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- Abbott, Allan
(författare)
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The Coping Strategy Questionnaire
- 2010
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Ingår i: Journal of Physiotherapy. - : Elsevier. - 1836-9553 .- 1836-9561. ; 56:1, s. 63-63
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Mojtaba, Mahnaz, et al.
(författare)
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Downton Fall Risk Index during hospitalisation is associated with fall-related injuries after discharge : a longitudinal observational study
- 2018
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Ingår i: Journal of Physiotherapy. - : AUSTRALIAN PHYSIOTHERAPY ASSOC. - 1836-9553 .- 1836-9561. ; 64:3, s. 172-177
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Tidskriftsartikel (refereegranskat)abstract
- Questions: Among older people who are hospitalised, what is the predictive validity of the Downton Fall Risk Index (DFRI) in relation to fall-related injury after discharge? What is the predictive validity of the DFRI among males and females in this setting? Design: Prospective, longitudinal, observational study. Participants: All hospital admissions during 2012 at three geriatric clinics in the Stockholm County Council were monitored. Patients aged > 65 years who did not die during the admission and who lived in the Stockholm County Council region were included. Outcome measures: The DFRI consists of five modules: previous falls, medication, sensory deficits, mental state, and gait. Three or more points indicate an increased fall risk. Data on DFRI, health status and medications were collected prior to discharge. Data regarding fall-related injuries were collected up to 6 months after discharge. Poisson multivariate regression analyses were conducted to evaluate the association between DFRI and fall-related injuries. Results: In total, 6650 patients were analysed. The cut-off >= 3 points in the DFRI was significantly associated with fall-related injury when confounding variables were controlled for (IRR 1.94, 95% CI 1.60 to 2.38). Among individual modules, only previous falls (IRR 2.58, 95% CI 2.22 to 3.01) and unsafe gait (IRR 1.79, 95% CI 1.53 to 2.09) were associated with fall-related injuries. Stratified analyses showed a higher risk ratio for men compared to women regarding the DFRI, but the test for an interaction effect was not significant. Conclusion: The risk of post-discharge fall-related injury is increased among older hospitalised people with an increased fall risk, according to the DFRI, especially those who had previous falls or unsafe gait. Although the DFRI tool is predictive, previous falls and gait are the measures that are most worthy of focus.
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- Nilsen, Per, et al.
(författare)
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Towards evidence-based physiotherapy - research challenges and needs
- 2013
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Ingår i: Journal of Physiotherapy. - : Elsevier. - 1836-9553 .- 1836-9561. ; 59:3, s. 143-144
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The evidence-based practice (EBP) movement has gained ground steadily in physiotherapy over the past decade. Influential researchers and clinicians have argued that physiotherapists have a moral and professional obligation to move away from assessment and treatment methods based on anecdotal testimonies or opinion (Grimmer-Somers 2007). However, the growing volume of high-quality clinical research makes it difficult for clinicians to keep pace with the latest evidence. Simultaneously, the practice of physiotherapy has become increasingly complex due to changes in health care systems that entail higher demands on physiotherapists to provide effective and efficient management of patients amidst high patient turnover.
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- Nooijen, Carla F., et al.
(författare)
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A behavioural intervention increases physical activity in people with subacute spinal cord injury : a randomised trial
- 2016
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Ingår i: Journal of Physiotherapy. - : Elsevier BV. - 1836-9553 .- 1836-9561. ; 62:1, s. 35-41
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Tidskriftsartikel (refereegranskat)abstract
- QUESTIONS: For people with subacute spinal cord injury, does rehabilitation that is reinforced with the addition of a behavioural intervention to promote physical activity lead to a more active lifestyle than rehabilitation alone? DESIGN: Randomised, controlled trial with concealed allocation, intention-to-treat analysis, and blinded assessors. PARTICIPANTS: Forty-five adults with subacute spinal cord injury who were undergoing inpatient rehabilitation and were dependent on a manual wheelchair. The spinal cord injuries were characterised as: tetraplegia 33%; motor complete 62%; mean time since injury 150 days (SD 74). INTERVENTION: All participants received regular rehabilitation, including handcycle training. Only the experimental group received a behavioural intervention promoting an active lifestyle after discharge. This intervention involved 13 individual sessions delivered by a coach who was trained in motivational interviewing; it began 2 months before and ended 6 months after discharge from inpatient rehabilitation. OUTCOME MEASURES: The primary outcome was physical activity, which was objectively measured with an accelerometer-based activity monitor 2 months before discharge, at discharge, and 6 and 12 months after discharge from inpatient rehabilitation. The accelerometry data were analysed as total wheeled physical activity, sedentary time and motility. Self-reported physical activity was a secondary outcome. RESULTS: The behavioural intervention significantly increased wheeled physical activity (overall between-group difference from generalised estimating equation 21minutes per day, 95% CI 8 to 35). This difference was evident 6 months after discharge (28minutes per day, 95% CI 8 to 48) and maintained at 12 months after discharge (25minutes per day, 95% CI 1 to 50). No significant intervention effect was found for sedentary time or motility. Self-reported physical activity also significantly improved. CONCLUSION: The behavioural intervention was effective in eliciting a behavioural change toward a more active lifestyle among people with subacute spinal cord injury. TRIAL REGISTRATION: NTR2424.
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- Wadell, Karin
(författare)
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Water-based exercise is more effective than land-based exercise for people with COPD and physical comorbidities
- 2014
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Ingår i: Journal of Physiotherapy. - : Elsevier BV. - 1836-9553 .- 1836-9561. ; 60:1, s. 57-57
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Tidskriftsartikel (refereegranskat)abstract
- Question: In patients with chronic obstructive pulmonary disease (COPD) who have physical comorbidities, is water-based exercise more effective than land-based exercise for improving exercise capacity and health-related quality of life (HRQoL)? Design: Randomised controlled trial with concealed allocation and blinding of outcome assessors. Setting: The outpatient department or hydrotherapy pool of a hospital in Sydney, Australia. Participants: Adults with stable COPD were included if they had at least one physical comorbid condition that was likely to compromise their capacity to participate in land-based exercise (eg, musculoskeletal conditions, peripheral vascular disease, neurological conditions or body mass index ≥32 kg/m2). Exclusion criteria were unstable cardiac disease or a contraindication to water-based exercise, such as open wounds or incontinence. Randomisation allocated 18 participants to the water-based exercise (WBE) group, 20 to the land-based exercise (LBE) group and 15 to the control group. Interventions: Both WBE and LBE required participants to attend three 60-minute sessions each week, for 8 weeks. The WBE group and LBE group were matched as closely as possible in terms of intensity and the muscle groups exercised. Intensity was titrated to achieve moderate dyspnoea. Those in the control group continued with usual medical care. Outcome measures: The primary outcome was exercise capacity measured using the endurance shuttle walk test (ESWT) at 8 weeks. Results: A total of 45 participants completed the study. On completion of the training period, compared with the control group, greater gains were seen in the distance walked during the ESWT in the WBE group (309 m, 95% CI, 96 to 522 m) but not in the LBE group (81 m, 95% CI, −136 m to 297 m). The gains seen in the WBE group were also greater than those seen on the LBE group (228 m, 95% CI, 19 to 438 m). Similar results were demonstrated for the distance achieved during the incremental shuttle walk test and the fatigue domain of the Chronic Respiratory Disease Questionnaire (ie, a domain of HRQoL). Conclusion: In people with COPD and physical comorbidities, WBE appears to confer greater gains in exercise capacity and fatigue, when compared with LBE
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- Boden, Ianthe, et al.
(författare)
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Preoperative physiotherapy prevents postoperative pulmonary complications after major abdominal surgery: a meta-analysis of individual patient data.
- 2024
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Ingår i: Journal of physiotherapy. - 1836-9561.
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Tidskriftsartikel (refereegranskat)abstract
- Among patients having elective abdominal surgery, how much does preoperative physiotherapy education with breathing exercise training reduce the incidence of postoperative pulmonary complications (PPCs), hospital length of stay and 12-month mortality? How stable are the treatment effects across different PPC definitions, including pneumonia? How much do the treatment effects on PPC, hospital length of stay and mortality vary within clinically relevant subgroups?Individual participant-level meta-analysis (n= 800) from two randomised controlled trials analysed with multivariable regression.Adults undergoing major elective abdominal surgery.Experimental participants received a single preoperative session with a physiotherapist within 4 weeks of surgery and educated on PPC prevention with breathing exercises and early mobilisation. They were taught breathing exercises and instructed to start them immediately on waking from surgery. The control group received no preoperative or postoperative physiotherapy, or early ambulation alone.PPC, hospital length of stay and 12-month mortality.Participants who received preoperative physiotherapy had 47% lower odds of developing a PPC (adjusted OR 0.53, 95% CI 0.34 to 0.85). This effect was stable regardless of PPC definition. Effects were greatest in participants who smoked, were aged ≤ 45years, had abnormal body weight, had multiple comorbidities, or were undergoing bariatric or upper gastrointestinal surgery. Participants having operations ≤ 3 hours in duration were least responsive to preoperative physiotherapy. Participants with multiple comorbidities were more likely to have a shorter hospital stay if provided with preoperative physiotherapy (adjusted MD -3.2 days, 95% CI -6.2 to -0.3). Effects on mortality were uncertain.There is strong evidence to support preoperative physiotherapyin preventing PPCs after elective abdominal surgery.
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