bluuebunny/crossref_metadata_2025_split huggingface dataset:
Testing Functional Performance in People With Parkinson Disease
Authors: Brusse Kevin J , Zimdars Sandy , Zalewski Kathryn R , Steffen Teresa M 
Published: February 2017

Abstract
Background and Purpose. Although the Unified Parkinson's Disease Rating Scale (UPDRS) is the most common performance measure for people with Parkinson disease (PD), the Berg Balance Scale (BBS), Forward Functional Reach Test (FFR), Backward Functional Reach Test (BFR), Timed “Up & Go” Test (TUG), and gait speed may be used to quantify some aspects of functional performance not measured by the UPDRS. The purpose of this study was to describe the relationship among a set of tests of balance, walking performance, and mobility in people with PD. Subjects. Twenty-five community-dwelling adults (11 female, 14 male) with a diagnosis of PD were recruited from PD support groups in southeastern Wisconsin and consented to participate in the study. The mean age of the participants was 76 years (SD=7). The average Hoehn and Yahr Stage Scale score was 2. Methods. Functional abilities of each subject were assessed with the UPDRS, BBS, FFR, BFR, TUG, and gait speed. Spearman and Pearson correlations were performed. Results. The UPDRS total score was correlated with the BBS (r =−.64, P&lt;.001), FFR (r =−.52, P&lt;.05), and TUG (r =.50, P&lt;.05) measurements. The BBS is the only test of functional performance where scores correlate with all other functional tests and the UPDRS. Discussion and Conclusions. The UPDRS total score may not reflect a comprehensive measure of mobility in people with PD. Because the BBS scores correlate both with UPDRS scores and with scores of all other tests of functional performance, the BBS appears to be a good overall measure of function in this population.
Limb-Loaded Cycling Program for Locomotor Intervention Following Stroke
Authors: Brown David A , Nagpal Sabina , Chi Sam 
Published: February 2017

Abstract
Background and Purpose. This case report describes implementation of a limb-loaded cycling (LLC) training program as a feasible exercise for people in early phases of locomotor training following stroke. Case Description. Two individuals with early-stage poststroke hemiplegia participated in the LLC program as an adjunct to physical therapy intervention. Performance of LLC involved cycling while supporting progressive amounts of applied load and weight shifting from one lower extremity to the other lower extremity. The LLC was conducted daily during 2 to 3 weeks of inpatient rehabilitation. Outcomes. The LLC progressed with increases in weight bearing and force generation, as evidenced by larger amounts of limb loading during pedaling. The patients tolerated all loads without cardiorespiratory distress. Discussion. Limb-loaded cycling can accommodate people with little force-generating capability or weight-bearing ability as they practice locomotor skills. Gains in locomotor ability may be aided by the addition of this exercise regimen to patients' daily physical therapy.
Trunk Muscle Stabilization Training Plus General Exercise Versus General Exercise Only: Randomized Controlled Trial of Patients With Recurrent Low Back Pain
Authors: Koumantakis George A , Watson Paul J , Oldham Jacqueline A 
Published: February 2017

Abstract
Background and Purpose. The purpose of this randomized controlled trial was to examine the usefulness of the addition of specific stabilization exercises to a general back and abdominal muscle exercise approach for patients with subacute or chronic nonspecific back pain by comparing a specific muscle stabilization–enhanced general exercise approach with a general exercise–only approach. Subjects. Fifty-five patients with recurrent, nonspecific back pain (stabilization–enhanced exercise group: n=29, general exercise–only group: n=26) and no clinical signs suggesting spinal instability were recruited. Methods. Both groups received an 8-week exercise intervention and written advice (The Back Book). Outcome was based on self-reported pain (Short-Form McGill Pain Questionnaire), disability (Roland-Morris Disability Questionnaire), and cognitive status (Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia, Pain Locus of Control Scale) measured immediately before and after intervention and 3 months after the end of the intervention period. Results. Outcome measures for both groups improved. Furthermore, self-reported disability improved more in the general exercise–only group immediately after intervention but not at the 3-month follow-up. There were generally no differences between the 2 exercise approaches for any of the other outcomes. Discussion and Conclusion. A general exercise program reduced disability in the short term to a greater extent than a stabilization-enhanced exercise approach in patients with recurrent nonspecific low back pain. Stabilization exercises do not appear to provide additional benefit to patients with subacute or chronic low back pain who have no clinical signs suggesting the presence of spinal instability.
Physical Therapy Interventions for Patients With Stroke in Inpatient Rehabilitation Facilities
Authors: Jette Diane U , Latham Nancy K , Smout Randall J , Gassaway Julie , Slavin Mary D , Horn Susan D 
Published: February 2017

Abstract
Background and Purpose. The purpose of this study was to describe physical therapy provided to patients with stroke in inpatient rehabilitation facilities. Subjects and Methods. Data were collected from 972 patients with stroke receiving physical therapy services at 6 rehabilitation facilities in the United States. Descriptive statistics were derived to describe physical therapy sessions, including proportion of therapy time spent in specific functional activities and proportion of those activities that included any of 59 interventions. Results. Mean length of stay was 18.7 days (SD=10.3), and patients received physical therapy, on average, 13.6 days (SD=7.8). Patients attended, on average, 1.5 (SD=0.3) physical therapy sessions per day, with each session lasting 38.1 minutes (SD=17.1). Gait and prefunctional activities were performed most frequently (31.3% and 19.7% of total treatment time, respectively). For gait activity, physical therapists used balance and postural awareness training in more than 50% of sessions and used strength training for more than 50% of sessions of prefunctional activities. Eighty-six percent of the patients received evaluation, and 84% of the patients and families received education. Discussion and Conclusion. Therapists selected an eclectic approach to intervention rather than specific intervention techniques. The approach to patients' care included interventions to remediate impairments and to compensate for functional limitations. Therapists also reported frequently using motor control and motor learning approaches to facilitate all activities. This approach to care is largely consistent with existing stroke care guidelines and advances in the scientific theories of motor control and motor learning.
The Kappa Statistic in Reliability Studies: Use, Interpretation, and Sample Size Requirements
Authors: Sim Julius , Wright Chris C 
Published: February 2017

Abstract
Purpose. This article examines and illustrates the use and interpretation of the kappa statistic in musculoskeletal research. Summary of Key Points. The reliability of clinicians' ratings is an important consideration in areas such as diagnosis and the interpretation of examination findings. Often, these ratings lie on a nominal or an ordinal scale. For such data, the kappa coefficient is an appropriate measure of reliability. Kappa is defined, in both weighted and unweighted forms, and its use is illustrated with examples from musculoskeletal research. Factors that can influence the magnitude of kappa (prevalence, bias, and nonindependent ratings) are discussed, and ways of evaluating the magnitude of an obtained kappa are considered. The issue of statistical testing of kappa is considered, including the use of confidence intervals, and appropriate sample sizes for reliability studies using kappa are tabulated. Conclusions. The article concludes with recommendations for the use and interpretation of kappa.
Evaluation of Female Pelvic-Floor Muscle Function and Strength
Authors: Bø Kari , Sherburn Margaret 
Published: February 2017

Abstract
Evaluation of pelvic-floor muscle (PFM) function and strength is necessary (1) to be able to teach and give feedback regarding a woman's ability to contract the PFM and (2) to document changes in PFM function and strength throughout intervention. The aims of this article are to give an overview of methods to assess PFM function and strength and to discuss the responsiveness, reliability, and validity of data obtained with the methods available for clinical practice and research today. Palpation, visual observation, electromyography, ultrasound, and magnetic resonance imaging (MRI) measure different aspects of PFM function. Vaginal palpation is standard when assessing the ability to contract the PFM. However, ultrasound and MRI seem to be more objective measurements of the lifting aspect of the PFM. Dynamometers can measure force directly and may yield more valid measurements of PFM strength than pressure transducers. Further research is needed to establish reliability and validity scores for imaging techniques. Imaging techniques may become important clinical tools in future physical therapist practice and research to measure both pathophysiology and impairment of PFM dysfunction.
Decreased Trunk Angular Displacement During Sitting Down: An Early Feature of Aging
Authors: Dubost Véronique , Beauchet Olivier , Manckoundia Patrick , Herrmann François , Mourey France 
Published: February 2017

Abstract
Background and Purpose. Trunk motion plays an important role in achieving both sit-to-stand and stand-to-sit transfers. However, these 2 body transfers depend on different postural and mechanical constraints. Although the effects of aging on sit-to-stand transfers have been widely studied, there is a lack of information concerning stand-to-sit transfers. The aim of this study was to determine how angular displacements of the trunk and shank are affected by aging during sit-to-stand and stand-to-sit transfers. Subjects. Ten community-dwelling older adults (mean age=75.9 years, SD=3.2) and 9 young adults (mean age=26.8 years, SD=4.7) volunteered to participate. Methods. Maximal angular displacements of the trunk and shank with respect to the vertical (ie, orientation angles) were measured, during standing up and sitting down, using an optoelectronic movement analyzer. Results. For standing up, there was no difference between the young and older adults with regard to both maximal orientation angles. During sitting down, the maximal shank orientation angle was not affected by age, whereas the older adults had a smaller trunk motion compared with the young adults (approximately 10° less). Discussion and Conclusion. The results showed that older adults tended to minimize the forward body displacement during sitting down. This strategy could be seen as an adaptive mechanism to decrease the risk of anterior disequilibrium. The authors suggest that this feature could be used as an early marker of aging on postural control.
Development and Testing of a Self-report Instrument to Measure Actions: Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL)
Authors: Guccione Andrew A , Mielenz Thelma J , DeVellis Robert F , Goldstein Marc S , Freburger Janet K , Pietrobon Ricardo , Miller Sarah C , Callahan Leigh F , Harwood Kenneth , Carey Timothy S 
Published: February 2017

Abstract
Background and Purpose. Physical therapy is faced with the challenge of producing evidence that physical therapy interventions are effective. The fundamental question confronting physical therapy is whether or not physical therapy interventions make a contribution to function, health, and well-being. The individual's ability to perform actions can serve as a theoretical construct related to movement and health around which physical therapy interventions can be assessed. To this end, the aims of this study were: (1) to develop a self-report instrument to assess ability to perform mobility actions in an adult outpatient population and (2) to assess the psychometric properties of such an instrument in the appropriate population. Subjects and Methods. An instrument was developed to assess difficulty and confidence related to 24 actions. Descriptive statistics and measures of reliability, validity, and responsiveness were computed. A total of 391 patients participated in the study. Results. The coefficient for reliability was in the required range, and measures of validity and responsiveness were established as well. Three factors were identified. Discussion and Conclusion. The instrument provides the beginning of documentation of outcomes in movement to identify the unique contributions of physical therapist practice.
Collecting Health History Information: The Accuracy of a Patient Self-administered Questionnaire in an Orthopedic Outpatient Setting
Authors: Boissonnault William G , Badke Mary Beth 
Published: February 2017

Abstract
Background and Purpose. The utility of patient self-administered health history questionnaires has been extensively studied in physician practice settings, but little such research has been done in populations germane to physical therapist practice. The purpose of this study was to document the accuracy of a self-administered questionnaire for collecting patients' history of illness, surgery, and medication use. Subjects. Outpatient orthopedic surgery candidates (n=100, 54% female, 46% male; mean age=46.9 years) with common orthopedic disorders were recruited. Methods. Using the same form, patient health history information was recorded separately by patient self-report and by an experienced health care practitioner. Patient questionnaire responses were compared for accuracy with responses generated by the practitioner and those found in the medical record. Results. The mean percentage of agreement across questionnaire items was 96% (range=57%–100%); the mean kappa value was .69 (range=.154–1.0). Of the total questionnaire responses across all patients (n=9,436), 2.55% (n=241) of the responses were noted “yes” on the practitioner questionnaire, but not on the patient questionnaire; 1.8% of the items (n=174) were noted “yes” on the patient questionnaire, but not on the practitioner questionnaire. Discussion and Conclusion. The results support the accuracy of patient self-administered health history questionnaires in reporting important health history information.
Navicular Drop Measurement in People With Rheumatoid Arthritis: Interrater and Intrarater Reliability
Authors: Shrader Joseph A , Popovich John M , Gracey G Chris , Danoff Jerome V 
Published: February 2017

AbstractBackground and Purpose. Navicular drop (ND) measurement may be a valuable examination technique for patients with rheumatoid arthritis (RA). However, no data exist on reliability for this technique in patients with RA. The purposes of this study were: (1) to determine interrater and intrarater reliability of ND measurements in people with RA, (2) to compare ND values of people with RA with published normative data, and (3) to investigate ND measurement error associated with the use of skin markings. Subjects. Ten women (20 feet) with RA consented to participate. Methods. Patients completed demographic and function questionnaires. Navicular height (NH) measurements were taken by 2 physical therapists and 1 physical therapist student, following four 1-hour training sessions, using standardized methods and a digital height gauge. Four different NH measurements were taken 3 times on each foot by each of the 3 examiners during a morning session and then repeated during an afternoon session on the same day. Navicular drop values were calculated, including ND1 (as reported in the literature), ND2 (compensating for skin error), and ND3 (single-limb stance). Intraclass correlation coefficients (ICCs) and standard errors of measurement (SEMs) were used to establish reliability. Results. Means (±SD) for each ND measure for sessions 1 and 2, respectively, were as follows: ND1=8.36±5.29 mm and 8.29±5.24 mm, ND2=9.95±5.44 mm and 9.57±5.37 mm. The ICCs (2,1 and 2,k, respectively) for all interrater measurements ranged from .67 to .92 (SEM=2.0–3.3 mm) and from .85 to .97 (SEM=1.1–2.0 mm). The ICCs (2,1 and 2,k, respectively) for intrarater measurements ranged from .73 to .95 (SEM=1.3–2.8 mm) and from .90 to .98 (SEM=0.7–1.6 mm). Paired t tests showed the means of ND1 and ND2 for each examiner and for both sessions were significantly different. Discussion and Conclusion. The results suggest that ND measurements for people with RA can be taken reliably by clinicians with varied experience. The ND values for our subjects were slightly greater than reported normal values of 6 to 8 mm. Error associated with skin markings was statistically significant for all sessions and examiners.
Physical Therapist Management of an Adult With Osteochondritis Dissecans of the Knee
Authors: Johnson Michael P 
Published: February 2017

AbstractBackground and Purpose. Osteochondritis dissecans (OCD) primarily occurs between 10 and 20 years of age. Adult patients (&gt;20 years) tend to respond poorly to nonsurgical management. This case report describes the physical therapist management of an adult with OCD at the tibiofemoral joint. Case Description. A 24-year-old woman had insidious onset of right knee pain. Magnetic resonance imaging confirmed the diagnosis of OCD. Interventions included iontophoresis, strengthening exercises, and instruction in strategies to minimize loading across the knee. Outcome. The patient received 5 intervention sessions. At discharge and 9-month follow-up, she reported 95% function (Single Assessment Numeric Evaluation) and no pain while performing full work duties. Discussion. This case illustrates the process, including the use of evidence, of making clinical decisions about the physical therapist management of an adult with OCD.
Sensitivity to Change and Responsiveness of the Global Physiotherapy Examination (GPE-52) in Patients With Long-Lasting Musculoskeletal Pain
Authors: Kvåle Alice , Skouen Jan Sture , Ljunggren Anne Elisabeth 
Published: February 2017

Abstract
Background and Purpose. The sensitivity to change and the responsiveness of the Global Physiotherapy Examination (GPE-52) were examined in patients with localized and widespread long-lasting musculoskeletal pain. Subjects. All included patients were on sick leave and constituted the treatment group in a randomized controlled study. Two hundred forty-seven patients (64% women; mean age=43.6 years, SD=10.4) were included. At entry, the patients were categorized into 3 groups according to pain localization. Patients who returned fully to work were compared with those who did not. Methods. The GPE-52 has composite scores in 5 main domains—posture (8 tests), respiration (8 tests), movement (16 tests), muscle (12 tests), and skin (8 tests)—and was administered before and after 4 weeks of multidisciplinary outpatient treatment and at a 6-month follow-up examination. The first 61 patients also were re-examined after 18 months. Results. In this study, the GPE-52 and its 5 main domains were demonstrated to be sensitive to change, measured 6 and 18 months after treatment, in different groups of patients with long-lasting musculoskeletal pain. Responsiveness to important change, defined in this study as return to work, was found only for the total GPE-52 score and within the movement and respiration domains. Responsiveness to important change was greater in patients with localized pain than in patients with widespread pain. Discussion and Conclusion. Although the total GPE-52 score was sensitive to change in patients with long-lasting musculoskeletal pain, a shorter test battery including only the respiration and movement domain scores might be appropriate as an outcome measure in intervention studies for patients with long-lasting musculoskeletal pain.
Specialized Neuromuscular Training to Improve Neuromuscular Function and Biomechanics in a Patient With Quiescent Juvenile Rheumatoid Arthritis
Authors: Myer Gregory D , Brunner Hermine I , Melson Paula G , Paterno Mark V , Ford Kevin R , Hewett Timothy E 
Published: February 2017

Abstract
Background and Purpose. The purpose of this case report is to describe a novel multidisciplinary approach for evaluating and preparing a patient with quiescent juvenile rheumatoid arthritis (JRA) for safe sports participation. Case Description. The patient was a 10-year-old girl with a history of bilateral knee arthritis who desired to participate in soccer and basketball. Range of motion and manual muscle testing of the lower extremity were within normal limits. Neuromuscular testing included kinematic and kinetic testing, isokinetic assessment, and postural stability testing. The patient's gait was near normal; however, she had narrowed step width and increased knee flexion at heel-strike. Landing analysis during a box drop vertical jump task showed increased and imbalanced (right versus left lower extremity) peak impact forces. The testing was followed by specialized neuromuscular training (SNT). Outcomes. Following SNT, heel-strike and step width were within normal limits, peak impact forces on the box drop test decreased by 31%, imbalance decreased by 46%, and vertical jump increased 15%. The isokinetic strength ratio between knee flexors and extensors and the overall balance measures were within normal limits and equal bilaterally. Discussion. Patients with quiescent JRA may have abnormal biomechanics, which could place them at increased risk for injury or future articular cartilage damage. Specialized neuromuscular training may have helped to decrease the patient's risk for future injury or disease progression.
Discriminative, Predictive, and Evaluative Properties of a Trunk Control Measure in Patients With Stroke
Authors: Wang Chun-Hou , Hsueh I-Ping , Sheu Ching-Fan , Hsieh Ching-Lin 
Published: February 2017

Abstract
Background and Purpose The trunk control items of the Postural Assessment Scale for Stroke Patients (PASS-TC) have been proposed for use in examining patients with stroke. The purpose of this study was to examine the discriminative and predictive validities and the evaluative properties of the PASS-TC at 14, 30, 90, and 180 days after stroke onset. Subjects and Methods A total of 269 patients with stroke participated in this prospective study. The PASS-TC was administered at the 4 time points after stroke onset. The distributions of the PASS-TC scores were used to determine the discriminative ability to distinguish between individuals at the 4 time points. A comprehensive activities of daily living (CADL) measure was administered 1 year after stroke onset as an external criterion for examining the predictive ability of the PASS-TC. Changes in PASS-TC scores between the intervals of 14 to 30, 30 to 90, and 90 to 180 days after stroke onset were used to examine the evaluative properties of the measure. Results The PASS-TC scores exhibited differences between the patients with disability and the patients without disability at the 4 time points. The scale, however, showed a notable ceiling effect at the 4 time points (&gt;30% of the subjects), indicating a limited discriminative ability between individuals. The scores of the PASS-TC at the 4 time points were moderately correlated with the CADL scores at 1 year after stroke onset (Spearman ρ≥.5), evidence of its predictive validity. The responsiveness of the PASS-TC was moderate at 14 to 30 days after stroke (standardized response mean [SRM]=.65) and limited at 30 to 90 and 90 to 180 days after stroke (SRM=.42 and .02, respectively). Discussion and Conclusion The results provide evidence that the PASS-TC can predict CADL function at 1 year after a stroke, but the discriminative and evaluative abilities are limited over the first 6 months after a stroke. To promote the utility of the PASS-TC in stroke research, it will be necessary to reduce its ceiling effect and improve its evaluative ability.