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At least 1,405 records · Page 78Linked to original sources
PubMed2000

Sensitivity and specificity of the indicators of sincere effort of the EPIC lift capacity test on a previously injured population.

STUDY DESIGN: Randomized control post-test only. OBJECTIVES: To investigate the reliability and validity of the EPIC Lift Capacity test's indicators of sincere effort. SUMMARY OF BACKGROUND DATA: The EPIC Lift Capacity test (ELC) (Employment Potential Improvement Corp., Santa Ana, CA) is a functional evaluation tool used to identify physical limitations involved in lifting and manual materials handling. Identification of insincere effort is an integral component of such functional testing because of the potential secondary gain issues surrounding the various populations typically involved in this form of testing. The purpose of this study was to determine the sensitivity and specificity of the "indicators of sincere effort" of the EPIC Lift Capacity test when used on a previously injured population typical of subjects for which the test is designed. METHODS: Subjects consisted of 41 volunteers (age 22 to 58 years) with a previously diagnosed musculoskeletal pathology of the spine or extremities. Volunteers were randomized into either the control group, instructed to give a sincere maximum effort, or the experimental group, instructed to give an insincere effort at 50% of their perceived maximum effort. All tests were administered by certified clinical evaluators according to the standardized EPIC Lift Capacity test protocol.- RESULTS: Overall accuracy in identifying participants' level of effort was 86.84%. The indicators of valid effort exhibited both high positive (94.44%) and negative (80.00%) predictive values. The indicators of valid effort accounted for 94.9% of the total variance in the determination of the subjects' overall effort level. Interrater reliability for agreement of subjects' overall effort was good (interclass correlation coefficient = 0.82). CONCLUSIONS: Through use of standardized indicators of sincere effort, certified EPIC Lift Capacity test evaluators were able to predict sincerity of effort with a high degree of reliability and validity. The rater's systematicobservational evaluation of effort was shown to be the single best indicator of sincere effort.

Adult↗
PubMedDate not supplied

The measurement of performance in a physical therapy clinical program. A ROI approach.

This research presents the development and implementation of a measurement model that yields the return on investment (ROI) in a physical therapy clinical program. A performance measurement model was constructed, which determined the ROI of a clinical program in physical therapy using revenue, patient outcomes, staff productivity, costs, and patient satisfaction. Implementation used archival data for 2 groups of patients in a back and neck rehabilitation program. An expert panel was formed to review the model. Based on the results, ROI provided a more comprehensive tool to measure performance than traditional evaluation measures. ROI appears beneficial, making it a useful tool for health care professionals to measure the performance of PT clinical programs.

Adult↗
PubMed2004

Intra-abdominal pressure and activation of abdominal muscles in highly trained participants during sudden heavy trunk loadings.

STUDY DESIGN: Ten participants were exposed to heavy sudden trunk loads as they might occur during patient handling. OBJECTIVES: The aim was to observe if well-trained men and women use their full rate of intra-abdominal pressure (IAP) development when exposed to heavy sudden trunk loads. Further, to elucidate to what degree the rectus abdominus muscle is activated when the IAP is developed. SUMMARY OF BACKGROUND DATA: Well-trained judo fighters are used to heavy sudden trunk loads and can produce a high IAP. It is unknown whether they use their full potential. IAP can increase the spinal stability and has been suggested to unload the spine. The unloading effect will, however, disappear if the development of the IAP demands substantial activity in the vertical fibers of the abdominal muscles. METHODS: Five male and five female well-trained judo and jujitsu fighters were exposed to heavy sudden trunk loadings through imitated patient handling situations where the patient fell and the fighters should hold the patient and prevent the fall. IAP was measured with a catheter in the stomach. Along with the IAP measurement, EMG was measured on the abdominal muscles, and the load on the low back was quantified by a three-dimensional dynamic biomechanical calculation of the torques at the L4-L5 joint. RESULTS: The well-trained judo fighters did not use their full potential of the IAP development when exposed to the heavy sudden trunk loads, but the women had to use a higher level of their IAP and extension torque capacity to comply with the heavy loads. The rectus abdominus muscle does not contribute to the IAP development when the trunk is exposed to a sudden heavy load.

Abdominal Muscles↗
PubMed2005

Back to basics: managing gunshot injuries in East Timor.

BACKGROUND: The management of patients following severe trauma requires a combination of skills. Among these are accurate clinical assessment, basic resuscitation measures, basic general surgical skills and techniques, good decision making and team leadership. More technically advanced imaging and investigations are often useful and can enhance clinical assessment but should not replace the basic elements. In situations where more advanced investigations are not available good outcomes can be achieved by application of the basic principles in trauma management and surgery. This article describes a mass casualty situation of gunshot wounds managed with limited resources and the outcomes. METHODS: A series of gunshot wounds managed in a single day at Dili National Hospital, Dili, East Timor is described. The presentation of the patients, initial assessment of injuries and haemodynamic stability are detailed in addition to the subsequent surgical treatment, complications and outcomes. The information was obtained from hospital records and personal recollection of the treating doctors. All injuries were documented with digital photography. All patients were managed by two surgeons who also supervised their postoperative course and reported on their outcomes. Surgical procedures on all of the patients were performed by the named two consultant surgeons and one basic surgical trainee. RESULTS: Fourteen patients were treated for gunshot injuries. All were single bullet injuries. Six trajectories involved the thoracic or abdominal cavity (one trajectory traversed both). Eight injuries were to limbs or soft tissue of the pelvis and included four compound fractures. Surgical intervention was needed for all patients ranging from emergency laparotomy for haemodynamic instability through to wound debridements. Thirteen patients survived and were discharged from hospital within 3 weeks. One patient died of uncontrolled haemorrhage. CONCLUSIONS: In the present series of gunshot injuries managed with limited resources a good outcome was achieved with the application of basic principles. The present series emphasizes the importance of basic trauma management as outlined in courses such as Emergency Management of Severe Trauma and the use of basic surgical techniques as taught during the Advanced Surgical training program.

Adolescent↗
PubMed2006

A distant-range, suicidal shotgun wound of the back.

The case being reported is one of a shotgun fatality with a thoracic back wound. A 23-year-old man was shot from a distance with trajectories going from back to front and on a nearly horizontal level. These findings observed in the autopsy could represent homicide, but scene investigation and police records were interpreted and it became clear that the case was suicide. Thus, this case shows that the determination of the manner of death requires a careful forensic investigation including autopsy findings, scene investigation, and reconstruction of the events.

Adult↗
PubMed2006

Prescriptive patterns of nurse practitioners and physicians.

PURPOSE: To compare the prescriptive patterns of nurse practitioners (NPs) and physicians in a primary care setting for the treatment of sinusitis, bronchitis, musculoskeletal injury, and back pain. DATA SOURCES: One hundred charts were reviewed for each condition for a total of 400 charts (200 of the charts were for NP providers, and 200 were for physician providers). CONCLUSIONS: While the mean scores of the differences in prescriptive patterns were found to be statistically significant in only one instance, the overall findings indicate slight differences in the administration of medications for patients. Additionally, NPs prescribed more over-the-counter medications and provided more nonpharmacotherapeutic interventions for their patients than the physicians. IMPLICATIONS FOR PRACTICE: The results, although statistically significant in only one category, indicate that NPs may be more cautious in their prescriptive interventions and provide more teaching for patients.

Adolescent↗
PubMed2006

In vivo lumbar erector spinae oxygenation and blood volume measurements in healthy men during seated whole-body vibration.

Exposure to whole-body vibration is implicated as one of the occupational risk factors for lower back disorders; however, its influence on the lumbar muscle physiology is still poorly understood. The objective of this study was to investigate the effects of backrest support and hand grip contractions on lumbar muscle oxygenation and blood volume responses during seated whole-body vibration using continuous dual-wave near-infrared spectroscopy. Thirteen healthy men were exposed to frequencies of 3, 4.5 and 6 Hz on a vibration simulator, in randomized order on separate days. Each day the duration of the protocol was 30 min. During the fifth minute of vibration 'with' and 'without' backrest support, participants performed maximal rhythmic hand grip contractions for 1 min. In general, erector spinae oxygenation and blood volume showed a trend to decrease with vibration exposure compared to the control condition. However, these responses were not influenced by the change in vibration frequency (P > 0.05). Sitting without backrest resulted in a greater decrease in oxygenation (by 27%, P = 0.02) and blood volume (by 11%, P = 0.05) than with backrest, implying a deficiency in oxygen supply owing to the sitting posture. Compared to the vibration-only condition, hand grip work decreased both oxygenation (by 22%, P = 0.003) and blood volume responses (by 13%, P = 0.04), suggesting that postural load due to prolonged sitting combined with physical activity during vibration might further burden paraspinal muscles. The influence of adipose tissue thickness of the lumbar muscle on optically derived oxygenation and blood volume changes was inconclusive.

Adipose Tissue↗