To control movement, the brain has to integrate proprioceptive information from a variety of mechanoreceptors. The role of proprioception in daily activities, exercise, and sports has been extensively investigated, using different techniques, yet the proprioceptive mechanisms underlying human movement control are still unclear. In the current work we have reviewed understanding of proprioception and the three testing methods: threshold to detection of passive motion, joint position reproduction, and active movement extent discrimination, all of which have been used for assessing proprioception. The origin of the methods, the different testing apparatus, and the procedures and protocols used in each approach are compared and discussed. Recommendations are made for choosing an appropriate technique when assessing proprioceptive mechanisms in different contexts.
Positive therapeutic alliance ratings between physical therapists and patients are associated with improvements of outcomes in LBP. Future research should investigate the factors explaining this relationship and the impact of training interventions aimed at optimizing the alliance.
Movement deficits associated with expressing specific emotions and an association with quality-of-life measures were identified in patients with long-term facial nerve paralysis who saw themselves as not effective at facial expression of emotions. To improve management of emotional expression in patients with facial nerve paralysis, a broader approach is recommended, linking the practitioner's treatment goals with patient-driven outcome goals.
The limited evidence suggests patient-centred interaction styles related to the provision of emotional support and allowing patient involvement in the consultation process enhance the therapeutic alliance. Clinicians can use this evidence to adjust their interactions with patients to include communication strategies that strengthen the therapeutic alliance.
Objective To establish the prevalence of enuresis in 5–12‐year‐old Australian children, to evaluate the impact of enuresis on the children and their families and to identify common methods of managing enuresis.
Subjects and methods A self‐administered questionnaire was completed voluntarily by the parents of 2292 5–12‐year‐old children during attendance at electoral polling booths in Sydney, Australia. The questionnaire inquired specifically after the child's age, gender and frequency of wetting.
Results From a response rate of 74%, the overall prevalence of any reported nocturnal enuresis was 18.9% and any day wetting 5.5%. The prevalence of marked nocturnal enuresis (at least weekly) and marked day wetting was 5.1% and 1.4%, respectively. Using a 10‐point visual analogue scale to measure parental concern about their child's enuresis, the mean concern score was 3.1. There was a moderate but significant relationship between the frequency of enuretic episodes and the parental concern score. Of the enuretic children, 34% had consulted with a health worker. These children were 1.4 years older and wet more frequently than those enuretic children who had not sought help. The management of enuresis involved a mean of 3.9 strategies, primarily behavioural techniques administered by the family. The lowest cure rate was seen in the children who wet more frequently. Significantly more of the dry children woke spontaneously at night to void compared with the enuretic children. There was a trend towards greater spontaneous arousal in the children who wet less frequently.
Conclusion These results suggest that prevalence rates for day and night wetting in Australia are similar to those in previous studies reported from the northern hemisphere. Australian families did not report a high level of concern about enuresis, even in the older child. The problem was managed primarily within the family.
A short programme of task-specific strengthening exercise and training for children with cerebral palsy, run as a group circuit class, resulted in improved strength and functional performance that was maintained over time.
For clinical grading of voluntary movement, there is good correlation between ratings given on the Sydney and Sunnybrook systems, and within each system there is good reliability. The assessment of synkinesis was far less reliable within, and less related between, systems. Although the reliability of the House Brackmann system was found to be high, examination of individual grades revealed some wide variation between trained observers.
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