Purpose: To identify, using a social ecological model, the multi-level facilitators and barriers that shape the lived experience of rehabilitation following anterior cruciate ligament reconstructive (ACLR) surgery. Method: Semi-structured interviews with 12 adults who experienced rehabilitation following ACLR surgery. Thematic analysis of qualitative data was completed following Braun and Clarke's framework. Results: The experience of rehabilitation was influenced by intrapersonal, interpersonal, physical, institutional, community, and policy level factors. Conclusions: A patient's ability to successfully complete a rehabilitation program, particularly home exercises, can be situated within a social and ecological context in ways that could improve patient adherence and compliance.
Objectif: déterminer, au moyen d'un modèle socioécologique, les incitations et les obstacles multiniveaux qui orientent l'expérience vécue de la réadaptation après la reconstruction du ligament croisé antérieur (RLCA). Méthodologie: entrevues semistructurées auprès de 12 adultes qui sont allés en réadaptation après une RLCA. Les chercheurs ont procédé à l'analyse thématique des données qualitatives au moyen du cadre de Braun et Clarke. Résultats: l'expérience de réadaptation était influencée par des facteurs intrapersonnels, interpersonnels, physiques, institutionnels, communautaires et politiques. Conclusions: la capacité d'un patient à exécuter l'intégralité d'un programme de réadaptation, particulièrement des exercices à domicile, peut être située dans un contexte socioécologique, de manière à améliorer l'adhésion et l'assiduité de ce patient.
Introduction: Knee range of motion is a critical measure of progress after knee injury and knee surgery. However, many patients do not understand the importance of knee range of motion and most do not have a way to self-monitor their knee range of motion at home. The patient being able to measure their own range of motion can provide improved access to this critical health metric, and could improve adherence with their daily knee range of motion exercises. The purpose of this technical report is to determine if a mobile app, Curovate, can provide reliable measures of knee range of motion compared to standard goniometric measurements. Procedures: There were four positions of knee flexion and four positions of knee extension each measured twice with a standard goniometer and four different mobile devices with the app Curovate. The reliability and validity of the Curovate app was tested across mobile devices and operating systems and compare to goniometric knee range of motion measurements. A total of 80 measurements were taken. All testing was completed on a healthy 23-year-old male with no knee pathology. Results: A strong positive correlation, Pearson's r > = 0.9985, for all positions of knee flexion and extension across all four mobile devices as well as each mobile device compared to standard goniometric measurements. Conclusions: This article presents a unique method for patients to measure their knee range of motion using the mobile app Curovate. Overall, the mobile app, Curovate, was found to have a strong positive correlation across four mobile devices with varying operating systems and compared to goniometric measurements. Level of evidence: 4.
BACKGROUND: Balance assessment and training is utilized by clinicians and their patients to measure and improve balance. There is, however, little consistency in terms of how clinicians, researchers, and patients measure standing balance. Utilizing the inherent sensors in every smartphone, a mobile application was developed to provide a method of objectively measuring standing balance. OBJECTIVE: We aimed to determine if a mobile phone application, which utilizes the phone's accelerometer, can quantify standing balance. METHODS: Three smartphones were positioned simultaneously above the participants' malleolus and patella and at the level of the umbilicus. Once secured, the myAnkle application was initiated to measure acceleration. Forty-eight participants completed 8 different balance exercises separately for the right and left legs. Accelerometer readings were obtained from each mobile phone and mean acceleration was calculated for each exercise at each ankle and knee and the torso. RESULTS: Mean acceleration vector magnitude was reciprocally transformed to address skewness in the data distribution. Repeated measures ANOVAs were completed using the transformed data. A significant 2-way interaction was revealed between exercise condition and the body position of the phone (P<.001). Post-hoc tests indicated higher acceleration vector magnitude for exercises of greater difficulty. ANOVAs at each body position were conducted to examine the effect of exercise. The results revealed the knee as the location most sensitive for the detection of differences in acceleration between exercises. The accelerometer ranking of exercise difficulty showed high agreement with expert clinical rater rankings (kappa statistic>0.9). CONCLUSIONS: The myAnkle application revealed significantly greater acceleration magnitude for exercises of greater difficulty. Positioning of the mobile phone at the knee proved to be the most sensitive to changes in accelerometer values due to exercise difficulty. Application validity was shown through comparison with clinical raters. As such, the myAnkle app has utility as a measurement tool for standing balance.
PURPOSE: The purpose of this case report is to demonstrate the importance of a thorough patient interview. The case involves a man referred for physical therapy for a musculoskeletal dysfunction; during the patient interview, a psychiatric disorder was recognized that was later identified as schizophrenia. A secondary purpose is to educate physical therapists on the recognizable signs and symptoms of schizophrenia.Client description: A 19-year-old male patient with chronic shoulder, elbow, and wrist pain was referred for physical therapy. During the interview, the patient reported that he was receiving signals from an electronic device implanted in his body.Measures and outcome: The physical therapist's initial assessment identified a disorder requiring medical referral. Further management of the patient's musculoskeletal dysfunction was not appropriate at this time. INTERVENTION: The patient was referred for further medical investigation, as he was demonstrating signs suggestive of a psychiatric disorder. The patient was diagnosed with schizophrenia by a psychiatrist and was prescribed Risperdal. IMPLICATIONS: This case study reinforces the importance of a thorough patient interview by physical therapists to rule out non-musculoskeletal disorders. Patients seeking neuromusculoskeletal assessment and treatment may have undiagnosed primary or secondary psychiatric disorders that require recognition by physical therapists and possible medical referral.
Protective Devices , Spleen , Splenomegaly , Sports , Adolescent , Basketball , Humans , Male , Ontario
UNLABELLED: In order for functional and sport specific activities to occur, knee flexion and extension range of motion (ROM) is necessary. Loss of full ROM at the knee joint can be detrimental to the function of the lower extremity and treatment is needed to regain full function of ROM. Research supports the use of the sustained force to increase knee ROM. This article presents a unique method of attaining sustained force. The technique is cost effective, involves equipment already available in most physical therapy clinics, conserves time, and provides consistent force overtime without causing the therapist fatigue. DISCUSSION: Despite the fact clinical research has been performed, a poor appreciation exists for the appropriate clinical use of sports massage. CONCLUSION: Additional studies examining the physiological and psychological effects of sports massage are necessary in order to assist the sports physical therapist in developing and implementing clinically significant evidence based programs or treatments.
