Articles I’ve been reading

Free Child Walking on White Round Spheres Balance Creative Commons

Work has been crazy with long hours recently, so though I have been reading my time at home has been spent with my wife instead of blogging on the research.  Here is a brief recap of some of the articles – I hope to be able to be more thorough in the near future.

1. A way to improve balance:

Han K, Ricard MD, Fellingham GW. Effects of a 4-week exercise program on balance using elastic tubing as a perturbation force for individuals with a history of ankle sprains. J Orthop Sports Phys Ther. 2009; 39:246-255.

RCT trial comparing balance (using a force plate) between those with chronic ankle instability and those who were healthy, both being enrolled in a program using elastic tubing and stepping (forward, backward, cross-over and reverse cross-over) over 4 weeks. Both groups had improved balance at the end of the four weeks and retained gains when measured four weeks later.

2. Hip OA clinical practice guidelines:

Cibulka MT, White DM, Woehrle J, Harris-Hayes M, Enseki K, Fagerson TL, Slover J, Godges J. Hip pain and mobility deficits – hip osteoarthritis: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2009; 39:A1-25.

I appreciate the EBP guideline that the Ortho Section created for hip OA (I haven’t read the others but I’ll be looking for them shortly), including diagnosis, differential diagnosis, outcome measures, activity limitations/ participation restriction measures, and interventions.

3.Knee OA treatment options for those who have increased pain in weight bearing:

Lin D, Lin CJ, Lin Y, Jan M. Efficacy of 2 non-weight-bearing interventions, proprioception training versus strength training for patients with knee osteoarthritis: a randomized clinical trial. J Orthop Sports Phys Ther. 2009; 39:450-457.

RCT trial comparing a proprioceptive training program to a strength training program (both non-weight bearing), using the WOMAC Osteoarthritis Index, walking time on 3 terrains, knee strength, and knee proprioception. Both exercises improved outcomes, but the proprioceptive training improved proprioception and strength training had a greater effect on knee extensor strength.

4. An outcome measure expanded:

Yeung TSM, Wessel J, Stratford P, Macdermid J. Reliability, validity and responsiveness of the Lower Extremity Functional Scale for inpatients of an orthopaedic rehabilitation ward. J Orthop Sports Phys Ther. 2009; 39:468-477.

First time tested for inpatients – found to be reliable and responsive, and able to assess change. Great idea for an outcome measure to track from inpatient to outpatient PT to show improvement not just within your area of practice but also help out others who may be treating the patient later.

5. Evidence for gluteal muscle exercises:

Distefano LJ, Blackburn JT, Marshall SW, Padua DA. Gluteal muscle activation during common therapeutic exercises. J Orthop Sports Phys Ther. 2009; 39:532-540.

Great timing to get this article in July, right after I started working with a patient with a THA – gave me better ideas how to progress and challenge him for glut med and max.

Picture credit: Free Child Walking on White Round Spheres Balance Creative Commons, originally uploaded by Pink Sherbet Photography

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