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1.  BEYOND STATISTICAL SIGNIFICANCE: CLINICAL INTERPRETATION OF REHABILITATION RESEARCH LITERATURE 
Evidence‐based practice requires clinicians to stay current with the scientific literature. Unfortunately, rehabilitation professionals are often faced with research literature that is difficult to interpret clinically. Clinical research data is often analyzed with traditional statistical probability (p‐values), which may not give rehabilitation professionals enough information to make clinical decisions. Statistically significant differences or outcomes simply address whether to accept or reject a null or directional hypothesis, without providing information on the magnitude or direction of the difference (treatment effect). To improve the interpretation of clinical significance in the rehabilitation literature, researchers commonly include more clinically‐relevant information such as confidence intervals and effect sizes. It is important for clinicians to be able to interpret confidence intervals using effect sizes, minimal clinically important differences, and magnitude‐based inferences. The purpose of this commentary is to discuss the different aspects of statistical analysis and determinations of clinical relevance in the literature, including validity, significance, effect, and confidence. Understanding these aspects of research will help practitioners better utilize the evidence to improve their clinical decision‐making skills.
Level of evidence:
5
PMCID: PMC4197528  PMID: 25328834
Clinical significance; evidence based practice; statistical significance
2.  BALANCE TRAINING FOR THE OLDER ATHLETE 
As the older adult population increases in size, the number of older adults participating in sport activities will also likely increase proportionally with a concomitant increase in musculoskeletal injuries. Age-associated functional declines in muscle strength and the sensory systems, in addition to several other issues, contribute to reductions in balance that may increase fall risk There are a variety of ways to evaluate balance and fall-risk, and each older adult should be regularly screened in order to evaluate any changes in the ability to maintain postural stability. Balance training is a useful intervention in rehabilitation of postural stability impairments as well as in training programs for performance enhancement. One scientifically-based approach is Sensorimotor Training (SMT) which can be characterized as a progressive balance training program using labile surfaces to provide adequate and safe challenges to the older athlete's balance. SMT addresses both static and dynamic components of balance as well as the multitude of systems that control balance in order to train effective strategies and elicit automatic postural responses in order to enhance postural stability. The authors believe that SMT should become part of the regular training regimen for the aging athlete. For the sport and orthopedic healthcare professional, an understanding of the physiologic changes that occur with age, the means by which balance can be assessed, and how SMT programs can be developed and implemented is crucial in addressing the growing number of older athletes that they will see.
Level of Evidence:
5
PMCID: PMC3812830  PMID: 24175135
Aging; balance assessment; balance training; postural stability
3.  RESEARCH DESIGNS IN SPORTS PHYSICAL THERAPY 
Research is designed to answer a question or to describe a phenomenon in a scientific process. Sports physical therapists must understand the different research methods, types, and designs in order to implement evidence‐based practice. The purpose of this article is to describe the most common research designs used in sports physical therapy research and practice. Both experimental and non‐experimental methods will be discussed.
PMCID: PMC3474303  PMID: 23091780
Research design; research methods; scientific process
4.  CURRENT CONCEPTS IN MUSCLE STRETCHING FOR EXERCISE AND REHABILITATION 
Stretching is a common activity used by athletes, older adults, rehabilitation patients, and anyone participating in a fitness program. While the benefits of stretching are known, controversy remains about the best type of stretching for a particular goal or outcome. The purpose of this clinical commentary is to discuss the current concepts of muscle stretching interventions and summarize the evidence related to stretching as used in both exercise and rehabilitation.
PMCID: PMC3273886  PMID: 22319684
Exercise; fitness; rehabilitation; stretching
5.  CERVICOGENIC HEADACHES: AN EVIDENCE-LED APPROACH TO CLINICAL MANAGEMENT 
Cervicogenic headache (CGH), as the diagnosis suggests, refers to a headache of cervical origin. Historically, these types of headaches were difficult to diagnose and treat because their etiology and pathophysiology was not well-understood. Even today, management of a CGH remains challenging for sports rehabilitation specialists. The purpose of this clinical suggestion is to review the literature on CGH and develop an evidence-led approach to assessment and clinical management of CGH.
PMCID: PMC3201065  PMID: 22034615
Headache; neck pain; muscle imbalance
6.  SHOULDER MUSCLE IMBALANCE AND SUBACROMIAL IMPINGEMENT SYNDROME IN OVERHEAD ATHLETES 
Subacromial impingement is a frequent and painful condition among athletes, particularly those involved in overhead sports such as baseball and swimming. There are generally two types of subacromial impingement: structural and functional. While structural impingement is caused by a physical loss of area in the subacromial space due to bony growth or inflammation, functional impingement is a relative loss of subacromial space secondary to altered scapulohumeral mechanics resulting from glenohumeral instability and muscle imbalance. The purpose of this review is to describe the role of muscle imbalance in subacromial impingement in order to guide sports physical therapy evaluation and interventions.
PMCID: PMC3105366  PMID: 21655457
7.  Effectiveness of Elastic Resistance in Rehabilitation of Patients With Patellofemoral Pain Syndrome 
Sports Health  2011;3(2):190-194.
Context:
Patellofemoral pain syndrome (PFPS) is associated with muscle imbalance at the knee and hip. Therapeutic exercise is effective at reducing pain associated with PFPS.
Objective:
To identify and analyze clinical trials of elastic resistance in patients with PFPS to determine its efficacy.
Data Sources:
PubMed, CINAHL, and PEDro databases were searched for terms relevant to PFPS rehabilitation in patients aged 12 to 40 years.
Study Selection:
Only peer-reviewed clinical trials lasting at least 4 weeks and specifying the use of elastic resistance in their protocols were included.
Data Extraction:
Eight eligible studies were analyzed for design, sample, intervention, outcomes, and clinical application.
Results:
The studies included in this review lacked high-quality design, often using exercise as a “quasi-control” condition. Most studies did not provide specific exercise prescription or progression. Although participants in each study reported significant improvements in pain, deficiencies in scientific design limit the conclusion.
Conclusion:
Elastic resistance exercise may reduce pain and improve function and strength in patients with PFPS.
doi:10.1177/1941738111398595
PMCID: PMC3445141  PMID: 23016008
patellofemoral pain; elastic resistance; therapeutic exercise
8.  ADHESIVE CAPSULITIS: USE THE EVIDENCE TO INTEGRATE YOUR INTERVENTIONS 
Frozen shoulder syndrome, clinically known as adhesive capsulitis, is a painful and debilitating condition affecting up to 5% of the population. Adhesive capsulitis is considered fibrosis of the glenohumeral joint capsule with a chronic inflammatory response. Patients experience pain, limited range of motion, and disability generally lasting anywhere from 1 to 24 months. The purpose of this clinical suggestion is to review the pathophysiolgy of adhesive capsulitis and discuss physical therapy interventions which are supported by evidence, thereby enhancing evidence-based practice.
PMCID: PMC3096148  PMID: 21655385
Adhesive capsulitis; physical therapy interventions
9.  A NEW EXERCISE FOR TENNIS ELBOW THAT WORKS! 
Eccentric exercise has been effectively used in the management of tendinopathies in multiple regions of the body. Lateral epicondylosis (“tennis elbow”) is a common tendinopathy that has shown improvement following treatment utilizing isokinetic eccentric exercise. A novel exercise was developed for home-based eccentric exercise that has shown promise for use with patients with lateral epicondylosis. Clinicians should be aware of this exercise and consider it as an evidence-based intervention.
PMCID: PMC2971639  PMID: 21589674

Results 1-9 (9)