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JournalofOrthopaedic&SportsPhysical骨科和運(yùn)動(dòng)物理治療(丁昊徐醫(yī)IncreasingtheImpactofPeer-ReviewedPublicationsThroughTailoredStrategies:sforPracticeFeatureinPeer-reviewedresearchmanuscriptspublishedbyJOSPTandsimilarjournalsareacornerstoneofthehealthresearch“system.”Theyareacriticalmechanismthroughwhichresearcherssharetheirfindingswithinterestedreaders.Alimitationofpeer-reviewedpublications,however,istheirabilitytoconveyimportantfindingstononresearcherreadersinawaythatismeaningfulandpracticaltothem.Inrecognitionofthesepersisting“research-to-actiongaps,”thefieldofknowledgetranslationhasemerged.Tooptimizeknowledgetransfer,amoreactivedisseminationapproachthattailorsthemessageandformattoeachspecificaudienceisrequired.ItiswiththisfocusthatJOSPThaslaunchedanewfeaturetargetedatrehabilitationclinicians,titledsforPractice.Welookforwardtocontinuingtodevelopandevaluatethisfeaturein ingissues.ClinicalPredictionRulesThatDon'tHoldUp—WheretoGoFromClinicalpredictionrules(CPRs)arecreatedtohelpguideclinicaldecisionmaking.Todothis,theyusethepresenceorabsenceofcertainfactorsthathavebeenshowntomeaningfullypredictapatient'sprognosis,diagnosis,orresponsetotreatment.Whilerepresentingaseminalmethodologicalstepforwardinindividualizedcare,oneofthemaindrawbacksofCPRscontinuestobevalidationstudiesthatdonotsupporttheinitiallyderivedCPR.ThisisparticularlyimportantbecausevalidationofCPRsinanindependentpatientpopulationpriortoclinicalimplementationisessential.WhyisitquitecommonforexistingCPRstofalldownatthevalidationstage?Andwhatdoesthismeanforresearchthataimstoindividualizetreatment?=KinesioTaDoesNotProvideAdditionalBenefitsinPatientsWithChronicLowBackPainWhoReceiveExerciseandManualTherapy:ARandomizedControlledTrialBackground.Manyclinicalpracticeguidelinesendorsebothmanualtherapyandexerciseaseffectivetreatmentoptionsforpatientswithlowbackpain.Tooptimizetheeffectsofthe mendedbytheguidelines,anewinterventionknownasKinesioTaisbeingwidelyusedinthesepatients.Objectives.TodeterminetheeffectivenessofKinesioTainpatientswithchronicnonspecificlowbackpainwhenaddedtoaphysicaltherapyprogramconsistingofexerciseandmanualMethods.Onehundredforty-eightpatientswithchronicnonspecificlowbackpainwererandomlyallocatedtoreceive10(twiceweekly)sessionsofphysicaltherapy,consistingofexerciseandmanualtherapy,orthesametreatmentwiththeadditionofKinesioTaappliedtothelowerback.Theprimary eswerepainintensityanddisability(5weeksafterrandomization)andthesecondary eswerepainintensity,disability(3monthsand6monthsafterrandomization),globalperceivedeffect,andsatisfactionwithcare(5weeksaftertreatment).Datawerecollectedbyablindedassessor.Results.Nobetween-groupdifferenceswereobservedintheprimary esofpainintensity(meandifference,?0.01points;95%confidenceinterval[CI]:?0.88,0.85)ordisability(meandifference,1.14points;95%CI:?0.85,3.13)at5weeks'follow-up.Inaddition,nobetween-groupdifferenceswereobservedforanyoftheother esevaluated,exceptfordisability6monthsafterrandomization(meandifference,2.01points;95%CI:0.03,4.00)infavorofthecontrolConclusion.PatientswhoreceivedaphysicaltherapyprogramconsistingofexerciseandmanualtherapydidnotgetadditionalbenefitfromtheuseofKinesioTa.ARandomizedControlledTrialComparingtheMcKenzieMethodtoMotorControlExercisesinPeopleWithChronicLowBackPainandaDirectionalPreferenceBackground.Motorcontrolexercisesarebelievedtoimprovecoordinationofthetrunkmuscles.ItisunclearwhetherincreasesintrunkmusclethicknesscanbefacilitatedbyapproachessuchastheMcKenziemethod.Furthermore,itisunclearwhichapproachmayhavesuperiorclinicalObjectives.TheprimaryaimwastocomparetheeffectsoftheMcKenziemethodandmotorcontrolexercisesontrunkmusclerecruitmentinpeoplewithchroniclowbackpainclassifiedwithadirectionalpreference.Thesecondaryaimwastoconductabetween-groupcomparisonofesforpain,function,andglobalperceivedMethods.SeventypeoplewithchroniclowbackpainwhodemonstratedadirectionalpreferenceusingtheMcKenzieassessmentwererandomizedtoreceive12treatmentsover8weekswiththeMcKenziemethodorwithmotorcontrolapproaches.All eswerecollectedatbaselineandat8-weekfollow-upbyblindedassessors.Results.Nosignificantbetween-groupdifferencewasfoundfortrunkmusclethicknessofthetransversusabdominis(?5.8%;95%confidenceinterval[CI]:?15.2%,3.7%),obliquusinternus(?0.7%;95%CI:?6.6%,5.2%),andobliquusexternus(1.2%;95%CI:?4.3%,6.8%).recoverywasslightlysuperiorintheMcKenziegroup(?0.8;95%CI:?1.5,?0.1)ona?5to+5scale.Nosignificantbetween-groupdifferenceswerefoundforpainorfunction(P=.99andP=.26,Conclusion.Wefoundnosignificanteffectoftreatmentgroupfortrunkmusclethickness.ParticipantsreportedaslightlygreatersenseofperceivedrecoverywiththeMcKenziemethodthanwiththemotorcontrolapproach.TheEffectivenessofPhysicalAgentsforLower-LimbSoftTissueInjuries:ABackground.Softtissueinjuriestothelowerlimbbringasubstantialhealthandeconomicburdentosociety.Physicalagentsarecommonlyusedtotreattheseinjuries.However,theeffectivenessofmanysuchphysicalagentsisnotclearlyestablishedintheli Objective.Toevaluatetheeffectivenessandsafetyofphysicalagentsforsofttissueinjuriesofthelowerlimb.Methods.Wesearched5databasesfrom1990to2015forrandomizedcontrolledtrials(RCTs),cohortstudies,andcase-controlstudies.Pairedreviewersindependentlyscreenedtheretrieved tureandappraisedrelevantstudiesusingtheScottishIntercollegiateGuidelinesNetworkcriteria.Studieswithahighriskofbiaswereexcluded.Wesynthesizedlow-risk-of-biasstudiesaccordingtoprinciplesofbest-evidencesynthesis.Results.Wescreened10261articles.Of43RCTsidentified,20hadahighriskofbiasandwereexcludedfromthe ysis,and23RCTshadalowriskofbiasandwereincludedinthe Theavailablehigher-qualityevidencesuggeststhatpatientswithpersistentntarfasciitismaybenefitfromultrasoundorfootorthoses,whilethosewithpersistentmidportionAchillestendinopathymaybenefitfromshockwavetherapy.However,thecurrentevidencedoesnotsupporttheuseofshockwavetherapyforrecentntarfasciitis,low-Dyetaforpersistentntarfasciitis,low-levellasertherapyforrecentanklesprains,orsplintsforpersistentmidportionAchillestendinopathy.Finally,evidenceontheeffectivenessofthefollowinginterventionsisnotestablishedinthecurrentli ture:(1)shockwavetherapyforpersistentntarfasciitis,(2)cryotherapyorassistivedevicesforrecentanklesprains,(3)bracesforpersistentmidportionAchillestendinopathy,and(4)taorelectricmusclestimulationforpalofemoralpainsyndrome.Conclusion.AlmosthalftheidentifiedRCTsthatevaluatedtheeffectivenessofphysicalagentsforthemanagementoflower-limbsofttissueinjurieshadahighriskofbias.High-qualityRCTsarestillneededtoassesstheeffectivenessofphysicalagentsformanagingthebroadrangeoflower-limbsofttissueinjuries.Theeffectivenessofmostinterventionsremainsunclear.PhysicalAgentsforSoftTissueTheclinicalmanagementofsofttissueinjuriesofthelowerlimbcommonlyincludesphysicalagentssuchaselectrotherapyorultrasound.However,theevidenceabouttheeffectivenessofphysicalagentsvaries,andtheiruseremainscontroversial.Asystematicreviewofrandomizedclinicaltrials(RCTs),publishedintheJuly2016issueofJOSPT,examinedthebenefitsandsafetyrisksofvariousphysicalagentsforsofttissueinjuriesofthelowerlimb.Importantly,thereviewlookedcloselyatthequalityoftheRCTsandfocusedonstudieswithlowriskofbias.InthissforPractice,theauthorsexintheimpactoftheirfindingsforclinicianstreatingpatientswithsuchmusculoskeletalconditions.Reliabilityofa ysisfor ysisofrunninggaitisfrequentlyperformedinorthopaedicandsportsmedicinepracticestoassessbiomechanicalfactorsthatmaycontributetoinjury.However,thereliabilityofawhole-bodyassessmenthasnotbeendetermined.Objective.Todeterminetheintraraterandinterraterreliabilityofthequalitativeassessmentofspecificrunningkinematicsfroma2-dimensional. ysiswasperformedon srecordedfrom15individuals(8male,7female)runningataself-selectedpace(3.17±0.40m/s,8:28±1:04min/mi)usingahigh-speedcamera(120framespersecond).These swereindependentlyratedon2occasionsby3experiencedphysicalthesusingastandardizedqualitativeassessment.Fifteensagittalandfrontalnekinematicvariableswereratedona3-or5-pointcategoricalscaleatspecificeventsofthegaitcycle,includinginitialcontact(n=3)andmidstance(n=9),oracrossthefullgaitcycle(n=3).The framenumbercorrespondingtoeachgaiteventwasalsorecorded.Intraraterandinterraterreliabilityvalueswerecalculatedforgait-eventdetection(intraclasscorrelationcoefficient[ICC]andstandarderrorofmeasurement[SEM])andtheindividualkinematicvariables(weightedkappa[κw]).Results.Gait-eventdetectionwashighlyreproduciblewithinraters(ICC=0.94–1.00;SEM,0.3–1.0frames)andbetweenraters(ICC=0.77–1.00;SEM,0.4–1.9frames).Elevenofthe15kinematicvariablesdemonstratedsubstantial(κw=0.60–0.799)orexcellent(κw>0.80)intrarateragreement,withtheexceptionoffoot-to-center-of-massposition(κw=0.59),forefootposition(κw=0.58),ankledorsiflexionatmidstance(κw=0.49),andcenter-of-massverticalexcursion(κw=0.36).Interrateragreementforthekinematicmeasuresvariedmorewidely(κw=0.00–0.85),with5variablesshowingsubstantialorexcellentreliability.Conclusion.Thequalitativeassessmentofspecifickinematicmeasuresduringrunningcanbereliablyperformedwiththeuseofahigh-speedcamera.Detectionofspecificgaiteventswashighlyreproducible,aswerecommonkinematicvariablessuchasrearfootposition,foot-strikepattern,tibialinclinationangle,kneeflexionangle,andforwardtrunklean.Othervariablesshouldbeusedwithcaution.TheEffectofVelocityofJointMobilizationonCorticospinalExcitabilityinIndividualsWithaHistoryofAnkleSprainBackground.Jointmobilizationandmanipulationdecreasepainandimprovepatientfunction.Yet,theprocessesunderlyingthesechangesarenotwellunderstood.Measuresofcorticospinalexcitabilityprovideinsightintopotentialmechanismsmediatedbythecentralnervoussystem.Objectives.Toinvestigatethedifferentialeffectsofjointmobilizationandmanipulationatthetalocruraljointoncorticospinalexcitabilityinindividualswithresolvedsymptomsfollowinganklesprain.Methods.Twenty-sevenparticipantswithahistoryofanklesprainwererandomlyassignedtothecontrol,jointmobilization,orthrustmanipulationgroup.Themotor-evokedpotential(MEP)andcorticalsilentperiod(CSP)ofthetibialisanteriorand emiuswereobtainedwithtranscranialmagneticstimulationatrestandduringactivecontractionofthetibialisanterior.TheslopesofMEP/CSPinput/outputcurvesandthe alMEP/CSPvalueswerecalculatedtoindicatecorticospinalexcitability.Behavioralmeasures,includingankledorsiflexionanddynamicbalance,wereevaluated.Results.Arepeated-measures ysisofvarianceoftheMEPslopeshowedasignificantgroup-by-timein ctionforthetibialisanterioratrest(P=.002)andduringactivecontraction(P=.042).Afterintervention,thethrustmanipulationgrouphadanincreaseincorticospinalexcitability,whilethecorticospinalexcitabilitydecreasedinthemobilizationgroup.Thethrustmanipulationgroup,butnotothergroups,alsodemonstratedasignificantincreaseinthe MEPamplitudeofthetibialisanteriorafterintervention.Conclusion.Thefindingssuggestthatjointmanipulationandmobilizationhavedifferenteffectsoncorticospinalexcitability.Theincreasedcorticospinalexcitabilityfollowingthrustmanipulationmayprovideawindowforphysicalthestooptimizemusclerecruitmentandsubsequentlymovement.ThetrialwasregisteredatClinicalTrials. SpineKinematicsDuringProneExtensioninPeopleWithandWithoutLowBackPainandAmongClassification-SpecificLowBackPainSubgroupsBackground.Spineextensionisusedinphysicaltherapyduringexaminationandtreatmentforlowbackpain(LBP).However,kinematicsduringproneextensionhavenotbeenexaminedusing3-Dmotioncapture.Objectives.TheprimarypurposewastodeterminedifferencesinspinekinematicsduringproneextensionbetweensubjectswithandwithoutLBP.AnexploratoryysiswasconductedtoexaminekinematicdifferencesamongLBPsubgroups.Methods.Kinematicsofthethoracicandlumbarspinewereexaminedduringproneextension,usingopticalmotioncapture,in18subjectswithLBPand17subjectswithoutLBP(controlgroup).Excursionofeachspinalregionwascalculatedfortheentiremovementandduring25%incrementsofextensionmovementduration.SubjectswithLBPwereexaminedandassignedtosubgroupsusing3differentclassificationsystemsforLBP.Repeated-measures variancetestswereusedtoexamineeffectsofgroup(LBP,control),spineregion,andincrementofmovementduration,andtoexploreeffectsofLBPsubgroup.Results.Forspinekinematics,therewasasignificantgroup-by-regionin ctioneffect(P<.05).SubjectswithLBPdisyedlesslowerlumbarextension(13.3°±4.9°)thancontrolsubjects(21.4°±9.2°).Themajorityoflowerlumbarextensionoccurredduringthefirst50%ofthemotionforsubjectswithLBP.Subgroup-by-regionin ctioneffectsweresignificantfor2of3LBPclassificationsystems(P<.05).Conclusion.SubjectswithLBPdisyedlesslowerlumbarextensionthancontrolsubjectsduringproneextension.Thesedifferencesshouldbeconsideredwhenevaluatingandprescribingproneextension.Theinterpretationofsubgroupdifferenceswithproneextensionkinematicsislimitedinthecurrentstudybythesmallsamplesize,butmayneedtobeconsideredinfuturestudiesofspinekinematics.BehavioroftheLineaAlbaDuringaCurl-upTaskinDiastasisRectusAbdominis:AnObservationalStudyBackground.Rehabilitationofdiastasisrectusabdominis(DRA)generallyaimstoreducetheinter-rectusdistance(IRD).Wetestedthehypothesisthatactivationofthetransversusabdominis(TrA)beforeacurl-upwouldreduceIRDnarrowing,withlesslineaalba(LA)distortion/deformation,whichmayallowbettertransferbetweensidesoftheabdominalObjectives.ThisstudyinvestigatedbehavioroftheLAandIRDduringcurl-upsperformednaturallyandwithpreactivationoftheTrA.Methods.Curl-upswereperformedby26womenwithDRAand17healthycontrolparticipantsusinganaturalstrategy(automaticcurl-up)andwithTrApreactivation(TrAcurl-up).Ultrasoundimageswererecordedat2pointsabovetheumbilicus(UpointandUXpoint).UltrasoundmeasuresofIRDandanovelmeasureofLAdistortion(distortionindex:averagedeviationoftheLAfromtheshortestpathbetweentherecti)werecomparedbetween3tasks(rest,automaticcurl-up,TrAcurl-up),betweengroups,andbetweenmeasurementpoints(ysisofvariance).Results.Automaticcurl-upbywomenwithDRAnarrowedtheIRDfromrestingvalues(meanU-pointbetween-taskdifference,?1.19cm;95%confidenceinterval[CI]:?1.45,?0.93;P<.001meanUX-pointbetween-taskdifference,?0.51cm;95%CI:?0.69,?0.34;P<.001),butLAdistortionincreased(meanU-pointbetween-taskdifference,0.018;95%CI:0.0003,0.041;P=.046andmeanUX-pointbetween-taskdifference,0.025;95%CI:0.004,0.045;P=.02).AlthoughTrAcurl-upinducednonarrowingorlessIRDnarrowingthanautomaticcurl-up(meanU-pointdifferencebetweenTrAcurl-upversusrest,?0.56cm;95%?0.82,?0.31;P<.001andmeanUX-pointbetween-taskdifference,0.02cm;95%CI:?0.22,0.19;P=.86),LAdistortionwasless(meanU-pointbetween-taskdifference,?0.025;95%?0.037,?0.012;P<.001andmeanUX-pointbetween-taskdifference,?0.021;95%CI:?0.005;P=.01).Inter-rectusdistanceandthedistortionindexdidnotchangefromrestordifferbetweentasksforcontrols(P≥.55).Conclusion.NarrowingoftheIRDduringautomaticcurl-upinDRAdistortstheLA.Thedistortionindexrequiresfurthervalidation,butfindingsimplythatlessIRDnarrowingwithTrApreactivationmightimprovetransferbetweensidesoftheabdomen.TheclinicalimplicationisthatreducedIRDnarrowingbyTrAcontraction,whichhasbeendiscouraged,maypositivelyimpactabdominalmechanics.PrevalenceofSymptomsofDepression,Anxiety,andPosttraumaticStressDisorderinWorkersWithUpperExtremityComintsBackground.Symptomsofdepression,panicdisorder(PD),andposttraumaticstressdisorder(PTSD)havebeenassociatedwithmusculoskeletalcomintsandcouldrepresentbarrierstorecoveryininjuredworkers.Objectives.Todeterminetheprevalenceofsymptomsofdepression,PD,andPTSDutilizingthePatientHealthQuestionnaire(PHQ)inacohortofpatientspresentingtoanupperextremityinjured-workerclinic;secondarily,toidentifyanyrelationshipsbetweenpatientsscreeningpositiveandpatient-reported emeasures.Methods.In2010,418patientscompletedthePHQduringtheirinitialevaluation.PatientswithPHQscoresexceedingthresholdvaluesforsymptomsofdepression,PD,orPTSDwerecomparedbasedonpatient-reported escores,includingtheDisabilitiesoftheArm,ShoulderandHandquestionnaire(DASH)andMedical esStudy36-ItemShort-FormHealthSurvey(SF-36).Theprevalenceofsymptoms,andtheirrelationshipwithpresentingcomintsand es,werecalculated.Results.Thirty-onepercentofpatientsscoredabovethresholdsforsymptomsofatleast1mentalhealthdisorder.Ofthosewhoscreenedpositive,67%screenedpositivefordepression,44%forPTSD,and50%forPD,with43%ofpatientspositiveformultiplesymptoms.Patientsexperiencingneckpainhadsignificantlyhigherscreeningratesofdepressivesymptoms(62.5%versus20.1%,P=.004)andPD(37.5%versus12.9%,P=.044)comparedwithotherpresentingcomints.Similarly,patientswithchronicpainhadhigherratesofdepression(54.5%versus20.1%,P=.006),PD(63.6%versus12%,P<.001),andPTSD(36.4%versus14.8%,P=.05)comparedwithotherpresentingcomints.PatientsendorsingdepressivesymptomshadsignificantlylowerSF-36mentalcomponentsummaryscores(26.3±10.7versus37.6±9.9,P<.001)andhighershortened-versionDASH(72.3±16.7versus61.5±11.1,P=.003)andDASHworkscores(86.5±19.2versus82.1±20.1,P=.007)comparedtopatientsendorsingotheritemsonthePHQ.Conclusion.Inthisprospectivecohortstudyofinjuredworkers,weidentifiedarelativelyhighprevalenceofsymptomsofpsychologicaldisordersutilizingthePHQ,withonethirdofinjuredworkersscreeningpositiveforsymptomsofdepression,PD,orPTSD.Furtherlongitudinalfollow-upisnecessarytodeterminetheimpactontreatment TreatmentofProgressiveFirstMetatarsophalangealHalluxValgusDeformity:ABiomechanicallyBasedMuscle-StrengtheningApproachSynopsis.Halluxvalgusisaprogressivedeformityofthefirstmetatarsophalangealjointthatchangestheanatomyandbiomechanicsofthefoot.Todate,surgeryistheonlytreatmenttocorrectthisdeformity,thoughtherecurrencerateisashighas15%.Thisclinicalcommentaryprovidesinstructioninastrengtheningapproachfortreatmentofhalluxvalgusdeformity,byaddressingthemomentactionsof5musclesidentifiedashavingtheabilitytocounterthehalluxvalgusprocess.Unlikesurgery,musclestrengtheningdoesnotcorrectthedeformity,but,instead,reducesthepainandassociatedgaitimpairmentsthataffectthemobilityofpeoplewholivewiththedisorder.Thisreviewisorganizedin4parts.Part1definesthetermsoffootmotionandposture.Part2detailstheanatomyandbiomechanics,anddescribeshowthefootischangedwithdeformity.Part3detailsthemusclestargetedforstrengthening;theintrinsicsbeingtheabductorhallucis,adductorhallucis,andtheflexorhallucisbrevis;theextrinsicsbeingthetibialisposteriorandfibularislongus.Part4instructstheexerciseandreviewstherelatedli ture.Instructionsaregivenfortheshort-foot,thetoe-spread-out,andtheheel-raiseexercises.Theroutinemaybeperformedbyalmostanyoneathomeandmaybeadoptedintophysicalthepractice,withintenttostrengthenthefootmusclesasanadjuncttoalmostanyprotocolofcare,butespeciallyforthetreatmentofhalluxvalgusdeformity.Bunion:StrengtheningFootMusclestoReducePainandImproveFootpaindiscouragesphysicalactivity,andlessactivityharmsoverallhealth.Bunion,extraboneandtissueatthebaseofthebigtoe,isafrequentcauseoffootpain.Morethan64millionAmericanshavebunionsthatcanleadtopainfulwalking.Bunionsaffectsome35%ofwomenovertheageof65.Bunionscanberemovedbysurgery,whichcanreducepainandimproveyourabilitytowalkandexercise,butupto15%ofbunionsreturn.Weakmusclesmayyaroleinbunion-relatedpainandmovementproblems.InareviewofpriorresearchandcommentaryonthistopicpublishedintheJuly2016issueofJOSPT,theauthoridentifiesmuscle-strengtheningexercisesthatmayhelppeoplewithbunions.A31-year-oldfemalestudentwasreferredtophysicaltherapywithachiefcomintofproximal,posteriorleftthighpainthatbeganinsidiously12monthsprior,andprogressivelyworsenedwhiletrainingforahalf-marathon.A,softmasswasidentifiedjustinferiortotheischialtuberositythatwastenderandpainfultopalpation,recreatingthepatient'schiefcomint.Radiographicfindingswerenegativeforaedavulsionfractureattheischialtuberosity.Therefore,thephysicianperformedmusculoskeletalultrasonography,whichrevealedasuperficialhypoechoicmasswithvascularflow.Magneticresonanceimagingandasubsequentbiopsyledtothediagnosisofabenignvascularmalformation.FibularFractureinaFemaleRugbyA20-year-oldfemalerugbyyerwasinjuredwhenanopponentlandedonherlegduringamatch.Twelvedaysafterinjury,theteam'scertifiedathletictrainerreferredthepatienttoaphysicaltheduetopain.Followingfluoroscopicimaging,whichwasutilizedbythephysicalthebecausestandardradiographswereunavailableincloseproximity,shewasreferredforradiographs,whichdemonstratedamidfibulardiaphysealfracture.Physical物理治療(濱醫(yī)袁汝斌TheSingle-CaseReportingGuidelineInBEhaviouralInterventions(SCRIBE)2016行為的2016年單一個(gè)案指導(dǎo)方針(抄寫Wedevelopedareportingguidelinetoprovideauthorswithguidanceaboutwhatshouldbereportedwhenwritingapaperforpublicationinascientificjournalusingaparticulartypeofresearchdesign:thesingle-caseexperimentaldesign.ThisreportdescribesthemethodsusedtodeveloptheSingle-CaseReportingguidelineInBEhaviouralinterventions(SCRIBE)2016.Asaresultof2onlinesurveysanda2-daymeetingofexperts,theSCRIBE2016checklistwasdeveloped,whichisasetof26itemsthatauthorsneedtoaddresswhenwritingaboutsingle-caseresearch.ThisarticlecomplementsthemoredetailedSCRIBE2016ExnationandElaborationarticle(Tateetal.,2016)thatprovidesarationaleforeachoftheitemsandexamplesofadequatereportingfromtheliture.Boththeseresourceswillassistauthorstopreparereportsofsingle-caseresearchwithclarity,completeness,accuracy,andtransparency.Theywillalsoprovidejournalreviewersandeditorswithapracticalchecklistagainstwhichsuchreportsmaybecriticallyevaluated.We mendthattheSCRIBE2016isusedbyauthorspreparingmanuscriptsdescribingsingle-caseresearchforpublication,aswellasjournalreviewersandeditorswhoareevaluatingsuchmanuscripts.Reportingguidelines,suchastheConsolidatedStandardsofReportingTrials(CONSORT)Statement,improvethereportingofresearchinthemedicalliture(Turneretal.,2012).ManysuchguidelinesexistandtheCONSORTExtensiontoNonpharmacologicalTrials(Boutronetal.,2008)providessuitableguidanceforreportingbetween-groupsinterventionstudiesinthebehavioralsciences.TheCONSORTExtensionforN-of-1Trials(CENT2015)wasdevelopedformultiplecrossovertrialswithsingleindividualsinthemedicalsciences(Shamseeretal.,2015;Vohraetal.,2015),butthereisnoreportingguidelineintheCONSORTtraditionforsingle-caseresearchusedinthebehavioralsciences.WedevelopedtheSingle-CaseReportingguidelineInBEhaviouralinterventions(SCRIBE)2016tomeetthisneed.ThisStatementarticledescribesthemethodologyofthedevelopmentoftheSCRIBE2016,alongwiththe eof2Delphisurveysandaconsensusmeetingofexperts.Wepresenttheresulting26-itemSCRIBE2016checklist.ThearticlecomplementsthemoredetailedSCRIBE2016ExnationandElaborationarticle(Tateetal.,2016)thatprovidesarationaleforeachoftheitemsandexamplesofadequatereportingfromtheliture.Boththeseresourceswillassistauthorstopreparereportsofsingle-caseresearchwithclarity,completeness,accuracy,andtransparency.Theywillalsoprovidejournalreviewersandeditorswithapracticalchecklistagainstwhichsuchreportsmaybecriticallyevaluated.NationalProfileofPhysicalThesinCriticalCareUnitsofSriLanka:LowerMiddle-eCountryBackground.Theavailabilityandroleofphysicalthesincriticalcareisvariableinresource-poorsettings,includinglower ecountries.Objective.Theaimofthisstudywastodetermine:(1)theavailabilityofcriticalcarephysicaltheservices,(2)theequipmentandtechniquesusedandneeded,and(3)thetrainingandcontinuousprofessionaldevelopmentofphysicalthes.Methods.Allphysicalthesworkingincriticalcareunits(CCUs)ofstatehospitalsinSriLankawerecontacted.Thestudytoolusedwasaninterviewer-administeredephonequestionnaire.Results.Theresponseratewas100%(N=213).Sixty-onepercentofthephysicalthesweremen.Ninety-fourpercentoftherespondentswereatleastdiplomaholdersinphysicaltherapy,and6%hadnon–physicaltherapydegrees.Most(n=145,68%)hadengagedinsomecontinuousprofessionaldevelopmentinthepastyear.Themajority(n=119,56%)attendedtopatientsafterreferralfrommedicalstaff.Seventy-sevenpercent,98%,and96%workedatnights,onweekends,andonpublicholidays,respectively.Physicalthescommonlyperformmanualhyperinflation,breathingexercises,manualairwayclearancetechniques,limbexercises,mobilization,positioning,andposturaldrainageintheCCUs.Lackofspecialisttraining,lackofadequatephysicaltherapystaffnumbers,aheavyworkload,andperceivedlackofinfectioncontrolinCCUswerethemaindifficultiestheyidentified.Limitations.DetailsontheproportionsoftimespentbythephysicalthesintheCCUs,wards,ormedicaldepartmentswerenotcollected.Conclusions.TheavailabilityofphysicaltheservicesinCCUsinSriLanka,alower ecountry,wascomparabletothat ecountries,asperavailableliture,termsofserviceavailabilityandstaffing,althoughthedensityofphysicalthesremainedverylow,criticalcaretrainingwaslimited,andresourcelimitationstophysicaltherapypracticeswereRaisingthePriorityofLifestyle-Related municableDiseasesinPhysicalTherapyGiventheiren
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