PT 2.2 2014 Student Dossier

PHYSICAL THERAPY ENGLISH 2.2 2014

STUDENTS DOSSIER

Case reports:

A patient with Cervical Pain 1

Online search for clinical information: Cervical Pain 2

Case Reports: Slices of Real Life 5

Online search for clinical information: Chronic Ankle Sprain 6

Analyzing Language: Expressing Health Science Concepts in English 9

Oral Presentation: Evidence-Based Case Study 10

Professional Journal Reading:

Scanning to recognize article types and research design features 14

Pre-Listening: What is a systematic review? 28

Introduction to Systematic Reviews: Reflexology 29

Behavioral treatment for low back pain 31

Exercise for management cancer-related fatigue 33

Foot Orthosis A Systematic Review 35

Effects of IF current therapy in the management of MS Pain 36

Review of therapeutic Ultrasound 37

Group Project

Group Project steps 38

Selecting a general research project 39

Narrowing the topic 41

Finding general background information 43

Finding related research abstracts 44

Formulating a research question: The PICO method 45

Planning your search: Establishing inclusion criteria 49

Representing your search: Flow chart representations 50

Organizing your data: Data tables and data extraction 52

Methodological Quality 65

Presenting your Group Project 68

Writing a summary of findings 70

Citations 71

Answering Research Questions 74

Grammar Exercises

Connecting Ideas and Phrases 79

Summary chart of linker, transition expressions, etc. 81

Summary of patterns of punctuation 82

Linking Expressions 1 83

Linking Expressions 2 84

Paired conjunctions 85

Citation Practice 87

PH

YS

ICA

L T

HE

RA

PY

EN

GL

ISH

2.2

D

os

sie

r Te

rm 2

20

14

Dossier, Physical Therapy English 2.2 2014 page 1

UIC Idiomes jcp 28.2.12b Listening to a clinical description

A Patient with Cervical Pain

Listen to a Physical Therapists description of a patient. Take notes:

The patient:

Current problem:

Past Medical History:

Physical examination:

Treatment:

Outcome:

How will you search for information to clarify this case?

What keywords will you use?

Where will you look for information?


UIC Idiomes Angls jcp 5.3.12 Table to document online search for information

Question What is the prevalence of neck pain?

Terms I used to find my answer neck pain prevalence (pubmed)

My source of information

The prevalence of neck pain in the world population: a systematic critical review of the literature. Fejer R, Kyvik KO, Hartvigsen J.Eur Spine J. 2006 Jun; 15(6):834-48. Epub 2005 Jul 6. http://www.ncbi.nlm.nih.gov/pubmed/15999284

My answer

The 1-year prevalence was estimated in 22 studies. Based on fairly homogeneous definitions of NP, the prevalence ranged from 16.7% [8] to 75.1% for the entire adult population (1770 years), with a mean of 37.2%

The authors answer

The reported 12-month prevalence of neck pain varies from 30% to 50%, and lifetime prevalence is approximately 70%.

The authors source of information

Gross AR, Haines T, Goldsmith CH, et al. Knowledge to action: a challenge for neck pain treatment. J Orthop Sports Phys Ther.2009;39:351363

Question

Terms I used to find my answer


My answer

The authors answer


Question



My answer

The authors answer




Question



My answer

The authors answer


Question



My answer

The authors answer


Question



My answer

The authors answer



Question



My answer

The authors answer


Question



My answer

The authors answer



UIC/ Idiomes/ Angls Cincies de la salut mld.516

Objective to practice reading comprehension about case reports and become familiar with editorial structure

5

10

15

20

25

Case Reports: Slices of Real Life to Complement Evidence Irene R McEwen

With the growing emphasis on evidence-based practice, are case reports outdated relics of the

professional literature? Clinicians, educators, and students increasingly ask this question when

they see that case reports appear near the bottom of the hierarchy of evidencelisted above

only expert opinion. It's true that case reports cannot establish cause-and-effect

relationships between interventions

and outcomes. It's also true that case reports cannot prove reliability or validity

of measurements

and cannot identify prognostic variables. What, then, do case reports contribute to evidence-

based practice?

Case reports are descriptions of practice. Although most case

reports published in Physical

Therapy describe one or more patients, case reports can focus on any aspect of physical therapy

that has not already been described well in the professional literature.

No other type of written

professional communication gives the replicable, detailed, and credible descriptions of practice

that case reports provide. They describe every step in the physical therapist patient/client

management process: examination, evaluation, diagnosis, prognosis, and intervention.

Textbooks do not give this level of detail, and continuing education case examples

rarely

provide an evidence-based rationale for clinical decisions. Research reports often describe an

intervention or the use of a measurement in replicable detail, but they almost never describe

the

entire decision-making process for an individual patientand that process is the reality that

clinicians and students face every day. Case reports are real life.

Case reports describe what physical therapists and physical

therapists assistants ideally do. I say

"ideally" because a good case report exemplifies the definition of evidence-based

practice"the

integration of the best available research evidence with clinical experience and patient values."

Research evidence is important, but it is not the only component of evidence-based practice.

Even when research evidence is available, clinicians need to consider the evidence along with

their own experiences and their patients' preferences and unique circumstances.

What if research evidence is not available? This happens all

the time, and it is not a barrier to

writing a publishable case report. Authors just need to give solid rationale for their

decisions

and the necessary details about what they did and why. Perhaps the case report will stimulate

research that will provide needed evidence in the future. One of the purposes of

case reports is

to identify relevant variables for researchers to investigate.

Discussion Questions

1. To what audience is this article addressed?

2. Where would you find this article?

3. What is unique to case reports? What can they do that other research cannot?

4. What are case reports not able to do in the context of an evidence-base Physical Therapy

practice?



Chronic Ankle Sprain

More practice searching online for clinical information: Documenting my search.

Question



My answer

The authors answer


Question



My answer

The authors answer


Question



My answer

The authors answer




Question



My answer

The authors answer


Question



My answer

The authors answer


Question



My answer

The authors answer



Question



My answer

The authors answer


Question



My answer

The authors answer



UIC/ Idiomes/ Angls Cincies de salut mld.05.03.12

Objective to reflect on how certain concepts are expressed in English

Analyzing language: expressing health sciences concepts in English

1. Read the sentences below. They refer to certain health sciences concepts that are

widely used in the literature. How do you think the phrases in bold are expressed in

English?

a. En pacientes con un trastorno de ansiedad es frecuente observar embotamiento de la reactividad

general.

b. Estos signos y sntomas no son compatibles con el diagnstico de fibromialgia.

c. La clnico desarroll un proceso holstico de deteccin de sndrome de dolor regional complejo.

d. La incidencia de esguinces de tobillo en la poblacin no deportista es desconocida.

e. Las extremidades superiores son afectadas con mayor frecuencia que las extremidades inferiores.

f. Las mujeres tienen una mayor probabilidad de desarrollar trastornos depresivos.

g. Las vctimas reexperimentan el acontecimiento traumtico.

h. Los factores psicolgicos desempean un papel importante.

i. Representan un 18-30% de todas las fracturas con un pico de incidencia a los 11-12 aos.

j. Se evaluaron los resultados psicolgicos de los sobrevivientes de accidentes automovilsticos.

2. Scan the introduction that your teacher gives you for sentences that express the

phrases in bold. Based on the information you find, write these sentences in English.

3. Categorize the sentences. What aspect of health sciences is each sentence

referring to?

4. Discuss patterns in spelling, grammar and vocabulary that you observe in the English

expressions.


Oral Presentation: Evidence-Based PT Case Study

You will prepare an EBPT case presentation. Based on a case of a patient you treated or

observed during your clinical training, you should think of a clinical question. You will

search online for information IN ENGLISH that answers your clinical question. In the Oral

Presentation you will present the case, the question, how you searched for the answer to the

question, and how to apply this information in the future, if applicable.

The EBPT oral presentation will be done individually and should last NOT MORE THAN

15 minutes. You should turn in a paper copy of your slides on the day of the presentation.

What information do you need to include?

Remember you may need more than one slide for some of these categories.

Physical Therapy English

2.2

EBPT Case Presentation

A patient with.

Name

Date

Patient presentation

Chief complaint

History: Current and

previous problems

Physical

examination/Diagnostic tests

Patient presentation

Treatment

Outcome

A Clinical Question that

arose:

Search for Evidence:

Term(s): What term(s) did I

use?

Source(s): What source(s)

did I consult?

Search results

What was the answer to my

question?

Clinical applications: How

can I apply this information?


U.I.C. / Idiomes / Angls

Cincies de la Salut gn.418ap

Objective: To provide guidelines and tips for oral

presentations.

Guidelines and tips for oral presentations on an Evidence-based Physical

Therapy Case Study:

As you are preparing your presentation keep the following in mind.

Keep the text on the slide to a minimum, just enough to orient your audience to what you are talking about. Remember the audience needs a reason to listen to you and not

ignore you and read the slides by themselves.

Know more than what you have on the slides, so you can answer questions and explain.

It is useful to have a printout of your presentation with the pagina de notas. This way you do not have to keep looking back at the screen to know what is on it.

When you present remember to:

Look at the audience when you speak (all of the audience, not just the teacher).

Stand close enough to the screen so that you can point to what you are talking about.

Speak loud enough for your audience to hear you, including the people in the back.


Notes on oral presentations

Notes for presenters

Good morning/afternoon. My name is________________. I am going to present a patient I

saw in my clinical training.

First / To begin with, this patient is ___________________________ (patients background. example: a 65-year-old, retired female. She plays golf and cares for grandchildren).

The patient presented with ________________ (chief complaint: symptoms). The patients

past medical history included _____________ (what, when, how?). The patient had

undergone ___________ (previous treatments and diagnostic tests). He/she was diagnosed

with_____________ (diagnosis). On examination, ______________ (signs) were observed.

Is that clear? Do you have any questions so far? (Check comprehension in the audience)

Has anyone seen a similar case? How was it similar / different? (Ask your audience to participate)

The patient was treated with ____________ (actual treatment).

Is that clear? Do you have any questions so far? (Check comprehension in the audience)

Finally, I would like to explain what the outcome for this patients was ____________ .

During my clinical training with this patient, some important questions arose. Firstly,

__________ (Clinical question #1). And secondly, ___________________. (Clinical question #2).

The terms that I used in my search for answers were: _____________________ (keywords).

In order to answer my clinical questions I consulted ________________ as my sources of

information. I identified these abstracts:______________________________. The answer

to my questions were the following: ______________________________(explain what you learned from the abstracts and how to apply this information into your clinical practice).

Now I would be happy to answer questions.

Thank you for your attention.

Vocabulary: present with, undergo, be diagnosed with, on examination, , be observed, be

treated with. Others:

Notes for audience 1. Treat the speakers with respect. Dont converse. 2. Take notes. 3. Ask questions if you want clarification or if you want further information. 4. When the presentation is finished, clap.

UIC / Idiomes / Angls / Cincies de la Salut / mks.139


Evaluation of Oral Presentation

Student: ______________________________ Date of presentation: __________

Partner: _______________________________

Condition: ________________

1. Eye contact with audience

No eye contact Appropriate contact

2. Mode of delivery

Read / Not prepared Did not read / Prepared

3. Use/organization/clarity of PowerPoint slides

Too wordy, language errors Clear, concise, no mistakes

4. Clarification of vocabulary and content

None/Insufficient Appropriate

5. Language use (Grammar & Vocabulary)

Lack of variety and/or accuracy Wide variety and accuracy in

in structure and vocabulary structure and vocabulary

6. Clarity / Pronunciation (of crucial vocabulary)

Difficult to understand/Mispronunciations Easy to understand/Accurate

General comments:

0 10

0 10

0 10

0 10

0 10

UIC / Idiomes / Angls / Cincies de la Salut / Physiotherapy A2 jcp 27b

0 10


Scanning to recognize article types and research design features

Rationale: An important skill is rapid scanning to assess article type and qualitythis

involves looking at Medline titles and abstracts or the first pages of journal

articles for certain key words like review, case report, etc. or trial, randomized,

retrospective, etc. Pages 15 to 27 contain texts from physical therapy journals.

Tasks: 1) Scan each page quickly and check the appropriate box in the columns under

article types (


Text 1

PHYS THER

Vol. 81, No. 5, May 2001, pp. 1127-1134

Changes in Attitudes and Perceptions About Research in Physical Therapy Among Professional Physical Therapist Students and New Graduates

Barbara H Connolly, Norwood S Lupinnaci and Andrew J Bush BH Connolly, PT, EdD, is Professor and Chair, Department of Physical Therapy, College of Allied Health

Sciences, University of Tennessee Health Science Center, 822 Beale St, Memphis, TN 38363 (USA)

Background and Purpose. The physical therapy profession, through

its published educational accreditation

standards and its normative model of professional education, has addressed the importance

of educating

physical therapist students in the basic principles and application of research. The purpose of this study was to

conduct a longitudinal study of students relative to (1) their perception of knowledge with respect to research,

(2) their perception of what source should be used (evidence-based practice

or traditional protocols) for clinical

decision making, and (3) their perception of what should be used in a clinical setting

for patient management.

Subjects. Thirty-six students during the final year of their professional program from a sample of

115 physical

therapist students who requested 2 consecutive physical therapist classes completed the entire sequence of

pretest and posttest survey administrations. Seventy-nine students did not complete the entire sequence.

Methods. A 10-item 5-point Likert-type questionnaire was designed by the authors to probe

the students'

attitudes and perceptions about research, their level of comfort and confidence in reading and applying research

findings published in the literature, and their personal habits regarding reading the professional literature. An

expert panel consisting of internal and external reviewers was used for construction

of the questionnaire. The

questionnaire was completed by the students immediately preceding their research methods course,

immediately after the completion of that course, and following the second research course, which included

statistics and development of a research proposal. The subjects also completed the questionnaire

after 1 year of

physical therapy practice. Friedman's analysis of variance was used as an omnibus test to detect differences

across time. In addition, a follow-up analysis using the Wilcoxon signed-rank procedure to examine differences

between baseline data and data obtained during each follow-up was done for all

items to determine whether a

difference occurred at a time other than at the final posttest survey administration. Results. The

students

showed differences on 5 of the 10 items on the questionnaire during the study. Discussion and Conclusion.

These items related to reading peer-reviewed professional journals, critically reading

professional literature,

relevance and importance of evidence-based clinical practice, and level of comfort with knowledge in research.

Key Words: Attitudes Educational outcomes Research

1. Summarize the objectives of this study in your own words. 2. How many students began this study? _______ How many completed it? _______

3. How many times did students complete the questionnaire?

4. Infer some questions included in the survey

a) about attitudes and perceptions about research

b) about students level of comfort and confidence in reading and applying research

findings

published in the literature

c) about students personal habits

regarding reading the professional literature


Text 2

PHYS THER

Vol. 86, No. 7, July 2006, pp. 910-911

Interpreting Systematic Reviews: Sometimes, More Is Better Rebecca L Craik, Editor in Chief

Many of us remember when it was common for journals to publish literature reviews in

which content experts summarized topical information for the reader. A review of the

literature, however, does not protect the reader against the bias of the content

expert. In fact,

a literature review provides an opportunity for experts to support their bias using relevant

literature.

The systematic review, on the other hand, is designed to locate, appraise, and synthesize

primary studies reliably, using a scientific method that is intended to decrease bias and

errors.1 The clinical

problem should be focused and clearly stated, and each component

of

the review should be carefully described: the systematic strategy used to search for relevant

articles, the method used to critically appraise the articles before they are included

in the

review, the method used to collect data from the selected articles, and the methods used to

synthesize those collected data.

2 The Cochrane Collaboration

3 is one of the best-known

organizations that provide an infrastructure for conducting, maintaining, and updating

systematic reviews of the effectiveness of health care interventions. However, because the

systematic reviews overseen by the Cochrane Collaboration are not comprehensive,

many

journals commonly publish systematic reviews on relevant topics, rather than literature

reviews.

You may be surprised to find that Physical Therapy has published 2 systematic reviews

examining the effectiveness of physical therapy interventions for temporomandibular

disorders. In the May 2006 issue, McNeely, Armijo Olivo, and Magee published "A

Systematic Review of the Effectiveness of Physical Therapy Interventions for

Temporomandibular Disorders"; in this issue, Medlicott and Harris publish "A Systematic

Review of the Effectiveness of Exercise, Manual Therapy, Electrotherapy, Relaxation

Training, and Biofeedback in the Management of Temporomandibular Disorder."

Medlicott

and Harris contacted me when the May issue was published and offered to forgo publication

of their article. Although their gesture was noble, I decided to publish both articles.

1. What is the source of this article?

2. What year was it published?

3. How many authors are there?

Circle True or False

4. True / False According to this article literature reviews provide objective analysis of

information from different studies.

5. True / False All systematic reviews are published by Chocrane Collaboration

6. True / False The Chocrane Collaboration is a well respected source of systematic

reviews.

http://www.ptjournal.org/cgi/content/full/86/7/910?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=%22literature+review%22&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT#R1#R1http://www.ptjournal.org/cgi/content/full/86/7/910?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=%22literature+review%22&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT#R2#R2http://www.ptjournal.org/cgi/content/full/86/7/910?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=%22literature+review%22&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT#R3#R3


Text 3

PHYS THER

Vol. 87, No. 5, May 2007, pp. 545-555

Effect of Aerobic Training on Walking Capacity and Maximal Exercise Tolerance in Patients With Multiple Sclerosis: A Randomized Crossover Controlled Study Anais Rampello, Marco Franceschini, Massimo Piepoli, Roberto Antenucci, Gabriella

Lenti, Dario Olivieri and Alfredo Chetta Background and Purpose Physical deconditioning is involved in the impaired exercise

tolerance of patients with multiple sclerosis (MS), but data on the effects of aerobic training

(AT) in this population are scanty. The purpose of this study was to compare the effects

of

an 8-week AT program on exercise capacityin terms of walking capacity and maximum

exercise tolerance, as well as its effects on fatigue and health-related quality of lifeas

compared with neurological rehabilitation (NR) in subjects with MS.

Subjects and Methods

Nineteen subjects (14 female, 5 male; mean age [ SD]=418 years) with mild to moderate

disability secondary to MS participated in a randomized crossover controlled study. Eleven

subjects (8 female, 3 male; mean age [ SD]=446 years) completed the study.

Results

After AT, but not NR, the subjects walking distances and speeds during a self-paced walk

were significantly improved, as were their maximum work rate, peak oxygen uptake, and

oxygen pulse during cardiopulmonary exercise tests. The increases in

peak oxygen uptake

and maximum work rate, but not in walking capacity, were significantly higher after AT, as

compared with after NR. Additionally, the subjects who were most disabled

tended to benefit

more from AT. There were no differences between AT and NR in effects on fatigue, and the

results showed that AT may have partially affected health-related quality of life.

Discussion

and Conclusion The results suggest that AT is more effective than NR in improving

maximum exercise tolerance and walking capacity in people with mild to moderate disability

secondary to MS.

1. What journal was the article published in? __________________________________

2. How many authors contributed to this article? _______________________________

3. Were the results of this study positive, negative, or inconclusive?________________

4. What was/were the objective outcome measure(s) used?_______________________

______________________________________________________________________

5. What was/were the subjective outcome measure(s) were used? __________________

______________________________________________________________________

6. How many weeks total was the study period? ________________________________

7. What was the control treatment? __________________________________________

TRUE OR FALSE?

8. All the subjects received aerobic training. T / F

9. All the outcome measures showed improvement. T / F

10. NR was more effective than AT. T / F

11. Some subjects responded better to therapy than others. T / F

12. This study would rank high on the evidence ladder. T / F

13. Draw a scheme showing the groups of subjects and the treatments (if any) that they

received. Indicate the number of people involved in each group. Also draw the treatment

and assessment timeline.


Text 4

The American Journal of Sports Medicine 28:S (2000)

2000 American Orthopaedic Society for Sports Medicine

Football Injuries and Physical Symptoms: A Review of the Literature Jiri Dvorak, MD

* and Astrid Junge, PhD

Schulthess Clinic, Zurich, Switzerland

Football is one of the most popular sports worldwide. The frequency of football injuries is

estimated to be approximately 10 to 35 per 1000 playing hours. The majority of injuries

occur in the lower extremities, mainly in the knees and ankles; the number

of head injuries is

probably underestimated. The average cost for medical treatment per football injury is

estimated to be $150 (U.S. dollars). Considering the number of active football

players

worldwide, the socioeconomic and financial consequences of injury are of such a proportion

that a prevention program to reduce the incidence of injuries is urgently required. For

this

reason, an analysis of intrinsic (person-related) and extrinsic (environment-related) risk

factors was undertaken based on a review of the current literature. It was concluded that the

epidemiologic information regarding the sports medicine aspects of football injuries is

inconsistent and far from complete because of the employment of heterogeneous methods,

various definitions of injury, and different characteristics of the assessed teams.

The aim of

this study was to analyze the literature on the incidence of injuries and symptoms in football

players, as well as to identify risk factors for injury and to demonstrate possibilities

for

injury prevention.

1. What was/were the authors objectives?

2. Were they able to achieve this objective? ______ Why or why not?

3. Based on the abstract, do you think this article is likely to have useful clinical applications for your practice? _______ Why or why not?

http://ajs.sagepub.com/misc/terms.shtml


Text 5

Therapeutic Effects of Yoga for Children: A Systematic Review of the Literature.

Review Pediatric Physical Therapy. 20(1):66-80, Spring 2008.

Galantino, Mary Lou PT, PhD, MSCE; Galbavy, Robyn PT, MPT; Quinn, Lauren DPT

Abstract: Purpose: We completed a systematic review of the literature on the effect of yoga on quality

of life and physical outcome measures in the pediatric population. We explored various

databases and included case-control and pilot studies, cohort and randomized controlled

trials that examined yoga as an exercise intervention for children.

Summary of Key Points: Using the Sackett levels of evidence, this article reviews the

literature on yoga as a complementary mind-body movement therapy. We address the

research through three practice patterns according to the Guide to Physical Therapist

Practice and provide considerations for the inclusion of yoga into clinical practice.

Statement of Conclusions and Recommendations for Clinical Practice: The evidence shows

physiological benefits of yoga for the pediatric population that may benefit children through

the rehabilitation process, but larger clinical trials, including specific measures of quality of

life are necessary to provide definitive evidence.

1. Were the outcome measures in this study subjective, objective or both? ___________

2. According to the evidence ladder, how would you rank the four types of studies reviewed in this article.

3. The articles reviewed examined yoga as a substitute for other types of physical therapy. True / False

4. This review found that yoga had a positive result on some objective outcome measures, subjective outcome measures or both? ______________________


Text 6

PHYS THER

Vol. 75, No. 12, December 1995, pp. 1075-1081

Pelvic-floor rehabilitation, Part 2: Pelvic-floor reeducation with interferential currents and exercise in the treatment of genuine stress incontinence in postpartum women--a cohort study

C Dumoulin, DE Seaborne, C Quirion-DeGirardi, and SJ Sullivan Hopital Ste-Justine de Montreal, Quebec, Canada.

BACKGROUND AND PURPOSE: This descriptive cohort study investigated a physical therapy

program of pelvic-floor neuromuscular electrostimulation (NMES) combined with exercises, with

the aim of developing a simple, inexpensive, and conservative treatment for postpartum genuine

stress incontinence (GSI). SUBJECTS: Eight female subjects with urodynamically established GSI

persisting more than 3 months after delivery participated in the study. The subjects ranged in age

from 24 to 37 years (X = 32, SD = 4.2). METHODS: This was a descriptive multiple-subject cohort

study. Each subject received a total of nine treatment sessions during 3 consecutive weeks,

consisting of two 15-minute sessions of NMES followed by a 15-minute pelvic-floor muscle exercise

program. Patients also practiced daily pelvic-floor exercises during the 3-week treatment period. The

treatment intervention was measured using three separate variables. Maximum muscle contractions

(pretraining, during training, and post-training) were measured indirectly as pressure, using

perineometry. Urine loss pretraining and posttraining was measured by means of a Pad test. Self-

reported frequency of incontinence was recorded daily throughout the period of the study, using a

diary. Data were analyzed using a one-way repeated-measures analysis of variance (ANOVA), a

Wilcoxon signed-ranks test, and a Friedman two-way ANOVA by ranks. RESULTS: The results

indicated that maximum pressure generated by pelvic-floor contractions was greater and both the

quantity of urine loss and the frequency of incontinence were lower following the implementation of

the physical therapy program. Five subjects became continent, and three others improved. A follow-

up survey 1 year later confirmed the consistency of these results. CONCLUSION AND

DISCUSSION: The results suggest that the proposed physical therapy program may influence

postpartum GSI. Further studies are needed to validate this simple, inexpensive, and conservative

physical therapy protocol. [Dumoulin C, Seaborne DE, Quirion-DeGirardi C, Sullivan SJ. Pelvic-

floor rehabilitation, part 2: pelvic-floor reeducation with interferential currents and exercise in the

treatment of genuine stress incontinence in postpartum women--a cohort study.

1. What was the objective of this study?

2. What was the cohort for this study?

3. All interventions took place at the treatment center? TRUE / FALSE

4. What were the outcome measures?

5. According to the authors what type of study is this?

6. Based on what you have learned about different types of studies, what type of study would you say this is?

7. What features of this study helped you make this decision.


Text 7

Arthroscopy. 2007 Dec;23(12):1320-1325.e6.

A meta-analysis of the incidence of anterior cruciate ligament tears as a function of

gender, sport, and a knee injury-reduction regimen.

Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K.

Illinois Sports Medicine & Orthopaedic Centers, Glenview, Illinois 60025, USA.

PURPOSE: The literature has shown that anterior cruciate ligament (ACL) tear rates vary by

gender, by sport, and in response to injury-reduction training programs. However, there is no

consensus as to the magnitudes of these tear rates or their variations as a function of these

variables. For example, the female-male ACL tear ratio has been reported to be as high as

9:1. Our purpose was to apply meta-analysis to the entire applicable literature to generate

accurate estimates of the true incidences of ACL tear as a function of gender, sport, and

injury-reduction training. METHODS: A PubMed literature search was done to identify all

studies dealing with ACL tear incidence. Bibliographic cross-referencing was done to

identify additional articles. Meta-analytic principles were applied to generate ACL

incidences as a function of gender, sport, and prior injury-reduction training. RESULTS:

Female-male ACL tear incidences ratios were as follows: basketball, 3.5; soccer, 2.67;

lacrosse, 1.18; and Alpine skiing, 1.0. The collegiate soccer tear rate was 0.32 for female

subjects and 0.12 for male subjects. For basketball, the rates were 0.29 and 0.08,

respectively. The rate for recreational Alpine skiers was 0.63, and that for experts was 0.03,

with no gender variance. The two volleyball studies had no ACL tears. Training reduced the

ACL tear incidence in soccer by 0.24 but did not reduce it at all in basketball.

CONCLUSIONS: Female subjects had a roughly 3 times greater incidence of ACL tears in

soccer and basketball versus male subjects. Injury-reduction programs were effective for

soccer but not basketball. Recreational Alpine skiers had the highest incidences of ACL tear,

whereas expert Alpine skiers had the lowest incidences. Volleyball may in fact be a low-risk

sport rather than a high-risk sport. Alpine skiers and lacrosse players had no gender

difference for ACL tear rate. Year-round female athletes who play soccer and basketball

have an ACL tear rate of approximately 5%. LEVEL OF EVIDENCE: Level IV, therapeutic

case series. 1. What is the source of this article? _________________________

2. What year was it published? __________________________

3. How many authors were there? __________________________

4. The authors wanted to study _____. a. the incidence of ACL tears among athletes b. gender differences in ACL tears c. the number of ACL tears in relation to preventative measures, sex and type of activity d. age-related risk factors contributing to ACL tears

5. What variables seem to affect the likelihood of person experiencing an ACL injury? ________

___________________________________________________________________________

6. Which sport had the highest incidence of ACL tears? __________________________

7. Which sport had the lowest incidence of ACL tears? __________________________

javascript:AL_get(this,%20'jour',%20'Arthroscopy.');http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Prodromos%20CC%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Han%20Y%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Rogowski%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Joyce%20B%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Shi%20K%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1


Text 8

PHYS THER

Vol. 77, No. 8, August 1997, pp. 812-819

Predicting the probability for falls in community-dwelling older adults A Shumway-Cook, M Baldwin, NL Polissar, and W Gruber

Department of Physical Therapy, Northwest Hospital, Seattle, WA 98133, USA.

BACKGROUND AND PURPOSE: The objective of this retrospective case-control study

was to develop a model for predicting the likelihood of falls among community-dwelling

older adults. SUBJECTS: Forty-four community-dwelling adults (> or = 65 years of age)

with and without a history of falls participated. METHODS: Subjects completed a health

status questionnaire and underwent a clinical evaluation of balance and mobility function.

Variables that differed between fallers and nonfallers were identified, using t tests and cross

tabulation with chi-square tests. A forward stepwise regression analysis was carried out to

identify a combination of variables that effectively predicted fall status. RESULTS: Five

variables were found to be associated with fall history. These variables were analyzed using

logistic regression. The final model combined the score on the Berg Balance Scale with a

self-reported history of imbalance to predict fall risk. Sensitivity was 91%, and specificity

was 82%. CONCLUSION AND DISCUSSION: A simple predictive model based on two

risk factors can be used by physical therapists to quantify fall risk in community-dwelling

older adults. Identification of patients with a high fall risk can lead to an appropriate referral

into a fall prevention program. In addition, fall risk can be used to calculate change resulting

from intervention 1.

What background information do the authors give for this study? ___________________

2. What is their objective?____________________________________________________

3. What group of patients represents the case in this study? ________________________

4. What group of patients represents the control in this study? ______________________

5. How many variables contribute to a history of falls?______________________________

6. What are they?__________________________________________________________


Text 9

Md Med J 1999 Jan-Feb;48(1):7-11

Long-term functional results after manipulation of the frozen shoulder.

Reichmister JP, Friedman SL. Department of Orthopaedic Surgery, Sinai Hospital, USA.

The use of shoulder manipulation in the treatment of frozen shoulder syndrome remains

controversial. Opponents cite the risk of dislocation, fracture, nerve palsy, and rotator cuff

tearing as limiting the usefulness of manipulation. A retrospective study of 38 shoulder

manipulations in 32 patients was performed. These patients were followed for an average

time of 58 months. The patients were examined in follow up for combined shoulder range of

motion, external and internal rotation strength, and status of the long head of the biceps.

Manipulation was performed in all patients by the senior author and supervised physical

therapy was begun within 24 hours of the manipulation. The average recovery time was 13

weeks. In this series, 97% of patients had relief of pain and recovery of near complete range

of motion, although 8% required a second manipulation to obtain a successful result. Mild

weakness to manual muscle testing was present in 5.3% of patients in external rotation and

10.5% of patients in internal rotation. There was no deterioration of shoulder function with

time. In fact, most patients improved even more with passage of time. There was no

evidence of biceps tendon rupture or rotator cuff insufficiency at the time of follow up in

any of the patients. No fractures, dislocations or nerve palsies were observed, although one

patient who had no premanipulation arthrogram was found to have a rotator cuff tear a few

months after failed manipulation. Manipulation of the shoulder can therefore be offered to

reduce the pain and period of disability in patients who fail conservative treatment of frozen

shoulder syndrome.

1. This abstract describes a __.

a) randomized controlled trial

b) case report c) retrospective study

d) review of the medical literature

2. This study was probably carried out __.

a) because frozen shoulder syndrome is a painful disorder b) because other studies have criticized manipulation as a treatment for frozen shoulder

c) to determine if shoulder manipulation is an effective treatment for frozen shoulder d) to determine the long-term effect of frozen shoulder syndrome

TRUE or FALSE? 3. ___ The subjects were probably former patients of one of the authors.

4. ___ Shoulder manipulation can be considered a conservative treatment for frozen shoulder. 5. ___ The 32 subjects probably began treatment for frozen shoulder at different baselines.

6. ___ Patients received no treatment for frozen shoulder apart from shoulder manipulation. 7. ___ No injury that could have been due to shoulder manipulation was found in any of the

subjects.

8. ___ Three patients were given shoulder manipulation twice. 9. ___ One outcome measure was probably a VAS for pain.


Text 10

Physical Therapy Volume 80 Number 4 April 2000 Work-Related Musculoskeletal Disorders in Physical Therapists: Prevalence, Severity, Risks, and Responses Jean E Cromie, Valma J Robertson, and Margaret O Best

Background and Purpose. Physical therapists are at risk for work-related musculoskeletal

disorders (WMSDs). Little is known of how therapists respond to injury or of what actions

they take to prevent injury. The purpose of this study was to investigate the prevalence and

severity of WMSDs in physical therapists, contributing risk factors, and their responses to

injury. Subjects. As part of a larger study, a systematic sample of 1 in 4 therapists on a state

register (n=824) was surveyed. Methods. An 8-page questionnaire was mailed to each

subject. Questions investigated musculoskeletal symptoms, specialty areas, tasks and job-

related risk factors, injury prevention strategies, and responses to injury. Results. Lifetime

prevalence of WMSDs was 91%, and 1 in 6 physical therapists moved within or left the

profession as a result of WMSDs. Younger therapists reported a higher prevalence of

WMSDs in most body areas. Use of mobilization and manipulation techniques was related

to increased prevalence of thumb symptoms. Risk factors pertaining to workload were

related to a higher prevalence of neck and upper-limb symptoms, and postural risk factors

were related to a higher prevalence of spinal symptoms. Conclusion and Discussion.

Strategies used to reduce work-related injury in industry may also apply to physical

therapists. Increased risk of thumb symptoms associated with mobilization techniques

suggests that further research is needed to establish recommendations for practice. The

issues for therapists who move within or leave the profession are unknown, and further

research is needed to better understand their needs and experiences. [Cromie JE, Robertson

VJ, Best MO. Work-related musculoskeletal disorders in physical therapists: prevalence,

severity, risks, and responses. Phys Ther. 2000;80:336-351.] Key Words: Musculoskeletal disorders, Occupational injury, Physical therapy, Risk

factors.

1. What is the authors objective?

2. What were the features of the study population?

3. What was the study design?

4. Data was collected on ____. (Circle all that apply.)

5. What does WMSD mean? _______________________________________________

f) preventive measures adopted g) work history h) work responsibilities i) body mass index j) anthropometric variables

a) adaptation and attitudes toward injuries b) areas of expertise c) level of education d) occupational risk factors e) physical complaints


6. The results showed that __________. a) 1 in 6 physical therapists reported lifetime prevalence of WMSDs. b) 91% of young physical therapists moved within or left the profession due to

WMSDs.

c) there is a higher prevalence of symptoms among younger physical therapists. d) use of mobilization and manipulation techniques was the cause of most disorders.

7. Based on your knowledge of your profession what types tasks performed by PTS are likely to lead to the development of musculoskeletal disorders? What types of

preventative measures do you know of to reduce the risk of developing a WMSD?

Discuss with a partner.

8. _______ led to thumb problems. a) lack of recommendations for practice b) performing mobilization techniques c) workload factors d) work-related musculoskeletal disorders

9. _____ triggered cervical and arm problems. a) amount and type of work b) lifting patients c) muscle strength d) posture

10. Poor sitting or standing positions put a physical therapist at risk for ________. a) back pain b) hip joint and circulation problems c) problems in the cervical vertebrae d) upper and lower limb joint pain

11. Do you find it surprising that younger therapists reported a higher prevalence of WMSDs in most body areas? What do you think might account for this phenomenon?

Discuss with a partner.

12. In the conclusion, the authors suggest that physical therapists can benefit from _____.

a) strategies used to prevent injury in industry b) mobilization techniques to strengthen their thumbs. c) existing research on their needs and experiences. d) exercises that industrial workers do to reduce such problems as thumb

hypermobility

13. Which issues does the author believe need further research?


Text 11

Effect of acupuncture-like electrical stimulation on chronic tension-type headache: a

randomized, double-blinded, placebo-controlled trial

The Clinical Journal of Pain 2007 May;23(4):316-322

OBJECTIVE: The aim of this study was to examine the effect of acupuncture-like

electrical stimulation on chronic tension-type headache (TTH) in a randomized, double-

blinded, placebo-controlled study. METHODS: Thirty-six patients (18 men, 18 women)

with chronic TTH in accordance with the criteria of International Headache Society were

investigated. The patients were randomly assigned into 2 groups: a treatment group and a

placebo group. Pain duration, pain intensity on a 0 to 10 cm visual analog scale, number of

headache attacks, and use of medication were recorded in a diary for 2 weeks before

treatment (baseline), early stage of treatment (Treat-1; 2 wk), late stage of treatment (Treat-

2; 4 wk), and after the end of treatment (Post-1, Post-2, Post-3 corresponding to 2, 4, and 6-

wk follow-up). The patients also provided an overall evaluation of the treatment effect at

each stage. Patients were taught how to use either an acupuncture-like electrical stimulator

or a sham stimulator (identical but incapable of delivering an electric current) and then

instructed to use the device at home. Six acupoints, bilateral EX-HN5, GB 20, LI 4, were

selected to be stimulated 3 minutes for each point, twice a day. Friedman repeated measure

analysis of variance on rank was used to test the data. RESULTS: The pain duration was

shortened at Treat-1 and pain intensity was decreased at Treat-1 and Treat-2 compared with

baseline. The overall evaluation of the 2 treatments indicated improvements in both the

treatment and the placebo groups, but with no significant difference between the groups (p >

0.061). Despite the apparent improvement in both the treatment and placebo groups, a

decrease in analgesic use was only observed in the treatment group. There was also a

significant positive correlation between the reported intensity of the stimulus-evoked

sensation and the evaluation of the effect of either active or placebo treatments (p = 0.039).

CONCLUSIONS: The use of acupuncture-like electrical stimulation was not associated

with significant adverse effects. These results indicate that acupuncture-like electrical

stimulation is a safe and potentially analgesic-sparing therapy that may be considered as an

adjunctive treatment for patients with chronic TTH although the clinical effect on pain

seems to be marginal in the present set-up. 1. During the study did the researchers know which patients were receiving the acupuncture-like

electrical stimulation and which patients were receiving the placebo? _______ 2. How many weeks was the duration of the study?_________ 3. Mark the timeline with the various stages of the study. 4. Did the placebo treatment cause a sensation? _______ 5. What factor affected the effect of the treatment?

a. the subjects sex b. whether patients received acupuncture-like electrical stimulation or placebo c. how intensely the patient felt the application of treatment

6. Do the authors feel acupuncture-like electrical stimulation is a possible substitute for other

treatments TTH? ________ 7. Could the results of this study be applied to anyone suffering a headache? Why or why not?

______________________________________________________________


Text 12

PHYS THER

Vol. 88, No. 1, January 2008, pp. 98-104

DOI: 10.2522/ptj.20070033

Undetected Hangman's Fracture in a Patient Referred for Physical Therapy for the Treatment of Neck Pain Following Trauma Michael D Ross and John M Cheeks

Background and Purpose: This case report describes a patient referred for physical therapy

treatment of neck pain who had an underlying hangman's fracture that precluded physical

therapy intervention.

Case Description: This case involved a 61-year-old man who had a sudden onset of neck

pain after a motor vehicle accident 8 weeks before his initial physical therapy visit.

Conventional radiographs of his cervical spine taken on the day of the accident

did not reveal

any abnormalities. Based on the findings at his initial physical therapy visit, the physical

therapist ordered conventional radiographs of the cervical spine to rule out the

possibility of

an undetected fracture.

Outcomes: The radiographs revealed bilateral C2 pars interarticularis defects consistent

with a hangman's fracture. The patient was referred to a neurosurgeon for immediate review.

Based on a normal neurological examination, a relatively low level of pain,

and the results of

radiographic flexion and extension views of the cervical spine (which revealed no evidence

of instability), the neurosurgeon recommended that the patient continue with

nonsurgical

management.

Discussion: In patients with neck pain caused by trauma, physical therapists should be alert

for the presence of cervical spine fractures. Even if the initial radiographs are negative for

a

fracture, additional diagnostic imaging may be necessary for a small number of patients,

because they may have undetected injuries that would necessitate medical referral and

preclude physical therapy intervention.

1. What is the source of this abstract? ___________________

2. What year was it published? ___________________

3. The patients neck pain developed over time. True / False.

4. How was the hangmans fracture detected? ______________________

5. Was the patient able to continue with physical therapy? ___________

Why do the authors feel the presentation of this case was important?


UIC/ Idiomes/Angls Cincies de la salut gn.66

Objective: Review of vocabulary for PowerPoint Presentation gn.66 What is a systematic review

PRE-LISTENING: In English 1 and 2.1 you learned about two basic types of research: non-

experimental and experimental. Look at the following types of studies and say what type of

research it is.

1. ______________________ Cohort

2. ______________________ Case Report

3. ______________________ Randomized Controlled Trial

4. ______________________ Cross-sectional Survey

5. ______________________ Case-control

What do you remember about the designs of each type of study? What types of research

questions are they best for answering?

Here is the hierarchy of evidence pyramid we looked at in English 1. Do you remember where each type

of research is located in the pyramid?

Case-control studies Case series and case reports

Systematic reviews Editorials and expert opinions

Randomized controlled trials Cohort studies



Objective: to reflect on the importance of systematic reviews

Before you read:

1. Reflexology is a popular complementary therapy. What do you know about it?

2. For what sorts of conditions might it be a useful treatment?

3. Do you think it is effective therapy?

Med J Aust. 2009 Sep 7;191(5):263-6.

Is reflexology an effective intervention? A systematic review of

randomised controlled trials.

Ernst E.

Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth,

Exeter, United Kingdom. [email protected]

OBJECTIVE:

To evaluate the evidence for and against the effectiveness of reflexology for treating any

medical condition.

DATA SOURCES:

Six electronic databases were searched from their inception to February 2009 to identify all

relevant randomised controlled trials (RCTs). No language restrictions were applied.

STUDY SELECTION AND DATA EXTRACTION:

RCTs of reflexology delivered by trained reflexologists to patients with specific medical

conditions. Condition studied, study design and controls, primary outcome measures,

follow-up, and main results were extracted.

DATA SYNTHESIS:

Of 217 publications identified, 18 RCTs met all the inclusion criteria. The studies examined

a range of conditions: anovulation, asthma, back pain, dementia, diabetes, cancer, foot

oedema in pregnancy, headache, irritable bowel syndrome, menopause, multiple sclerosis,

the postoperative state and premenstrual syndrome. There were > 1 studies for asthma, the

postoperative state, cancer palliation and multiple sclerosis. Five RCTs yielded positive

results. Methodological quality was evaluated using the Jadad scale. The methodological

quality was often poor, and sample sizes were generally low. Most higher-quality trials did

not generate positive findings.

CONCLUSION:

The best evidence available to date does not demonstrate convincingly that reflexology is an

effective treatment for any medical condition.

1. What is the source of this abstract? ____________

2. When was it published? _______________

3. Where does the researcher work? __________________

4. What were the inclusion criteria? ___________________________________

5. How many different aspects of the trials were compared? ________________

6. How many studies were included in this review? ________________

http://www.ncbi.nlm.nih.gov/pubmed/19740047http://www.ncbi.nlm.nih.gov/pubmed?term=%22Ernst%20E%22%5BAuthor%5D


TRUE / FALSE: Write T or F in the blank

7. _____ The year of study publication was not an inclusion criteria.

8. _____ All the studies reviewed were in English.

9. _____ Five RCTs had high methodological quality.

10. _____ Only one RCT had been conducted for most conditions.

Reflect:

1. Why might the author be interested in whether more than one RCT had been conducted on a particular condition?

2. Read the following statement from Reflexology Association of Australia and discuss why the results of this systematic review are so different from the RAAs claims.

Think about what we have learned about different kinds of studies.

Reflexology can address your particular needs. Painful, congested or overactive states

within the body can be balanced and normalised. Thousands of documented case studies

from around the world have demonstrated the benefits for:

[premenstrual tension]

Migraine

Sinus

Colic

Menopause

Constipation/Diarrhoea

Back Pain

Neck Pain

Sciatica

Shoulder Pain

Asthma

Stroke

Menstrual Irregularities

Reflexology Association of Australia (http://www.reflexology.org.au)



Objective: Introduce basic concepts of systematic reviews

Behavioural treatment for chronic low-back pain

Henschke N, Ostelo RWJG, van Tulder MW, Vlaeyen JWS, Morley S, Assendelft WJJ,

Main CJ. Behavioural treatment for chronic low-back pain. Cochrane Database of

Systematic Reviews 2010, Issue 7. Art. No.: CD002014. DOI:

10.1002/14651858.CD002014.pub3.

Abstract

Background: Behavioural treatment is commonly used in the management of chronic low-

back pain (CLBP) to reduce disability through modification of maladaptive pain behaviours

and cognitive processes. Three behavioural approaches are generally distinguished: operant,

cognitive, and respondent; but are often combined as a treatment package. Objectives: To

determine the effects of behavioural therapy for CLBP and the most effective behavioural

approach. Methods: The Cochrane Back Review Group Trials Register, CENTRAL,

MEDLINE, EMBASE, and PsycINFO were searched up to February 2009. Reference lists

and citations of identified trials and relevant systematic reviews were screened. Randomised

trials on behavioural treatments for non-specific CLBP were included. Two review authors

independently assessed the risk of bias in each study and extracted the data. If sufficient

homogeneity existed among studies in the pre-defined comparisons, a meta-analysis was

performed. We determined the quality of the evidence for each comparison with the

GRADE approach.

Results: We included 30 randomised trials (3438 participants) in this review, up 11 from the

previous version. Fourteen trials (47%) had low risk of bias. For most comparisons, there

was only low or very low quality evidence to support the results. There was moderate

quality evidence that: i) operant therapy was more effective than waiting list (SMD -0.43;

95%CI -0.75 to -0.11) for short-term pain relief; ii) little or no difference exists between

operant, cognitive, or combined behavioural therapy for short- to intermediate-term pain

relief; iii) behavioural treatment was more effective than usual care for short-term pain relief

(MD -5.18; 95%CI -9.79 to -0.57), but there were no differences in the intermediate- to

long-term, or on functional status; iv) there was little or no difference between behavioural

treatment and group exercise for pain relief or depressive symptoms over the intermediate-

to long-term; v) adding behavioural therapy to inpatient rehabilitation was no more effective

than inpatient rehabilitation alone. Conclusion: For patients with CLBP, there is moderate

quality evidence that in the short-term, operant therapy is more effective than waiting list

and behavioural therapy is more effective than usual care for pain relief, but no specific type

of behavioural therapy is more effective than another. In the intermediate- to long-term,

there is little or no difference between behavioural therapy and group exercises for pain or

depressive symptoms. Further research is likely to have an important impact on our

confidence in the estimates of effect and may change the estimates.

1. What is the source of this abstract? ____________

2. When was it published? _______________


3. The goal of this review was to _____ (Circle Two)

a. compare behavioral therapy to other types of physical therapy in the treatment of

low-back pain.

b. Determine if behavioral therapy is an effective intervention for chronic low-back

pain.

c. See if one type of behavioral therapy is better than another.

d. Determine how different types of behavioral therapy are combined in the

treatment of CLBP.

4. How many databases were searched? _________

5. What does this statement from the methods section mean? If sufficient homogeneity existed among studies in the pre-defined comparisons, a meta-analysis was

performed.

6. Based on this abstract, under what circumstances (if any) would you recommend behavioral therapy over other types of therapy?

7. In the conclusion the authors say that further research is likely to have an important impact on their confidence in the estimates of effect and may change the estimates.

Why do you think they say this?

TRUE / FALSE: Write T or F in the blank

8. _____ This review looks at RCTs of people suffering long-term back pain resulting

from an injury.

9. _____ About half of the studies had a moderate to high risk of bias.

10. _____ Waiting list most likely refers to a control group.

11. _____ The authors have conducted this type of systematic review before.

12. _____ Overall the evidence supporting the effectiveness of behavioral therapy is

good.

Vocabulary: Find the term in the text for the following definitions.

a. to select, reject, consider, or group (people, objects, ideas, etc.) by examining

systematically ___________________.

b. Grading of Recommendations Assessment, Development and Evaluation

_____________.

c. A distortion of results that may occur if randomization is not properly carried out or

if subjects or researchers know which group they have been allocated to

_____________.

d. a patient who stays in a hospital while receiving medical care or treatment

_____________.

http://dictionary.reference.com/browse/patienthttp://dictionary.reference.com/browse/whohttp://dictionary.reference.com/browse/Medical


UIC Idiomes Angls jcp 10.04.12 Reading comprehension abstract of a systematic review

Exercise for the management of cancer-related fatigue in adults

1. Fiona Cramp1,*, 2. James Daniel2

Editorial Group: Cochrane Pain, Palliative and Supportive Care Group

Published Online: 21 JAN 2009

DOI: 10.1002/14651858.CD006145.pub2

Copyright 2010 The Cochrane Collaboration.

Cramp F, Daniel J. Exercise for the management of cancer-related fatigue in adults.

Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD006145. DOI:

10.1002/14651858.CD006145.pub2.

Author Information

1. University of the West of England, Faculty of Health & Life Sciences, Bristol, UK

2. University of the West of England, School of Psychology, Bristol, UK

Publication History

1. Published Online: 21 JAN 2009

Background Cancer-related fatigue is now recognised as an important symptom associated with cancer and its treatment. A number of studies have investigated the effects

of physical activity in reducing cancer-related fatigue with no definitive conclusions

regarding its effectiveness.

Objectives To evaluate the effect of exercise on cancer-related fatigue both during and after cancer treatment.

Search methods The Cochrane Controlled Trials Register (CENTRAL/CCTR), MEDLINE (1966 to July 2007), EMBASE (1980 to July 2007), CINAHL (1982 to July

2007), British Nursing Index (January 1984 to July 2007), AMED (1985 to July 2007),

SIGLE (1980 to July 2007), and Dissertation Abstracts International (1861 to July 2007)

were all searched using key words. Reference lists off all studies identified for inclusion and

relevant reviews were also searched. In addition, relevant journals were hand searched and

experts in the field of cancer-related fatigue were contacted.

Selection criteria Randomised controlled trials (RCTs) that investigated the effect of exercise on cancer-related fatigue in adults were included.

Data collection and analysis Two review authors independently assessed the methodological quality of studies and extracted data based upon predefined criteria. Where

data were available meta-analyses were performed for fatigue using a random-effects model.

Main results Twenty-eight studies were identified for inclusion (n = 2083 participants), with the majority carried out on participants with breast cancer (n = 16 studies; n = 1172

participants). A meta-analysis of all fatigue data, incorporating 22 comparisons provided

data for 920 participants who received an exercise intervention and 742 control participants.

At the end of the intervention period exercise was statistically more effective than the

control intervention (SMD -0.23, 95% Confidence Interval (CIs) -0.33 to -0.13).

Conclusions Exercise can be regarded as beneficial for individuals with cancer-related fatigue during and post cancer therapy. Further research is required to determine the optimal

type, intensity and timing of an exercise intervention.

http://onlinelibrary.wiley.com/o/cochrane/clabout/articles/SYMPT/frame.html


UIC Idiomes Angls jcp 10.04.12 Reading comprehension abstract of a systematic review

Exercise for the management of cancer-related fatigue in adults

1. What is the source of this abstract?

2. How many authors are listed?

3. Where do the authors work?

4. When was this abstract published?

5. This is a/an___ study.

a. non-experimental b. experimental c. integrative

6. Why do the authors think that this study is necessary?

7. What did the authors want to determine?

8. How many databases were searched?

9. What other sources of studies were identified?

10. What were the inclusion criteria for studies?

11. How many studies met the inclusion criteria?

12. How many studies included patients who did not have breast cancer?

13. How many studies were submitted to meta analysis?

14. What outcome measure was compared in the meta analysis?

15. Exercise___cancer fatigue.

a. increases b. decreases c. has no effect on

16. Which kind of exercise is better in the treatment of cancer fatigue?

17. What areas need to be explored in future research?

18. What are the clinical recommendations based on this study?


Pre-reading activities TASK I Read the following text.

Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis--critical appraisal and commentary.

CLINICAL QUESTION: Among patients with or at risk for musculoskeletal overuse conditions,

(1) do foot orthoses provide clinically meaningful improvements, and (2) are foot orthoses cost-

effective? DATA SOURCES: Studies published through September 28, 2005, were identified by

using MEDLINE, EMBASE, CINAHL and Pre-CINAHL, Physiotherapy Evidence Database

(PEDro), PubMed, SPORTDiscus, Biological Abstracts, Web of Science, Allied Health and

Complementary Medicine Database, and the full Cochrane Library. Reference lists of included

randomized controlled trials (RCTs) and identified systematic reviews were searched by hand.

STUDY SELECTION: Studies were included if (1) they were RCTs that included the use of foot

orthoses (either custom or prefabricated) in 1 of the intervention groups, (2) the clinical problem was

an overuse condition as defined by the American College of Foot and Ankle Orthopedics and

Medicine guidelines for which foot orthoses were recommended, and (3) at least 1 clinically relevant

outcome was measured for a minimum of 1 week. Limits were not placed on year of publication,

status of publication, or language.

1. What were the authors inclusion criteria?

2. Where did they look for their information?

3. What do you think was the oldest source of information available in their search? The newest?

TASK II Answer the questions below about a study about interferential current therapy.

You are going to read an abstract about a study with the title, The effects of interferential current therapy in management of musculoskeletal pain.

1. Write what you think the authors initial research question was:

______________________________________________________________?

Analyze it using the PICO model.

2. How do you think this question arose? Why did they need to answer this question?

3. This study was a systematic review. If you were a member of this research team, what

inclusion criteria would you apply to find evidence to answer your question?

4. Where would you look?

5. How many articles do you think could meet your criteria? Explain your answer.

a. 500

6. Write a hypothesispredict the answer to this research question.


TASK III Read the abstract below. Label the sections with the following terms:

BACKGROUND CONCLUSION

DATA EXTRACTION DATA SOURCES

DATA SYNTHESIS PURPOSE

The effects of interferential current therapy in management of

musculoskeletal pain

Interferential current (IFC) is a common electrotherapeutic modality used to treat pain. Although IFC is

widely used, the available information regarding its clinical efficacy is debatable. The aim of this

systematic review and meta-analysis was to analyze the available information regarding the efficacy of

IFC in the management of musculoskeletal pain. Randomized controlled trials were obtained through a

computerized search of bibliographic databases (ie, CINAHL, Cochrane Library, EMBASE, MEDLINE,

PEDro, Scopus, and Web of Science) from 1950 to February 8, 2010. Two independent reviewers

screened the abstracts found in the databases. Methodological quality was assessed using a compilation

of items included in different scales related to rehabilitation research. The mean difference, with 95%

confidence interval, was used to quantify the pooled effect. A chi-square test for heterogeneity was

performed. A total of 2,235 articles were found. Twenty studies fulfilled the inclusion criteria. Seven

articles assessed the use of IFC on joint pain; 9 articles evaluated the use of IFC on muscle pain; 3

articles evaluated its use on soft tissue shoulder pain; and 1 article examined its use on postoperative

pain. Three of the 20 studies were considered to be of high methodological quality, 14 studies were

considered to be of moderate methodological quality, and 3 studies were considered to be of poor

methodological quality. Fourteen studies were included in the meta-analysis. Interferential current as a

supplement to another intervention seems to be more effective for reducing pain than a control treatment

at discharge and more effective than a placebo treatment at the 3-month follow-up. However, it is

unknown whether the analgesic effect of IFC is superior to that of the concomitant interventions.

Interferential current alone was not significantly better than placebo or other therapy at discharge or

follow-up. Results must be considered with caution due to the low number of studies that used IFC alone.

In addition, the heterogeneity across studies and methodological limitations prevent conclusive

statements regarding analgesic efficacy.

7. How did their question arise?

a. Because most practitioners question its effectiveness

b. Because of inconclusive evidence regarding its ability to reduce pain

c. The safety of IFC has not yet been tested

8. What were the authors inclusion criteria? Consider the following aspects:

a. Intervention

b. Study design

c. Outcome measures

d. Time limits

9. Where did they decide to search for their information?

10. How long have the effects of IFS been studied?

11. The results _____.

a. strongly support the use of IFS for musculoskeletal pain

b. do not support the use of IFS for musculoskeletal pain at all

c. suggest that the use of IFS in some cases of musculoskeletal pain may be somewhat

beneficial

d. cleared up the current debate about the use of IFS for musculoskeletal pain


Physical Therapy Volume 81:7 (July 2001)

A Review of Therapeutic Ultrasound: Effectiveness Studies Valma J Robertson and Kerry G Baker

Background and Purpose. Therapeutic ultrasound is one of the most widely and frequently

used electrophysical agents. Despite over 60 years of clinical use, the effectiveness of

ultrasound for treating people with pain, musculoskeletal injuries, and soft tissue lesions

remains questionable. This article presents a systematic review of randomized controlled

trials (RCTs) in which ultrasound was used to treat people with those conditions. Each trial

was designed to investigate the contributions of active and placebo ultrasound to the patient

outcomes measured. Depending on the condition, ultrasound (active and placebo) was used

alone or in conjunction with other interventions in a manner designed to identify its

contribution and distinguish it from those of other interventions. Methods. Thirty-five

English-language RCTs were published between 1975 and 1999. Each RCT identified was

scrutinized for patient outcomes and methodological adequacy. Results. Ten of the 35 RCTs

were judged to have acceptable methods using criteria based on those developed by Sackett

et al. Of these RCTs, the results of 2 trials suggest that therapeutic ultrasound is more

effective in treating some clinical problems (carpal tunnel syndrome and calcific tendinitis

of the shoulder) than placebo ultrasound, and the results of 8 trials suggest that it is not.

Discussion and Conclusion. There was little evidence that active therapeutic ultrasound is

more effective than placebo ultrasound for treating people with pain or a range of

musculoskeletal injuries or for promoting soft tissue healing. The few studies deemed to

have adequate methods examined a wide range of patient problems. The dosages used in

these studies varied considerably, often for no discernible reason.

1. In your own words, why was this review carried out? _____________________________________________________________

2. Give the author-date citation formula for his article. _______________ 3. What does RCT stand for? _______________ 4. How many articles in total did the authors study? ______ 5. Why were the results of some of these articles excluded from this review? Explain in

your own words.

_____________________________________________________________

6. In all the studies reviewed, was ultrasound used alone as a treatment? _____________________________________________________________

7. Translate the first sentence of the Discussion & Conclusion section. _____________________________________________________________

8. In your own words, explain what the last sentence of the abstract means. _____________________________________________________________

9. Rate this article in terms of its relevance and importance to your profession.

10. In your professional opinion, what are the clinical implications of this research?

U.I.C. / Idiomes / Angls

Cincies de la Salut / Physiotherapy / mks.271

Objective: An abstract of a review article.

Not important Important


Group Project Steps

Steps that you will follow:

Step

Worksheet/document/dossier page

Identify your areas of interest jcp.21.03.12 Selecting a research topic

(individual) p39/40

Form a research group + Decide on your

topic+ narrow the topic

MESH Keywords related to your topic

P41/42

Set up a group glossary

Review the literature for basic background

Information: General websites and

abstracts

Literature search: General Information: General

Websites related to the topic jcp.27.03.12 p43

Literature search:

5 abstracts related to the topic p44

Formulate a research question using PICO

method

Mld.10.04.12 Formulating an answerable

question p45/46/47/48

Planning your search: Inclusion criteria Planning your search p49

Documenting your search: Flowcharts P50/51

Extracting Information/Tables P52-62

Synthesizing Information/draw

conclusions

P63-64

Evaluating Methodological Quality P65-67

Oral Presentation of your research

process process.

P68/69

jcp.09.05.12 Oral presentation guidelines

Write up a written report of your research P70


UIC/ Idiomes/ Angls Cincies de la salut mld.20.03.12

Objective to prepare for selecting an area of research

Selecting a general Topic

Identifying one workable study topic is perhaps the most challenging part of a

research project. Each of the infinite study topics has its own set of virtues and

shortcomings. Topic selection is one of the few steps in research

wherecreativity is not only allowed but required. Although study design, data

collection, and data analysis must all follow a restrictiveprotocol of accepted

methods, picking a study topic calls for expression of personal interests.

Brainstorming and concept mapping

A brainstorming session can be a good starting point for identifying a research

topic. Use the categories in (see table below) to identify areas of personal interest. Spend a day,

several days, or even weeks jotting down possible research areas. Check with friends and

colleagues about their ideas. Search abstract databases, and skim journals and books for ideas

about potential research themes.

The goal is to create a list of possible research topics and to make it as long as possible. This is not

the stage for eliminating ideas because they do not appear feasible. Think big! The ideas do not

need to be well formed. Begin by simply listing several health conditions or po

Documents

PT 2.2 2014 Student Dossier