Showing papers in "Physiotherapy Canada in 2005"
42 citations
TL;DR: Insight is gained 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.
Abstract: 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...
39 citations
29 citations
25 citations
TL;DR: To identify factors associated with adherence to prescribed exercises in elderly, community-dwelling people with knee and/or hip osteoarthritis, logistic regression was used to investigate associations among variables at the beginning of a home exercise program, after 4 weeks of performing exercises, and at the end of the 8-week program.
Abstract: Purpose: To identify factors associated with adherence to prescribed exercises in elderly, community-dwelling people with knee and/or hip osteoarthritis. Methods: Logistic regression was used to investigate associations among variables at the beginning of a home exercise program, after 4 weeks of performing exercises (test 2), and at the end of the 8-week program (test 3). Outcome measures were self-reported home exercise adherence at tests 2 and 3, and the predictors were exercise adherence behaviour in the clinic, concurrent physical activity, perception of being physically inactive, and correctness of exercise performance. Results: Home exercise adherence at test 2 was associated with “in-clinic” exercise adherence behaviour at test 2 (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.09–2.01). There were significant associations between home exercise adherence at test 3 and (1) home exercise adherence at test 2 (OR = 19.86; 95% CI = 4.84–81.56); (2) concurrent physical activity at test 3 (OR = ...
24 citations
TL;DR: Compared with the PEP Mask, there were no significant between-group differences in the slopes of the QWB or CRQ, and the mean slope or annual rate of change of forced expiratory volume in 1 second (FEV1) percent predicted was 2.0.
Abstract: 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 score...
22 citations
TL;DR: The results from this study indicate that although the items on the CB&M were appropriate for the 30- to 59-year age categories, some items still posed a challenge to healthy participants because most were unable to score full points on theCB&M.
Abstract: Purpose: The purpose of the study was to describe and compare scoring patterns on the Community Balance and Mobility Scale (CB&M) in healthy men and women between 30 and 59 years of age. Methods: Following criterion testing on 5 individuals, 90 healthy volunteers who met the inclusion criteria and consented to participate in the study were tested on the CB&M. The subjects were recruited through quota sampling in three age categories: 30 to 39 years, 40 to 49 years, and 50 to 59 years, with 15 men and 15 women in each age category. The groups were not matched for any anthropometric variables. Results: Women within the age category of 50 to 59 years had significantly lower scores on the CB&M compared with all other age and gender categories. Conclusions: The results from this study indicate that although the items on the CB&M were appropriate for the 30- to 59-year age categories, some items still posed a challenge to healthy participants because most were unable to score full points on the CB&M. The normat...
19 citations
17 citations
TL;DR: The client's home as the context in which physiotherapy services are provided has meaning beyond merely the location where the therapeutic intervention occurs.
Abstract: Purpose: Recent changes in health service delivery have resulted in a shift in provision of services from the hospital to the community. These changes require an examination of the knowledge and skills used by physiotherapists working in the home setting. The purpose of this study is to understand the practice of physiotherapy within the context of the elderly client's home. Method: Using semistructured interviews with 12 home-based physiotherapists, a focussed ethnographic approach was used to explore the practice of home care physiotherapy in Ontario. Data were analyzed using a coding/categorizing approach. Results: The client's home as the context in which physiotherapy services are provided has meaning beyond merely the location where the therapeutic intervention occurs. Practicing in the world of the client requires a broad array of knowledge and skills that go far beyond notions of traditional physiotherapy. Physiotherapists in the community rely heavily on their tacit, professional craft knowledge,...
16 citations
15 citations
TL;DR: The experimental (E) group received treatment from a primary therapist in addition to their overall medical care, and a trend towards improvement was found in the E group in all clinical measures at discharge.
Abstract: Purpose: To evaluate the outcomes of patients with rheumatoid arthritis (RA) receiving treatment from a rheumatology-trained primary therapist and to assess the feasibility of the research protocol. Method: The experimental (E) group received treatment from a primary therapist in addition to their overall medical care. The usual care (UC) group continued receiving usual medical care. The first 10 patients completed the Health Assessment Questionnaire, a pain visual analogue scale, and the Arthritis Community Research and Evaluation Unit RA Knowledge Questionnaire. Patients were classified as clinical responders if they showed 20% improvement in two-thirds of core measures between baseline and 6 months. Baseline assessment was performed immediately prior to randomization. All patients completed the EuroQol and a monthly health resource use questionnaire. Results: A trend towards improvement was found in the E group (n = 11) in all clinical measures at discharge (approximately 6 weeks from baseline) and 6 m...
TL;DR: Although correlations of r = r = .87 to .89 were observed between scores on the WOMAC physical function and the LEFS questionnaires, the standard error of estimate associated with using one questionnaire to predict Scores on the other was large and the relative efficiency of the women's health status measures was similar.
Abstract: Purpose: The purpose of this study was to determine the relationship between two functionally oriented health status measures, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Lower Extremity Functional Scale (LEFS), in patients awaiting or having undergone total knee arthroplasty (TKA) Methods: Patients who were on the waiting list for TKA (n = 150) or who had undergone TKA (n = 150) received a mailed questionnaire Results: Responses were tabulated for 187 completed questionnaires Although correlations of r = 87 to 89 were observed between scores on the WOMAC physical function and the LEFS questionnaires, the standard error of estimate associated with using one questionnaire to predict scores on the other was large (F6 to F8) The relative efficiency of the WOMAC and the LEFS was similar, as were their relationships with the patients' ability to walk and ascend or descend stairs Respondents indicated no clear preference for either questionnaire Conclusions: Althou
TL;DR: Averaging measurements taken on different occasions and applying patient-specific measures represent effective strategies for detecting improvement in patients who present with small but important limitations in functional status.
Abstract: Purpose: Our purpose was to describe the challenges associated with detecting improvement of patients who present with small but important limitations in functional status. There are three components to this article: (1) introduction of the challenges, (2) presentation of proposed solutions, and (3) case illustrations. Summary of Key Points: Three factors contribute to the identified challenges: (1) little room is available on the scale to detect improvement, (2) regression towards the mean, and (3) the nonlinear properties of most self-report measures. Two strategies were identified to overcome these challenges: (1) to average the results of measurements performed on different occasions and (2) to apply a patient-specific measure. Examples of the successful application of these strategies are presented for two patients with low back pain. Conclusions: Averaging measurements taken on different occasions and applying patient-specific measures represent effective strategies for detecting improvement in pati...
TL;DR: Quarterly quadriceps atrophy and torque deficit can be substantial long after tibial plateau fracture, and Eccentric torque was the most sensitive measure of torque deficit, showing only partial recovery after exercise-induced muscle damage.
Abstract: Purpose: The purposes of this case report were (1) to describe muscle volume and torque-generating capacity of the quadriceps muscle in a 46-year-old woman 16 years following tibial plateau fracture and (2) to compare the decline and recovery of quadriceps torque following exerciseinduced muscle damage between the affected and unaffected lower extremity (LE). Methods: Magnetic resonance imaging was used to determine quadriceps volume. Repeated measures of concentric, eccentric, and isometric torque and muscle soreness were acquired for quadriceps bilaterally during four baseline tests, as well as 2 hours and 1, 2, 11, 12, and 13 days after exerciseinduced muscle damage (eccentric exercise). Results: At baseline, the affected quadriceps showed profound atrophy (74% of unaffected quadriceps volume) and deficits in all torque measures. Exercise-induced muscle damage resulted in slight delayed-onset muscle soreness and a decrease in all torque measures bilaterally. In the affected LE at 13 days after exercise, eccentric torque did not recover and isometric torque on the affected side recovered only partially. Conclusions: Quadriceps atrophy and torque deficit can be substantial long after tibial plateau fracture. Eccentric torque was the most sensitive measure of torque deficit, showing only partial recovery after exercise-induced muscle damage.
TL;DR: The point prevalence increased substantially between the first and second years and continued at this higher level during the fourth year and second- and fourth-year students were approximately twice as likely to experience neck problems compared with firs...
Abstract: Purpose: To determine the point prevalence of and risk factors associated with neck problems in undergraduate physiotherapy students. Method: In March 2001, all undergraduate students enrolled in the bachelor of physiotherapy program at the University of South Australia were invited to participate in this study. Students completed a reliable and valid questionnaire over four recall periods, eliciting information as to the prevalence of neck problems and possible risk factors (environmental factors and students' demographic characteristics). Results: Two hundred fifty students (response rate = 72%) participated. The prevalence of neck problems was 61% over the lifetime, 55% over the previous year, 38% over the previous month, and 32% over the previous week. The point prevalence increased substantially between the first and second years and continued at this higher level during the fourth year. Second- and fourth-year students were approximately twice as likely to experience neck problems compared with firs...
TL;DR: In this paper, the reliability of tibial rotation range of motion (ROM) measurements taken with subjects in sitting and supine positions was evaluated using a gravity and magnetic-referenced goniometer.
Abstract: Purpose: Although suggested to be an important component of physiologic knee function, the ability to accurately assess tibial rotation range of motion (ROM) is currently limited by a lack of reliability data for clinically practical measurement tools. The purpose of the present study was to estimate the reliability of tibial rotation ROM measurements taken with subjects in sitting and supine positions. Methods: Thirty healthy subjects (mean age 37 ± 12 years) completed maximal active internal and external tibial rotation movements in sitting and supine positions. ROM was assessed on two occasions and by two raters using a gravity- and magnetic-referenced goniometer. Results: There were significant differences between internal and external rotation ROM values (p < .05) and between values obtained with subjects in sitting and supine positions (p < .05). Intraclass correlation coefficients (ICCs) suggested that test–retest reliability for all measurements was excellent (ICC = 0.83–0.93), whereas interrater ...
TL;DR: The CE “profiles” of physiotherapists who treat individuals with work-related back pain are described, that is, combinations of courses most frequently attended by physiotherAPists in this group.
Abstract: 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 mo...
TL;DR: The findings of this study support concurrent validity and known group validity for the 13-metre walk test for elderly individuals awaiting total hip replacement.
Abstract: 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 characteristic
TL;DR: A practical guide for women who are facing, or who have recently had, a hysterectomy, a vaginal repair, or surgery for stress incontinence can be found in this article.
Abstract: This practical guide is written for women who are facing, or who have recently had, a hysterectomy, a vaginal repair, or surgery for stress incontinence.