bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age- and Gender-Related Test Performance in Community-Dwelling Elderly People: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and Gait Speeds
Authors: Steffen Teresa M , Hacker Timothy A , Mollinger Louise 
Published: February 2017

Abstract
Background and Purpose. The interpretation of patient scores on clinical tests of physical mobility is limited by a lack of data describing the range of performance among people without disabilities. The purpose of this study was to provide data for 4 common clinical tests in a sample of community-dwelling older adults. Subjects. Ninety-six community-dwelling elderly people (61–89 years of age) with independent functioning performed 4 clinical tests. Methods. Data were collected on the Six-Minute Walk Test (6MW), Berg Balance Scale (BBS), and Timed Up & Go Test (TUG) and during comfortable- and fast-speed walking (CGS and FGS). Intraclass correlation coefficients (ICCs) were used to determine the test-retest reliability for the 6MW, TUG, CGS, and FGS measurements. Data were analyzed by gender and age (60–69, 70–79, and 80–89 years) cohorts, similar to previous studies. Means, standard deviations, and 95% confidence intervals for each measurement were calculated for each cohort. Results. The 6MW, TUG, CGS, and FGS measurements showed high test-retest reliability (ICC [2,1]=.95–.97). Mean test scores showed a trend of age-related declines for the 6MW, BBS, TUG, CGS, and FGS for both male and female subjects. Discussion and Conclusion. Preliminary descriptive data suggest that physical therapists should use age-related data when interpreting patient data obtained for the 6MW, BBS, TUG, CGS and FGS. Further data on these clinical tests with larger sample sizes are needed to serve as a reference for patient comparisons.
Three Perspectives on Physical Therapist Managerial Work
Authors: Schafer D Sue 
Published: February 2017

Abstract
Background and Purpose. The nature of managerial work in the commercial sector has not been studied since the 1970s, and little is known about the work of managers in the health care sector. In this study, the perceived importance of managerial role and skill categories among 3 groups of physical therapists were studied to better understand the work priorities of physical therapist managers. Subjects. Two groups of subjects were physical therapist managers in hospitals or private practices. A third group consisted of faculty members in professional physical therapist education programs. Methods. Respondents (n=343) rated the importance of 75 managerial activities. Responses related to 16 predetermined work categories were placed in rank order by group. A multivariate analysis of variance (MANOVA) was used to identify differences among groups. Results. All groups identified communication, financial control, entrepreneur, resource allocator, and leader as the 5 most important categories and rated technical expert and figurehead as least important. The MANOVA showed differences between faculty members and private practice managers in 15 work categories, between hospital-based managers and private practice managers in 9 categories, and between faculty members and hospital-based managers in 8 categories. Discussion and Conclusion. Work setting appears to have an impact on level of importance placed on managerial work categories. The strongest candidates for “universal” physical therapist managerial work categories were communication, financial control, and resource allocator.
The Effect of Transcutaneous Electrical Stimulation on Spinal Motor Neuron Excitability in People Without Known Neuromuscular Diseases: The Roles of Stimulus Intensity and Location
Authors: Hardy SG Patrick , Spalding Thomas B , Liu Hao , Nick Todd G , Pearson Rebecca H , Hayes Antonio V , Stokic Dobrivoje S 
Published: February 2017

AbstractBackground and Purpose. The Hoffmann reflex (H-reflex) is widely acknowledged as an indirect indicator of spinal motor neuron excitability. The purpose of this study was to determine whether transcutaneous electrical stimulation (TES), applied over the dorsiflexors or plantar flexors of the ankle, would alter the soleus muscle's H-reflex. Attention was focused on the roles of stimulus intensity and location. Subjects. Thirty-two volunteers without known neuromuscular diseases (17 women [53%]; mean years of age=27, SD=7.3, range=21–48) were studied. Methods. Subjects were randomly assigned to 1 of 4 groups, and TES was administered for 15 minutes. Stimulation site and intensity varied according to group assignment. H-reflexes were recorded before and for 10 minutes after TES. Results. H-reflex amplitudes increased following TES at sensory threshold, whereas H-reflex amplitudes did not change following TES at 1.5 times motor threshold. The site of stimulation did not influence the resulting H-reflexes. Discussion and Conclusion. Low-intensity TES increases H-reflex amplitudes (and presumably the excitability of spinal motor neurons to Ia afferent input) in subjects without known neuromuscular diseases. High-intensity TES had little influence on H-reflex amplitudes.
Agility and Perturbation Training for a Physically Active Individual With Knee Osteoarthritis
Authors: Fitzgerald G Kelley , Childs John D , Ridge Tara M , Irrgang James J 
Published: February 2017

Abstract
Background and Purpose. People with knee osteoarthritis (OA) sometimes report episodes of knee instability that limit their activities of daily living. The episodes of instability are similar to those reported by people with knee ligament injuries. The authors believe that modifications of interventions that are used to promote knee stability in individuals with knee ligament injuries can be used to enhance knee stability and function in people with knee OA. The purpose of this case report is to describe the development and implementation of an agility and perturbation training program that was used in conjunction with traditional rehabilitation activities for a patient with knee OA. Case Description. The patient was a 73-year-old woman with a diagnosis of bilateral knee OA. Her chief complaints were knee pain and episodes of partial“giving way” at the knee during walking, stair climbing, and participation in tennis and golf. The patient participated in 12 treatment sessions at a frequency of 2 visits per week. The rehabilitation program consisted of lower-extremity stretching, strengthening and endurance exercises that were supplemented with a variety of walking-based agility training techniques, and perturbation training techniques. Outcome. At the completion of rehabilitation, the patient was able to walk on level surfaces and stairs and return to playing golf and tennis without episodes of instability and with reduced pain. Discussion. Supplementing rehabilitation programs for people with knee OA with a modified agility and perturbation training program may assist them in returning to higher levels of physical activity with less pain and instability following rehabilitation. Further research is needed to determine the role of agility and perturbation training in people with knee OA.
The Influence of a Move to Program Management on Physical Therapist Practice
Authors: Miller Patricia A , Solomon Patricia 
Published: February 2017

Abstract
Background and Purpose. The purpose of this qualitative study was to examine how a move to program management (PM) from a traditional department structure affected the professional practice of physical therapists in a large Canadian teaching hospital. Subjects. Twenty-five physical therapists participated in 1 of 5 focus groups, and 4 physical therapists participated in individual interviews. Methods. Focus groups and structured interviews were conducted by an experienced facilitator who was not a physical therapist. All focus groups and interviews were audiotaped and transcribed. Using an open-coding technique, 2 investigators undertook line-by-line analysis of each transcript to identify and code specific events related to the physical therapists' experiences. The investigators reached a consensus on all coding categories and then identified themes. Results. Seven themes that addressed issues of affect (a sense of loss, low morale, and positive coping), professional practice (loss of professional development activities, professional advantages, the assuming of multiple roles), and patient care were identified. Discussion and Conclusion. Physical therapists who were deployed from a department to a program described both positive and negative effects of the move to PM on their practice. There were reported influences on their personal affect, professional practice, and patient care. Staff and physical therapy administrators need to be aware of potential implications of an organization's move to PM on the professional practice of frontline staff.
Rehabilitation for Balance and Ambulation in a Patient With Attention Impairment Due to Intracranial Hemorrhage
Authors: Tappan Rachel S 
Published: February 2017

Abstract
Background and Purpose. The purpose of this case report is to describe physical therapy to improve the balance and ambulation of a 16-year-old patient with attention impairment following intracranial hemorrhage. Case Description. The patient initially had frequent losses of balance, especially in distracting environments, due in part to decreased attention. He was managed with a balance and ambulation training program that incorporated the principles of cognitive rehabilitation for attention impairments. Outcomes. Following 11 weeks of outpatient therapy, the patient returned to independent ambulation at school without losses of balance. Discussion. Research is needed to determine the interaction between balance and attention in patients with brain injury and effective treatment for patients with decreased balance related to attention impairments.
Patient Satisfaction With Outpatient Physical Therapy: Instrument Validation
Authors: Beattie Paul F , Pinto Mary Beth , Nelson Martha K , Nelson Roger 
Published: February 2017

Abstract
Background and Purpose. Patient satisfaction with physical therapy is used as an outcome variable. The purpose of this study was to develop and test an instrument used to determine which variables are associated with the satisfaction of patients receiving outpatient physical therapy. Subjects. During the pilot study, 191 patients participated, and 1,868 patients then participated in the main phase of this work. Methods. Using a survey instrument developed by the authors, subjects responded to global questions concerning overall satisfaction with physical therapy. Content validation of the instrument was investigated using item correlation, principal components analysis, and factor analysis. Reliability was measured using the standard error of measurement. Concurrent validity was investigated by correlating summary scores of the final survey instrument with global measures of satisfaction. Results. Reliability was best for a 10-item questionnaire. Patient satisfaction was most associated with items that reflected a high-quality interaction with the therapist (eg, time, adequate explanations and instructions to patients). Environmental factors such as clinic location, parking, time spent waiting for the therapist, and type of equipment used were not strongly correlated with overall satisfaction with care. Discussion and Conclusion. Because the time the therapist spent with patients and the behavior of the therapists are important for patient satisfaction, emphasis on cost-cutting, high patient volume, and the use of “care extenders” may jeopardize satisfaction.
Short-Term Effects of Workstation Exercises on Musculoskeletal Discomfort and Postural Changes in Seated Video Display Unit Workers
Authors: Fenety Anne , Walker Joan M 
Published: February 2017

Abstract
Background and Purpose. In recent years, a number of exercise programs have been developed for computer operators in order to promote movement and to reduce musculoskeletal discomfort. Tests of the effectiveness of these exercise programs, especially in field trials, are rare. The authors tested the hypothesis that doing regular, short-term (&lt;10 days) exercises while at a workstation would decrease musculoskeletal discomfort and increase in-chair movement (ICM). Subjects. Eleven directory assistance operators (8 female, 3 male) with no recent history of musculoskeletal problems volunteered. Methods. In-chair movement was measured by tracking the center of pressure at the buttock-chair interface as subjects sat on a pressure-sensitive mat. Musculoskeletal discomfort was rated through the use of the Body Part Discomfort Scale (BPDS) and a body map. We used a revised Dataspan exercise program. Operators were tested for 2 hours, on 2 occasions: before and after doing exercises for 3- to 5-day shifts. During each test, ICM was measured during three 15-minute periods at the start of the test and at the end of hours 1 and 2. Subjects rated musculoskeletal discomfort per body part using the BPDS at 30, 60, and 120 minutes of each test. The effects of exercises on ICM and BPDS ratings were examined with a two-way repeated-measures analysis of variance with day (2) × time (3) designs. Results. When subjects were doing their exercises, ICM was higher at the start and hour 1, and perceived discomfort was lower during each test period (start, hour 1, and hour 2). When not exercising, subjects' musculoskeletal discomfort increased over time and was higher during all test periods. Discussion and Conclusion. Exercises done by video display unit operators while at a workstation resulted in short-term decreases in both musculoskeletal discomfort and postural immobility. These results suggest that workstation exercises may be beneficial.
Environmental Demands Associated With Community Mobility in Older Adults With and Without Mobility Disabilities
Authors: Shumway-Cook Anne , Patla Aftab E , Stewart Anita , Ferrucci Luigi , Ciol Marcia A , Guralnik Jack M 
Published: February 2017

Abstract
Background and Purpose. In this study, the influence of 8 dimensions of the physical environment on mobility in older adults with and without mobility disability was measured. This was done in order to identify environmental factors that contribute to mobility disability. Subjects. Subjects were 36 older adults (≥70 years of age) who were recruited from 2 geographic sites (Seattle, Wash, and Waterloo, Ontario, Canada) and were grouped according to level of mobility function (physically able [ability to walk ½ mile (0.8 km) or climb stairs without assistance], physically disabled). Methods. Subjects were observed and videotaped during 3 trips into the community (trip to grocery store, physician visit, recreational trip). Frequency of encounters with environmental features within each of the 8 dimensions was recorded. Differences in baseline characteristics and environmental encounters were analyzed using an analysis of variance or the Fisher exact test, as appropriate. Results. Mobility disability among older adults was not associated with a uniform decrease in encounters with environmental challenges across all dimensions. Environmental dimensions that differed between subjects who were physically able and those with physical disability included temporal factors, physical load, terrain, and postural transition. Dimensions that were not different included distance, density, ambient conditions (eg, light levels and weather conditions), and attentional demands. Discussion and Conclusion. Understanding the relationship of the environment to mobility is crucial to both prevention and rehabilitation of mobility disability in older adults. Among older adults, certain dimensions of the environment may disable community mobility more than others.
Treatment of Visual Neglect in Elderly Patients With Stroke: A Single-Subject Series Using Either a Scanning and Cueing Strategy or a Left-Limb Activation Strategy
Authors: Bailey Maggie J , Riddoch M Jane , Crome Peter 
Published: February 2017

AbstractBackground and Purpose. The presence of unilateral visual neglect (UVN) may adversely affect functional recovery, and rehabilitation strategies that are practical for use in clinical settings are needed. The purpose of this study was to evaluate the use of 2 approaches to reduce UVN in people who have had strokes. Subjects. Seven elderly patients with stroke and severe left UVN, aged 60 to 85 years, were recruited from a stroke rehabilitation unit. Methods. A nonconcurrent, multiple-baselines-across-subjects approach, with an A-B-A treatment-withdrawal single-subject experimental design, was used. Five subjects received a scanning and cueing approach, and 2 subjects received a contralesional limb activation approach, for 10 one-hour sessions. In the former approach, active scanning to the left was encouraged by the therapist, using visual and verbal cues and a mental imagery technique, during reading and copying tasks and simple board games. In the latter approach, functional and goal-oriented left upper-limb activities in neglected hemispace were encouraged. Unilateral visual neglect was examined by a masked (blinded) examiner throughout all phases using the Star Cancellation Test, the Line Bisection Test, and the Baking Tray Task. Data were analyzed using visual and inferential statistical techniques. Results. Both subjects who received limb activation and 3 of the 5 subjects who received scanning and cueing showed a reduction in UVN in one or more tests. This improvement was maintained during the withdrawal phase. Discussion and Conclusion. Both approaches had a positive effect of reducing aspects of UVN in some subjects relative to no-treatment baselines. However, causality cannot be assured in the absence of controls. The approaches are practical for use in rehabilitation settings. These procedures warrant further replication across subjects, settings, and therapists.
Balance Confidence Among People With Lower-Limb Amputations
Authors: Miller William C , Speechley Mark , Deathe A Barry 
Published: February 2017

AbstractBackground and Purpose. Confidence in a person's balance has been shown to be an important predictor of social activity among people with lower-limb amputations. The purposes of this study were to describe confidence in balance among people with transtibial or transfemoral lower-limb amputations and to compare people whose amputations were due to vascular and nonvascular causes. Subjects and Methods. A survey of a sample of 435 community-dwelling individuals from 2 regional clinics was conducted. The sample consisted of people with unilateral transfemoral (26.7%) and transtibial (73.3%) amputations who lost their limb for vascular (53%) and nonvascular (47%) reasons. The mean age of the primarily male (71%) sample was 62.0 years (SD=15.7). Results. Mean scores, using the Activities-specific Balance Confidence (ABC) Scale, were 63.8 for the total sample, 54.1 for the subjects with amputations due to vascular reasons, and 74.7 for the subjects with amputations due to nonvascular reasons. Given a maximum possible ABC Scale score of 100, the results suggest that confidence was low. A difference between the subjects with amputations due to vascular reasons and those with amputations due to nonvascular reasons was observed over each item of the ABC Scale. Variables that were statistically related to balance confidence included age, sex, etiology, mobility device use, the need to concentrate while walking, limitations in activities of daily living, depression, and fear of falling. Discussion and Conclusion. Balance confidence scores among the study sample were low when compared with values previously reported by other researchers. Confidence was particularly low among individuals who had their amputation for vascular reasons. Balance confidence might be an important area of clinical concern.
Prediction of Postoperative Pulmonary Complications on the Basis of Preoperative Risk Factors in Patients Who Had Undergone Coronary Artery Bypass Graft Surgery
Authors: Hulzebos Erik HJ , Van Meeteren Nico LU , De Bie Rob A , Dagnelie Pieter C , Helders Paul JM 
Published: February 2017

Abstract
Background and Purpose. Pulmonary complications are among the most frequently reported complications after coronary artery bypass graft (CABG) surgery. However, the risks of postoperative pulmonary complications (PPCs) are not equal for all patients. The aim of this study was to develop a model, based on preoperative factors, for classifying patients with high and low risks for PPCs in order to implement tailored interventions. Subjects and Methods. Postoperative pulmonary complications were examined in 117 adult patients who had undergone elective CABG surgery at the University Medical Centre Utrecht, Utrecht, the Netherlands. The presence of preoperative risk factors (N=12) that have been described in the literature was noted for each patient. A risk model was developed by use of logistic regression analysis. Results. Preoperative risk factors for developing PPCs were an age of ≥70 years, productive cough, diabetes mellitus, and a history of cigarette smoking. Protective factors against the development of PPCs were a predicted inspiratory vital capacity of ≥75% and a predicted maximal expiratory pressure of ≥75%. These risk and protective factors were included in the model (sensitivity=87% and specificity=56%), and a sum score for its clinical use was generated. Discussion and Conclusion. Six factors that can be determined easily before surgery, with need for only simple pulmonary testing, can provide a model for identifying patients at risk of developing PPCs after CABG surgery.
Establishing Minimal Clinically Important Differences for Scores on the Pediatric Evaluation of Disability Inventory for Inpatient Rehabilitation
Authors: Iyer Lakshmi V , Haley Stephen M , Watkins Mary P , Dumas Helene M 
Published: February 2017

AbstractBackground and Purpose. Standardized pediatric assessment tools such as the Pediatric Evaluation of Disability Inventory (PEDI) numerically quantify changes during rehabilitation through test scores, but they are unable to provide client-specific information regarding important changes in function. The purpose of this study was to identify the smallest change in PEDI scores during inpatient rehabilitation that was considered to be a minimal clinically important difference (MCID) by physical therapists and other clinicians. Subjects and Methods. A retrospective review was done of the medical charts of 53 children and youth (1–19 years of age) discharged from an inpatient rehabilitation hospital. Fifteen clinicians (5 physical therapists, 6 occupational therapists, and 4 speech and language pathologists) who were masked to the PEDI scores provided ratings of the magnitude of functional changes during inpatient rehabilitation using a Likert scale and a visual analog scale (VAS). Ratings by clinicians were reduced to 4 categories, including the MCID, and compared with PEDI change scores. Results. The MCIDs ranged from 6 to 15 points (X̄=11.5, 95% confidence interval=±2.8) for all PEDI scales. Likert scale and VAS ratings were correlated (τ=.73–.80). Discussion and Conclusion. Across all scales, PEDI change scores on the order of about 11% (0–100 scale) appear to be meaningful to clinicians during a child's or adolescent's inpatient rehabilitation. These data can serve as a starting point for interpreting group and individual changes on the PEDI during physical therapy intervention in inpatient rehabilitation.