Educational needs of adults who undergo total hip and knee replacement surgery encompass a broad range of topics, confirming the importance of offering an all-inclusive information package regarding total hip and total knee replacement.
Patients with AS perceive the benefits of exercise, with average EBBS benefits scores comparable to historical controls with similar conditions. Despite positive perceptions, the majority of patients with AS did not report participating in exercise on a frequent basis.
The new 2017 diagnostic criteria for hypermobile Ehlers–Danlos Syndrome (hEDS) provide a framework for diagnosing hEDS but are more stringent than the previous Villefranche criteria. Our clinical experience at the GoodHope EDS clinic was that the 2017 criteria left many highly symptomatic patients without a diagnosis of hEDS. We conducted a retrospective cohort study to confirm our clinic experience and assess the accuracy of the 2017 diagnostic criteria for hEDS in patients who had a previous hEDS diagnosis based on the Villefranche criteria. Our study found that 15% (n = 20 of 131) of patients with a prior diagnosis of hEDS met the 2017 diagnostic criteria, and many of the traits used to distinguish hEDS were not significantly more frequent in patients who met 2017 criteria versus those who did not. In both groups objective systemic manifestations were found less frequently than subjective systemic manifestations. Beighton score (BS) as assessed by primary care practitioner was found to be higher than assessment by EDS practitioner in 81% (n = 74 of 91) of cases. Generalized joint hypermobility was confirmed in only 46% (n = 51 of 111) of patients who had a previous diagnosis of hEDS. Higher BS did not correlate with increased number of systemic manifestations in our cohort. Common comorbidities of hEDS were found with similar frequency in those who met 2017 criteria and those who did not. Based on our cohort, the 2017 hEDS diagnostic criteria require refinement to improve its diagnostic accuracy.
Purpose: The purpose of this study was to examine barriers to accessing physical therapy (PT) services in Ontario primary health care with respect to funding sources and wait times. Methods: A stratified random sample of 1100 registered Ontario PTs and 3000 Ontario family physicians were surveyed by mail in 2004. Relationships were examined between PT wait times, funding source, geographical region and caseload composition. Results: Physicians identified the cost of private rehabilitation and long wait times as the most common barriers to referring patients to rehabilitation. Wait times for PT were longer in publicly funded settings than in privately funded practice settings (p, 0.001) and in the North (p, 0.001) and East (p 5 0.010) regions of Ontario compared with the most urban region of Ontario. Patients with chronic musculoskeletal conditions, cardiopulmonary conditions and general debility were at least three times more likely to receive PT services at publicly funded than privately funded practice settings. Furthermore, patients with acute musculoskeletal conditions were less likely to receive PT services in publicly funded practice settings (odds ratio 5 0.11, 95% confidence interval 5 0.05-0.23). Conclusions: Current Ontario health-care structures may affect access to PT services for vulnerable populations such as those with chronic conditions, those lacking private health insurance and those living in less urban regions of Ontario.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.