Physical therapy
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Randomized Controlled Trial Comparative Study
Effectiveness of continuous passive motion and conventional physical therapy after total knee arthroplasty: a randomized clinical trial.
This randomized clinical trial was conducted to compare the effectiveness of 3 in-hospital rehabilitation programs with and without continuous passive motion (CPM) for range of motion (ROM) in knee flexion and knee extension, functional ability, and length of stay after primary total knee arthroplasty (TKA). ⋯ The results of this study do not support the addition of CPM applications to conventional physical therapy in rehabilitation programs after primary TKA, as applied in this clinical trial, because they did not further reduce knee impairments or disability or reduce the length of the hospital stay.
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Randomized Controlled Trial Clinical Trial
Can elderly patients who have had a hip fracture perform moderate- to high-intensity exercise at home?
The majority of patients after a hip fracture do not return to prefracture functional status. Depression has been shown to affect recovery. Although exercise can reduce impairments, access issues limit elderly people from participating in facility-based programs. The primary purpose of this study was to determine the effects and feasibility of a home exercise program of moderate- or high-intensity exercise. A secondary purpose was to explore the relationship of depression and physical recovery. ⋯ High-intensity exercise performed in the home is feasible for people with hip fracture. Larger sample sizes may be necessary to determine whether the exercise regimen is effective in reducing impairments and improving function. Depression may play a role in the level of improvement attained.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Implementation of clinical guidelines on physical therapy for patients with low back pain: randomized trial comparing patient outcomes after a standard and active implementation strategy.
An active strategy was developed for the implementation of the clinical guidelines on physical therapy for patients with low back pain. The effect of this strategy on patients' physical functioning, coping strategy, and beliefs regarding their low back pain was studied. ⋯ The authors found no additional benefit to applying an active strategy to implement the physical therapy guidelines for patients with low back pain. Active implementation strategies are not recommended if patient outcomes are to be improved.
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Randomized Controlled Trial Clinical Trial
Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain.
The purpose of this randomized controlled trial was to examine the usefulness of the addition of specific stabilization exercises to a general back and abdominal muscle exercise approach for patients with subacute or chronic nonspecific back pain by comparing a specific muscle stabilization-enhanced general exercise approach with a general exercise-only approach. ⋯ A general exercise program reduced disability in the short term to a greater extent than a stabilization-enhanced exercise approach in patients with recurrent nonspecific low back pain. Stabilization exercises do not appear to provide additional benefit to patients with subacute or chronic low back pain who have no clinical signs suggesting the presence of spinal instability.
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Randomized Controlled Trial Clinical Trial
Relationship of physical examination findings and self-reported symptom severity and physical function in patients with degenerative lumbar conditions.
Limited data are available to assist clinicians in clinical decision making. The purpose of this study was to examine the relationships of symptom provocation during physical examination (PE) procedures and self-report of symptom severity and function in patients with degenerative lumbar conditions. ⋯ The association between PE findings and self-reported symptom severity in this sample is consistent with the pathoanatomy of degenerative spinal conditions and indicates that movement that narrows the foraminal space contributes to symptom severity. The quadrant test distinguished those subjects with clinically meaningful low back symptom severity but was not predictive of impaired function. This study illustrates the potential benefit of identifying clinical PE measures that are reflective of condition severity and back-specific function in patients with similar clinical syndromes.