Physical Therapists in Primary Care Are Interested in High Quality Evidence Regarding Efficacy of Therapeutic Ultrasound for Knee Osteoarthritis: A Provincial Survey.

Physical Therapists in Primary Care Are Interested in High Quality Evidence Regarding Efficacy of Therapeutic Ultrasound for Knee Osteoarthritis: A Provincial Survey.

ScientificWorldJournal. 2013; 2013: 348014
Macintyre NJ, Busse JW, Bhandari M

Recent high-level evidence favours therapeutic ultrasound (US) for reducing pain in people with knee osteoarthritis (OA). It is unknown how current practice patterns align with current evidence regarding US efficacy and whether physical therapists perceive a need for further high-level evidence. We conducted a descriptive electronic survey to characterize the beliefs and use of US among physical therapists in Ontario treating people with nonsurgical knee OA. Most of the 123 respondents (81%) reported at least some use of US with 45% using it often or sometimes. The main goal for using US was to reduce pain in the surrounding soft tissue (n = 66) and/or the knee joint (n = 43). Almost half (46%) endorsed the belief that US is likely to be beneficial for clients with nonsurgical knee OA. Most respondents (85%) expressed interest in the results of a randomized controlled trial evaluating the effectiveness of US on pain and physical function. Patterns of use reflect the respondents’ belief that US is likely to be beneficial for knee OA pain. HubMed – rehab


Diversity in Defining End of Life Care: An Obstacle or the Way Forward?

PLoS One. 2013; 8(7): e68002
Gysels M, Evans N, Meñaca A, Higginson IJ, Harding R, Pool R,

The terms used to describe care at the end of life (EoL), and its definitions, have evolved over time and reflect the changes in meaning the concept has undergone as the field develops. We explore the remit of EoL care as defined by experts in EoL care, from across Europe and beyond, to understand its current usage and meanings.A qualitative survey attached to a call for expertise on cultural issues in EoL care was sent to experts in the field identified through the literature, European EoL care associations, and conferences targeted at EoL care professionals. Respondents were asked to identify further contacts for snowball recruitment.The responses were analysed using content and discourse analysis.Responses were received from 167 individuals (33% response rate), mainly from academics (39%) and clinical practitioners working in an academic context (23%) from 19 countries in Europe and beyond. 29% of respondents said explicitly that there was no agreed definition of EoL care in practice and only 14% offered a standard definition (WHO, or local institution). 2% said that the concept of EoL care was not used in their country, and 5% said that there was opposition to the concept for religious or cultural reasons. Two approaches were identified to arrive at an understanding of EoL care: exclusively by drawing boundaries through setting time frames, and inclusively by approaching its scope in an integrative way. This led to reflections about terminology and whether defining EoL care is desirable.The global expansion of EoL care contributes to the variety of interpretations of what it means. This complicates the endeavour of defining the field. However, when diversity is taken seriously it can open up new perspectives to underpin the ethical framework of EoL care. HubMed – rehab


Femoral neck stress fracture in a female athlete: a case report.

J Chiropr Med. 2012 Dec; 11(4): 273-279
Avrahami D, Pajaczkowski JA

The purpose of this case report is to describe chiropractic rehabilitation of a master’s-level athlete with proximal femoral stress fracture and provide a brief discussion of stress fracture pathology.A 41-year-old female master’s-level endurance athlete presented with chronic groin pain later diagnosed and confirmed by magnetic resonance imaging as a stress fracture of the femoral neck. After diagnosis, the patient was referred to a doctor of chiropractic at week 1 of the non-weight-bearing physical rehabilitation process. At that time, the patient presented with sharp and constant groin pain rated 6/10 on a numeric rating scale.This patient avoided weight-bearing activity for 8 weeks while cross-training and was able to return to her sport after this period. The patient was progressed through a series of non-weight-bearing strengthening exercises for the lower extremity. Myofascial release therapy was performed on the gluteal, hip flexor, and groin muscle groups to improve range of motion. Motion palpation testing the lumbar and sacroiliac joints was performed during each session, and manipulative therapy was performed when necessary. The patient was seen once a week for 8 weeks. Reevaluation was performed at week 8; at that time, the patient reported no groin pain (0/10). The patient was discharged from care and referred back to the supervising physician for clearance to return to sporting activities. One month after discharge, she reported that she was pain free and had fully returned to sport activities.This case report demonstrates the importance of a through clinical history, physical examination, and magnetic resonance imaging in the accurate diagnosis of a patient with chronic groin pain and that chiropractic care can contribute to rehabilitation programs for these injuries. HubMed – rehab


Conservative management of recurrent lumbar disk herniation with epidural fibrosis: a case report.

J Chiropr Med. 2012 Dec; 11(4): 249-253
Welk AB, Werdehausen DN, Kettner NW

A retrospective case report of a 24-year-old man with recurrent lumbar disk herniation and epidural fibrosis is presented. Recurrent lumbar disk herniation and epidural fibrosis are common complications following lumbar diskectomy.A 24-year-old patient had a history of lumbar diskectomy and new onset of low back pain and radiculopathy. Magnetic resonance imaging revealed recurrent herniation at L5/S1, left nerve root displacement, and epidural fibrosis.The patient received a course of chiropractic care including lumbar spinal manipulation and rehabilitation exercises with documented subjective and objective functional and symptomatic improvement.This case report describes chiropractic management including spinal manipulative therapy and rehabilitation exercises and subsequent objective and subjective functional and symptomatic improvement. HubMed – rehab



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