Spine Curve Measures Taken in Individuals with Osteoporosis and Osteopenia Using the IONmed Mobile Phone Application Are Highly Consistent with Digital Inclinometer Measures

Introduction. This study determined the agreement between measures of standing posture in individuals at risk of osteoporotic fracture obtained using the IONmed mobile phone application and a digital inclinometer. Methods. One experienced rater assessed 20 adults, aged 55–88 years, attending an outpatient osteoporosis clinic. A standardized protocol was duplicated to acquire a single measure of spine curvature (lumbosacral angle, lordosis, kyphosis) using the IONmed mobile phone application and a digital inclinometer. Interdevice agreement was determined using the intraclass correlation coefficient (ICC) with 95% confidence intervals (CI) and standard error of the measurement (SEM) with 95% CI and Bland-Altman plots. Results. ICC (95% CI) for lumbosacral angle, lordosis, and kyphosis is 0.97 (0.92, 0.99), 0.97 (0.92, 0.99), and 0.99 (0.98, 1.0), respectively. SEM (95% CI) for lumbosacral angle, lordosis, and kyphosis is 0.99° (0.75, 1.44), 1.33° (1.01, 1.94), and 1.23° (0.94, 1.80), respectively. Measurement bias is small. Conclusions. In our sample, the IONmed mobile phone application provides measures highly consistent with the digital inclinometer measures of standing posture. This method offers clinicians a quick, convenient way of identifying alterations in spine alignment which require followup and remediation.

Injured Workers Perspectives on Recovery following Non-Life-Threatening Acute Orthopaedic Trauma: A Descriptive Study

Background. Little is known about the recovery process following non-life-threatening acute orthopaedic trauma from the viewpoint of the injured person. A better understanding could facilitate optimal rehabilitative planning. Objective. To explore patients’ views on factors important to them in recovery following non-life threatening acute orthopaedic trauma. Methods. Descriptive study utilizing content analysis and chi-square analysis. To better understand recovery expectations, 168 adults who had sustained non-life threatening acute orthopaedic trauma were surveyed at 2, 12, and 26 weeks after injury and invited to respond to the following question “what are the most important things necessary for you to best recover?” Results. According to participant’s responses, major themes on recovery involved a return to health and a return to health but with an ongoing plan, and for a minority (12%) recovery involved a focus on their current status. The study found that some recovery expectations changed over time. Conclusion. The journey to recovery is complex, often prolonged, and highly individual. Responses suggest that some injured persons need more assistance for a successful recovery than others. Those who appeared “caught in the moment” of the injury may benefit from clinical and rehabilitative management focusing on long-term recovery and acceptance of the injury event.

Supportive Care Needs following Cancer Treatment: A Comparison of Breast and Brain Cancer in an Australian Cohort

Objective. To assess and identify patient-reported supportive care needs following definitive treatment in persons with breast cancer (BC) and primary brain tumours (gliomas) (BT) in an Australian community cohort and to assess the commonalities and/or discrepancies of the reported needs in these oncological populations. Methods. A prospective cross-sectional survey of persons with BC (n=85) and BT (n=106) using questionnaires for supportive care needs, psychological morbidity, and quality of life. Results. BT participants were younger than BC patients (mean ages 51 and 57 years). The median time since diagnosis for both groups was over 2 years. The level of psychological morbidity, mainly depression, was high in both groups: BC (22%) and BT (20%). Participants in both groups reported at least one need (“met” or “unmet”). The BC patients reported higher numbers of “needs” and “unmet” needs compared with BT patients (mean 13.7 versus 11.6 needs; “unmet” needs mean 6.0 versus 4.1). The common “met” and “unmet” needs highlighted by both groups were comparable; the domain for most “met” needs included comprehensive cancer care, while “unmet” needs related to existential survivorship issues. Conclusion. Despite successful treatment many cancer survivors experience unmet supportive care needs in longer term. Understanding the impact of these beyond the acute phase is important as care shifts to community settings. More research in existential survivorship issues is needed.

Effect of Box Taping as an Adjunct to Stretching-Strengthening Exercise Program in Correction of Scapular Alignment in People with Forward Shoulder Posture: A Randomised Trial

Objective. The objective of this study was to provide preliminary estimates of effects of box taping as an adjunct to stretching-strengthening exercise program on scapular alignment in healthy subjects with forward shoulder posture (FSP). Methods. Sixty subjects were screened and 38 asymptomatic subjects with FSP were allocated into box taping and standard treatment group using block randomization. Both groups received a supervised stretching-strengthening exercise program and postural advice for 15 sessions over 3 weeks. In addition, box taping was applied to the intervention group. Static and dynamic scapular alignment was recorded at baseline, 7th and 15th sessions. Differences over time and between the treatment groups were determined using repeated measures of analysis of variance (ANOVA). Results. Twenty subjects completed the study. Both interventions were well tolerated and resulted in improvements in static and dynamic postural indicators over time in both groups (P<0.05) except for dynamic scapular alignment by the 15th session. We were under powered to detect differences between the groups (P<0.05). Conclusions. This study suggests postural exercises improve scapular alignment; but a large RCT is required to determine whether the addition of box taping is indicated, and whether this preventative approach reduces the incidence of upper quarter musculoskeletal disorders. This trial is registered with CTRI/2013/10/004095.

Differences in Symptoms among Adults with Canal versus Otolith Vestibular Dysfunction: A Preliminary Report

Despite the importance of symptomatology in the diagnosis of vestibular dysfunction, the qualitative nature of the symptoms related to semicircular canal (canal) versus otolith dysfunction is not fully understood. The purpose of this study was to compare symptoms, and their severity, in individuals with canal versus otolith peripheral vestibular dysfunction. A subjective tool, the Descriptive Symptom Index (DSI), was developed to enable categorization of symptoms as rotary, linear, imbalance or falls, and nondistinct. Fourteen adults were recruited and grouped based on vestibular function testing: canal only dysfunction, otolith only dysfunction, or canal and otolith dysfunction. Also, the Dizziness Handicap Inventory (DHI) was used to grade the severity of perceived limitations due to symptoms. The DSI was reliable and differentiated those with canal (rotary symptoms) versus otolith (linear symptoms) dysfunction. Most individuals with otolith only dysfunction did not report rotary symptoms. DHI scores were significantly higher in those with otolith dysfunction, regardless of canal functional status. All who experienced falls had otolith dysfunction and none had canal only dysfunction. Results support the importance of using linear and rotary descriptors of perceived disorientation as part of diagnosing vestibular dysfunction.

Horizontal and Declined Squats in Healthy Individuals: A Study of Kinematic and Muscle Patterns

Squats are frequently incorporated in physiotherapy programmes and performed in different ways. Accordingly, muscle and kinematic patterns also differ. The objective was to compare the kinematics and EMG patterns of the major muscles of knee and ankle joints during different squat exercises on horizontal (HP) and 25° decline (DP) boards. Seventeen healthy individuals performed squats on HP and DP with bilateral support and restriction of trunk movements in the sagittal plane. The knee and ankle angular displacements in the sagittal plane and the EMG activities of the major muscles of the lower limb in four subphases of movement were recorded and analyzed. For the descending phase of the HP squats, the angular excursion, as well as the initial and final positions, was smaller for the knee (P<0.05) but larger for the ankle (P=0.01). For the ascending phase of the HP squats, the initial and final positions were larger for the ankle (P<0.02) and the final position was smaller for the knee (P=0.05). All muscles remained activated and showed similarity between the tasks (P>0.44), except for the tibialis anterior in both squat exercises (P<0.03). The HP and DP squats produced different kinematics (knee and ankle joints) but did not modify the EMG strategy for both movement phases.

Clinical Features of Bell’s Palsy in Children and Outcomes of Physical Therapy: A Retrospective Study

The aim of this study was to describe clinical features of Bell’s palsy (BP) in children and outcomes of physical therapy interventions. Medical records of 186 patients with diagnosis of BP were reviewed. The severity of facial nerve dysfunction was graded according to House Brackmann Facial Nerve Grading Scale (HB FGS). After one month, patients who had HB FGS grade three or more were included in a physical therapy programme consisting of superficial heat, massage, exercises, and electrical stimulation. Among 186 children with BP, 167 children had a severity of HB FGS grade three or more and 19 had the incomplete type at the time of the diagnosis. After one month follow-up, 144 patients fully recovered, 35 patients recovered partially, while 7 patients had no recovery. Patients who had not fully recovered one month after onset of paralysis were included in the physical therapy programme. There was statistically significant difference between pretreatment and posttreatment HB FGS scores in patients who had not fully recovered one month after onset of paralysis. We concluded that the prognosis of BP in children seems to be good with higher recovery rate and physical therapy programme might be an effective method to facilitate recovery in patients with poor prognosis.

Psychometric Evaluation of the Perceived Stress Scale in Multiple Sclerosis

Multiple sclerosis (MS) is a progressive disease characterized by neurological symptoms and sometimes heightened levels of distress. The Perceived Stress Scale (PSS) is often used in MS samples to measure stress but has not been validated in this population. Participants (n=446) completed the PSS as well as measure of depression, anxiety, and mental and physical health. Factor analyses indicated that the general factor of a bifactor model accounted for a large amount of the variance in the 14-item and 10-item versions of the PSS. The 4-item PSS had two factors, the Stress subscale and the Coping subscale, but a one-factor model also fits the data well. Total scores and both subscales had sufficient reliability and validity for all versions of the PSS, although a few items of the 14-item PSS had low item-total correlations. This study supports the use of the total score of the PSS in MS but also suggests that the 10-item PSS had better psychometric properties than the 14-item PSS.

An Exploratory Study of the Elements of Successful Service Dog Partnerships in the Workplace

The use of service or assistance dogs has increased over the past three decades but is still considered by many to be an emerging concept for assisting people with disabilities to navigate a number of environments. This is predominately due to the minimal research that has been done on the effect and promising practices. One area, employment, has been completely overlooked in research related to service dogs. This research project undertook an exploratory study to gather data on the elements of service dog partnerships that have been successful in the workplace. A structured methodology using mixed methods was used to gather ideas from a diverse group of stakeholders, people with service dogs, trainers, vocational rehabilitation counselors, and other healthcare professionals, to form a common framework for addressing the issue in future research and development of interventions. The results identified 68 elements that respondents perceived and rated to be important or highly important to the phenomenon. They were categorized into six clusters: (1) dog preparation, (2) monitoring, (3) employee competence, (4) legal knowledge, (5) information and education, and (6) coworker preparation. The discussion identified key points that might support the development of successful employment outcomes for people working with service dogs.

Metronome-Cued Stepping in Place after Hemiparetic Stroke: Comparison of a One- and Two-Tone Beat

Hemiparetic gait is characterised by temporal asymmetry and variability, and these variables are improved by auditory cueing. Stepping in place incorporates aspects of gait and may be a useful tool for locomotor training. The aim of this pilot study was to investigate the use of a single-tone and dual-tone metronome to cue stepping in place after hemiparetic stroke. Eight participants completed an uncued baseline stepping condition and two cued stepping conditions utilising a single-tone and a dual-tone metronome. Step times were determined from force plate data, and asymmetry and variability were calculated for the three conditions. Step time asymmetry was significantly reduced in the single-tone condition compared to baseline, and paretic step time variability was significantly reduced in both cued conditions. The single-tone metronome appeared to be preferred to the dual-tone metronome based on participant feedback. The results of this pilot study suggest that metronome cueing produces similar benefits on stepping in place to previously reported findings in walking. Further research on whether stepping in place to a metronome can be used for locomotor training is needed.