bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative Study of Novice Physical Therapists' Experiences in Private Practice
Authors: Solomon Patricia , Miller Patricia A. 
Published: September 2008

Purpose: The purpose of this study was to gain insight into the experiences of novice physiotherapists whose initial employment was in private practice and to gain an understanding of how they adapted to their new role. Methods: Using a qualitative grounded theory approach, 10 novice physiotherapists employed in private practice participated in a semistructured telephone interview. Transcribed interviews were analyzed through an open coding technique. Seven thematic areas emerged from the data. Results: The novice physiotherapists experienced feelings of stress and insecurity during the transition from student to practitioner. Dealing with issues related to insurance patients and with challenging patients contributed to their feelings of being overwhelmed. Supportive environments with other physiotherapists willing to be role models and mentors assisted in allowing the novices to learn and quickly adapt to their new professional role. Conclusions: Employers, educators, and colleagues can use strategies to promote a successful transition from student to practitioner by novice physiotherapists whose initial work experience is in private practice.
The Flutter Device versus the PEP Mask in the Treatment of Adults with Cystic Fibrosis
Authors: Newbold M. Ellen , Tullis Elizabeth , Corey Mary , Ross Brenda , Brooks Dina 
Published: September 2008

Purpose: The purpose of this study was to compare the effectiveness of the Flutter device (Axcan Scandipharm Inc., Birmingham, AL) with that of the PEP Mask (Astra Tech AB, Molndal, Sweden) in the treatment of adults with cystic fibrosis (CF). Methods: Forty-two adults (mean age 29 F 8.4 years) were recruited from the Adult Cystic Fibrosis Program at St. Michael's Hospital and were randomly assigned to airway clearance treatment with either the Flutter device or the PEP Mask. Pulmonary function tests, the Quality of Well-Being Scale (QWB), and the Chronic Respiratory Disease Questionnaire (CRQ) were administered 1 month postrecruitment and every 3 months thereafter for 13 months. Results: Using linear regression, the mean slope or annual rate of change of forced expiratory volume in 1 second (FEV1) percent predicted was 2.0 (F 8.1) for the Flutter group and 4.2 (F 8.0) for the PEP group (p=.4). There were no significant between-group differences in the slopes of the QWB (p=.3) or CRQ (p = 1.0) total scores. The power to detect differences was low (0.137). Conclusions: When comparing the Flutter device and the PEP Mask in the treatment of adults with CF over a 13-month period, there were no significant differences in pulmonary function or health-related quality of life. A much larger sample would be needed to conclude with confidence that there were no between-group differences. Therefore, additional research is needed to further examine the effectiveness of the Flutter device and the PEP Mask.
13-Metre Walk Test Applied to the Elderly with Musculoskeletal Impairment: Validity Study
Authors: Mori Brenda , Lundon Katie , Kreder Hans J. 
Published: September 2008

Purpose: The purpose of this study was to examine concurrent validity and known group validity for the 13-metre walk test. Methods: Preoperative data were collected from a sample of elderly individuals awaiting total hip replacement. The measures used were the Timed Up & Go Test, 13-metre walk test, 6-minute walk test, Stair Performance Measure, and the three subscales from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: Scores on the 13-metre walk test were significantly correlated with each of the other functional outcome measures, although the magnitude of the correlations with the WOMAC subscales was modest. Subjects performed the 13-metre walk test at a greater velocity than the 6-minute walk test (p < .01). Individuals with gait aids performed more poorly than those without (p < .01). Conclusions: The findings of this study support concurrent validity and known group validity for the 13-metre walk test. Information regarding additional psychometric characteristics, that is, the interrater and intrarater reliability and responsiveness of the 13-metre walk test, would be valuable to further support its use.
Continuing Education of Physiotherapists Involved in Treating Persons with Work-Related Back Pain
Authors: Poitras Stéphane , Blais Régis , Swaine Bonnie , Rossignol Michel , Perron Michèle 
Published: September 2008

Purpose: Physiotherapists often use continuing education (CE) courses to acquire new knowledge, but little is known about the types and combinations of CE courses attended. The objective of this study was to describe the CE “profiles” of physiotherapists who treat individuals with work-related back pain. Methods: Physiotherapists answered a self-administered questionnaire about the CE courses attended after initial training. They also provided demographic information, including years of practice, university of graduation, and distance of workplace from urban centres. Multiple correspondence analysis with hierarchical classification was used to identify CE profiles, that is, combinations of courses most frequently attended by physiotherapists in this group. Results: Responses were received from 332 physiotherapists (response rate of 81.4%) working in 199 randomly selected clinics in Quebec. A very high proportion (88.9%) reported having attended at least one CE course related to back pain treatment. The most common area of CE was mobilization (53.9% of therapists). Others included osteopathy (21.7%), varied CE (15.9%), and neural mobilization/muscle reeducation (8.5%). Years of practice and university of graduation were significantly related (p < .05) to CE profiles, whereas distance from urban centres was not. Conclusions: The variations in CE profiles among physiotherapists treating the same type of clientele raise questions regarding the potential for important differences in the knowledge base used to treat workers with back pain. More effective CE strategies are needed to promote evidencebased knowledge among physiotherapists involved in back pain treatment for injured workers.
Principles of Aerobic Testing and Training
Authors: Dolmage Thomas E. , Goldstein Roger S. 
Published: September 2008

Purpose: This review provides a bridge between assessment of the physiologic response to exercise testing and application of the principles of aerobic training by physiotherapists in a clinical setting. It is intended to be of interest to physiotherapists who do not conduct clinical exercise tests but may be presented with the results of such tests. Summary of Key Points: Small changes in the physiologic capacity of patients with limited reserve (cardiovascular, respiratory, or neuromuscular) often have a substantial impact on their symptoms and ability to perform daily activities. The primary outcome measure of an exercise test is aerobic capacity (oxygen uptake), the main determinant of the ability to sustain the power requirements of repetitive physical activity. The test protocol is designed to enable a wide range of exercise intensity (power) to be presented over a short time, under controlled conditions. Key indicators of the appropriateness of the systemic response include an increase in heart rate and ventilation. Aerobic training will enhance peak oxygen uptake and therefore have a substantial impact on physical performance. Conclusions: Understanding the physiologic basis of aerobic testing will assist physiotherapists in using exercise tests to design, monitor, and evaluate aerobic training programs.
Informed Shared Decision-Making: A Model for Physical Therapy Education and Practice?
Authors: Bainbridge Lesley A. , Harris Susan R. 
Published: September 2008

Purpose: The goals of this article are (1) to define informed shared decision-making (ISDM); (2) to present and discuss several conceptual frameworks for ISDM; (3) to list a set of ISDM competencies developed initially for physicians; and (4) to present strategies for applying these ISDM competencies to the education and practice of physical therapy. Summary of Key Points: ISDM provides a framework for communicating with clients or patients in which elements of client-centred care, evidence-based practice, and informed choice are integrated. Research has shown that patients who are more informed and more involved in their own decision-making are more likely to participate in treatment programs and experience better health outcomes. Conclusions: ISDM is a communication framework that can be used by physical therapists to incorporate client-centred care, informed choice, and evidence-based practice. It is our hope that this article will inspire our physical therapist colleagues to embrace the concepts underlying ISDM and to evaluate its merits within both educational and clinical contexts.
Aerobic Exercise Interventions for People Living with HIV/AIDS: Implications for Practice, Education, and Research
Authors: O'Brien Kelly , Nixon Stephanie , Tynan Anne-Marie , Glazier Richard H. 
Published: September 2008

Purpose: The purpose of this article is to present the results of a systematic review that investigated the effects of aerobic exercise interventions in people living with HIV/AIDS and to discuss the implications for physical therapy practice, education, and research. Summary of Key Points: A systematic review was conducted based on the Cochrane Collaboration protocol. Eleven randomized trials of HIVpositive adults who performed aerobic exercise three times per week for at least four weeks were identified. Thirteen meta-analyses were performed. The main results indicated that aerobic exercise was associated with significant improvements in some outcomes of cardiopulmonary status (maximum oxygen consumption) and psychological status (depression-dejection symptoms). Conclusions: Performing continuous or interval aerobic exercise or a combination of continuous aerobic exercise and progressive resistive exercise for at least 24 minutes three times per week for at least five weeks appears to be safe and may be beneficial for adults living with HIV. These findings should be interpreted cautiously owing to small sample sizes and high withdrawal rates within individual studies. The results of this review support the role of exercise and, more broadly, the role of rehabilitation practice, education, and research in the care and treatment of persons living with HIV.
Effects of a Six-Week Eccentric Exercise Program on Patients with Patellar Tendinopathy: Single-Subject Research Study
Authors: Dumont Tyler L. , MacIntyre Donna L. , Harris Susan R. 
Published: September 2008

Purpose: Eccentric exercise is commonly recommended in the conservative treatment of chronic tendinopathies. This single-subject research study evaluated the effects of a six-week eccentric exercise program developed for patients with patellar tendinopathy (jumper's knee). Methods: Four patients (mean age 23.75 years; three female, one male) with unilateral patellar tendinopathy participated in this study. A nonconcurrent multiple baseline design was implemented and involved repeated measures of knee pain, knee function, and peak isometric force of the quadriceps and hamstring muscles. Measurements of isokinetic average torque of the quadriceps and hamstring muscles were collected prebaseline and postintervention. The intervention phase involved a six-week eccentric exercise program. Data were analyzed both visually and statistically. Results: Visual results indicated reductions in intensity (n = 3) and unpleasantness (n = 3) of knee pain, improved knee function (n = 3), increased isometric quadriceps peak force of the ipsilateral side (n = 3) and the contralateral side (n = 4), increased isometric hamstring peak force of the ipsilateral side (n = 1) and the contralateral side (n = 1), and increased concentric average torque of the ipsilateral quadriceps (n = 2) and the contralateral side (n = 3). Most visual analyses were supported by the C-statistic. Discussion: The eccentric exercise program showed mixed clinical benefits for four patients with patellar tendinopathy. However, none of the patients achieved full recovery within the suggested six-week treatment period.
Aerobic Exercise for Children
Authors: Darrah Johanna , Kelly Michelle 
Published: September 2008

Purpose: Pediatric physical therapists are becoming increasingly involved in designing and implementing fitness programs for both typically developing children and children with cerebral palsy. This review discusses some of the methodological challenges associated with evaluating aerobic exercise in children, as well as current evidence on the effects of aerobic exercise for children with motor disabilities, specifically cerebral palsy. We then provide some general guidelines about implementing aerobic exercise programs with children. Summary of Key Points: Our knowledge of the effect of aerobic fitness programs in children is limited. Research designs that fail to control for important child variables such as age and maturity; inadequate control of program parameters such as intensity, duration, and frequency; and the use of many different outcome measures make it difficult to discern the true effects of aerobic exercise. Furthermore, outcomes evaluating the components of activity and participation are seldom included. Conclusions: Recent research suggests that children, both typically developing and those with chronic conditions, can benefit physiologically from aerobic exercise. However, the effect of aerobic exercise on functional outcomes for children with motor disabilities is not well understood.
Diagnostic and Therapeutic Decision-Making: Exploring the Role of Pretest Probability in Patients with Rotator Cuff Pathology
Authors: Razmjou Helen , Haines Ted , Holtby Richard 
Published: September 2008

Purpose: The purpose of this article is to describe the indicators of diagnostic validity and to demonstrate the informative value of the pretest probability of two tests, the supraspinatus test and magnetic resonance imaging (MRI), on diagnosis and management by using three case scenarios of rotator cuff pathology as examples. Summary of Key Points: Patients' attributes and validity indices of clinical tests are important to consider in reaching an optimal diagnosis. We compared the impact of the supraspinatus (Jobe) test with MRI of the shoulder in three fictional cases with different severity of rotator cuff pathology. The methodological approach of clinical decision-making at the patient level is discussed. Conclusion and Recommendations: Clinicians are required to make decisions based on incomplete data and imperfect clinical tests with falsenegative and false-positive results. Estimating the pretest probability of pathology is often an educated guess. However, without an explicit estimate of the pretest probability of suspected pathology, a test result has no clearly defined informative value. The Bayesian approach provides a logically correct way to arrive at a specific post-test probability.
Value of Confidence Intervals in Determining Clinical Significance
Authors: McNeely Margaret L. , Warren Sharon 
Published: September 2008

Purpose: Establishing treatment effectiveness is a priority for both clinicians and clinical researchers in the rehabilitation field. Although there is a need for high-quality research in rehabilitation, there is also a need for clinicians to learn and practise the skills of critically appraising research literature. In critically appraising the literature, understanding the role of the confidence interval is essential. The purpose of this review is to draw attention to the value of confidence intervals in interpreting the clinical significance of trial findings. Summary of Key Points: Confidence intervals can be calculated for many different statistical procedures and are advocated for assessing both statistical and clinical significance. Confidence intervals are particularly useful in helping avoid possibly erroneous conclusions that two groups have similar results when non-significant findings are reported. Conclusions: Probability values and confidence intervals are complementary and closely related mathematically. The function of the confidence interval is fundamentally an inferential one. Confidence intervals are, thus, of particular relevance when interpreting research findings. Confidence intervals should be reported in the results of clinical trials or, if not included, should be calculated wherever possible.
Accuracy of Assignment of Orthopedic Inpatients to Receive Weekend Physical Therapy Services in an Acute Care Hospital
Authors: Taylor Lisa , Goodman Kristen , Soares Daniela , Carr Heather , Peixoto Gina , Fox Pat 
Published: September 2008

Purpose: To ascertain whether physical therapists (PTs) were accurately applying hospital criteria when assigning patients to weekend PT services in an acute care hospital. Methods: A retrospective chart review was performed on patients assigned to weekend PT services while staying in an inpatient orthopedic unit. Data extraction forms were completed to establish the accuracy of 299 entries to the weekend list. Quantitative analysis was performed to determine the percentage of inaccurate assignments and the percentage of patients who were treated on the weekend and to compare the patient profiles of those accurately and inaccurately assigned with the weekend list. Results: The percentage of subjects inaccurately assigned to weekend PT services (7.4 per cent) was relatively small. Profiles of those inaccurately assigned were not found to differ significantly from those accurately assigned. Weekend therapy staff treated the majority of inaccurately assigned patients. However, this was not found to reduce the availability of treatment to accurately assigned patients. Conclusions: These findings suggest that criteria are being used by PTs with an acceptable level of accuracy to assign patients to weekend PT services. However, further investigation is required for validation and standardization of weekend PT services criteria.
Aerobic Testing and Training for Persons with Multiple Sclerosis: A Review with Clinical Recommendations
Authors: Howe Jo-Anne A. , Gomperts Michelle A. 
Published: September 2008

Purpose: In this article, we review the evidence for aerobic training in persons with multiple sclerosis (MS). The effects of aerobic training on enhancing cardiovascular fitness, muscle strength, and health-related quality of life (HRQOL) and reducing risk factors for cardiovascular disease are summarized. Clinical considerations and recommendations for aerobic testing and training are also presented. Summary of Key Points: Persons with MS may limit their participation in physical activity, predisposing them to deconditioning and additional disability, previously attributed to the disease process itself. However, individuals with mild to moderate levels of disability who participate in aerobic training can improve aerobic fitness, muscle strength, and HRQOL and reduce the risk factors for cardiovascular disease. Aerobic testing and training are safe for these patients provided that they are adequately screened and managed for fatigue, dysautonomia, and thermosensitivity. These historical concerns should not preclude active participation in aerobic training as current evidence suggests that the benefits outweigh the risks. Conclusions: To minimize activity limitations and participation restrictions and enhance physical and psychosocial well-being, aerobic exercise should be promoted and included in the overall management plan of clients with MS.
Evidence-Based Stroke Rehabilitation: Case Analysis Using the International Classification of Functioning, Disability and Health Framework
Authors: Penney Jennifer , MacKay-Lyons Marilyn J. , McDonald Alison 
Published: September 2008

Purpose: The purpose of this case report is to provide an evidence-based analysis of the progress and outcomes of a patient undergoing stroke rehabilitation using the International Classification of Functioning, Disability and Health (ICF) as a clinical framework. The analysis involves a description of the anticipated motor recovery of this patient, based on retrospective and prospective studies, and a comparison of expected outcomes with actual outcomes. Methods: This case analysis involved a 62-year-old man who participated in 12 weeks of stroke rehabilitation after sustaining lacunar infarcts in the right basal ganglia and temporal lobe. Standardized outcome measures were used to document change in impairments in body functions and structures, activity limitations and participation restrictions over a one-year period. Contextual factors and baseline findings were used to predict the subject's functional outcome based on the available literature. The actual outcome was then compared with the predicted outcome. Results: By using the available evidence, we predicted, with reasonable accuracy, the functional outcome of the patient. Conclusions: ICF is a useful framework for analyzing outcomes of stroke rehabilitation. Suggestions for future research are provided, based on the findings of this case.
Factor Analysis: An Overview in the Field of Measurement
Authors: O'Brien Kelly 
Published: September 2008

Purpose: This article provides an overview of factor analysis from the perspective of measurement in clinical research. Summary of Key Points: Factor analysis is a statistical technique that identifies interrelationships among a set of items in an instrument and/or questionnaire and groups them into homogeneous domains. Exploratory factor analysis can be used to reduce the number of items in a questionnaire and identify its underlying domains. Confirmatory factor analysis can be used to test a hypothesis about the domain structure of a questionnaire. Principal component analysis and common factor analysis are the most common techniques and differ based on the amount of variability that is analyzed among items. Steps of the factor analytical process include assessing correlation matrices, factor extraction, choosing the number of factors to retain, assessing the factor loading matrix, factor rotation and factor interpretation. Because no standardized method exists, factor analysis involves decision-making at each step. Conclusions: The different techniques and methods of factor analysis each have unique strengths and limitations. Clinicians and researchers reviewing articles on factor analysis should ensure that authors state a priori their purpose, conceptual approach, preferred technique and methods that will guide their decision-making.