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Physiotherapy in the acute setting

Josie Merchant, Gemma Kitsos, Samantha Ashby, Alex Kitsos, Isobel J Hubbard
Objective. To assess whether acute stroke patients in rural hospitals receive less occupational therapy and physiotherapy than those in metropolitan hospitals. Design. Retrospective case-control study of health data in patients ≤10 days after stroke. Setting. Occupational therapy and physiotherapy services in four rural hospitals and one metropolitan hospital. Participants. Acute stroke patients admitted in one health district. Main Outcome Measures. Frequency and duration of face-to-face and indirect therapy sessions...
2016: Stroke Research and Treatment
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Nicola Totton, Joanna M Charles, Claire A Hawkes, Val Morrison, Zoe Hoare, Michelle Williams, Aaron W Pritchard, Swapna Alexander, Andrew Lemmey, Robert T Woods, Catherine Sackley, Pip Logan, Rhiannon T Edwards, Clare Wilkinson
OBJECTIVE: To conduct a rigorous feasibility study for a future definitive parallel-group randomised controlled trial (RCT) and economic evaluation of an enhanced rehabilitation package for hip fracture. SETTING: Recruitment from 3 acute hospitals in North Wales. Intervention delivery in the community. PARTICIPANTS: Older adults (aged ≥65) who received surgical treatment for hip fracture, lived independently prior to fracture, had mental capacity (assessed by clinical team) and received rehabilitation in the North Wales area...
October 5, 2016: BMJ Open
Bertrand Glize, Manon Mauclere, Pierre-Alain Joseph, Igor Sibon, Patrick Dehail
OBJECTIVE: Access to a specialized rehabilitation is limited for most of post stroke patients who are often transferred in non-specialized rehabilitation hospitals. We have set up a multidisciplinary mobile team working in these hospitals. The aim of this pilot study was to describe the contribution of our mobile team specialized in post acute care of stroke. MATERIALS/PATIENTS AND METHODS: We collected the changes in the management of rehabilitation for 31 patients hospitalized in non-specialized rehabilitation hospital referred to our mobile team...
September 2016: Annals of Physical and Rehabilitation Medicine
Dennis Caine, Glen Bergeron, Brett J Goodwin, Jessica Thomas, Caroline G Caine, Sam Steinfeld, Kevin Dyck, Suzanne André
A cross-sectional design was employed retrospectively to evaluate injuries self-reported by 71 pre-professional ballet dancers over one season. Some of the descriptive findings of this survey were consistent with those of previous research and suggest particular demographic and injury trends in pre-professional ballet. These results include gender distribution, mean age and age range of participants, training hours, injury location, acute versus overuse injuries, as well as average number of physiotherapy treatments per dancer...
2016: Journal of Dance Medicine & Science
H P French, R Galvin
OBJECTIVES: With a shift in musculoskeletal physiotherapy from secondary to primary care in Ireland, this study aimed to explore physiotherapists' experiences of providing musculoskeletal physiotherapy in primary care to gain an insight into their changing roles, challenges in service delivery and continuing professional development (CPD) needs. DESIGN: Qualitative design using focus group interviews. SETTING: Primary care physiotherapy services in the Republic of Ireland...
June 10, 2016: Physiotherapy
Ines Serrada, Michelle N McDonnell, Susan L Hillier
OBJECTIVE: To investigate the amount of time and types of interventions used during therapy sessions in the acute setting following stroke. METHODS: A systematic search of relevant databases was conducted. Studies were eligible if they were observational studies of adults with a confirmed diagnosis and within 4 weeks post-stroke; receiving Physiotherapy (PT) and/or Occupational Therapy (OT); and the outcome included amount of therapy time devoted to UL and/or types of interventions...
July 15, 2016: NeuroRehabilitation
Lara A Kimmel, Susan M Liew, James M Sayer, Anne E Holland
OBJECTIVES: To investigate the effects of intensive acute hospital physiotherapy for patients with isolated hip fractures. DESIGN, SETTING: Single-institution, prospective, randomised trial at a level 1 trauma centre in Melbourne, March 2014 - January 2015. PARTICIPANTS: 92 patients aged 65 years or more with isolated hip fractures. Patients were excluded if the fracture was subtrochanteric or pathological, or if post-operative orders required the patient to be non-weight-bearing on the operated leg...
July 18, 2016: Medical Journal of Australia
Taweewat Wiangkham, Joan Duda, M Sayeed Haque, Jonathan Price, Alison Rushton
INTRODUCTION: Whiplash-associated disorder (WAD) causes substantial social and economic burden internationally. Up to 60% of patients with WAD progress to chronicity. Research therefore needs to focus on effective management in the acute stage to prevent the development of chronicity. Approximately 93% of patients are classified as WADII (neck complaint and musculoskeletal sign(s)), and in the UK, most are managed in the private sector. In our recent systematic review, a combination of active and behavioural physiotherapy was identified as potentially effective in the acute stage...
2016: BMJ Open
Breda H Eubank, Nicholas G Mohtadi, Mark R Lafave, J Preston Wiley, Aaron J Bois, Richard S Boorman, David M Sheps
BACKGROUND: Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1) to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2) to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm...
2016: BMC Medical Research Methodology
Benjamin D Bray, Geoffrey C Cloud, Martin A James, Harry Hemingway, Lizz Paley, Kevin Stewart, Pippa J Tyrrell, Charles D A Wolfe, Anthony G Rudd
BACKGROUND: Studies in many health systems have shown evidence of poorer quality health care for patients admitted on weekends or overnight than for those admitted during the week (the so-called weekend effect). We postulated that variation in quality was dependent on not only day, but also time, of admission, and aimed to describe the pattern and magnitude of variation in the quality of acute stroke care across the entire week. METHODS: We did this nationwide, registry-based, prospective cohort study using data from the Sentinel Stroke National Audit Programme...
July 9, 2016: Lancet
Diane M Dennis, Christine N Duncan, Mary Pinder, Charley A Budgeon, Wendy J Jacob
AIMS AND OBJECTIVES: To assess the consistency and safety of manual hyperinflation delivery by nurses of variable clinical experience using a resuscitator bag during physiotherapy treatment. BACKGROUND: Manual hyperinflation involves the delivery of larger than normal gas volumes to intubated patients and is routinely used by nurses in collaboration with physiotherapists for the management of retained sputum. The aim is to deliver slow deep breaths with an inspiratory hold without unsafe airway pressures, lung volumes or haemodynamic changes...
August 2016: Journal of Clinical Nursing
Belinda Karyn Judd, Jennifer Ailsey Alison, Donna Waters, Christopher James Gordon
INTRODUCTION: Simulation-based clinical education often aims to replicate varying aspects of real clinical practice. It is unknown whether learners' stress levels in simulation are comparable with those in clinical practice. The current study compared acute stress markers during simulation-based clinical education with that experienced in situ in a hospital-based environment. METHODS: Undergraduate physiotherapy students' (n = 33) acute stress responses [visual analog scales of stress and anxiety, continuous heart rate (HR), and saliva cortisol] were assessed during matched patient encounters in simulation-based laboratories using standardized patients and during hospital clinical placements with real patients...
August 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Ruth McCullagh, Eimear O'Connell, Sarah O'Meara, Ivan Perry, Anthony Fitzgerald, Kieran O'Connor, N Frances Horgan, Suzanne Timmons
BACKGROUND: Older adults experience functional decline in hospital leading to increased healthcare burden and morbidity. The benefits of augmented exercise in hospital remain uncertain. The aim of this trial is to measure the short and longer-term effects of augmented exercise for older medical in-patients on their physical performance, quality of life and health care utilisation. DESIGN & METHODS: Two hundred and twenty older medical patients will be blindly randomly allocated to the intervention or sham groups...
2016: BMC Geriatrics
Christina Emilson, Ingrid Demmelmaier, Stefan Bergman, Per Lindberg, Eva Denison, Pernilla Åsenlöf
OBJECTIVE: To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting. DESIGN: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants. INTERVENTIONS: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition). MAIN MEASURES: Pain-related disability was the primary outcome...
March 23, 2016: Clinical Rehabilitation
Kylie N Johnston, Shylie Mackintosh, Matthew Alcock, Amy Conlon-Leard, Stephen Manson
BACKGROUND: Clinical placements in acute hospitals present challenges for students with vision impairment who are being educated as health care professionals. Legislation in Australia supports reasonable adjustments to education, thus students with vision impairment have completed accredited courses and gained professional registration. However the implementation of inherent requirement statements suggesting that adequate visual acuity is required to complete a physiotherapy program may create barriers to access for such students...
2016: BMC Medical Education
Cameal Sinclair, Nicole Brunton, Wilma M Hopman, Len Kelly
PURPOSE: To understand the postoperative acute-care physiotherapy course for First Nations people returning after total hip replacement (THR) to remote communities with limited rehabilitation services and to evaluate length of stay and attainment of functional milestones after THR to determine to what extent an urban-based clinical pathway is transferrable to and effective for First Nations patients in a rural setting. METHODS: Data were collected retrospectively by reviewing charts of patients who underwent THR in the Northwest Ontario catchment area from 2007 through 2012...
August 2015: Physiotherapy Canada. Physiothérapie Canada
Sarah Elizabeth Goldberg, Jo Cooper, Adrian Blundell, Adam Lee Gordon, Tahir Masud, Ravisankar Moorchilot
BACKGROUND: advanced nurse practitioners (ANPs) are experienced nurses who undertake some activities traditionally performed by medical staff. There are four pillars of advanced practice: advanced clinical skills, leadership, education and research. ANPs are starting to specialise in the management of older adults with frailty in the acute hospital. However, the role and competencies required for this have not been well defined. This study aimed to establish an expert consensus on the role description and essential competencies for ANPs working with older people with frailty to develop a curriculum...
January 2016: Age and Ageing
Molly V Driediger, Carly D McKay, Craig R Hall, Paul S Echlin
OBJECTIVE: To understand women's self-presentation experiences in the rehabilitation setting, and their attitudes and preferences toward the social and physical features of the rehabilitation environment. DESIGN: Qualitative study. SETTING: Outpatient physiotherapy clinic. PARTICIPANTS: Ten women (age 18 to 64) with high social physique anxiety (Social Physique Anxiety Scale score ≥25) referred for physiotherapy following acute injury...
October 23, 2015: Physiotherapy
Anthea Rhoda, Natalie Cunningham, Simon Azaria, Gerard Urimubenshi
BACKGROUND: The provision of rehabilitation differs between developed and developing countries, this could impact on the outcomes of post stroke rehabilitation. The aim of this paper is to present provision of in-patient stroke rehabilitation. In addition the challenges experienced by the individuals with participation post discharge are also presented. METHODS: Qualitative and quantitative research methods were used to collect data. The quantitative data was collected using a retrospective survey of stroke patients admitted to hospitals over a three- to five-year period...
2015: BMC Health Services Research
Vicky Stewart, M Dilani Mendis, Jeffrey Rowland, Nancy Low Choy
OBJECTIVES: To construct a new vestibular screening tool to identify likely vestibular disorders and guide referral of dizzy patients presenting to hospital and to test the vestibular screening tool for construct and discriminative validity and reliability of physiotherapy assessors. DESIGN: Methodologic study. SETTING: Emergency and acute hospital wards of a metropolitan hospital. PARTICIPANTS: Adults (N=114) presenting to hospital with dizziness (mean age, 67...
December 2015: Archives of Physical Medicine and Rehabilitation
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