Physiotherapy
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To investigate the relationship between dry needling-induced twitch response and change in pain, disability, nociceptive sensitivity, and lumbar multifidus muscle function, in patients with low back pain (LBP). ⋯ The twitch response during dry needling might be clinically relevant, but should not be considered necessary for successful treatment.
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Age-related changes in the trunk (abdominal and lumbar multifidus) muscles and their impact on physical function of older adults are not clearly understood. ⋯ Overall, the evidence base in older people has significant limitations, so the role of physiotherapy interventions aimed at these muscles remains unclear. The results point to areas in which further research could lead to clinically useful outcomes. These include determining the role of the trunk muscles in the physical function of older adults and disease; developing and testing rehabilitation programmes for older people with spinal conditions and lower back pain; and identifying modifiable factors that could mitigate age-related changes.
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Observational Study
Patient reported outcome measures (PROMs) for goalsetting and outcome measurement in primary care physiotherapy, an explorative field study.
Routine use of patient reported outcome measures (PROMs) may provide an effective way of monitoring patient valued outcomes. In this study we explored (1) the current use of PROMs; (2) to what extent the goals correspond with the selected PROMs; (3) the health outcomes based on PROMs. ⋯ PROMs were used in the majority of the patients, showed improved health outcomes and fitted moderately with goals. The results of this study can be used for future research assessing the routine use of outcome measurements with PROMs.
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Foot pain is common and disabling and thought to be associated with muscle weakness. Understanding the relationship between pain and weakness may help identify effective treatment targets. ⋯ There is evidence of a significant association between foot pain and muscle weakness when foot pain is of high intensity and primarily measured by toe flexion force. However there is inconsistent evidence that lower intensity foot pain is associated with other measures of foot muscle weakness or size. Systematic Research Registry ID reviewregistry166.
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The culture of current clinical practice calls for collaboration between therapists and patients, sharing power and responsibility. This paper reports on the findings of a qualitative study of exercise prescription for patients with NSCLBP, taking into account issues such as decision making and how this accords with patient preferences and experiences. ⋯ Shared decision making did not appear to happen in physiotherapy clinical practice, but equally may not be what every patient wants. The overall feeling of the patients was that the therapist was dominant in structuring the interactions, leaving the patients feeling disempowered to question and contribute to the decision making.