 
Published: February 2017

AbstractThe structural organization of peripheral nerves enables them to function while tolerating and adapting to stresses placed upon them by postures and movements of the trunk, head, and limbs. They are exposed to combinations of tensile, shear, and compressive stresses that result in nerve excursion, strain, and transverse contraction. The purpose of this appraisal is to review the structural and biomechanical modifications seen in peripheral nerves exposed to various levels of physical stress. We have followed the primary tenet of the Physical Stress Theory presented by Mueller and Maluf (2002), specifically, that the level of physical stress placed upon biological tissue determines the adaptive response of the tissue. A thorough understanding of the biomechanical properties of normal and injured nerves and the stresses placed upon them in daily activities will help guide physical therapists in making diagnoses and decisions regarding interventions. [Topp KS, Boyd BS. Structure and biomechanics of peripheral nerves: nerve responses to physical stresses and implications for physical therapist practice.]
Effect of High-Intensity Inspiratory Muscle Training on Lung Volumes, Diaphragm Thickness, and Exercise Capacity in Subjects Who Are Healthy
Authors: Enright Stephanie J , Unnithan Viswanath B , Heward Clare , Withnall Louise , Davies David H 
Published: February 2017

Abstract
Background and Purpose. Previous investigations have demonstrated that a regimen of high-intensity inspiratory muscle training (IMT) resulted in changes in ventilatory function and exercise capacity in patients with chronic lung disease, although the effect of high-intensity IMT in subjects who are healthy is yet to be determined. The purpose of this study, therefore, was to examine whether high-intensity IMT resulted in changes in ventilatory function and exercise capacity in subjects who were healthy. Subjects. Twenty subjects were randomly assigned to 2 groups. Methods. The training group completed an 8-week program of IMT set at 80% of maximal effort. The control group did not participate in any form of training. Baseline and posttraining measures of body composition, pulmonary function, inspiratory muscle function (including maximal and sustained maximal inspiratory pressures [MIP and SMIP]), relaxed and contracted diaphragm thickness and thickening ratio (Tdi.rel, Tdi.cont, and TR), and exercise capacity were determined. Results. The training group demonstrated significant increases in MIP, SMIP, Tdi.cont, TR, VC, total lung capacity, and exercise capacity compared with the control group, which demonstrated no change from baseline measurements at 8 weeks. Discussion and Conclusion. The findings of this study suggest that high-intensity IMT results in increased contracted diaphragm thickness and increased lung volumes and exercise capacity in people who are healthy. [Enright SJ, Unnithan VB, Heward C, et al. Effect of high-intensity inspiratory muscle training on lung volumes, diaphragm thickness, and exercise capacity in subjects who are healthy.
Effectiveness of Physical Therapy for the Management of Chronic Spine Disorders: A Propensity Score Approach
Authors: Freburger Janet K , Carey Timothy S , Holmes George M 
Published: February 2017

AbstractBackground and Purpose. Evidence on the effectiveness of physical therapy for the management of chronic spine disorders is limited. The purpose of this study was to use a large current database, the National Spine Network database, to assess the effectiveness of physical therapy in the management of chronic spine disorders. Subjects. The participants were people who had spine problems lasting 3 months or longer and who were seen for an initial visit and a follow-up visit (N=4,479) at 1 of 17 US spine centers. Methods. A propensity score approach was used to create a matched sample of participants who received physical therapy (intervention group) and participants who did not receive physical therapy (control group). The 2 groups were similar with regard to more than 50 baseline characteristics. Outcomes were assessed with the Oswestry Disability Index (ODI) and the 36-Item Short-Form Health Survey (SF-36). Results. Both the intervention and control groups improved between the initial and the follow-up visits on ODI scores and on SF-36 physical function, role physical, and bodily pain scores. Although the amount of improvement in the outcome measures was significantly greater for the intervention group than for the control group, the differences were small (3–5 points). When the subgroup of participants who had the greatest propensity for receiving physical therapy was examined, differences in the amount of improvement between the intervention and control groups were larger (5–13 points). Discussion and Conclusion. Physical therapy was effective in the management of chronic spine disorders in participants with the greatest propensity for receiving physical therapy. When the entire sample was considered, differences in the amount of improvement between the intervention and control groups were not clinically relevant. [Freburger JK, Carey TS, Holmes GM. Effectiveness of physical therapy for the management of chronic spine disorders: a propensity score approach.
Exercise Adherence Following Physical Therapy Intervention in Older Adults With Impaired Balance
Authors: Forkan Rebecca , Pumper Breeanna , Smyth Nicole , Wirkkala Hilary , Ciol Marcia A , Shumway-Cook Anne 
Published: February 2017

Abstract
Background and Purpose. This study looked at adherence, and factors affecting adherence, to a prescribed home exercise program (HEP) in older adults with impaired balance following discharge from physical therapy. Subjects. The subjects were 556 older adults (≥65 years of age) who were discharged from physical therapy during the period 2000 to 2003. Methods. A survey was developed to determine participation in a HEP. Univariate logistic regressions identified specific barriers and motivators that were associated with exercise participation following discharge from physical therapy. Results. Ninety percent of respondents reported receiving a HEP; 37% no longer performed it. Change in health status was the primary reason for poor adherence to a HEP. Eight barriers (no interest, poor health, weather, depression, weakness, fear of falling, shortness of breath, and low outcomes expectation) were associated with a lack of postdischarge participation in exercise. Discussion and Conclusions. Exercise adherence following discharge from a physical therapy program is poor among older adults. Barriers, not motivators, appear to predict adherence. [Forkan R, Pumper B, Smyth N, et al. Exercise adherence following physical therapy intervention in older adults with impaired balance.
Age-Related Effects in Sequential Motor Learning
Authors: Shea Charles H , Park Jin-Hoon , Wilde Braden Heather 
Published: February 2017

Abstract
Background and Purpose. When learning multi-element movement sequences, participants organize individual elements into subsequences. Imposing this type of structure on the elements leads to the efficient production of sequences because the processing of all but the first elements in a subsequence can be completed prior to their execution. The primary purpose of this study was to determine whether older adults organize lengthy movement sequences with the same efficiency as young adults. Subjects and Methods. Participants were young adults (N=8, 19–23 years of age) and older adults (N=8, 65–68 years of age). The task required participants to move a lever as quickly as possible to targets sequentially projected on a tabletop. At various stages during practice, random practice blocks were inserted between the repeated sequence blocks. Repeated and random sequence retention tests were administered after 24 hours. Results. The results indicated that the young adults performed the repeated sequences substantially faster than the older adults and that this difference increased over practice. On the retention tests, there were no differences in response time for the random sequence blocks, but the young performers were substantially faster than the older performers when repeated sequences were used. No differences were detected in the interview or on the recognition (χ2=1.22, P&gt;.05) and completion (χ2=0.89, P&gt;.05) tests designed to determine explicit or implicit knowledge of the sequences. Discussion and Conclusion. Analysis of the sequence structure indicated that the older adults did not organize their responses into subsequences as effectively as the young adults. The failure of older adults to optimally organize movement sequences may contribute to the overall slowing of sequential movement production. [Shea CH, Park JH, Wilde Braden H. Age-related effects in sequential motor learning. Phys Ther. 2006;86:478–488.]
Resting Position Variables at the Shoulder: Evidence to Support a Posture-Impairment Association
Authors: Borstad John D 
Published: February 2017

Abstract
Background and Purpose.A relationship between posture and impairment at the shoulder is theorized, but not supported by evidence. It is proposed that posture and impairment are not directly related, but linked by movement dysfunction. The purpose of this analysis was to explore the relationships among posture, pectoralis minor muscle length, and movement alterations at the shoulder. Subjects. Subjects who were asymptomatic for shoulder pathology were divided into 2 groups of 25 subjects each based on normalized pectoralis minor muscle resting length. Methods. Scapula orientation, thoracic kyphosis, and pectoralis minor muscle lengths were measured, and ratios and indexes of postural variables were calculated. All variables were analyzed for correlations and group differences. Results. Significant group differences were demonstrated for several posture variables, including thoracic spine kyphosis and scapular internal rotation. The distance from the sternal notch to the coracoid process demonstrated the highest correlation with pectoralis minor muscle length. Discussion and Conclusion. The findings indicate a relationship between posture and pectoralis minor muscle length and support a proposed model linking posture, an anatomical variable, movement dysfunction, and impairment. [Borstad JD. Resting position variables at the shoulder: evidence to support a posture-impairment association. Phys Ther. 2006;86:549–557.]
Effects of Exercise Training on Heart Rate Variability After Coronary Angioplasty
Authors: Tsai Mei-Wun , Chie Wei-Chu , Kuo Terry BJ , Chen Ming-Fong , Liu Jen-Pei , Chen Tony Hsiu-Hsi , Wu Ying-Tai 
Published: February 2017

Abstract
Background and Purpose. Cardiac autonomic dysfunction is associated with risk of restenosis and cardiovascular mortality in patients after percutaneous transluminal coronary angioplasty (PTCA). Analysis of heart rate variability (HRV) is an important, widely used method for assessing cardiac autonomic regulation. The purpose of this study was to investigate the effect of exercise training on HRV in subjects after PTCA. Subjects and Methods. A total of 84 subjects who had undergone PTCA were recruited for this study. The subjects (age [mean±SD]=57.0±9.3 years) were randomly assigned to either an exercise group to undergo an 8-week outpatient exercise program or a control group to undergo usual care. Heart rate variability was measured for 5 minutes in the supine resting position at baseline and at the end of 8 weeks. Results. The parasympathetically modulated HRV of the subjects in the exercise group increased significantly compared with the HRV of subjects in the control group. The effects of training on HRV were independent of angioplasty type (balloon or stent) and were unrelated to whether the subjects had received previous PTCA. Discussion and Conclusion. Exercise training can increase parasympathetic modulation of cardiac function in people after they have undergone successful PTCA. Our results suggest that analysis of HRV can be extended to assess the effect of exercise training on cardiac autonomic dysfunction in people after coronary angioplasty.
Use of Item Response Analysis to Investigate Measurement Properties and Clinical Validity of Data for the Dynamic Gait Index
Authors: Chiu Yi-Po , Fritz Stacy L , Light Kathye E , Velozo Craig A 
Published: February 2017

AbstractBackground and Purpose. The Dynamic Gait Index (DGI) is a standardized clinical assessment that aids in evaluating a subject’s ability to modify gait in response to changing demands. The purpose of this study was to use Rasch measurement theory to examine whether the DGI rating scale meets suggested psychometric guidelines, whether the hierarchical order of DGI tasks is consistent with a clinically logical testing procedure, and whether the DGI represents a unidimensional construct. Subjects. Subjects were 84 community-dwelling male veterans (age range=64–88 years; mean±SD=75±6.47 years). Methods. Data were retrieved retrospectively from the participants’ clinical records. The Rasch measurement model with the WINSTEPS program was used in this study because it offers distinct advantages over traditional psychometric approaches. Results. Overall, the DGI showed sound item psychometric properties. Each of the original 4 rating scale categories appeared to distinctly identify subjects at different ability levels. The analysis revealed a clear item difficulty hierarchical order that is generally consistent with clinical expectations. In addition, fit statistics and principal components analysis indicated that the 8 items of the DGI appear to represent a single construct. Discussion and Conclusion. The results suggest that the rating scale of the DGI is used appropriately for community-dwelling older subjects with balance problems. The findings support the continued use of this well-constructed scale for clinical and research assessment in a community-dwelling population of older subjects. [Chiu YP, Fritz SL, Light KE, Velozo CA. Use of item response analysis to investigate measurement properties and clinical validity of data for the Dynamic Gait Index.