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Physical therapy ethics

Maria Claudia Rodríguez, Perla Villamor, Tatiana Castillo
INTRODUCTION: Pain is a disease by itself and it's a public health concern of major implication in children, not just because of the emotional component of the child and his family, but also due to the potential morbidity and mortality involving it. A proper assessment of pain it's a challenge in the pediatric population, due to their lack of understanding and verbalization of hurt. Additionally, a satisfactory treatment of pediatric pain can be arduous due to a lack of clinical knowledge, insufficient pediatric research, and the fear to opioid side effects and addiction...
November 2016: International Journal of Pediatric Otorhinolaryngology
Eduard Shantsila, Ronnie Haynes, Melanie Calvert, James Fisher, Paulus Kirchhof, Paramjit S Gill, Gregory Y H Lip
INTRODUCTION: Patients with atrial fibrillation frequently suffer from heart failure with preserved ejection fraction. At present there is no proven therapy to improve physical capacity and quality of life in participants with permanent atrial fibrillation with preserved left ventricular contractility. OBJECTIVE: The single-centre IMproved exercise tolerance In heart failure With PReserved Ejection fraction by Spironolactone On myocardial fibrosiS In Atrial Fibrillation (IMPRESS-AF) trial aims to establish whether treatment with spironolactone as compared with placebo improves exercise tolerance (cardiopulmonary exercise testing), quality of life and diastolic function in patients with permanent atrial fibrillation...
October 5, 2016: BMJ Open
Andoret van Wyk, Carina A Eksteen, Piet J Becker, Barbara M Heinze
INTRODUCTION: Visual impairment, specifically eye movement disorders and vestibular dysfunction may have a negative influence on the functional recovery in post-stroke patients. This type of sensory dysfunction may further be associated with poor functional outcome in patients' post-stroke. METHODS: In phase 1, a cross-sectional survey (n = 100) will be conducted to determine the prevalence of eye movement disorders and vestibular dysfunction in patients who sustained a stroke...
2016: Frontiers in Neurology
Walter A Wohlgemuth, Rene Müller-Wille, Veronika Teusch, Simone Hammer, Moritz Wildgruber, Wibke Uller
OBJECTIVES: To assess the treatment-induced changes of health-related quality-of-life (HRQoL) in patients with venous malformations (VM) who underwent ethanol gel sclerotherapy. METHODS: The prospective study in children and adults was approved by the local ethics committee. 31 patients (mean age 23.42 years, range 6.6 - 46.5; 26 female, 5 male) with VM were included. Patients' self-assessed HRQoL was measured before and after treatment using psychometrically validated questionnaires for adults and children...
October 4, 2016: European Radiology
Mohammad Reza Pourahmadi, Morteza Taghipour, Ismail Ebrahimi Takamjani, Mohammad Ali Sanjari, Mohammad Ali Mohseni-Bandpei, Abbas Ali Keshtkar
INTRODUCTION: Lumbar disc herniation (LDH) is a common condition in adults and can impose a heavy burden on both the individual and society. It is defined as displacement of disc components beyond the intervertebral disc space. Various conservative treatments have been recommended for the treatment of LDH and physical therapy plays a major role in the management of patients. Therapeutic exercise is effective for relieving pain and improving function in individuals with symptomatic LDH...
September 27, 2016: BMJ Open
Alain Yelnik, Cedric Andriantsifanetra, Peggy Reinert, Mathilde Evrard, Hélène Marneff, Marie Wanepain, Margaux Barbie, Johann Beaudreuil, Jean Pascal Devailly, Eric Vicaut
OBJECTIVE: Active and intensive physical therapy (PT) facilitates motor recovery when provided at a subacute stage after stroke. The efficiency of very early intensive PT (within the 2 first weeks) has been much less investigated. Early intensive rehabilitation might be beneficial for neural plasticity but also detrimental by worsening the cerebral ischemia. The AVERT study (Bernhardt 2015) showed negative effect of high dose of very early mobilisation. MATERIAL/PATIENTS AND METHODS: Patients have been recruited in this multicentre randomized controlled trial (9 stroke units with PRM teams) to compare "soft" (20 min/day apart from respiratory needs) versus "intensive" PT (idem+45 minutes of intensive exercises/day), initiated within the 72 first hours after a first hemispheric stroke...
September 2016: Annals of Physical and Rehabilitation Medicine
Karen Hansen Kallesøe, Andreas Schröder, Rikard K Wicksell, Per Fink, Eva Ørnbøl, Charlotte Ulrikka Rask
INTRODUCTION: Functional somatic syndromes (FSS) are common in adolescents, characterised by severe disability and reduced quality of life. Behavioural treatments such as acceptance and commitment therapy (ACT) has shown promising results in children and adolescents with FSS, but has focused on specific syndromes such as functional pain. The current study will compare the efficacy of group-based ACT with that of enhanced usual care (EUC) in adolescents with a range of FSS operationalised by the unifying construct of multiorgan bodily distress syndrome (BDS)...
September 15, 2016: BMJ Open
Alison S Clay, Cheryl Misak
Health systems, granting agencies, and professional societies are increasingly involving patients and their family members in the delivery of healthcare and the improvement of health sciences. This is a laudable advance toward fully patient-centered medicine. However, patient engagement is not a simple matter, either practically or ethically. The complexities include: i) the physical limitations that patients and their family members may have, from travelling to meetings to special dietary needs; ii) the emotional sensitivities patients and their families might experience-from distress at discussions of disease prognosis, outcomes, and therapies to being inexperienced at public speaking; iii) the fact that advocacy efforts by patients and family members, which may be encouraged at the national level, may threaten individual professionals providing care to individual patients and may result in risk to patients...
August 30, 2016: Annals of the American Thoracic Society
Francisca Rego, Rui Nunes
In palliative care, a biopsychosocial-spiritual model is essential to address the patient in its totality. Spirituality is often a relevant issue in such settings, yet there is a need to differentiate spirituality from religion. Spirituality in palliative care focuses on the psychological and spiritual aspects of care, helping to relieve the physical, emotional, social and spiritual distresses of the patient, family members and healthcare professionals, produced in such conditions. Psychologists, according to their ethical responsibilities, may include the assessment of their patients' spiritual needs in therapy, as it will help to identify the patients' values, belief systems, spiritual history, distress and needs...
August 15, 2016: Journal of Health Psychology
Helen Anwander, Kawan S Rakhra, Gerd Melkus, Paul E Beaulé
BACKGROUND: T1ρ MRI has been shown feasible to detect the biochemical status of hip cartilage, but various region-of-interest strategies have been used, compromising the reproducibility and comparability between different institutions and studies. QUESTIONS/PURPOSES: The purposes of this study were (1) to determine representative regions of interest (ROIs) for cartilage T1ρ mapping in hips with a cam deformity; and (2) to assess intra- and interobserver reliability for cartilage T1ρ mapping in hips with a cam deformity...
August 9, 2016: Clinical Orthopaedics and related Research
Tiffany Field
This paper is a review of empirical studies, review and meta-analysis publications on yoga from the last few years. The review includes demographics/prevalence of yoga as a practice, bibliometric analyses of the yoga publications and the use of yoga for physical fitness and cognitive function. Most of the studies reviewed here involve yoga effects on psychiatric and medical conditions. These include pregnancy, prenatal and postpartum depression; stress, PTSD, anxiety, and obesity; cardiovascular conditions including hypertension; pain syndromes including arthritis, headaches and low back pain; autoimmune conditions including asthma, type II diabetes and multiple sclerosis; immune conditions including HIV and breast cancer; and aging problems including balance, osteoporosis and Parkinson's...
August 2016: Complementary Therapies in Clinical Practice
Oscar Fernández, Roberto Cachán-Cruz
One of the major transformations in religion in contemporary societies has been the decline of church institutions and their reconstruction within a diverse network of associations, therapies, markets and other unconventional spiritual services. Based on extensive ethnographic fieldwork on religious behaviours and dynamics in sports contexts, and taking the similarities between sport and religion as the point of departure, this paper analyses, reflects on and theorises about the symbolic affinities of these two contemporary social institutions...
July 27, 2016: Journal of Religion and Health
Peter Østergren, Anne-Mette Ragle, Henrik Jakobsen, Tobias Wirenfeldt Klausen, Anders Vinther, Jens Sønksen
INTRODUCTION: Level 1 evidence supports the use of supervised exercise to mitigate the adverse effects of androgen deprivation therapy (ADT) in men with prostate cancer. The data, however, have been generated in controlled research settings and might not be transferable to daily clinical practice. This article describes the design of an ongoing prospective observational study to evaluate the potential benefits of exercise in daily clinical practice. METHODS AND ANALYSIS: Men diagnosed with prostate cancer starting or already receiving ADT at our facility are invited to participate in a 12-week exercise programme implemented as the standard of care...
2016: BMJ Open
Nina Buchtele, Peter Schellongowski, Andja Bojic, Alexander Hermann, Oliver Robak, Wolfgang Lamm, Thomas Staudinger
INTRODUCTION: Data on prolonged extracorporeal membrane oxygenation (ECMO) usage in influenza associated acute respiratory distress syndrome (ARDS) are lacking. Furthermore, no consensus exists on when to terminate ECMO treatment in refractory cases. This report highlights additional treatment measures and complications in prolonged ECMO therapy and discusses associated ethical burdens. CASE REPORT: We report on a 64-year-old man with confirmed H1N1 influenza virus infection who was successfully weaned from 65-day ECMO treatment with an excellent outcome...
July 4, 2016: International Journal of Artificial Organs
Dagmar Tučková, Miloslav Klugar, Eliška Sovová, Markéta Sovová, Lenka Štégnerová
INTRODUCTION: Based on more than 5 decades of epidemiological studies, it is now widely accepted that higher physical activity patterns and levels of cardiorespiratory fitness are associated with better health outcomes. Therefore, it is necessary to consider how treatment methods affect these two components. Clinically, one very important question concerns the influence of aerobic performance on patients being treated for hypertension. The administration of β-blockers can significantly reduce maximal-and especially submaximal-aerobic exercise capacity...
2016: BMJ Open
Mukadder Mollaoğlu, Pelin Çelik
AIMS AND OBJECTIVES: To identify nursing services and assess patient satisfaction in patients who present to the emergency department. BACKGROUND: Emergency nursing care is a significant determinant of patient satisfaction. Patient satisfaction is often regarded as a reliable indicator of the quality of services provided in the emergency department. DESIGN: This is a descriptive study. METHODS: Eighty-four patients who presented to the university emergency department were included in the study...
October 2016: Journal of Clinical Nursing
Aimee Goel
Spinal cord injury (SCI) remains one of the most physically, psychologically and socially debilitating conditions worldwide. While rehabilitation measures may help limit disability to some extent, there is no effective primary treatment yet available. The efficacy of stem cells as a primary therapeutic option in spinal cord injury is currently an area under much scrutiny and debate. Several laboratory and some primary clinical studies into the use of bone marrow mesenchymal stem cells or embryonic stem cell-derived oligodentrocyte precursor cells have shown some promising results in terms of remyelination and regeneration of damaged spinal nerve tracts...
April 2016: Journal of Craniovertebral Junction and Spine
Diego Arenas Moya, Alejandra Plascencia Gaitán, Denisse Ornelas Camacho, Humberto Arenas Márquez
Hospital malnutrition is a relevant clinical issue present in about 50% of patients that is associated with increased morbidity, mortality, and cost of care. Because of the relation of malnutrition with chronic and acute inflammatory processes secondary to disease, nutrition therapy is considered an important medical treatment. However, there is little discussion about the impact of another critical issue related to hospital malnutrition, that is, lack of appropriate food or nutrition therapy given to the patients...
June 2016: Nutrition in Clinical Practice
Nanna Rolving, Claus Vinther Nielsen, Finn Bjarke Christensen, Randi Holm, Cody Eric Bünger, Lisa Gregersen Oestergaard
BACKGROUND: Catastrophic thinking and fear-avoidance belief are negatively influencing severe acute pain following surgery causing delayed ambulation and discharge. We aimed to examine if a preoperative intervention of cognitive-behavioural therapy (CBT) could influence the early postsurgical outcome following lumbar spinal fusion surgery (LSF). METHODS: Ninety patients undergoing LSF due to degenerative spinal disorders were randomly allocated to either the CBT group or the control group...
2016: BMC Musculoskeletal Disorders
Joanna L Hudson, Rona Moss-Morris, David Game, Amy Carroll, Paul McCrone, Matthew Hotopf, Lucy Yardley, Joseph Chilcot
INTRODUCTION: Psychological distress is common in end-stage kidney disease (ESKD) and is associated with poorer health outcomes. Cognitive behavioural therapy (CBT) is recommended in UK clinical guidelines for the management of depression in people with long-term conditions. Access to skilled therapists competent in managing the competing mental and physical health demands of ESKD is limited. Online CBT treatments tailored to the needs of the ESKD population offers a pragmatic solution for under-resourced services...
2016: BMJ Open
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