Physical therapy
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Clinical Trial Controlled Clinical Trial
Reliability of physical examination items used for classification of patients with low back pain.
The purpose of this study was to examine the interrater reliability of measurements obtained by examiners administering tests proposed to be important for classifying low back pain (LBP) problems. ⋯ The results suggest that experienced therapist who had trained together were able to agree on the results of examinations and obtain an acceptable level of reliability. Future work should focus on testing of reliability when more than one therapist performs the examination and when therapist not trained by the test developer to administer the examination perform the tests. [Van Dillen LR, Sahrmann SA, Norton BJ, et al. Reliability of physical examination items used for classification of patients with low back pain.
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Comparative Study Clinical Trial
Reliability of clinical pressure-pain algometric measurements obtained on consecutive days.
Algometers have been used to measure muscle and other soft tissue tenderness. The purpose of this study was to investigate (1) "normal" pressure-pain threshold (PPT) in the biceps brachii muscle, (2) the reliability of repeated measurements of PPT in subjects without pain over 3 consecutive days, (3) the reliability of measurements of PPT between examiners, and (4) the number of measurements required to obtain a best estimate of PPT. ⋯ The PPT is a reliable measure, and repeated algometry does not change pain threshold in healthy muscle over 3 consecutive days. The PPT can be used to evaluate the development and decline of experimentally induced muscle tenderness. Reliability is enhanced when all measurements are taken by one examiner.
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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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The aim of this investigation was to study the effect of electrical stimulation on nociceptive responses within the lumbar levels of the rat spinal cord. ⋯ The results demonstrate that two modes of train electrical stimulation can produce two patterns of fast-onset (within milliseconds), short-duration (within 20 seconds) inhibition of field potentials in the spinal cord. These results provide evidence that noxious heat-related impulses are modulated by the presence of specific electrical stimulation. The clinical application of transcutaneous electrical nerve stimulation to block pain is supported.
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The purposes of this study were to develop screening tests for four low back pain (LBP) diagnoses based on patient reports concerning the severity of pain in various positions and during activities and then to examine the accuracy of these tests in assigning subjects to one of four LBP diagnostic categories. The accuracy of screening tests is determined by calculating sensitivity and specificity and is well established in epidemiology. ⋯ Although more than half of the subjects with a particular LBP diagnosis tested positive for that diagnosis, approximately two thirds of the subjects who tested positive for each of the diagnoses actually had another diagnosis. Negative tests may be more useful in that between 77% and 94% of the subjects without the diagnosis tested negative. Although patient reports of LBP response to position and activity are not sufficient for diagnosis, they may be useful in ruling out a particular diagnosis.