Physical therapy
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The purpose of this study was to determine the intertherapist reliability of judgments of stiffness and pain at L-1 to L-5 made using posteroanterior (PA) central pressure testing. ⋯ Judgments of stiffness made by experienced manipulative physical therapists examining patients in their own clinics were found to have poor reliability, whereas pain judgments had good reliability. Further investigation of this test is required in order to develop a more reliable method of assessing PA stiffness.
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Randomized Controlled Trial Comparative Study Clinical Trial
Assessing change over time in patients with low back pain.
This study compared the ability of the Roland-Morris (RM), Oswestry (OSW), and Jan van Breemen Institute (JVB) pain and function questionnaires to detect change over time. ⋯ Based on the latter finding, we believe the RM questionnaire may be the preferred instrument for assessing change over time in patients with low back pain.
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Meta Analysis Comparative Study
Are incentive spirometry, intermittent positive pressure breathing, and deep breathing exercises effective in the prevention of postoperative pulmonary complications after upper abdominal surgery? A systematic overview and meta-analysis.
The purpose of this meta-analysis was to quantitatively assess the conflicting body of literature concerning the efficacy of incentive spirometry (IS), intermittent positive pressure breathing (IPPB), and deep breathing exercises (DBEX) in the prevention of postoperative pulmonary complications in patients undergoing upper abdominal surgery. ⋯ Incentive spirometry and DBEX appear to be more effective than no physical therapy intervention in the prevention of postoperative pulmonary complications. There is no evidence to support a significant difference between any of the three modalities. [Thomas JA, McIntosh JM. Are incentive spirometry, intermittent positive pressure breathing, and deep breathing exercises effective in the prevention of postoperative pulmonary complications after upper abdominal surgery? a systematic overview and meta-analysis.
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This article reviews the principles of pulse oximetry and assesses the accuracy of pulse oximeter measurements obtained during exercise, based on reports of 10 studies that evaluated 24 pulse oximeters. Nine of the studies used cycle exercise, and 1 study utilized treadmill running for mode of activity. Subject populations included patients with cardiovascular or pulmonary disorders, nondisabled individuals, and athletes. ⋯ Recent studies suggest the current generation of finger-probe-equipped pulse oximeters may be more accurate than ear-probe-equipped models. We recommend that clinicians carefully secure the probe; monitor signal strength; be wary of %SpO2 values of < or = 68% to 78% to avoid undetected severe hypoxemia; and be alert to whether a patient is a smoker, in which case %SpO2 will likely be overestimated. Researchers interested in using pulse oximeter estimates should validate their particular pulse oximeter(s) via arterial blood sampling.
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Review
Injury to skeletal muscle fibers during contractions: conditions of occurrence and prevention.
Contraction-induced injury results in the degeneration and regeneration of muscle fibers. Of the three types of contractions--shortening (concentric), isometric, and lengthening (eccentric)--injury is most likely to occur and the severity of the injury is greatest during lengthening contractions. ⋯ The recovery from contraction-induced injury is usually complete within 30 days. Repeated exposures to protocols of lengthening contractions result in "trained" muscles that are not injured by the protocol that previously caused injury.