Category: Research

Here is a new study by Dutch physios published in the May issue of BMC Musculoskelet Disord. 2007 May 22;8:45.

The purpose was to investigate the ability to adherence to recommendations of the guideline Acute ankle injury, and to identify patient characteristics that determine adherence to the guideline. Interesting….there are so many good quality guidelines out there, however, do patients follow them closely?

The authors found that: “Adherence to individual recommendations varied from 71% to 100%. In 99 patients (57%) the physiotherapists showed adherence to all indicators. Adherence to preset maximum of six treatment sessions for patients with severe ankle injury was 81% (132 patients).”

The writers concluded that: “Adherence to the clinical guideline Acute ankle sprain showed that the guideline is applicable in daily practice. Adherence to the guideline, even in a group of physiotherapists familiar with the guideline, showed possibilities for improvement. The necessity to exceed the expected number of treatment sessions may be explained by co-morbidity and recurrent sprains. It is not clear why female patients were treated with more sessions. Experience of the physiotherapist reduced the number of treatment sessions. Quality indicators may be used for audit and feedback as part of the implementation strategy.”

Read the whole thing in free full text here.

** Photo by kimberly hurst

The new issues of those two journals were out last week. As usual, click on the right side “Top Physiotherapy Journals – Current Tables of Contents” link to view the last issues.

Alternatively, click below to view the last issues of :

* The Australian journal of physiotherapy

* Physiotherapy research international : the journal for researchers and clinicians in physical therapy

** Photo by Stuart Yeates

U.S.national survey data showed that grown-ups are not eating enough fruits and vegetables or getting enough regular exercise, especially white men, non-Hispanic black women, and Hispanic women, reported Judy Kruger, Ph.D., and colleagues in the April 6 issue of the CDC’s Morbidity and Mortality Weekly Report.

The Centers for Disease Control and Prevention reports that: “Among men, engaging in regular physical activity was significantly less common for non-Hispanic blacks (45.9%), Hispanics (42.5%), and A/PIs (37.5%) than for non-Hispanic whites (52.5%). Among women, regular physical activity was significantly lower among non-Hispanic blacks (36.3%) and Hispanics (42.3%) than among non-Hispanic whites (49.8%).”

To measure physical activity, respondents were asked how often they engaged in physical activities of moderate intensity (i.e., brisk walking, bicycling, vacuuming, gardening, or anything else that causes small increases in breathing or heart rate) and vigorous intensity (i.e., running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate) for at least 10 minutes at a time in a usual week. Respondents were classified as being regularly active if they reported engaging in moderate-intensity activity at least 30 minutes per day, 5 or more days per week, or vigorous-intensity activity at least 20 minutes per day, 3 or more days per week. Respondents were classified as insufficiently active if they reported engaging in physical activity for at least 10 minutes per week, but did not meet the requirements for regular activity. Respondents who reported no instances of physical activity of >10 minutes’ duration during a usual week were classified as inactive.

Read the whole report in full text here.

Do you encourage your patients to exercise? Do you exercise enough yourself?

** Photo by siebe

There is a new open access medical journal in Canada; and it has a bright future. Open Medicine was launched last month – April 2007 by a team of Canadian physicians and health professionals (including a health librarian).

The inaugural issue included this particular study –“ A systematic review of studies comparing health outcomes in Canada and the United States” written by two prominent clinicians in evidence-based medicine – Gordon Guyatt and P.J. Devereaux at McMaster University – and an interprofessional group of researchers from Canada and the United States.

The researchers’ purpose was to systematically review studies comparing health outcomes in the United States and Canada among patients treated for similar underlying medical conditions.

The paper shows that Canada’s healthcare system is as good or better than the United States’ and delivers care at half the cost. While neither country can claim hegemony, politicians and policy makers will note that health outcomes may be superior in Canada versus the United States, and are consistently as good.

Read the full study available here

** Photo by Ozyman

Peter Huijbregts has kindly let me know that the new issue of Journal of Manual & Manipulative Therapy is up online now. As usual, there is lots of free content, take a look yourself >> Volume 15, Number 1

** Photo by creativity+

Here is a new study from April’s BMC Geriatrics 2007, 7:7

The Dutch authors investigated how many nursing home residents receive PT. In addition, they analysed the factors that contribute to the variation in the provision of PT both between nursing homes and between residents.

The study has a good methodology with randomization implemented: “”A random sample of 600 elderly residents was taken from a random sample of 15 nursing homes. Residents had to be admitted for rehabilitation or for long-term care. Data were collected through interviews with the nursing home physician and the physiotherapist. Multilevel analysis was used to define the variation in the provision of PT and the factors that are associated with the question whether a resident receives PT or not. Furthermore the amount of PT provided was analysed and the factors that are associated with this.”

Authors results: “On average 69% of the residents received PT. The percentage of patients receiving treatment differed significantly across nursing homes, and especially the number of physiotherapists available, explained this difference between nursing homes. Residents admitted to a somatic ward for rehabilitation, and male residents in general, were most likely to receive PT. Residents who were treated by a physiotherapist received on average 55 minutes (sd 41) treatment a week. Residents admitted for rehabilitation received more PT a week, as were residents with a status after a total hip replacement.”

Conclusions: “PT is most likely to be provided to residents on a somatic ward, recently admitted for rehabilitation to a nursing home, which has a relatively large number of physiotherapists. This suggests a potential under-use of PT for long-term residents with cognitive problems. It is recommended that physiotherapists reconsider which residents may benefit from treatment. This may require a shift in the focus of physiotherapists from ‘recovery and discharge’ to ‘quality of life and well-being’.”

Read the whole thing in free full text (open access) on BioMed Central BMC Geriatrics here.

** Photo by RebelBlueAngel

Here is a recent article published in PLoS Medicine – an excellent open access medical journal.

Ness AR, Leary SD, Mattocks C, Blair SN, Reilly JJ, et al. (2007) Objectively Measured Physical Activity and Fat Mass in a Large Cohort of Children . PLoS Med 4(3): e97 doi:10.1371/journal.pmed.0040097

The UK authors carried out a cross sectional analysis on 5,500 12-year-old children enrolled in the Avon Longitudinal Study of Parents and Children. Total physical activity and minutes of moderate and vigorous physical activity (MVPA) were measured using the Actigraph accelerometer. Fat mass and obesity (defined as the top decile of fat mass) were measured using the Lunar Prodigy dual x-ray emission absorptiometry scanner. We found strong negative associations between MVPA and fat mass that were unaltered after adjustment for total physical activity. We found a strong negative dose-response association between MVPA and obesity. The odds ratio for obesity in adjusted models between top and the bottom quintiles of minutes of MVPA was 0.03 (95% confidence interval [CI] 0.01–0.13, p-value for trend <0.0001) in boys and 0.36 (95% CI 0.17–0.74, p-value for trend = 0.006) in girls.

They concluded: “We demonstrated a strong graded inverse association between physical activity and obesity that was stronger in boys. Our data suggest that higher intensity physical activity may be more important than total activity.”

In a nutshell, the article says that even a little extra exercise lowers kids’ risk of obesity – very interesting!!

Read the free full text here.

** Photo by foreversoul