| 1. |
- Conradsson, Mia, et al.
(författare)
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Berg Balance Scale : intrarater test-retest reliability among older people dependent in activities of daily living and living in residential care facilities
- 2007
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 87:9, s. 1155-1163
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Tidskriftsartikel (refereegranskat)abstract
- The Berg Balance Scale (BBS) is frequently used to assess balance in older people, but knowledge is lacking about the absolute reliability of BBS scores. The aim of this study was to investigate the absolute and relative intrarater test-retest reliability of data obtained with the BBS when it is used among older people who are dependent in activities of daily living and living in residential care facilities. The participants were 45 older people (36 women and 9 men) who were living in 3 residential care facilities. Their mean age was 82.3 years (SD=6.6, range=68-96), and their mean score on the Mini Mental State Examination was 17.5 (SD=6.3, range=4-30). The BBS was assessed twice by the same assessor. The intrarater test-retest reliability assessments were made at approximately the same time of day and with 1 to 3 days in between assessments. Absolute reliability was calculated using an analysis of variance with a 95% confidence level, as suggested by Bland and Altman. Relative reliability was calculated using the intraclass correlation coefficient (ICC). The mean score was 30.1 points (SD=15.9, range=3-53) for the first BBS test and 30.6 points (SD=15.6, range=4-54) for the retest. The mean absolute difference between the 2 tests was 2.8 points (SD=2.7, range=0-11). The absolute reliability was calculated as being 7.7 points, and the ICC was calculated to .97. Despite a high ICC value, the absolute reliability showed that a change of 8 BBS points is required to reveal a genuine change in function among older people who are dependent in activities of daily living and living in residential care facilities. This knowledge is important in the clinical setting when evaluating an individual's change in balance function over time in this group of older people.
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| 2. |
- Hammer, Ann M., et al.
(författare)
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Effects of forced use on arm function in the subacute phase after stroke : a randomized, clinical pilot study
- 2009
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Ingår i: Physical Therapy. - Alexandria, VA. : American Physical Therapy Association. - 0031-9023 .- 1538-6724. ; 89:6, s. 526-539
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVE: Following stroke, it is common to exhibit motor impairments and decreased use of the upper limb. The objective of the present study was to evaluate forced use on arm function during the subacute phase after stroke.DESIGN: A comparison of standard rehabilitation only and standard rehabilitation together with a restraining sling was made through a randomized, nonblinded, clinical pilot trial with assessments before intervention, after intervention, and at 1- and 3-month follow-ups.SETTING: The present study took place at the departments of rehabilitation medicine, geriatrics, and neurology at a university hospital.PARTICIPANTS: A convenience sample of 30 people 1 to 6 months (mean, 2.4 mo) after stroke was randomized into 2 groups (forced-use group and standard training group) of 15 people each. Twenty-six participants completed the 3-month follow-up.INTERVENTION: All participants received their standard rehabilitation program with training 5 days per week for 2 weeks as inpatients or outpatients. The forced-use group also wore a restraining sling on the nonparetic arm with a target of 6 hours per day.MEASUREMENTS: The Fugl-Meyer (FM) test, the Action Research Arm Test, the Motor Assessment Scale (MAS) (sum of scores for the upper limb), a 16-hole peg test (16HPT), a grip strength ratio (paretic hand to nonparetic hand), and the Modified Ashworth Scale were used to obtain measurements. RESULTS: The changes in the forced-use group did not differ from the changes in the standard training group for any of the outcome measures. Both groups improved over time, with statistically significant changes in the FM test (mean score changed from 52 to 57), MAS (mean score changed from 10.1 to 12.4), 16HPT (mean time changed from >92 seconds to 60 seconds), and grip strength ratio (mean changed from 0.40 to 0.55).LIMITATIONS: The limitations of this pilot study include an extended study time, a nonblinded assessor, a lack of control of treatment content, and a small sample size.CONCLUSIONS: The results of the present pilot study did not support forced use as a reinforcement of standard rehabilitation in the subacute phase after stroke. Forced use did not generate greater improvements with regard to motor impairment and capacity than standard rehabilitation alone. The findings of this effectiveness study will be used to help design future clinical trials with the aim of revealing a definitive conclusion regarding the clinical implementation of forced use for upper-limb rehabilitation.
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| 3. |
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| 4. |
- Johansson, Kajsa, et al.
(författare)
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Effects of acupuncture versus ultrasound for patients with impingement syndrome : Randomized clinical trial
- 2005
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Ingår i: Physical Therapy. - 0031-9023 .- 1538-6724. ; 85:6, s. 490-501
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose. There is no definitive evidence for the efficacy of the physical therapy interventions used for patients with impingement syndrome. The purpose of this study was to compare manual acupuncture and continuous ultrasound, both applied in addition to home exercises, for patients diagnosed with impingement syndrome. Subjects and Methods. Eighty-five patients with clinical signs of impingement syndrome were randomly assigned to either a group that received acupuncture (n=44) or a group that received ultrasound (n=41). Both interventions were given by physical therapists twice a week for 5 weeks in addition to a home exercise program. Scores from 3 shoulder disability measures, combined in the analysis, measured change during a period of 12 months. Results. Both groups improved, but the acupuncture group had a larger improvement in the combined score. Discussion and Conclusion. The results suggest that acupuncture is more efficacious than ultrasound when applied in addition to home exercises.
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| 6. |
- Littbrand, Håkan, 1966-, et al.
(författare)
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A high-intensity functional weight-bearing exercise program for older people dependent in activities of daily living and living in residential care facilities : evaluation of the applicability with focus on cognitive function
- 2006
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 86:4, s. 489-498
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Knowledge concerning the applicability and the effect of high-intensity exercise programs is very limited for older people with severe cognitive and physical impairments. The primary aim of this study was to evaluate the applicability of a high-intensity functional weight-bearing exercise program among older people who are dependent in activities of daily living and living in residential care facilities. A second aim was to analyze whether cognitive function was associated with the applicability of the program. SUBJECTS: The subjects were 91 older people (mean age=85.3 years, SD=6.1, range=68-100) who were dependent in personal activities of daily living and randomly assigned to participate in an exercise intervention. Their mean score for the Mini-Mental State Examination (MMSE) was 17.5 (SD=5.0, range=10-29). METHODS: A high-intensity functional weight-bearing exercise program was performed in groups of 3 to 7 participants who were supervised by physical therapists. There were 29 exercise sessions over 13 weeks. Attendance, intensity of lower-limb strength and balance exercises, and occurrence and seriousness of adverse events were the outcome variables in evaluating the applicability of the program. RESULTS: The median attendance rate was 76%. Lower-limb strength exercises with high intensity were performed in a median of 53% of the attended exercise sessions, and balance exercises with high intensity were performed in a median of 73% of the attended exercise sessions. The median rate of sessions with adverse events was 5%. All except 2 adverse events were assessed as minor and temporary, and none led to manifest injury or disease. No significant differences were observed in applicability when comparing participants with dementia and participants without dementia. In addition, there was no significant correlation between applicability and the MMSE score. DISCUSSION AND CONCLUSION: The results suggest that a high-intensity functional weight-bearing exercise program is applicable for use, regardless of cognitive function, among older people who are dependent in activities of daily living, living in residential care facilities, and have an MMSE score of 10 or higher.
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| 7. |
- Lundkvist Josenby, Annika, et al.
(författare)
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Longitudinal Construct Validity of the GMFM-88 Total Score and Goal Total Score and the GMFM-66 Score in a 5-Year Follow-up Study
- 2009
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 89:4, s. 342-350
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Tidskriftsartikel (refereegranskat)abstract
- Background. The Gross Motor Function Measure (GMFM) is the instrument most commonly used to measure gross motor function in children with cerebral palsy (CP). Different scoring options have been developed, and their measurement properties have been assessed. Limited information is available regarding longitudinal construct validity. Objective. The objective of this research was to study the longitudinal construct validity of 3 scoring options: the 88-item GMFM (GMFM-88) total, the GMFM-88 goal total, and the 66-item GMFM (GMFM-66). Design. A clinical measurement design was used in this study. Methods. Forty-one children with CP diplegia who were undergoing selective dorsal rhizotomy (SDR) were monitored with the GMFM for 5 years. The mean age at SDR was 4.4 years (range=2.5-6.6). Two subgroups for gross motor function before surgery were created according to the Gross Motor Function Classification System (GMFCS): GMFCS levels I to III and GMFCS levels IV and V. This study included results obtained before SDR and at 6, 12, and 18 months and 3 and 5 years after SDR. The effect size (ES) and the standardized response mean (SRM) were calculated. Results. At 6 months postoperatively, ES and SRM values were small (>= 0.5) for all GMFM scoring options. The GMFM-88 total and goal total scores showed large changes in ES values (range=0.8-0.9) and SRM values (range=0.9-1.3) at 12 months postoperatively, whereas the GMFM-66 scores showed lower ES values (range=0.3-0.4) and SRM values (range=0.7-0.8) for both subgroups. Later postoperatively, larger values for longitudinal construct validity were found. The ES and SRM values generally were lower for the GMFM-66 scores than for the GMFM-88 total and goal total scores. Limitations. All children underwent an extensive intervention, and changes in gross motor function were expected. Conclusion. All 3 scoring options showed large longitudinal construct validity in the long-term follow-up. The GMFM-88 total and goal total scores revealed large changes in gross motor function earlier postoperatively than the GMFM-66 scores.
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| 9. |
- Sandberg, Margareta, 1947-, et al.
(författare)
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Blood flow changes in the trapezius muscle and overlying skin following transcutaneous electrical nerve stimulation
- 2007
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 87:8, s. 1047-1055
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose: Various researchers have studied the effects of transcutaneous electrical nerve stimulation (TENS) on hemodynamics. The purpose of this study was to examine the effects of TENS on local blood flow in the trapezius muscle and overlying skin. Subjects: Thirty-three women who were healthy, aged 25 to 55 years, were randomly assigned to receive 1 of 3 different modes of TENS. Methods: Skin and muscle blood flow were monitored noninvasively using a new application of photoplethysmography for 15 minutes of TENS applied at high frequency (80 Hz) and sensory-level intensity and at low frequency (2 Hz) and motor-level intensity and for 15 minutes after stimulation. Subliminal 80-Hz TENS was used as a control. Blood flow was monitored simultaneously on stimulated and nonstimulated shoulders. Results: Blood flow in the trapezius muscle, but not skin blood flow, increased significantly with motor-level 2-Hz TENS, whereas no increase occurred with sensory-level 80-Hz TENS or subliminal 80-Hz TENS. Discussion and Conclusion: Muscle contractions induced by motor-level 2-Hz TENS appear to be a prerequisite for increasing blood flow in the trapezius muscle. However, high stimulation intensity may prevent increased blood flow in the overlying skin.
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