Physical therapy
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Review Practice Guideline Meta Analysis Guideline
Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions for neck pain.
A structured and rigorous methodology was developed for the formulation of evidence-based clinical practice guidelines (EBCPGs), then was used to develop EBCPGs for selected rehabilitation interventions for the management of neck pain. ⋯ This methodology of developing EBCPGs provides a structured approach to assessing the literature and developing guidelines that incorporates clinicians' feedback and is widely acceptable to practicing clinicians. Further well-designed RCTs are warranted regarding the use of several interventions for patients with neck pain where evidence was insufficient to make recommendations.
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Clinicians have used numerous strategies to combat wound infections, including topical and systemic administration of antibiotics, and various antiseptic agents such as hypochlorite (bleach) and hydrogen peroxide have been placed on wounds to kill bacteria or inhibit their growth. A commonly used antimicrobial agent is povidone-iodine (Betadine), a complex of iodine, the bactericidal component, with polyvinylpyrrolidone (povidone), a synthetic polymer. The most common commercial form is a 10% solution in water yielding 1% available iodine. ⋯ First, although there is a large body of research into various aspects of povidone-iodine use in wound care, the results are not always germane to the types of wound treatment most often provided by physical therapists. The relevance of in vitro studies regarding safety and effectiveness to in vivo use with patients may be limited. Much of the published research on wound healing uses animal wound models; however, the applicability of findings in animal studies to human wounds has been questioned.
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Physical therapists, as integral members of the multidisciplinary team in cardiac and pulmonary rehabilitation, should be knowledgeable about methods for assessing outcomes for their patients, and they need to understand the value of aggregated data in improving interventions. Definitions are discussed, and appropriate data used to monitor function are identified, including data used in the assessment of well-being. ⋯ A discussion of how to select outcomes to assess and the value of outcome information for program management is included. Therapists are in a position to encourage and participate in widespread, collaborative measurement of disease-specific clinical outcomes, patient functioning, and well-being, which should improve the effectiveness and efficiency of cardiopulmonary rehabilitation.