Purpose: To evaluate the intra-and inter-session test-retest agreement of a novel neck-strength assessment protocol using a hand-held dynamometer. Background: A literature review found a lack of neck-strength assessment protocols that are both portable and reliable. Hand-held dynamometry is a portable and inexpensive method of assessing muscle strength, but it is not commonly used for neck-strength assessment. Methods: A hand-held dynamometer was used to evaluate neck strength in 30 healthy participants. The device measured maximum force in cervical flexion, extension, side flexion, side flexion with rotation, and pure rotation, using the ipsilateral hand to apply isometric resistance over 3 seconds. Three measurements were taken over 6-8 days. Results: Test-retest intra-class correlation coefficients (ICCs) showed high reliability, ranging from 0.94 to 0.97 for all tested directions from Trial 1 to Trial 2 (intra-session reliability, ICC [2,1], absolute). ICC values demonstrated good to high inter-session reliability, ranging from 0.87 to 0.95 for all tested directions from Trial 1 to Trial 3 (ICC [2,1], absolute). Conclusion: The results suggest that the five test positions of the neck and upper-quadrant strength assessment protocol can be performed using hand-held dynamometry with good to high reliability.Key Words: muscle strength dynamometer; neck muscles; reproducibility of results. RÉ SUMÉObjectif : É valuer la convergence test-retest intra et intersessionnelle d'un nouveau protocole d'é valuation de la force du cou au moyen d'un dynamomè tre portatif. Contexte: Une recension des é crits a ré vé lé un manque de protocoles d'é valuation de la force du cou à la fois portables et fiables. La dynamomé trie manuelle est une mé thode portable et peu coû teuse d'é valuation de la force musculaire, mais elle n'est pas utilisé e couramment pour é valuer la force du cou. Mé thodes : On a utilisé un dynamomè tre portatif pour é valuer la force du cou chez 30 participants en bonne santé . On a mesuré la force maximale en flexion cervicale, extension, flexion laté rale, flexion laté rale avec rotation et rotation pure en utilisant la main ipsilaté rale pour appliquer une ré sistance isomé trique pendant 3 secondes. On a pris trois mesures en 6 à 8 jours. Assessing muscle strength is a fundamental part of patient care for physiotherapists. The value of a reliable tool to assess muscle strength has been emphasized, both to determine functional impairment and to develop appropriate therapeutic interventions. A review of the literature has shown a lack of neck-strength assessment protocols that evaluate side flexion and rotation along with flexion and extension and that are both portable and reliable. 1 Currently, fixed-frame dynamometry is the most widely recognized method of reliably assessing isometric neck strength. This method uses a large wallor frame-mounted machine with a fixed base, which are expensive and generally impractical for most clinical settings. 2 In contrast, hand-held dynamometers are portable...
The current study indicates that physicians and allied health professionals have similar EBP attitudes and knowledge. All professional groups seem to have suboptimal implementation of EBP. The nature of medical decision-making, its evidentiary pool, or longer experience with EBP may contribute to greater implementation amongst physicians.
Introduction: Neck pain is common, can be disabling and is costly to society. Physical modalities are often included in neck rehabilitation programs. Interventions may include thermal, electrotherapy, ultrasound, mechanical traction, laser and acupuncture. Definitive knowledge regarding optimal modalities and dosage for neck pain management is limited.Purpose: To systematically review existing literature to establish the evidence-base for recommendations on physical modalities for acute to chronic neck pain.Methods:A comprehensive computerized and manual search strategy from January 2000 to July 2012, systematic review methodological quality assessment using AMSTAR, qualitative assessment using a GRADE approach and recommendation presentation was included. Systematic or meta-analyses of studies evaluating physical modalities were eligible. Independent assessment by at least two review team members was conducted. Data extraction was performed by one reviewer and checked by a second. Disagreements were resolved by consensus.Results:Of 103 reviews eligible, 20 were included and 83 were excluded. Short term pain relief - Moderate evidence of benefit: acupuncture, intermittent traction and laser were shown to be better than placebo for chronic neck pain. Moderate evidence of no benefit: pulsed ultrasound, infrared light or continuous traction was no better than placebo for acute whiplash associated disorder, chronic myofascial neck pain or subacute to chronic neck pain. There was no added benefit when hot packs were combined with mobilization, manipulation or electrical muscle stimulation for chronic neck pain, function or patient satisfaction at six month follow-up.Conclusions:The current state of the evidence favours acupuncture, laser and intermittent traction for chronic neck pain. Some electrotherapies show little benefit for chronic neck pain. Consistent dosage, improved design and long term follow-up continue to be the recommendations for future research.
Purpose: To identify prognostic factors in the literature that may predict a poor recovery from acute occupational low back pain (LBP). Methods: Four international databases (Medline, CINAHL, EMBASE, and PsycINFO) were reviewed, searching all articles indexed up to November 2007 with the term low back pain combined with the terms prognostic, prospective, or cohort. Following application of inclusion criteria, 10 articles were found to be appropriate for data extraction. Each article was critically appraised by two independent reviewers. Statistical pooling was performed on any factor evaluated in at least three independent cohorts. Results: Seven cohorts were identified, with a total sample size of 2,484 subjects. Only three factors were followed in at least three cohorts and were therefore suitable for statistical pooling: female gender (OR ¼ 1.28, 95% CI: 1.03-1.58); pain radiation (OR ¼ 1.37, 95% CI: 0.79-2.39); and previous history of back pain (OR ¼ 0.91, 95% CI: 0.52-1.60). There was significant heterogeneity within the female gender factor; compensation of subjects for study participation appeared to moderate its effect. Conclusion: After statistical pooling, only female gender achieved statistical significance as a prognostic factor for prolonged recovery. Further research is necessary to determine prognostic factors for non-recovery in acute LBP.Key Words: chronic disability, chronic pain, higher-order analysis, occupational low back pain, prognosis Agnello A, Brown T, Desroches S, Welling U, Walton D. Can we identify people at risk of non-recovery after acute occupational low back pain? results of a review and higher-order analysis. Physiother Can. 2010;62:9-16. RÉ SUMÉObjectif : Identifier, dans la litté rature, les facteurs pronostiques susceptibles d'indiquer un piè tre ré tablissement d'une lombalgie professionnelle aiguë . Mé thode : Examen de quatre bases de donné es internationales : Medline, CINAHL, EMBASE et PsycINFO, dans le but de rechercher tous les articles ré pertorié s depuis novembre 2007 avec le mot « lombalgie » combiné à « pronostic », « prospective » ou « cohorte ». À la suite de l'application du critè re d'inclusion, dix articles ont é té jugé s approprié s pour faire l'objet d'une extraction de donné es. Chaque article a ensuite é té critiqué par deux ré viseurs indé pendants. Une mise en commun statistique a é té ré alisé e pour tous les facteurs ayant é té é valué s au sein d'au moins trois cohortes indé pendantes. Ré sultats : Sept cohortes ont é té identifié es, pour un é chantillon comptant au total 2 484 sujets. Seuls trois facteurs ont fait l'objet d'un suivi dans au moins trois cohortes et pouvaient, par consé quent, faire l'objet d'une mise en commun statistique. Les facteurs ayant fait l'objet d'un suivi sont : les sujets de sexe fé minin (RO ¼ 1,28, CI 95 %, 1,03 à 1,58), le degré de radiation de la douleur (RO ¼ 1,37, 0,79 à 2.39) et les anté cé dents de lombalgie (RO ¼ 0,91, 0,52 à 1.60). On a constaté une hé té rogé né ité considé rable chez les sujets de sex...
When between-patient confounding is minimized, there is a strong association between medial knee load and increased knee pain during walking. This article is protected by copyright. All rights reserved.
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