Eccentric exercise and shock-wave therapy benefit patients with chronic Achilles tendinopathy.

Aust J Physiother. 2007;53(2):131

Authors: Cook J

PMID: 17535151 [PubMed - in process]

(Source: Aust J Physiother)

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Patients with rheumatoid arthritis feel better after exercises in warm water than after similar exercises on land.

Aust J Physiother. 2007;53(2):130

Authors: Dagfinrud H, Christie A

PMID: 17535150 [PubMed - in process]

(Source: Aust J Physiother)

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Intrapulmonary percussive ventilation improves the outcomes of helmet ventilation.

Aust J Physiother. 2007;53(2):129

Authors: Ntoumenopoulos G

PMID: 17535149 [PubMed - in process]

(Source: Aust J Physiother)

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The physiotherapy workforce is ageing, becoming more masculinised, and is working longer hours: a demographic study.

Aust J Physiother. 2007;53(2):121-6

Authors: Schofield DJ, Fletcher SL

Question: Is the physiotherapy workforce significantly older in 2001 than 1986? What is the cumulative attrition of the workforce to 2001 and what is the predicted attrition by 2026? Is the workforce becoming masculinised? Is the workforce working longer hours? Design: Observational study using Australian Bureau of Statistics census data from 1986 to 2001 to predict workforce characteristics in 2026. Participants: All physiotherapists who responded to the 1986, 1991, 1996 and 2001 censuses: 5928, 7106, 8788 and 10039 respondents in each year respectively. Results: The physiotherapy workforce has aged significantly since 1986 (p < 0.001), and women are older than men (p < 0.001). Forty-one percent of the 2001 physiotherapy workforce is predicted to retire by 2026, although around one-third of physiotherapists continue working after age 65. While physiotherapy remains a female-dominated profession, the proportion of males is increasing and has risen from 16% in 1986 to 27% in 2001. Physiotherapists are working longer hours than they did in the past, and while this is partly due to the increasing proportion of males in the workforce, generation X and Y females are also more likely to work longer hours than their predecessors. Conclusion: The retirement of older, mostly female, physiotherapists may exacerbate existing workforce shortages, particularly in the public and aged care sectors. However, the growing proportion of male physiotherapists and their generally higher workforce participation may go some way to improving labour force capacity overall.

PMID: 17535148 [PubMed - in process]

(Source: Aust J Physiother)

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Most people with rheumatoid arthritis undertake leeisure-time physical activity in the Netherlands: an observational study.

Aust J Physiother. 2007;53(2):113-8

Authors: van den Berg MH, de Boer IG, le Cessie S, Breedveld FC, Vliet Vlieland TP

Question: What type of physical activity or exercise is undertaken by people with rheumatoid arthritis? What type of physical activity or exercise do they prefer? What is their attitude towards physical activity or exercise? What are the perceived barriers to undertaking physical activity or exercise? Design: Survey of a random sample of people with rheumatoid arthritis. Participants: Four hundred people with rheumatoid arthritis in the Netherlands. Results: Of the 252 people who returned the questionnaire (63% response) 201 (80%) people participated in some type of physical activity or exercise. Significantly more inactive people were male, less educated, and older than the active people. Of the active people, 45 (22%) participated exclusively in supervised activities, 72 (36%) in unsupervised activities, and 84 people (42%) combined supervised and unsupervised activities. Cycling and walking were the two unsupervised activities people performed most often. Supervised group exercise and unsupervised individual physical activity were reported as the favourite activities. Further, more people preferred being physically active under expert supervision than without supervision and preferred water-based over land-based activities. The most frequently-mentioned barriers were lack of energy, presence of pain, lack of motivation, lack of information, and fear of joint damage. Conclusion: The majority of people with rheumatoid arthritis participated in some physical activity or exercise, mostly under supervision. Preferences for types of activity varied, underpinning the need for a variety of options for people with rheumatoid arthritis.

PMID: 17535147 [PubMed - in process]

(Source: Aust J Physiother)

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Additional exercise does not change hospital or patient outcomes in older medical patients: a controlled clinical trial.

Aust J Physiother. 2007;53(2):105-11

Authors: de Morton NA, Keating JL, Berlowitz DJ, Jackson B, Lim WK

Question: What are the effects of additional exercise on hospital and patient outcomes for acutely-hospitalised older medical patients? Design: Controlled clinical trial. Participants: 236 patients aged 65 or older admitted to an acute care hospital with a medical illness between October 2002 and July 2003. Intervention: The experimental group received usual care plus an individually tailored exercise program administered twice daily from hospital admission to discharge. The control group received usual care only. Outcome measures: The primary outcome was discharge destination. Secondary outcomes were measures of activity limitation (Barthel Index, Timed Up and Go, Functional Ambulation Classification), length of stay, and adverse events. Results: There was no significant effect of the additional exercise program on any outcome. There were no significant differences between groups for the proportion of the patients discharged to home (RR 0.99, 95% CI 0.86 to 1.14) or inpatient rehabilitation (RR 0.76, 95% CI 0.30 to 1.51) or for measures of activity limitation at hospital discharge. A one day difference in length of stay was identified between groups but this difference was not significant (p = 0.45). There were no significant differences between groups for adverse events: 28-day readmission (RR 1.10, 95% CI 0.65 to 1.86), patient mortality (RR 1.15, 95% CI 0.16 to 8.0), intensive care admission (RR 0.16, 95% CI 0.01 to 3.13) and falls (RR 0.69, 95% CI 0.17 to 2.81). Conclusion: Additional physiotherapy intervention during hospitalisation did not significantly improve hospital or patient outcomes.

PMID: 17535146 [PubMed - in process]

(Source: Aust J Physiother)

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Sitting training early after stroke improves sitting ability and quality and carries over to standing up but not to walking: a randomised trial.

Aust J Physiother. 2007;53(2):97-102

Authors: Dean CM, Channon EF, Hall JM

Question: What is the effect of a sitting training protocol in people early after stroke on sitting ability and quality, and does it carry over to mobility? Design: Randomised placebo-controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. Participants: Twelve individuals who had a stroke less than three months previously and were able to sit unsupported. Intervention: The experimental group completed a 2-week sitting training protocol that involved practising reaching tasks beyond arm’s length. The control group completed a 2-week sham sitting training protocol that involved practising cognitive-manipulative tasks within arm’s length. Outcome measures: The primary outcome was sitting ability (maximum reach distance). Secondary outcomes were sitting quality (reach movement time and peak vertical force through affected foot during reaching) and carry over to mobility (peak vertical force through affected foot during standing up and walking speed during 10 m Walk Test). Outcome measures were taken before and after training and six months later. Results: After 2 weeks’ training, the experimental group had increased their maximum reach distance by 0.17 m (95% CI 0.12 to 0.21), decreased their movement time by 0.5 s (95% CI -0.8 to -0.2), increased their peak vertical force through the affected foot during reaching by 13% of body weight (95% CI 6 to 20) and increased their peak vertical force through the affected foot during standing up by 21% of body weight (95% CI 14 to 28) compared with the control group. After 6 months, significant between-group differences were maintained for maximum reach distance and peak vertical force through the affected foot during standing up. Conclusions: The sitting training protocol was both feasible and effective in improving sitting and standing up early after stroke and somewhat effective six months later.

PMID: 17535145 [PubMed - in process]

(Source: Aust J Physiother)

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Warm-up reduces delayed onset muscle soreness but cool-down does not: a randomised controlled trial.

Aust J Physiother. 2007;53(2):91-5

Authors: Law RY, Herbert RD

Question: Does warm-up or cool-down (also called warm-down) reduce delayed-onset muscle soreness? Design: Randomised controlled trial of factorial design with concealed allocation and intention-to-treat analysis. Participants: Fifty-two healthy adults (23 men and 29 women aged 17 to 40 years). Intervention: Four equally-sized groups received either warm-up and cool-down, warm-up only, cool-down only, or neither warm-up nor cool-down. All participants performed exercise to induce delayed-onset muscle soreness, which involved walking backwards downhill on an inclined treadmill for 30 minutes. The warm-up and cool-down exercise involved walking forwards uphill on an inclined treadmill for 10 minutes. Outcome measure: Muscle soreness, measured on a 100-mm visual analogue scale. Results: Warm-up reduced perceived muscle soreness 48 hours after exercise on the visual analogue scale (mean effect of 13 mm, 95% CI 2 to 24 mm). However cool-down had no apparent effect (mean effect of 0 mm, 95% CI -11 to 11 mm). Conclusion: Warm-up performed immediately prior to unaccustomed eccentric exercise produces small reductions in delayed-onset muscle soreness but cool-down performed after exercise does not.

PMID: 17535144 [PubMed - in process]

(Source: Aust J Physiother)

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Treadmill walking with body weight support is no more effective than cycling when added to an exercise program for lumbar spinal stenosis: a randomised controlled trial.

Aust J Physiother. 2007;53(2):83-9

Authors: Pua YH, Cai CC, Lim KC

Question: Is 6 weeks of treadmill walking with body weight support more effective than cycling in people with lumbar spinal stenosis when added to an exercise program? Design: Randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants: Sixty-eight patients aged 58 (SD with symptoms of lumbar spinal stenosis for 12 weeks (SD 49). Intervention: Participants performed either treadmill with body weight support or cycling, twice weekly, for 6 weeks. Both groups also received an exercise program consisting of heat, lumbar traction, and flexion exercises. Outcome measures: The primary outcome was disability measured using the modified Oswestry Disability Index. Secondary outcomes were disability, measured using the Roland-Morris Disability Questionnaire, pain severity, and patient perceived benefit. Measures were collected midway through intervention at 3 weeks and after intervention at 6 weeks. Results: There was no difference between the groups in reduction in disability or pain over the 6-week intervention period. The between-group difference in the modified Oswestry Disability Index was 3.2 points (95% CI -3.1 to 7.7) at 6 weeks, and in pain severity was 2 mm on a 100 visual analogue scale (95% CI -5 to 10). Furthermore, the wide confidence intervals associated with estimates of patient benefit are consistent with no difference between the two groups. However, both groups did improve. Conclusion: Treadmill with body weight support and cycling may be equally effective in the conservative management of people with lumbar spinal stenosis. However, the improvement observed in both groups was probably a combination of the intervention and the natural course of recovery of lumbar spinal stenosis.

PMID: 17535143 [PubMed - in process]

(Source: Aust J Physiother)

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A Saturday physiotherapy service may decrease length of stay in patients undergoing rehabilitaiton in hospital: a randomised controlled trial.

Aust J Physiother. 2007;53(2):75-81

Authors: Brusco NK, Shields N, Taylor NF, Paratz J

Question: Is additional Saturday physiotherapy intervention beneficial for inpatients undergoing rehabilitation? Design: Randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants: Two hundred and sixty-two inpatients undergoing rehabilitation in an Australian metropolitan hospital. Intervention: The experimental group received physiotherapy intervention from Monday to Saturday and the control group from Monday to Friday. Outcome measures: Primary outcomes were hospital and physiotherapy length of stay. Secondary measures were collected to reflect patient outcomes (health state, independence, activity, flexibility and strength) and burden of care (discharge destination, adverse events, and follow-up physiotherapy intervention). Results: There was a 3.2 day reduction for the experimental group (95% CI -0.5 to 6.9) in hospital length of stay and a 2.5 day reduction (95% CI -0.9 to 5.9) in physiotherapy length of stay. There was no significant between-group difference in change from admission to discharge for most of the secondary patient outcomes (health state, independence, activity, flexibility). The risk of the experimental group being categorised as strong relative to the control group was 1.2 (95% CI 0.99 to 1.50). The risk of not being discharged home, of having an adverse event, or requiring follow-up physiotherapy intervention was no greater for the experimental group than the control group. Conclusion: The provision of additional Saturday physiotherapy intervention resulted in a trend to shorter hospital and physiotherapy length of stay without affecting patient outcome unfavourably or increasing burden of care, suggesting that a larger multicentre trial is warranted.

PMID: 17535142 [PubMed - in process]

(Source: Aust J Physiother)

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