Category: Research

Sorry for not posting for a couple of days – that nasty cold kept me down for a while 🙂

Here is an interesting study from US, published recently in Clin Med Res. 2006 Dec;4(4):256-65. The researchers evaluated the short-term effect of a worksite-based walking incentive program to promote physical activity and well-being in employees of a private healthcare clinic.

The conclusions : “Preliminary findings of our study suggest that the goal of worksite programs designed to support employees in their efforts to improve or maintain their level of wellness is potentially achievable. Continuing research is needed to further assess whether persistent health benefits can be induced by worksite wellness programs.”

Interesting study…Read the full text here

** Photo by zenera

This is a very important article, published in the most recent PLoS Medicine – a rising medical journal (that one day I believe would be as important as Lancet and Jama). The journal is using open access format – so that anybody on the planet could access important medical information for free!

The article itself, written by Canadian researchers from Ottawa, led by Dr. David Moher – “Epidemiology and Reporting Characteristics of Systematic Reviews” is extremely important and interesting.

The editorial piece for that issue – “Many Reviews Are Systematic but Some Are More Transparent and Completely Reported than Others” has a good summary of the findings:

Some of them include:

“There were clear differences in the quality of reporting between Cochrane and non-Cochrane SRs…”

“The quality of reporting in many of the SRs was disappointing. Despite the guidelines of the Cochrane Collaboration and the QUOROM (Quality of Reporting of Meta-Analyses) initiative [2], important items were frequently missing, again mostly from non-Cochrane reviews. ”

“It is Cochrane policy that published reviews should be regularly updated. One-third of the CDSR reviews in Moher’s sample were in fact updates. However, updating is uncommon elsewhere; in the Moher sample, only 2% of non-Cochrane reviews were updates. Related to this issue is the observation that outside of the Cochrane Collaboration none of the reviews were registered with a central body. Hence, it would be hard to locate and access updates even if they were done.”

In my workshops and teachings , I am frequently saying the Systematic Reviews are among the highest level of evidence in health sciences. David Moher’s study shows us that not always and not all reviews are the same.

Extremely interesting! I encourage you all to take a thorough look into this article – it is free full text!!

Viva to open access 🙂

** Photo by midnightvelvet59

Here is a very recent article from Brasilian researchers published in Acta Cirurgica Brasileira, vol.22 no.2 – Mar./Apr. 2007

The purpose was to evaluate the effect of utilization of a specific training program of respiratory muscles on pulmonary function in tobacco smokers.

The protocol was developed in the Physiotherapy Laboratory of University Hospital (UH) for the Northern Region of Paraná. There is a detailed description of the protocol in the article.

They concluded that: “The application of the protocol of respiratory exercises with and without additional load in tobacco smokers produced immediate improvement in the performance of respiratory muscles, but this gain was more accentuated after 2 weeks of exercise.”

Here is the full text in PDF

** Photo by owen

This is from the series called “Cochrane for Clinicians: Putting Evidence into Practice”, published by the American Family Physician.

This short article from Vol. 75/No. 3 (February 1, 2007) tries to give an Evidence-Based Answer to a clinical question: What should physicians tell patients with type 2 diabetes about the role of exercise?

The authors cite a recent Cochrane review – Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev 2006;(3):CD002968, and conclude that: “Regular exercise reduces A1C levels, adiposity, and triglyceride levels. However, no research has definitively proved a benefit of exercise on patient-oriented outcomes such as diabetes-related morbidity and mortality.”

Take a look on the full text here.

** Photo credits – k-sphotos’ photos.

Here is an interesting article from BMJ (it is almost two years old – but still relevant) – BMJ 2005;330:189-191

It states: “Regular physical activity brings important health benefits at any age. Its importance for health in old age is highlighted repeatedly in the English national service framework for older people. Any potential hazards can be reduced by education and guidance of participants.”

See the full text here

* photo courtesy – sparkle glowplug

Here is a recent article from J Athl Train. 2006 Oct-Nov;41(4):466-9.

The authors (physios) have asked this clinical question – Do evidence-based interventions exist for the prevention and treatment of stress reactions and stress fractures in young active adults?

In a nutshell, the authors of this systematic review have concluded that: “Currently, no solid evidence-based interventions to prevent lower extremity stress reactions or fractures exist. Limited evidence suggests that “shock absorbing” insoles may reduce the overall incidence of lower extremity osseous injuries in military personnel. Unfortunately, research does not support the best design for inserts or footwear modifications. There is also insufficient evidence to determine if pre-performance stretching or calcium supplementation offers added protection from lower extremity osseous overuse injuries. Initial evidence supports the use of a pneumatic brace and early mobilization for the treatment of tibal stress reactions and fractures, but additional studies are required to validate these findings.”

Read the whole thing here (PDF, 60kb)

** photo credit – spidrwegian’s photo from flickr (it looks that the account is down now :). Thanks a lot for the Flickr group for pointing the copyright issue!

A long and sensitive post this time…

This study – J Med Libr Assoc. 2007 January; 95(1): 64–69, done by physios and one librarian, worked to explore the use of information resources by a sample of physical therapists, by examination of professional libraries, and identification of information resources in three U.S. sites (Southern California, Arizona, and Georgia). Participants included forty physical therapists with between five and twenty years of experience.

The authors found that the Internet and continuing education activities appeared to be the primary information sources for the physical therapists surveyed. The personal professional libraries of participants were limited in scope and contained titles copyrighted more than ten years ago. Access to peer-reviewed journals in the sample was limited primarily to those received as a benefit of professional association membership – which in Canada is even more limiting!

Participants did not maintain current print professional information resources. The majority of books in the personal and workplace professional libraries held copyrights dating from the time of the participants’ enrollment in an entry-level physical therapy program.

The study says that medical librarians may play an important role in shifting physical therapy towards evidence-based practice by collaborating in professional development for this group.

This is exactly what we are trying to do here in our collaboration project between the University of British Columbia’s Irving K. Barber Learning Centre and the Physiotherapy Association of British Columbia.

It reminds me of a quite recent article – “Do physiotherapists’ attitudes towards evidence-based practice change as a result of an evidence-based educational programme?: – http://tinyurl.com/3by3ux , that concluded that : “In this study, physiotherapists appeared to be in favour of the idea of EBP, yet they remained reluctant to change their practice. Opinion leaders were not easily identifiable by physiotherapists, suggesting that this method alone may not be an effective method of changing attitudes in clinical practice…”

Personally, I would love so much to see physiotherapy professional organizations, like Canadian Physiotherapy Association, offering more access to professional, easy-to-use and accessible online resources, like electronic books (e.g. Review of Medical Physiology via StatsRef! or Macnab’s Backache via Books@OVID) and articles (full text editions of MEDLINE and CINAHL from EBSCO or OVID would do wonders with physiotherapists professional info needs!).

Moreover, how can the patients trust their health professionals whose information sources are ten years out-of-date?

Thanks for David Rothman for emailing me the link to the article, even before I opened my PubMed alert for this journal 🙂

Here is an interesting study, published in Nov. 2006 British Medical Journal – BMJ. 2006 Nov 18;333(7577):1041. Epub 2006 Oct 6.

The researchers wanted to assess whether a physical activity intervention reduces body mass index in young children – 545 children in their preschool year, mean age 4.2 years (SD 0.2) at baseline.

They used enhanced physical activity programme in nursery (three 30 minute sessions a week over 24 weeks) plus home based health education aimed at increasing physical activity through play and reducing sedentary behaviour; and measured body mass index, expressed as a standard deviation score relative to UK 1990 reference data. Secondary measures were objectively measured physical activity and sedentary behaviour; fundamental movement skills; and evaluation of the process.

The study found that: “Group allocation had no significant effect on the primary outcome measure at six and 12 months or on measures of physical activity and sedentary behaviour by accelerometry. Children in the intervention group had significantly higher performance in movement skills tests than control children at six month follow-up (P=0.0027; 95% confidence interval 0.3 to 1.3) after adjustment for sex and baseline performance.”

CONCLUSIONS: Physical activity can significantly improve motor skills but did not reduce body mass index in young children in this trial.

Here is the free full text in BMJ (PDF, 105KB).

A new issue of the Journal of Manual & Manipulative Therapy is out. As usual, it includes some free content -> http://jmmtonline.com/current/

Peter Huijbregts, the journal editor, says that this is a special topic issue on myofascial pain syndrome.

This is one of the interesting articles in that issue –“Physical Therapy Diagnosis and Management of a Patient with Chronic Daily Headache: A Case Report”

Here is a long – awaited study design. The Dutch group of researchers from Amsterdam are about to run a randomised controlled trial that aims to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention to reduce neck and upper limb symptoms in computer workers.

Computer workers from seven Dutch companies with frequent or long-term neck and upper limb symptoms in the preceding six months and/or the last two weeks are randomised into three groups: (1) work style group, (2) work style and physical activity group, or (3) control group.

The work style intervention consists of six group meetings in a six month period that take place at the workplace, during work time, and under the supervision of a specially trained counsellor. The goal of this intervention is to stimulate workplace adjustment and to improve body posture, the number and quality of breaks and coping behaviour with regard to high work demands. In the combined (work style and physical activity) intervention the additional goal is to increase moderate to heavy physical activity. The control group receives usual care.

Primary outcome measures are degree of recovery, pain intensity, disability, number of days with neck and upper limb symptoms, and number of months without neck and upper limb symptoms. Outcome measures will be assessed at baseline and six and 12 months after randomisation. Cost-effectiveness of the group meetings will be assessed using an employer’s perspective.

The results of the study are expected in 2007. Alstublieft , we will wait 🙂 Here is the full text of their protocol in PDF format – 11 pages.