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Physical therapy in critical care

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https://www.readbyqxmd.com/read/29779794/understanding-pain-and-pain-management-in-elderly-nursing-home-patients-applying-an-interprofessional-learning-activity-in-health-care-students-a-norwegian-pilot-study
#1
Elin Damsgård, Hege Solgård, Karin Johannessen, Katrine Wennevold, Gunnvald Kvarstein, Gunn Pettersen, Beate Garcia
Pain is common among elderly patients in nursing homes. However, pain assessment and treatment are inadequate. Interprofessional treatment is recommended, and consequently interprofessional education in pain management is necessary. This pilot project aimed to describe how two interprofessional groups of students approached pain management in two nursing home patients. We formed two teams comprising one student from the nursing, physical therapy, pharmacy, and medical educations. Each team spent one day examining a patient with chronic pain at a nursing home and they developed pain management plans...
May 17, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29747662/progressive-mobility-program-and-technology-to-increase-the-level-of-physical-activity-and-its-benefits-in-respiratory-muscular-system-and-functionality-of-icu-patients-study-protocol-for-a-randomized-controlled-trial
#2
Debora Stripari Schujmann, Adriana Claudia Lunardi, Carolina Fu
BACKGROUND: Enhanced mobility in the Intensive Care Unit (ICU) could minimize the negative effects of critical illness, such as declines in cognitive, muscular, respiratory, and functional capacity. We aim to compare the functional status at ICU discharge of patients who underwent a progressive mobilization protocol versus patients who received conventional physiotherapy. We also examine the level of physical activity in the ICU, the degree of pulmonary and muscle function, and the length of stay to analyze correlations between these variables...
May 10, 2018: Trials
https://www.readbyqxmd.com/read/29686550/evidence-based-pain-medicine-for-primary-care-physicians
#3
REVIEW
Graves T Owen, Brian M Bruel, C M Schade, Maxim S Eckmann, Erik C Hustak, Mitchell P Engle
The last several decades have seen a marked increase in both the recognition and treatment of chronic pain. Unfortunately, patients frequently misunderstand both the nature of pain and the best practices for its treatment. Because primary care physicians treat the majority of chronic pain, they are ideally situated to provide evidence-based pain care. The majority of the medical evidence supports a biopsychosocial model of pain that integrates physical, emotional, social, and cultural variables. The goal of this primer is to assist primary care physicians in their understanding of pain, evaluation of the chronic pain patient, and ability to direct evidence-based care...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29684180/benchmarking-the-physical-therapist-academic-environment-to-understand-the-student-experience
#4
Richard K Shields, Shauna Dudley-Javoroski, Kelly J Sass, Marcie Becker
Background: Identifying excellence in physical therapist academic environments is complicated by the lack of nationally available benchmarking data. Objective: The objective of this study was to compare a physical therapist academic environment to another health care profession (medicine) academic environment using the Association of American Medical Colleges Graduation Questionnaire (GQ) survey. Design: The design consisted of longitudinal benchmarking...
April 19, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29669082/cognitive-functional-therapy-an-integrated-behavioral-approach-for-the-targeted-management-of-disabling-low-back-pain
#5
Peter B O'Sullivan, J P Caneiro, Mary O'Keeffe, Anne Smith, Wim Dankaerts, Kjartan Fersum, Kieran O'Sullivan
Biomedical approaches for diagnosing and managing disabling low back pain (LBP) have failed to arrest the exponential increase in health care costs, with a concurrent increase in disability and chronicity. Health messages regarding the vulnerability of the spine and a failure to target the interplay among multiple factors that contribute to pain and disability may partly explain this situation. Although many approaches and subgrouping systems for disabling LBP have been proposed in an attempt to deal with this complexity, they have been criticized for being unidimensional and reductionist and for not improving outcomes...
May 1, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29582429/early-intervention-mobilization-or-active-exercise-for-critically-ill-adults-in-the-intensive-care-unit
#6
REVIEW
Katherine A Doiron, Tammy C Hoffmann, Elaine M Beller
BACKGROUND: Survivors of critical illness often experience a multitude of problems that begin in the intensive care unit (ICU) or present and continue after discharge. These can include muscle weakness, cognitive impairments, psychological difficulties, reduced physical function such as in activities of daily living (ADLs), and decreased quality of life. Early interventions such as mobilizations or active exercise, or both, may diminish the impact of the sequelae of critical illness. OBJECTIVES: To assess the effects of early intervention (mobilization or active exercise), commenced in the ICU, provided to critically ill adults either during or after the mechanical ventilation period, compared with delayed exercise or usual care, on improving physical function or performance, muscle strength and health-related quality of life...
March 27, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29566739/collaborative-care-for-the-detection-and-management-of-depression-among-adults-receiving-antiretroviral-therapy-in-south-africa-study-protocol-for-the-cobalt-randomised-controlled-trial
#7
Lara Fairall, Inge Petersen, Babalwa Zani, Naomi Folb, Daniella Georgeu-Pepper, One Selohilwe, Ruwayda Petrus, Ntokozo Mntambo, Arvin Bhana, Carl Lombard, Max Bachmann, Crick Lund, Jill Hanass-Hancock, Daniel Chisholm, Paul McCrone, Sergio Carmona, Thomas Gaziano, Naomi Levitt, Tasneem Kathree, Graham Thornicroft
BACKGROUND: The scale-up of antiretroviral treatment (ART) programmes has seen HIV/AIDS transition to a chronic condition characterised by high rates of comorbidity with tuberculosis, non-communicable diseases (NCDs) and mental health disorders. Depression is one such disorder that is associated with higher rates of non-adherence, progression to AIDS and greater mortality. Detection and treatment of comorbid depression is critical to achieve viral load suppression in more than 90% of those on ART and is in line with the recent 90-90-90 Joint United Nations Programme on HIV/AIDS (UNAIDS) targets...
March 22, 2018: Trials
https://www.readbyqxmd.com/read/29559375/contemporary-outcomes-of-ecmo-used-as-bridge-to-lung-transplantation
#8
Ali H Hakim, Usman Ahmad, Kenneth R McCurry, Douglas R Johnston, Gosta B Pettersson, Marie Budev, Sudish Murthy, Eugene H Blackstone, Michael Z Tong
BACKGROUND: Extracorporeal membrane oxygenation (ECMO), when used as bridge to lung transplantation (BTT) identifies high-risk candidates. Recent advances in cannula design and patient selection fosters "awake ambulatory ECMO" as a viable option for critically ill candidates in an attempt to retard deconditioning while awaiting allografts. METHODS: From 2012 to 2015, 30 patients underwent ECMO as BTT. Candidacy for ECMO was determined prior to listing for transplant...
March 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29552425/clinician-driven-design-of-vitalpad-an-intelligent-monitoring-and-communication-device-to-improve-patient-safety-in-the-intensive-care-unit
#9
Luisa Flohr, Shaylene Beaudry, K Taneille Johnson, Nicholas West, Catherine M Burns, J Mark Ansermino, Guy A Dumont, David Wensley, Peter Skippen, Matthias Gorges
The pediatric intensive care unit (ICU) is a complex environment, in which a multidisciplinary team of clinicians (registered nurses, respiratory therapists, and physicians) continually observe and evaluate patient information. Data are provided by multiple, and often physically separated sources, cognitive workload is high, and team communication can be challenging. Our aim is to combine information from multiple monitoring and therapeutic devices in a mobile application, the VitalPAD , to improve the efficiency of clinical decision-making, communication, and thereby patient safety...
2018: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/29540410/clinical-effectiveness-of-patella-mobilisation-therapy-versus-a-waiting-list-control-for-knee-osteoarthritis-a-protocol-for-a-pragmatic-randomised-clinical-trial
#10
Regina Wing Shan Sit, Keith Kwok Wai Chan, Benjamin Hon Kei Yip, Daisy Dexing Zhang, Kenneth Dean Reeves, Ying Ho Chan, Vincent Chi Ho Chung, Samuel Yeung Shan Wong
INTRODUCTION: Knee osteoarthritis (KOA) is a common, disabling and costly medical condition. The patellofemoral joint is a critical source of pain in individuals with KOA, and coexistence of patellofemoral osteoarthritis (PFOA) and tibiofemoral osteoarthritis (TFOA) is sometimes observed. The identification of subgroups with PFOA and customised interventions to correct underlying pathomechanics is beneficial for individuals with KOA. This study aims to evaluate whether a clinic-based patella mobilisation therapy (PMT) leads to significant improvement in pain, physical function and quality of life of individuals with KOA...
March 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29508918/a-comparative-review-of-the-isotretinoin-pregnancy-risk-management-programs-across-four-continents
#11
REVIEW
Tom Kovitwanichkanont, Tim Driscoll
Isotretinoin has revolutionized the treatment of severe acne vulgaris, a condition which if left untreated may result in significant socio-psychological implications for those affected. Timely access to isotretinoin therapy is important to avoid the risks of potential physical and emotional scarring. However, due to its high risks of teratogenicity, isotretinoin must be used with care in females of childbearing potential. Since isotretinoin's introduction, numerous risk management programs have been implemented across the world in an attempt to prevent isotretinoin use in pregnancy...
March 6, 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29504870/measuring-patient-satisfaction-with-medical-services-using-social-media-generated-data
#12
Simon Geletta
Purpose The purpose of this paper is to discuss the results of an effort to use social media generated data for measuring patient satisfaction with medical care services. Traditionally, scientifically designed patient satisfaction surveys are used to provide such measurements. The goal here is to evaluate the possibility of supplementing patient satisfaction surveys with social media generated patient satisfaction measurements such that the later can be used either as validation or replacement for the former...
March 12, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29493803/material-matters-analysis-of-density-uncertainty-in-3d-printing-and-its-consequences-for-radiation-oncology
#13
Daniel F Craft, Stephen F Kry, Peter Balter, Mohammad Salehpour, Wendy Woodward, Rebecca M Howell
PURPOSE: Using 3D printing to fabricate patient-specific devices such as tissue compensators, boluses, and phantoms is inexpensive and relatively simple. However, most 3D printing materials have not been well characterized, including their radiologic tissue equivalence. The purposes of this study were to (a) determine the variance in Hounsfield Units (HU) for printed objects, (b) determine if HU varies over time, and (c) calculate the clinical dose uncertainty caused by these material variations...
April 2018: Medical Physics
https://www.readbyqxmd.com/read/29488311/why-prescribe-exercise-as-therapy-in-type-2-diabetes-we-have-a-pill-for-that
#14
REVIEW
Mathias Ried-Larsen, Christopher S MacDonald, Mette Y Johansen, Katrine B Hansen, Robin Christensen, Thomas P Almdal, Bente K Pedersen, Kristian Karstoft
The majority of T2D cases are preventable through a healthy lifestyle, leaving little room for questions that lifestyle should be the first line of defence in the fight against the development of T2D. However, when it comes to the clinical care of T2D, the potential efficacy of lifestyle is much less clear-cut, both in terms of impacting the pathological metabolic biomarkers of the disease, and long-term complications. A healthy diet, high leisure-time physical activity, and exercise are considered to be cornerstones albeit adjunct to drug therapy in the management of T2D...
February 28, 2018: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/29430447/mechanisms-involved-in-brain-dysfunction-in-mechanically-ventilated-critically-ill-patients-implications-and-therapeutics
#15
REVIEW
Marc Turon, Sol Fernández-Gonzalo, Candelaria de Haro, Rudys Magrans, Josefina López-Aguilar, Lluís Blanch
Critical illness may lead to significant long-term neurological morbidity and patients frequently develop neuropsychological disturbances including acute delirium or memory impairment after intensive care unit (ICU) discharge. Mechanical ventilation (MV) is a risk factor to the development of adverse neurocognitive outcomes. Patients undergoing MV for long periods present neurologic impairment with memory and cognitive alteration. Delirium is considered an acute form of brain dysfunction and its prevalence rises in mechanically ventilated patients...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29424188/revolving-door-respiratory-patients-a-rehabilitative-perspective
#16
Massimiliano Polastri, Lara Pisani, Andrea Dell'Amore, Stefano Nava
Rehabilitation is an integral component of care for patients affected by either acute or chronic pulmonary diseases. The key elements of rehabilitation treatment for critical respiratory patients are as follows: weaning from mechanical ventilation, respiratory therapy, physical reconditioning, and occupational therapy. It should be noted that patients affected by pulmonary diseases are prone to hospital re-admission due to frequent exacerbations, especially in cases with more severe stages of chronic obstructive pulmonary disease...
September 22, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29389741/defining-anabolic-resistance-implications-for-delivery-of-clinical-care-nutrition
#17
Robert W Morton, Daniel A Traylor, Peter J M Weijs, Stuart M Phillips
PURPOSE OF REVIEW: Skeletal muscle mass with aging, during critical care, and following critical care is a determinant of quality of life and survival. In this review, we discuss the mechanisms that underpin skeletal muscle atrophy and recommendations to offset skeletal muscle atrophy with aging and during, as well as following, critical care. RECENT FINDINGS: Anabolic resistance is responsible, in part, for skeletal muscle atrophy with aging, muscle disuse, and during disease states...
April 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29385821/reflections-of-patients-and-therapists-on-a-multidisciplinary-rehabilitation-programme-for-persons-with-brachial-plexus-injuries
#18
Renske M J Janssen, Ton Satink, Jos Ijspeert, Nens van Alfen, Jan T Groothuis, Tanya L Packer, Edith H C Cup
PURPOSE: There is lack of knowledge, evidence, and guidelines for rehabilitation interventions for persons with neuralgic amyotrophy (NA) or brachial plexus pathology. A first pilot study, evaluating the effect of an integrated rehabilitation programme, showed improvements in activity and participation levels. AIM: To gain insight, from the perspective of patients and therapists, into the critical ingredients of the programme, that contributed to improvements in activity and participation...
January 31, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29361051/non-small-cell-lung-carcinoma-clinical-reasoning-in-the-management-of-a-patient-referred-to-physical-therapy-for-costochondritis
#19
Craig P Hensley, Alicia J Emerson
Background and Purpose: Chest pain, a frequent complaint for seeking medical care, is often attributed to musculoskeletal pathology. Costochondritis is a common disorder presenting as chest pain. Initial physical therapist examination emphasizes red flag screening. Reexamination throughout the episode of care is critical, particularly when patients are not progressing and/or in the presence of complex pain presentations. The purpose of this case report is to describe the clinical reasoning process in the management of a patient referred to physical therapy with a medical diagnosis of costochondritis...
January 18, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29324562/effectiveness-of-interventions-to-prevent-pre-frailty-and-frailty-progression-in-older-adults-a-systematic-review
#20
João Apóstolo, Richard Cooke, Elzbieta Bobrowicz-Campos, Silvina Santana, Maura Marcucci, Antonio Cano, Miriam Vollenbroek-Hutten, Federico Germini, Barbara D'Avanzo, Holly Gwyther, Carol Holland
OBJECTIVE: To summarize the best available evidence regarding the effectiveness of interventions for preventing frailty progression in older adults. INTRODUCTION: Frailty is an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Evidence supporting the malleability of frailty, its prevention and treatment, has been presented. INCLUSION CRITERIA: The review considered studies on older adults aged 65 and over, explicitly identified as pre-frail or frail, who had been undergoing interventions focusing on the prevention of frailty progression...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
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