bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motivating factors for return to work
Authors: Gard Guvnor , Sandberg Ann Christine 
Published: March 2006

AbstractBackground and PurposeA new concept to increase return to work for patients listed as sick with chronic musculoskeletal pain has been used at a rehabilitation centre in Luleå, Sweden. The programme includes work for three days a week and intensive rehabilitation for two days a week, for 12 weeks, as a combination of ‘on the job’ training and rehabilitation after a period off work sick. The rehabilitation programme focused on pain reduction, identifying and finding solutions to pain problems in actual work and life situations and training of the functional capacities needed in the work and life situation. The aim of the study was to describe patients' perceptions of motivating factors for return to work.MethodsA phenomenological method was used. A naïve reading of interview notes was followed by structural analyses and reflections on the interpreted whole. Inclusion criteria for the study were musculoskeletal pain for at least one year and a period of at least four weeks' sick leave during that time. Ten patients, aged 30–54 years, participated in the study. An initial conceptual framework was developed to inform the scope of the study and to guide data collection and analysis.ResultsDifferent factors in the study framework influenced motivation to return to work. Among structural factors the division of labour at work was the most important motivator, particularly the ability to do as much as work colleagues, quantitatively and qualitatively. All the patients had jobs in the health‐care or service sectors, jobs with many social contacts. They perceived their work task content as being of minor importance compared to whether the tasks were perceived as meaningful or highly needed by others. All wanted a meaningful job content and a job which they could do in a satisfactory way according to their own norms and compared to colleagues. This highly increased motivation for return to work. Relationships (in terms of cooperation with colleagues and service to patients or clients) were important motivating factors for return to work. Self‐confidence was a new factor of importance for return to work; work tasks had to be meaningful and needed by others, work must be done in a way satisfactory for the individual and in a way that was acceptable to others in the group. Everyday responsibility, feedback and support in daily work tasks were important. These aspects increased self‐confidence. The results supported the development of a new conceptual framework for possible motivating factors for return to work.ConclusionsStructure, content, relationships, health and self‐confidence were all important motivating factors for return to work. Copyright © 1998 Whurr Publishers Ltd.
Changes in balance and locomotion measures during rehabilitation following stroke
Authors: Bernhardt Julie , Ellis Paul , Denisenko Sonia , Hill Keith 
Published: March 2006

AbstractBackground and PurposeThis study aimed to examine the utility of a number of measures of balance and locomotion for the purpose of measuring change in a group of stroke patients undergoing in‐patient rehabilitation. The aim was to select a core group of measures based on empirical evidence of usefulness rather than personal preference.MethodsTwenty‐nine stroke patients undergoing in‐patient rehabilitation (mean age 71.8 ± 10.5 years; 66% male) participated in the study. A prospective design was utilized with repeated measurement undertaken at four, six and eight weeks post‐stroke. Static standing, the Clinical Test of Sensory Interaction of Balance (CTSIB) (Shumway‐Cook & Horak, 1986), functional reach (FR), repetitive reach (RR), step test (ST), gait velocity, stride length and the Motor Assessment Scale (Carr et al., 1985) (walking item) were assessed at each interval.ResultsAll measures of dynamic balance showed significant change over the four‐week measurement period (p < 0.0036). Factor analysis identified two factors which grouped tests into static and dynamic, with a trend towards a third factor incorporating bipedal dynamic tests. Tests of static balance suffered from ceiling effects, whereas dynamic tests of balance and gait suffered from floor effects. Dynamic tests were more responsive (Standardized Response Measure (SRM) > 0.75) to change over the rehabilitation period than static tests.ConclusionsThe findings suggest that a clinically useful and responsive balance and mobility test battery should include one component of the CTSIB (Shumway‐Cook & Horak, 1986), RR (step stance), ST and gait velocity. Copyright © 1998 Whurr Publishers Ltd.
Functional capacity and early radiographic osteoarthritis in middle‐aged people with chronic knee pain
Authors: Larsson Ann‐Charlotte , Petersson Ingemar , Ekdahl Charlotte 
Published: March 2006

AbstractBackground and PurposeIn order to improve the physiotherapeutic treatment of patients with long‐standing knee pain, it it important to identify osteoarthritis (OA) of the knee at an early stage. The aim of the present study was to test the value of single functional measurement variables with the focus on the lower extremities for the association to early radiographic signs of OA of the knee. The classification by Ahlbäck grade I (joint space narrowing) was used in a cohort of 204 individuals aged 35–54 years with long‐standing knee pain.MethodsThe following five selected tests were employed: three tests of static and dynamic balance (Balance I–III); one test of muscle strength (one‐leg‐rising‐test, OLR); and one test of walking ability (time for walking 300 m indoors). Odds ratios (ORs) were calculated with a 95% confidence interval.Results and ConclusionsResults revealed that the selected tests of functional capacity due to rather low sensitivity (0.15–0.81), specificity (0.21–0.86) and inconclusive odds ratios (0.78–1.62) are probably of limited value as assessment tools to find radiographic knee OA in a younger population with mild OA. However, it is also possible to conclude that in middle‐aged individuals with chronic knee pain, the diagnosis of radiographic OA is not related to the functional capacity as measured in the present study. Copyright © 1998 Whurr Publishers Ltd.
Learning physiotherapy: students' ways of experiencing the patient encounter
Authors: Dahlgren Madeleine Abrandt 
Published: March 2006

AbstractBackground and PurposeThe aim of this paper was to describe and analyse the impact of formal education and professional experience on physiotherapy students' ways of experiencing interaction within a patient encounter.MethodTwo groups of physiotherapy students were interviewed on two occasions; during the second and last term of their formal education programme, and during the last term and after 18 months' professional experience. Data were subjected to a qualitative analysis. Changes in conceptions between the two interview occasions were described quantitatively.ResultsSubjects' ways of experiencing interaction within a patient encounter could be described in four main categories: Mutuality; Technicalism; Authority and Juxtaposition. Mutuality and Technicalism denoted an integration of the communicative and problem‐solving processes involved in the encounter, the former category from a patient‐centred and the latter from a physiotherapist‐centred perspective. Authority and Juxtaposition denoted a separation of the processes, the former from a physiotherapist‐centred perspective and the latter from a patient‐centred one.ConclusionsThe results show a trend as regards direction of change in conceptions from separated to integrated perspectives on the communicative and problem‐solving processes after the formal education programme. After 18 months' professional practice the Mutuality category dominated. Copyright © 1998 Whurr Publications Ltd.
Fall events described by people with Parkinson's disease: implications for clinical interviewing and the research agenda
Authors: Stack Emma , Ashburn Ann 
Published: March 2006

AbstractBackground and PurposeThe aim of this study was to describe the terminology used by people with Parkinson's disease (PD) when recounting falls and near‐misses (fall events) and to identify the surrounding circumstances.MethodThis cross‐sectional study (part of an investigation identifying risk factors for falling in PD) utilized structured interviews about falling, conducted in participants' homes. Content analysis of participants' descriptions of events was performed. Fifty‐five independently mobile, community‐dwelling people with PD, identified via general practices in Southampton took part in the study.ResultsMean participant age was 71.5 years (SD = 7.6 years); mean time since diagnosis was 3.6 years (SD = 2.3 years). Thirty‐four participants (62%) reported having fallen and 41 (75%) reported having nearly fallen in the previous 12 months. Recounting events, participants mentioned the location, frequency, process and landing, their activity and fall‐avoidance. Falls at home, tripping, events arising when turning, falling forward, frequent near‐misses and unsuccessful restoration of balance were commonly described.ConclusionsFrequent recounting of processes, locations and landings suggest these details are memorable and easily recalled. Eliciting the activities during which events occurred, their frequency and avoidance‐strategies, may necessitate probing by interviewers. An interview schedule is proposed. Aspects common to falls and near‐misses, particularly turning, suggest a natural progression of activity‐related falls. Copyright © 1999 Whurr Publishers Ltd.
Back pain in women post‐partum is not a unitary concept
Authors: Nilsson‐Wikmar Lena , Harms‐Ringdahl Karin , Pilo Christina , Pahlbäck Margareta 
Published: March 2006

AbstractBackground and PurposeAt least half of all pregnant women experience back pain at some time during pregnancy and some of them also have persisting back pain post‐partum. The aim of the present study was to identify and classify back problems in women post‐partum by use of different pain provocation tests and define their relationship to spinal sagittal configuration and mobility.MethodOne hundred and nineteen women with back pain persisting two months after delivery were interviewed and examined, on average 7.2 months post‐partum. Ten clinical pain provocation tests were performed. The first was performed to identify hip pain, the second to identify radiating pain and the other eight tests were performed to provoke pain in the areas of the posterior pelvic/sacroiliac joints, the symphysis pubis and the lumbar spine. The spinal sagittal configuration and mobility were measured in the thoracic and lumbar spine, respectively, with Debrunner's kyphometer (Protek AG, Berne, Switzerland).ResultsTwenty‐seven per cent of women had pain in the area of the posterior pelvic/sacroiliac joints, 18% in the area of the lumbar spine, 39% both in the area of the posterior pelvic/sacroiliac joints and in the lumbar spine, and in 16% no pain could be provoked. There were no statistically significant differences between the four groups with respect to the spinal sagittal configuration or the mobility in the thoracic or lumbar spine.ConclusionsBack pain post‐partum is not a unitary concept. Based on the clinical tests, women with back pain post‐partum can be separated into groups with different pain localizations. The measuring of the spinal sagittal configuration and mobility did not help to further identify or classify post‐partum back pain. Copyright © 1999 Whurr Publishers Ltd.
Intra‐ and inter‐rater reliability of an 11‐test package for assessing dysfunction due to back or neck pain
Authors: Ljungquist Therese , Harms‐Ringdahl Karin , Nygren Åke , Jensen Irene 
Published: March 2006

AbstractBackground and PurposeThe intra‐ and inter‐rater reliability of 11 tests assembled by physiotherapists for clinical purposes was investigated. Forty‐five patients and 23 healthy volunteers participated in the study.MethodTwenty‐one patients were tested simultaneously and independently by two physiotherapists to determine inter‐rater reliability for two raters. Twenty‐four patients and 11 healthy volunteers were tested by one physiotherapist three times in a week to determine intra‐rater reliability over time. Twelve healthy volunteers were tested by three different physiotherapists in a week to determine inter‐rater reliability for three raters.ResultsInter‐rater agreement for two simultaneous raters was clinically acceptable. Repeatability on three test occasions was clinically acceptable in six of the 11 tests. There were no systematic differences between occasions.ConclusionsIntraand inter‐rater reliability was acceptable for six of the 11 tests in the form described here: three gait tests, two functional lifting tests and a functional muscular endurance test in the right leg. If these tests are to be used as outcome measures, account must be taken of the size of the typical fluctuation in measurements shown. The repeatability figures given may be used as guidelines for interpreting the clinical value of possible changes in test values. Copyright © 1999 Whurr Publishers Ltd.
The legacy of being a research subject: follow‐up studies of participants in therapy research
Authors: Barnitt Rosemary , Partridge Cecily 
Published: March 2006

AbstractBackground and PurposeAn increase in research activity in physical therapy has led to a parallel increase in the numbers of patients, colleagues and members of the general public being used as subjects. Safeguards on the ethical aspects of research have been monitored through ethics committees whose task is to protect the interests of subjects. However, proposals are subject to ethical scrutiny prior to commencement of the research, before subjects have given consent. It is unusual for further monitoring to take place once the study is underway or, indeed, after it has finished. Few researchers have reported carrying out follow‐up studies of their subjects, therefore the ethical effect of research on subjects is not known. Our interest was in reports of subjects who had previously been research subjects.MethodFollow‐up studies were carried out on 156 subjects who had participated in research interviews. Phase 1 of the study included subjects with physical disabilities who lived in residential care (Rs subject group) (Barnitt and Canter, 1982). Phase 2 of the study comprised two research projects, (A) and (B), where subjects were physical therapists and occupational therapists (Ts subject group) (Barnitt, 1993; Barnitt and Partridge, 1997). Data were collected from the Rs subject group through visits, whereas the Ts subject group was sent a letter and short questionnaire three months after completion of an interview to elicit their views on the experience.ResultsEighty‐seven subjects responded to the approach, a response rate of 56%. Despite having consented to taking part in research, a number of subjects later had concerns about their involvement. These concerns included worries about confidentiality; expectations that had not been met, anger, disappointment, and loss of face. Other subjects reported positive outcomes from the experience.ConclusionResearchers should consider including subject follow‐up in their research design, particularly where sensitive research topics are being studied. Copyright © 1999 Whurr Publishers Ltd.
Predicting motor recovery of the upper limb after stroke rehabilitation: value of a clinical examination
Authors: Feys Hilde , De Weerdt Willy , Nuyens Godelieve , Van De Winckel Ann , Selz Beat , Kiekens Carlotte 
Published: March 2006

AbstractBackground and PurposeOnly a few studies have been conducted to predict motor recovery of the arm after stroke. The aims of this study were to identify which clinical variables, assessed at different points in time, were predictive of motor recovery, and to construct useful regression equations.MethodOne hundred consecutive stroke patients who had an obvious motor deficit of the upper limb were evaluated on entry to the study (two to five weeks post‐stroke) and at two, six and 12 months after stroke. The Brunnström–Fugl‐Meyer test was used as the outcome measure. Predictors included demographic data, overall disability, clinical neurological features, neuropsychological factors and secondary shoulder complications.ResultsIn multiple regression analyses, motor performance was invariably retained as the predictive factor with the highest R‐square. Other significant predictive variables were overall disability, muscle tone, proprioception and hemi‐inattention. Between 53% and 89% of the total amount of variance was accounted for in all selected models. The accuracy of prediction from clinical measurement in the acute phase diminished as the time span of measurement of outcome increased. Similarly, assessment of the variables at two and six months, rather than in the acute stage, resulted in a considerable improvement in the percentage variance explained at 12 months. The highest accuracy was obtained when predictions were made step‐by‐step in time.ConclusionsIt is possible to predict motor recovery of the upper limb accurately through the use of a few clinical measures. Predictive equations are proposed, the use of which are practicable in both clinical practice and research. Copyright © 2000 Whurr Publishers Ltd.
Effects of a three‐month therapeutic exercise programme on flexibility in subjects with low back pain
Authors: Kuukkanen Tiina , Mälkiä Esko 
Published: March 2006

AbstractBackground and PurposeSpinal and muscle flexibility have been studied intensively and used clinically as outcome measurements in the rehabilitation of subjects with low back pain. The results of previous studies are contradictory and there is a lack of longitudinal data on the effects of long term therapeutic exercise on flexibility.MethodA controlled experimental study was conducted to determine the effects of progressive therapeutic exercise on spinal and muscle flexibility. Eighty‐six chronic low back pain subjects fulfilled the inclusion criteria and were divided into three study groups: (1) intensive training group, (2) home exercise group and (3) control group. The intervention period lasted three months and measurements were performed at both the beginning of the study and immediately after intervention. Follow‐up measurements were carried out six and 12 months after baseline. Spinal flexibility was measured with lumbar flexion, extension, spinal lateral flexion and rotation, and muscle flexibility was measured with measurements of erector spinae, ham‐string and iliopsoas muscles. Also self‐reported outcomes of the Oswestry Index and Borg Scale — Back Pain Intensity were used. Associations between change (pre‐ to post‐treatment) were determined for the dependent variables.ResultsThe results showed no correlation between flexibility, the Oswestry Index or back pain intensity. After the first three‐month period lumbar flexion, extension and spinal rotation decreased among all subjects. Spinal rotation and erector spinae muscle flexibility improved significantly with intensive training. At the nine‐month follow‐up, erector spinae flexibility was still greater than at baseline. Hamstring flexibility increased among the intensive training and home exercise groups from pre‐ to post‐intervention. However, the degree of hamstring flexibility gained during training was subsequently lost following the period without programmed exercise in both training groups. Self‐reported outcome variables showed positive changes among the three study groups after the completion of intervention period, but these changes were only able to be maintained during subsequent follow‐ups for the intensive training and home exercise groups.ConclusionsThe findings suggest that flexibility does not play an important role in coping with chronic low back pain for subjects whose functional limitations are not severe. Also, it appears that the achieved gains in spinal and muscle flexibility may not be able to be maintained without continued exercise. Copyright © 2000 Whurr Publishers Ltd.
Effect of pulse repetition rate on the perception of thermal sensation with pulsed shortwave diathermy
Authors: Murray Charles Conor , Kitchen Sheila 
Published: March 2006

AbstractBackground and PurposePulsed shortwave diathermy (PSWD) is a form of therapy commonly used to enhance tissue repair and reduce pain. It is normally considered to be an athermal form of treatment; however, there is some evidence to suggest that thermal effects can arise with adequate dosage. The purpose of this study was to determine the pulse repetition rate (PRR) required to generate a ‘possible’ and ‘definite’ thermal sensation when PSWD was applied to the thigh.MethodThirty healthy subjects were randomly assigned to placebo or treatment groups. The treatment group was exposed to PSWD at a constant setting of pulse duration (400 µs) and pulse power (190 W) while the PRR was increased from 26 Hz to 400 Hz in 10 increments. Each dose was applied for a period of two minutes. At the end of each application, subjects were asked if they felt a (1) ‘possible’ or (2) ‘definite’ thermal sensation. Skin temperature was measured immediately after each application. Placebo subjects were exposed to PSWD at its lowest settings throughout the experiment (pulse power = 5W; pulse duration = 65 µs and PRR = 26 Hz).ResultsThe results showed a significant correlation (p<0.048) between PRR at ‘definite’ thermal sensation and skin temperature post‐treatment and PRR at ‘possible’ thermal sensation (p<0.001). Mean skin temperature increased significantly as PRR was increased, from 28.69 (±0.75) °C pre‐treatment to 31.14 (±1.04) °C post‐treatment, a mean difference of 2.34 °C.ConclusionsThese results suggest that PSWD at adequate dosages can generate thermal effects, and that there is a relationship between these thermal effects and the PRR used. These results may have significant implications for the safe use of PSWD in the clinical arena. Copyright © 2000 Whurr Publishers Ltd.
Visual judgements of steadiness in one‐legged stance: reliability and validity
Authors: Haupstein Travis , Goldie Patricia 
Published: March 2006

AbstractBackground and PurposeThere is a paucity of information about the validity and reliability of clinicians' visual judgements of steadiness in one‐legged stance. Such judgements are used frequently in clinical practice to support decisions about treatment in the fields of neurology, sports medicine, paediatrics and orthopaedics. The aim of the present study was to address the validity and reliability of visual judgements of steadiness in one‐legged stance in a group of physiotherapists.MethodA videotape of 20 five‐second performances was shown to 14 physiotherapists with median clinical experience of 6.75 years. Validity of visual judgement was established by correlating scores obtained from an 11‐point rating scale with criterion scores obtained from a force platform. In addition, partial correlations were used to control for the potential influence of body weight on the relationship between the visual judgements and criterion scores. Inter‐observer reliability was quantified between the physiotherapists; intra‐observer reliability was quantified between two tests four weeks apart.ResultsMean criterion‐related validity was high, regardless of whether body weight was controlled for statistically (Pearson's r=0.84, 0.83, respectively). The standard error of estimating the criterion score was 3.3 newtons. Inter‐observer reliability was high (ICC (2,1) = 0.81 at Test 1 and 0.82 at Test 2). Intra‐observer reliability was high (on average ICC (2,1) = 0.88; Pearson's r = 0.90). The standard error of measurement for the 11‐point scale was one unit.ConclusionsThe finding of higher accuracy of making visual judgements than previously reported may be due to several aspects of design: use of a criterion score derived from the variability of the force signal which is more discriminating than variability of centre of pressure; use of a discriminating visual rating scale; specificity and clear definition of the phenomenon to be rated. Copyright © 2000 Whurr Publishers Ltd.