Advances in Physiotherapy 

About: Advances in Physiotherapy is an academic journal published by Informa. The journal publishes majorly in the area(s): Rehabilitation & Randomized controlled trial. It has an ISSN identifier of 2167-9169. Over the lifetime, 322 publications have been published receiving 5081 citations.

Active patient involvement in the establishment of physical therapy goals: Effects on treatment outcome and quality of care

Abstract: Background: Little research has been carried out on the effects of involving patients in goal setting. The purpose of this study was to investigate the effects of active patient involvement in the establishment of physical therapy treatment goals. Outcome measures included both physical treatment results and patient ratings of the quality of care. Subjects and Methods: All patients (n=77) at the rehabilitation unit of the department of rheumatology at a Swedish university hospital were included in a randomized controlled trial. Control-group patients received physical therapy treatment according to traditional methods. Intervention-group patients were involved in a goal-forum intervention, where therapist and patient together established goals for treatment. All patients completed questionnaire surveys at discharge. Results: Stepwise logistic regression analysis revealed that patients in the intervention group were more likely to achieve better physical treatment results for range of motion, strength and ...

Test–retest reliability of a knee joint position sense measurement method in sitting and prone position

Abstract: There are many indications of defects in motor control being part of the aetiopathogenesis of degenerative joint diseases. Measurement of proprioceptive functions may increase our understanding of these diseases. Furthermore, reproducible tests will enable researchers to demonstrate the results of targeted physiotherapy. The purpose of this study was to determine the test–retest reliability of a method to measure knee joint position sense (JPS). Thirty-nine healthy volunteers (17 women, 18–50 years old) participated. The JPS was measured as the participant's ability to reproduce the same position in the right knee (target vs. estimated angle). The result was expressed as the difference between target and estimated angle. Measurements were repeated three times with three different target angles (prone position: 40°, 70°, 100° flexion; sitting position: 30°, 50°, 70° flexion), and for single leg and both legs. Three test sessions were performed with 1-h and 1-week interval. The outcome measure was the diffe...

What is collaborative reasoning

Abstract: Most physiotherapists would agree on the need to establish effective working relationships with their patients in order to achieve successful outcomes in therapy. Collaboration, as an entity in clinical practice, has continued to increase in importance due to a changing climate of healthcare. Traditional models of physiotherapy treatment based on the medical model and delivered in acute settings are giving way to newer models of practice, such as health promotion, that are patient or client centred and increasingly located in community settings. At the same time, the notion of patient compliance with physiotherapy advice and exercises, deriving from a medical model of practice, is being superseded by the notion of collaborative decision making (or reasoning) in physiotherapy. Recent physiotherapy literature suggests that collaborative decision making is an advanced clinical skill, while also casting doubt on just how well or consistently physiotherapists are able to set goals with their patients and nurtu...

Arm Lymphoedema, Shoulder Mobility and Muscle Strength after Breast Cancer Treatment ? A Prospective 2-year Study

Abstract: Arm lymphoedema and impaired shoulder mobility and muscle strength are well known side-effects to breast cancer treatment. The aim of this prospective study was to follow closely and describe the arm volume, range of motion of the shoulder and muscle strength of the shoulder and hand after breast cancer treatment in order to form a basis for further studies in the area including physiotherapy intervention. Sixty-one women treated for breast cancer with axillary dissection, with or without postoperative radiotherapy, were examined preoperatively and monthly until 6 months after the operation with 1- and 2-year follow-ups. 1 month after the operation, results revealed decrease in range of motion, after 2 months increase in arm volume difference and after the first 6 months decrease in muscle strength of shoulder adductors, flexors and internal rotators. A greater increase in arm volume difference and decrease in shoulder abduction, flexion and external rotation were noted throughout the follow-up period for...

Wisdom of practice

Abstract: Helders, in a 2003 editorial, acknowledges the continued interest in measurement of patient outcomes and at the same time calls for investigations of the patient care process itself (1). ‘‘You have to know and understand the care process itself in order to improve it.’’ As we continue to grapple with increased pressures for evidence in support of physical therapy interventions (treatment), we need to carefully examine our assumptions underlying physical therapy interventions and ask ourselves critical questions: What is a physical therapy intervention? To what extent, if any, is the physical therapist part of the intervention? What meaningful evidence do we seek in support of considering the therapist part of the interventions? If we assume that physical therapy interventions are defined by reimbursement guidelines and coding schemes as procedures, modalities and techniques, we limit our ability to create a dynamic theoretically responsive knowledge base. I offer this critical reflection on our work as physical therapists by drawing a page from another applied field, teaching. One of my mentors, Dr Lee Shulman, President of the Carnegie Foundation, in a recent book of essays on teaching, reflects on his work on investigating the knowledge base in teaching (2). He argues there are several areas of knowledge in teaching, including content knowledge, knowledge of pedagogy (teaching), curriculum knowledge, knowledge of learners and knowledge of the organizational context, and he proposed a new category of knowledge / pedagogical content knowledge. Pedagogical content knowledge (PCK) is a special amalgam of content and pedagogy that is unique to teaching. Shulman asserted that it is insufficient to merely distinguish between a teacher having content knowledge and knowledge of teaching methods, that there was something else happening in the actual act of teaching and that PCK represented a signal of a missing component in theories of teaching. The concept of PCK then became a symbol much like a new piece of furniture in the living room and as such created many opportunities for changing the landscape in educational research (2). We need a new piece of furniture in our physical therapy living room. While there are many categories of our knowledge base in physical therapy from foundation sciences to clinical and applied sciences, we perhaps overlook or take for granted what might be uniquely ours as physical therapists. If we accept the assumption that the therapist is indeed part of the physical therapy intervention, then we could also argue in similar fashion that there is specific knowledge embedded in the minds, thoughts, actions and interactions of therapists as they interact, touch, teach, facilitate movement through manual techniques, exercise and guide their patients toward improving function. Just as with PCK and teaching, is there part of our knowledge base that is uniquely the province of physical therapists and a special form of professional understanding? How would we discover and uncover such knowledge? I suggest that this is best done by putting on our research agenda serious investigations of the wisdom of practice. The practical wisdom and knowledge of practitioners of both experts as well as promising young novices is an important source of such knowledge (3). What counts as evidence in support of good practice cannot only come from randomized, controlled clinical trials of technical interventions. We need to remember that good science begins with observations, which lay the theoretical foundation and determine the conceptual parameters of the discipline. Qualitative research is an essential tool for this exploration (4). As a profession, we are theory poor, lacking conceptual models and frameworks that assist in linking theory and practice (5). I urge us to look around our living rooms of practice and see if we can describe a new piece of furniture that is uniquely ours.