No abstract. (Source: Physiotherapy Research International)

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Background and Purpose. Few studies have examined the experiences of students’ professional socialization in physiotherapy. This international longitudinal study aimed to study experiences of situated learning and change in a student cohort during a physiotherapy education programme. Method. A phenomenographic design with semi-structured interviews was carried out with a cohort of physiotherapy students from two sites, strategically selected for variation in gender, age, educational background, work experience and academic level. Interviews were carried out after each of the first five semesters in the programme by a team of researchers. Seventy-six interviews explored students’ learning experiences. Analysis identified the variation in experiences seen as important to becoming a physiotherapist. Results. Distinct perceptions of professional growth and progression are identified in four pathways of development: ‘Reflecting on Practice’; ‘Communicating with Others’; ‘Performing Skills’; and ‘Searching Evidence’. These pathways demonstrate qualitative differences in the focus of learning experiences and preferred learning context, and include learning in a context which supports reflection, learning as agreed by others in a context with patients and other professionals, learning physiotherapy skills in a practice context and learning formal knowledge in a context where theory can be linked with practice. Conclusions. In a cohort of students professional growth can be seen in a variety of development pathways. Each shows progress of professional growth in the ‘what’ as changes in experiences and the ‘how’ as ways of learning from them. In addition, the pattern of pathways in a cohort may change from one semester to another suggesting individuals may adopt different learning pathways throughout their education. Teaching staff are challenged to consider how they recognize a variation in development pathways in their student cohorts and how they purposefully ensure experiences to guide students through different learning pathways in socialization to become a physiotherapist. Copyright © 2006 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

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Background and Purpose. To assess if lifting performance can be modified and spine stresses reduced in workers who perform repetitive material-handling jobs in a warehouse environment via a novel real-time, movement-based feedback training protocol. Method. A pre-test/post-test group study design was used with a control group. Data were collected in a warehouse setting and analysed in a university setting. A convenience sample of 22 male warehouse employees was divided equally, based on height and weight, and assigned to either an experimental group or a control group. The experimental group received real-time, performance-based auditory feedback from their calculated moments during lifting or lowering using an electromagnetic tracking system. The electromagnetic tracking system was used to measure the side-bending, flexion and rotation moments during six lifts under four different conditions. A series of repeated-measures analyses of variance (ANOVA) (one between (Group); one within (Time)) was performed on the average maximum moments from six lifting or lowering cycles for all three directions: side-bending, flexion and rotation. Results. There were significant group X time interactions for the side-bending moment (p < 0.05) and the flexion moment (p < 0.05) but not the rotation moment (p > 0.05). Lower moments were found in the experimental group, which received the training and feedback, compared to the control group. Conclusions. Real-time, auditory feedback combined with coaching during lifting or lowering tasks may be effective in the short term (six weeks) in reducing the average maximum side-bending and flexion moments in warehouse workers. Further research is needed to determine the long-term effects of this training protocol on low back injury rates. Copyright © 2006 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

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Background and Purpose. The subscapularis (SSc) muscle is considered to perform a variety of roles during normal shoulder movement. The SSc is innervated by two or more discrete motor nerves and previous studies have indicated some difference in electromyographic (EMG) activity between the upper and lower portions of the muscle. The purpose of the present study was to compare EMG activity between the upper and lower portions of the SSc muscle during voluntary shoulder movements in normal healthy subjects. Method. Eight subjects were evaluated. A pair of intramuscular electrodes was inserted into each portion of the muscle. EMG data were recorded during the following movements: sagittal flexion; abduction in the coronal plane; and abduction in the scapular plane. Results. EMG onset of the upper portion of subscapularis occurred significantly earlier compared to the lower portion. Differences were also seen in the level and pattern of activation between the two portions, with upper SSc demonstrating higher levels of activation than the lower portion. Conclusions. These findings suggest that the upper and lower portions of SSc are differentially active during voluntary shoulder movements. Copyright © 2006 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

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Background and Purpose. Iontophoresis transcutaneously delivers anti-inflammatory and analgesic drugs for the treatment of musculoskeletal dysfunction. Lidocaine is a local anaesthetic with analgesic but no anti-inflammatory properties. The purpose of this investigation was to examine the clinical use of lidocaine iontophoresis-mediated analgesia in a larger treatment algorithm for five patients with lateral humeral epicondylalgia. Method. The investigation was a case series design of five subjects, aged 52 (±6) years, with epicondylalgia of 12-393 days’ duration. At each treatment session, the patients received cryotherapy, cross-fibre massage and passive stretch. Between sessions analgesia was provided by an 80 mA-min low-current, long-duration lidocaine iontophoresis (LI) over a 24-hour period. Patients were treated on an every-other-day basis for a total of three treatment sessions. Clinical improvements were determined by triplicate measurements of dolorimetric force over the affected epicondyle prior to treatment 1 (baseline), prior to sessions 2 and 3, and one week following the last session. Results. Patients demonstrated an increasing tolerance to dolorimetric force application prior to the next session. The force values prior to session 2 (3.1 (±1.1) Newton (N)) and one week following the third session (3.4 (±0.5) N) were significantly improved from the baseline values (2.1 (±0.9) N). Conclusions. Pain associated with lateral epicondylalgia decreased, and function improved in all patients at the final measurement. One patient returned during the 90-day follow-up period to seek additional medical attention. This investigation documents the potential for analgesia provided by LI in the rehabilitation process of musculoskeletal dysfunction. Copyright © 2006 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

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Background and Purpose. Adolescent spinal pain is a worldwide concern, with few longitudinal studies to validate concerns that an increasing number of adolescents report pain with age. The aim of the present study was to track reports of low back pain (LBP) in adolescents each year over a five-year period (between the ages of 13 and 17 years). Method. A longitudinal, observational, repeated-measures study, commencing in 1999. We followed a group of South Australian students throughout five years of high schooling, reporting on prevalence of recent low back pain each year. Results. In 1999, data were collected from 434 13-year-olds (82.5% eligible students). In the subsequent four years, the response rate from the 1999 sample was, respectively, 72.2%, 69.1%, 56.2% and 40.1%. A significant increasing prevalence of recent LBP was reported for girls and boys. The odds of girls reporting recent LBP in the final study year (fifth year) compared with the first year was 4.4 (95% CI 1.9-10.1), for boys 1.6 (95% CI 0.7-3.7). New cases of girls’ recent LBP decreased consistently over the study (90% in 2000, 46.1% in 2001, 42.1% in 2002 and 33% in 2003). New boys’ cases decreased in the second and third study years (85% in 2000, 45% in 2001) then increased (45.8% in 2002, 63.6% in 2003), suggesting less established patterns of occurrence. Conclusions. New cases of LBP reflected a decreasing percentage of total LBP reports over each study year for girls (suggesting increasing consistency of LBP occurrence with age). A different pattern was observed for boys, with a reversal of the downward trend after age 15 years, showing an increased percentage of LBP reports that reflected new cases in the final two study years. Copyright © 2006 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

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A single-subject, time-series design was used to describe a female with young-onset Parkinson’s disease who, after a period of 15 years, was demonstrating long term side effects of medication in addition to the progression of Parkinson’s disease. She underwent a bilateral pallidotomy to address these problems. Prior to her surgery, her spatiotemporal gait kinematics were measured at intervals before and after medication ingestion. The identical procedures were undertaken one month and at four months post-pallidotomy. In all three sessions, the Webster Scale scored her symptoms while her medication was not working (Off) and again when effective (On). After surgery, she was interviewed to obtain a qualitative impression of the outcome. Before the surgery, the gait parameters demonstrated a fluctuating profile. Forty-five minutes post-medication, her gait parameters approached normal levels but significant dyskinetic movements were evident. Her Webster Scale scores indicated advanced Parkinson’s disease particularly when Off. One-month post-pallidotomy, her gait parameters were more consistent with dyskinesias mildly present. Her Webster Scale scores were reduced while both Off and On. Four months post-pallidotomy her gait parameters were entirely consistent and within normal limits. Her Webster Scale scores were the same Off and On and no dyskinesias were detectable. The excellent result was probably enhanced by the patient’s dedication to regular exercise designed to minimize secondary physical complications. Copyright © 2006 John Wiley & Sons, Ltd. (Source: Physiotherapy Research International)

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No abstract. (Source: Physiotherapy Research International)

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No abstract. (Source: Physiotherapy Research International)

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Decisions nurses make while providing patient care to their client group will impact on the patient’s immediate and long-term outcomes and will also impact on service provision. Although many studies have focused on the clinical decision-making process itself within general nursing areas, little has been published as to what factors influence decisions in rheumatology nursing at the clinical level. Initial review of the literature suggested the following themes could influence decision-making: clinical decision-making, intuition, evidence-based practice, experiential learning, knowing the patient, skilled knowledge and rheumatology nursing. This article examines the literature surrounding clinical decision-making which may influence decision-making within rheumatology nursing practice. Copyright © 2006 John Wiley & Sons, Ltd. (Source: Musculoskeletal Care)

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