bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability of clinical balance outcome measures in the elderly
Authors: Giorgetti Marie Magliozzi , Harris Bette Ann , Jette Alan 
Published: March 2006

AbstractBackground and PurposeSimple, practical and reliable clinical balance outcome measures are needed to assess baseline status and response to treatment in older people. The reliability of the clinical measures used in this testing protocol had not been determined for this population. This study assessed the inter‐rater reliability of three commonly used clinical measuress of balance: one leg standing, tandem gait and functional reach.MethodTwo samples of older people were used: (1) non‐disabled and (2) disabled community dwellers. All testing was performed in a single session by two trained examiners according to a standardized protocol. Intra‐class correlations were calculated comparing the means of each clinical balance test for Examiner 1 with Examiner 2.ResultsReliability coefficients were 0.75 for one leg standing, 0.73 for functional reach, and 0.31 for tandem gait for the non‐disabled sample. Reliability coefficients were 0.85 for one leg standing, 0.79 for functional reach, and 0.62 for tandem gait for the disabled sample.ConclusionsThese findings for the one leg standing and functional reach testing protocols in disabled and non‐disabled older people can be used as outcome measures. Further study should be directed towards improving the reliability of the tandem gait test for use with older people. Copyright © 1998 Whurr Publications Ltd.
Improvement in ejection fraction by hydrotherapy as rehabilitation in patients with chronic pulmonary emphysema
Authors: Kurabayashi Hitoshi , Machida Izumi , Kubota Kazuo 
Published: March 2006

AbstractBackground and PurposeIt has been reported that breathing exercise by immersion in combination with expiring into water improved pulmonary function and blood–gas exchange in patients with chronic obstructive pulmonary disease (COPD). This effect may result from respiratory muscle exercise against hydraulic pressure and decreased dead space by increased sub‐abdominal pressure. Increased cardiac function by bathing is suggested to contribute to the effect. To clarify the effect of the breathing exercise by immersion on cardiac function, a study was made of cardiac function during the exercise in patients with emphysema.MethodEchocardiography, respiratory function test and arterial blood gas analysis were performed during a two‐month breathing exercise programme in a pool filled with 38°C water for 12 patients (aged 70.9 ± 9.1 years) with stable chronic pulmonary emphysema who were treated at our hospital between 1993 and 1996. The patients breathed in whilst standing in a pool and breathed out through the mouth while sinking the nose under water. This exercise was repeated for 30 min per day and continued for six days a week for two months.ResultsThe ejection fraction increased significantly after each 30‐minute exercise (N=12; p<0.01) as well as after the two‐month exercise programme (N=12, p<0.05). Left ventricular end‐diastolic and systolic dimensions at rest decreased significantly after the two‐month exercise programme (N=12, p<0.01). The ratio of forced expired volume in one second to forced vital capacity (FEV1:FVC) increased and PaCO2 decreased following this programme (N=12, p<0.05).ConclusionsThese results suggest that the breathing exercise by immersion is useful not only in treating emphysema but also in improving cardiac function. Copyright © 1998 Whurr Publications Ltd.
Prevalence of back, neck and shoulder problems in the inner city: implications for the provision of physiotherapy services in primary healthcare
Authors: Lock Catherine , Allgar Victoria , Jones Kevin , Marples Gwen , Chandler Colin , Dawson Pam 
Published: March 2006

AbstractBackground and PurposeMore general practitioners are offering physiotherapy services within primary healthcare; however, this provision may result in increased demand. Resource allocation, based on previous patterns of consultation for musculoskeletal conditions, may be inadequate since the need for treatment in the community may not have been met in the past. Therefore the aim of this study was to determine the prevalence of back, neck and shoulder problems that had restricted normal activity for more than one week during the last year and which health professionals (if any) patients had consulted about their symptoms.MethodA postal survey of 2400 adult patients selected at random from four general practices in Newcastle upon Tyne (600 from each practice).ResultsA total of 1546 questionnaires were returned, a 64% response rate. Overall, 40% of respondants reported having at least one back, neck and/or shoulder problem. Back problems were most common (30%), followed by those with neck (21%) and shoulder (20%) problems. Approximately one‐third of those with problems consulted no one, a further third consulted a general practitioner and only one in six consulted a physiotherapist.ConclusionsThere is a high prevalence of substantial back, neck and shoulder problems in the community and thus a wider provision of physiotherapy services within primary healthcare may be required to manage the considerable levels of potentially unmet need. Copyright © 1999 Whurr Publishers Ltd.
Motivation for change in patients with prolonged musculoskeletal disorders: a qualitative two‐year follow‐up study
Authors: Grahn Birgitta , Stigmar Kjerstin , Ekdahl Charlotte 
Published: March 2006

AbstractBackground and PurposeThe purpose of this study was to obtain a deeper understanding of the process of motivation for change in patients with prolonged musculoskeletal disorders and to identify factors that might influence change resulting in increased independence.MethodA qualitative two‐year follow‐up study. Data collection and analysis were performed according to the qualitative case study design. An initial conceptual framework was developed to bound and guide the study. Twenty patients were selected using purposive sampling with respect to motivation level (highly motivated to less‐motivated) to create a sample of maximum variation. Data were collected using repeated interviews and standardized scales. The study comprised three data collection periods.ResultsMotivation for change followed different processes depending on the level at entry to the study. The highly motivated patients improved in independence, the moderately motivated ones remained at an unchanged level and the less‐motivated patients became more dependent. Central themes of importance to the process of motivation for change were: the utilization of professional networks (healthcare, regional social insurance office), emotional support (nuclear family, close relatives), use of personal coping resources (energy, positive beliefs, problem‐solving) and social support at work (employers, colleagues).ConclusionsThe performance of a structured motivation analysis, including questions about emotional networks and social support at work in addition to the clinical examination of the patient, is recommended. This might guide healthcare professionals when it comes to motivation for change in the patient. Copyright © 1999 Whurr Publishers Ltd.
Forward Leaning Reaching task in Sitting (FLRS): a new measure for clinical evaluation of hamstring length in children
Authors: Salén Marianne , Hirschfeld Helga , Olsson Åsa 
Published: March 2006

AbstractBackground and PurposeIn this study, the rotation of the pelvis was taken into account when assessing the length of hamstrings. A new measure for clinical evaluation was developed to establish reference values of hamstring length in children without movement disabilities for different age groups. Subjects (N = 60) were 3‐, 6‐, 10‐ and 14‐year‐old children (N = 15 for each age group). These values could be helpful in deciding treatment interventions in children with movement disabilities, for example cerebral palsy, when hamstring length is in question.MethodThe study was performed with subjects sitting and reaching for a touch control on a wall whilst voluntarily rotating the pelvis forwards. By use of digitized video frames, the spatial angles of the lumbar spine and pelvis, as well as the joint angles of hip and knee, were computed at the initial and end positions of a forward leaning reaching task in sitting (FLRS). The active forward leaning induced a forward rotation of the pelvis, causing stretch on the hamstring muscle with extended knee.ResultsThe results of spatial and joint angle measurements suggest that the difference of the hip joint angle between initial erect and final forward leaned sitting may be used as reference values for hamstring length. Reference values are based on the mean (±SE) of means (mean of 15 children, that is, group and individual means of ten trials).ConclusionsThe age group reference values obtained may indirectly give information as to whether the hamstring length of a child with cerebral palsy is within the normative value of age‐related control subjects. The new test developed in this study provides a convenient means for measuring hamstring length and could enhance clinical evaluation. Copyright © 1999 Whurr Publishers Ltd.
Physical activity in the life of the patient with rheumatoid arthritis
Authors: Kamwendo Kitty , Askenbom Malin , Wahlgren Cecilia 
Published: March 2006

AbstractBackground and PurposePhysical activity is an important tool used by patients with rheumatoid arthritis (RA) in order to reduce inflammation and pain as well as preserve and improve function. The aim of this study was to investigate how patients with RA perceive and relate to physical activity in everyday life.MethodTen patients diagnosed with RA were interviewed. The data collected were transcribed and analysed for categories of meaning and main themes. Inter‐judge reliability was tested and showed an 81.5% agreement.ResultsThree themes were identified. The first represented a ‘driving force’ and included two positively loaded categories ‘satisfaction’ and ‘support’, and two negatively loaded categories ‘keep at bay’ and ‘intimidation’. The second theme was ‘hindrance’ and included the categories ‘internal barrier’ and ‘external barrier’ and, finally, the third theme ‘physical activity’ included the categories ‘organized activity’ and ‘everyday activity’.ConclusionPhysical exercise was an important strategy for patients with RA and was promoted primarily by patients' own experiences, positive as well as negative. A salutogenic (explaining health) approach to patient education, as well as an increased use of everyday activities as additional exercise, is advocated. Copyright © 1999 Whurr Publishers Ltd.
Relationship between balance abilities and mobility aids in elderly patients at discharge from an acute care setting
Authors: Graham Dorothea , Newton Roberta A 
Published: March 2006

AbstractBackground and PurposeAt the time of discharge from the acute care setting, patients may not be evaluated for a mobility aid and it is possible this may represent an unmet need. The first purpose of this study was to examine the agreement between the Berg Balance Test (BBT) (Newton, 1997) and the Global Balance Rating scale (GBR) (Leahy, 1991) in terms of acute care patients' need for mobility aids. The second was to determine if there was an increase in mobility aid usage at the time of discharge.MethodThirty inpatients (mean age 76.7 years) were assessed by use of the BBT and the GBR. The therapist rating patients with the GBR also determined the type of mobility aid provided at discharge.ResultsAt admission, 23/30 individuals did not use a mobility aid and seven used a cane. At discharge, nine subjects were independent ambulators, 10 needed a cane and 11 needed a walker. There was no significant agreement between the GBR in relation to the BBT to determine the need for a mobility aid. There was a significant increase (p = 0.05) in the number of subjects using a mobility aid at the time of discharge as compared to admission to the acute care setting.ConclusionsTherapists should not rely on the GBR as an indicator of balance, hence the need for an assistive device until reliability and validity measures have been conducted. Therapists should use a functional assessment tool, such as the BBT, since it is reliable and a valid measure of balance ability and has been demonstrated to predict cane use. Since patients are relatively inactive in the acute care setting, referral to physical therapy for functional assessment and mobility aid recommendations should be an integral part of discharge planning. Copyright © 1999 Whurr Publishers Ltd.
Validity of weight distribution and sway measurements of the Balance Performance Monitor
Authors: Haas Bernhard M , Burden Adrian M 
Published: March 2006

AbstractBackground and PurposeThe Balance Performance Monitor (BPM) is a device which provides auditory and visual feedback on weight distribution and the magnitude of lateral and anterior–posterior sway during quiet standing. This study investigated the validity of the measurements provided by the BPM using a Kistler force plate (KFP) as the gold standard.MethodPercentage weight distribution between the BPM foot plates was validated using both a series of calibration weights and the vertical component of ground reaction force, measured by the KFP, during normal standing in 18 young normal subjects. The lateral and anterior–posterior sway indices from the BPM were validated against the standard deviation of the position of the centre of pressure, again obtained using the KFP, during normal standing with eyes open and eyes closed and standing with feet together with eyes open. Concurrent validity of the percentage weight distribution measurements was assessed by calculating the ‘limits of agreement’ between the corresponding measurements from the BPM and KFP and the 95% confidence intervals for these ‘limits’. Differences in the units of measurement obtained from the BPM and KFP resulted in the concurrent validity of the sway indices being assessed using correlation and regression.ResultsExcellent agreement was found between the percentage weight distribution values provided by the BPM and the KFP, which showed that the BPM may read only 3% of body weight above or below that given by the KFP. High correlations (r = 0.61–0.99) were found between both the lateral and anterior–posterior sway indices from the BPM and the motion of the centre of pressure from the KFP in the respective direction. Despite this, further analysis of regression equations and the 95% prediction intervals showed poor concurrent validity of the BPM sway indices in relation to KFP measurements. This was thought to be due to the different methods by which the sway indices and the motion of the centre of pressure were calculated.ConclusionsThe BPM may be used to provide a valid measure of the symmetry aspect, but not necessarily the steadiness aspect of postural control. Copyright © 2000 Whurr Publishers Ltd.
Functional status among elderly Norwegian fallers living at home
Authors: Bergland Astrid , Pettersen Anne Marie , Laake Knut 
Published: March 2006

AbstractBackground and PurposeFalls and their after‐effects are important contributors to disability in old age, but may be mitigated. The relationship between self‐reported health and functioning and falling is examined in the present study.MethodThe study design was cross‐sectional. Data were collected from interviews with 431 community‐dwelling Norwegian subjects aged 67–97 years. Physical health was assessed through items from the Multidimensional Functional Assessment of Older Adults (MFAQ), supplemented with the Body Mass Index (BMI). General health/psychosocial health was assessed with the General Health Questionnaire (GHQ‐20), the Mini‐mental State Examination, two general health items and items concerning mental and social health from the MFAQ. Falls during the last six months were registered and scored 0 (no falls), 1(one fall) or 2 (two or more falls).ResultsDuring the previous six months 24.1% of subjects reported falling. Four variables: ‘Perceived difficulty in keeping balance in walking’, ‘Troubled by heart pounding/shortness of breath’, sum score on the GHQ factor ‘Depression/hopelessness’, and a higher value on BMI, were independently associated with number of falls reported.ConclusionsScore value on ‘Perceived difficulty in keeping balance in walking’ was the strongest significant predictor of falls in the present study. In contrast with other studies, no association between anxiety, general health and falling was observed. Copyright © 2000 Whurr Publishers Ltd.
Physiotherapists in Balint group training
Authors: Dahlgren Madeleine Abrandt , Almquist Andreas , Krook Johan 
Published: March 2006

AbstractBackground and PurposeBalint group training (BGT) is a method widely used for enhancing understanding of the relationship and communication between health professionals and their patients. Participants meet in small groups, on a regular basis, with a tutor to discuss their experiences of problem cases. The method was originally developed in the 1950s for enhancing understanding of the doctor–patient relationship. Few studies have focused on BGT and physiotherapists. The aim of the present study was to describe and analyse physiotherapists' experiences of participation in BGT as a means of learning and understanding the physiotherapist–patient relationship.MethodSemi‐structured, in‐depth interviews were conducted with three physiotherapists working in private practice, all participating in BGT. The intervews were transcribed and subjected to a qualitative analysis.ResultsThe results are presented in a sequential model, featuring eight themes in which the physiotherapists' experiences of the training process are portrayed.ConclusionsThe results suggest that BGT and sharing the experiences of others may be considered a way of enhancing understanding of the patient encounter in clinical practice, possibly to the benefit of physiotherapists and their patients. Copyright © 2000 Whurr Publishers Ltd.
Effect of positioning on respiratory synchrony in non‐ventilated pre‐term infants
Authors: Maynard Veronica , Bignall Simon , Kitchen Sheila 
Published: March 2006

AbstractBackground and PurposeBody position can play an important role in an infant's recovery from respiratory disease, but few studies have accounted for sleep state which is known to have a direct influence on the control of respiratory muscles as well as on metabolic and circulatory changes. The purpose of this study was to examine the influence of body position on respiratory function in pre‐term infants whilst accounting for sleep state.MethodThoraco‐abdominal motion was assessed using respiratory inductance plethysmography (RIP) to provide measures of relative rib cage (RC) and abdominal (AB) movement in ten non‐ventilated pre‐term infants. Continuous measurements of oxygen saturation (SaO2), pulse and heart rate (HR), were made and sleep state was recorded using behavioural criteria and electro‐oculogram (EOG) measurements.ResultsThe results showed a significant increase in HR in supine, but no significant difference in SaO2 as a function of position, compared to the prone position where a significant reduction was found in thoraco‐abdominal asynchrony for both groups and a reduction in variability in both HR and SaO2. Intra‐subject variability of thoraco‐abdominal motion as a function of position demonstrated no significant difference on return to supine or on return to prone, illustrating good repeatability of measures.ConclusionsProne positioning of pre‐term infants recovering from respiratory disease may improve respiratory function. As measured, the improvement in respiratory synchrony in prone position brings pre‐term infants' breathing pattern into line with that expected in term infants. Copyright © 2000 Whurr Publishers Ltd.
A comparison of the timing of muscle activity during sitting down compared to standing up
Authors: Ashford Stephen , De Souza Lorraine 
Published: March 2006

AbstractBackground and PurposeThis study was designed to investigate the temporal pattern of the activation and de‐activation of muscles during sitting down to a seated position. The aim was to determine if reproducible patterns existed in the timing of muscle activation and deactivation, in normal subjects, and to compare that produced for sitting down with the pattern produced for standing up.MethodThe 10 subjects used for the experiment were a convenience sample consisting of healthy male volunteers aged 19–32 years. The design was that of a descriptive study. Subjects were instructed to stand up and sit back down to a seated position. During this activity kinematic (movement) and electromyo‐graphic (EMG) data were collected. A pattern of timing for the activity of different muscles or groups was produced and this was compared with the movement occurring.ResultsThe study found a consistent pattern of EMG activity during sitting down from a standing position. This pattern was documented and the pattern was compared with that produced during standing up.ConclusionsThe results demonstrated that a consistent pattern of muscle activation and de‐activation was produced in this group of subjects during sitting down. The pattern of muscle activation and de‐activation for sitting down was documented. When comparing the pattern produced during sitting down with that produced during standing up it is apparent that some of the muscles were active during both movement patterns at the same relative point in the pattern. Copyright © 2000 Whurr Publishers Ltd.
Manual hyperinflation — Effects on respiratory parameters
Authors: Patman Shane , Jenkins Sue , Stiller Kathy 
Published: March 2006

AbstractBackground and PurposeManual hyperinflation (MH) of the lungs is commonly used by physiotherapists in the treatment of intubated mechanically ventilated patients with the aim of increasing alveolar oxygenation, reversing atelectasis or mobilizing pulmonary secretions. However, the efficacy of MH, used in isolation, has not been clearly established.MethodThis randomized, controlled trial investigated the effects of MH on lung compliance (CL), the arterial oxygen to fraction of inspired oxygen ratio (PaO2:FIO2) and the alveolar–arterial oxygen tension difference (A–a)PO2 in 100 medically stable, mechanically ventilated subjects who had undergone coronary artery surgery (CAS). Post‐CAS subjects were used for this study as they constitute a large, homogeneous and accessible group. Subjects were randomized to either a control group (non‐MH group) or to a treatment group (MH group) which received MH within four hours of surgery.ResultsAfter four minutes of MH there were significant improvements in CL, PaO2:FIO2 and (A–a)PO2 with values remaining above baseline measures at 60 min post‐intervention. The mean improvement in CL was 6 ml/cmH2O (approximately 15%), 56 mmHg for PaO2:FIO2 (approximately 17%) and 29 mmHg for (A–a)PO2 (approximately 17%) immediately post‐intervention. No significant changes in mean CL, PaO2:FIO2 or (A–a)PO2 were seen in the non‐MH group.ConclusionsMH performed in the stable ventilated patient significantly increased CL and PaO2:FIO2 and decreased (A–a)PO2, but the clinical significance of this improvement is unclear. Further investigations are required to validate the findings of this study as well as to determine the therapeutic value of MH on patient outcome. Copyright © 2000 Whurr Publishers Ltd.