Physical therapy
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Students and practicing physical therapists are expected to be clinical problem solvers. The absence of clinical problem solving may result in decreased individuality of patient services. ⋯ I present a model by comparing the behaviors of the problem solver with the behaviors of the nonproblem solver at each step in the problem-solving process and then discuss sources of confusion in the perception of problem solving. I provide examples and suggest applications of the model for improving clinical problem-solving abilities.
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Numerous publications devoted to the topic of transcutaneous electrical nerve stimulation (TENS) have appeared since the presentation of a special issue of Physical Therapy (December, 1978). This update article addresses contemporary information on efficacy, mode of application, treatment outcomes, and neurophysiological mechanisms relevant to this modality. ⋯ Perhaps the greatest advances in our understanding of TENS involve the recent development of mechanisms that might account for how different types of TENS work. Suggestions for predicting patient responses to TENS and for avenues of future inquiry are offered.
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The purpose of this paper is to identify competencies needed in the area of biomechanics for physical therapists. The discussion is divided into the following three areas: prevention of movement dysfunction, patient evaluation, and patient treatment. ⋯ Physical therapists must understand normal biomechanical development, pathomechanical development, biomechanics of normal movement, and pathomechanics of the musculoskeletal system. In addition, physical therapists should be experts in biomechanics of exercise and be able to analyze biomechanically various types of activities.
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Comparative Study
Effect of transcutaneous electrical nerve stimulation on human blood beta-endorphin levels.
We randomly assigned 42 subjects for treatment with transcutaneous electrical nerve stimulation (TENS) to one of three groups: conventional TENS--80 Hz; low frequency TENS--2 Hz; and a control group--TENS without batteries. Pain threshold measurements and blood beta-endorphin levels were obtained at regular intervals before, during, and for 17 hours after TENS application. We found no significant difference in blood beta-endorphin levels between the groups before, during, or immediately after TENS application. ⋯ The results indicated that TENS, with the stimulation characteristics used in this study, did not significantly change the measured plasma levels of beta-endorphin. The blind administration of naloxone hydrochloride, an opiate antagonist, did not significantly alter the perceived experimental pain of these subjects. We could find no evidence that TENS altered experimental pain threshold or plasma beta-endorphin levels.