Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice.

Purpose: In response to requests from physiotherapists for guidance on optimal stimulation of muscle using neuromuscular electrical stimulation (NMES), a review, synthesis, and extraction of key data from the literature was undertaken by six Canadian physical therapy (PT) educators, clinicians, and researchers in the field of electrophysical agents. The objective was to identify commonly treated conditions for which there was a substantial body of literature from which to draw conclusions regarding the effectiveness of NMES. Included studies had to apply NMES with visible and tetanic muscle contractions. Method: Four electronic databases (CINAHL, Embase, PUBMED, and SCOPUS) were searched for relevant literature published between database inceptions until May 2015. Additional articles were identified from bibliographies of the systematic reviews and from personal collections. Results: The extracted data were synthesized using a consensus process among the authors to provide recommendations for optimal stimulation parameters and application techniques to address muscle impairments associated with the following conditions: stroke (upper or lower extremity; both acute and chronic), anterior cruciate ligament reconstruction, patellofemoral pain syndrome, knee osteoarthritis, and total knee arthroplasty as well as critical illness and advanced disease states. Summaries of key details from each study incorporated into the review were also developed. The final sections of the article outline the recommended terminology for describing practice using electrical currents and provide tips for safe and effective clinical practice using NMES. Conclusion: This article provides physiotherapists with a resource to enable evidence-informed, effective use of NMES for PT practice.

Objectif : en réponse à des demandes de conseils de physiothérapeutes pour optimiser la stimulation musculaire à l'aide de la stimulation électrique neuromusculaire (SENM), une revue, une synthèse et une extraction de données de la littérature ont été entreprises par six formateurs, cliniciens et chercheurs en physiothérapie dans le domaine des agents électrophysiques. L'objectif était de cibler des affections couramment traitées ayant fait l'objet d'une quantité suffisante d'études pour tirer des conclusions concernant l'efficacité de la SENM. Les études devaient porter sur la SENM produisant des contractions musculaires visibles et toniques. Méthodes : quatre bases de données électroniques (CINAHL, Embase, PubMed et Scopus) ont été parcourues à la recherche d'études pertinentes publiées entre la création des bases de données et mai 2015. D'autres articles ont été tirés de bibliographies de revues systématiques et de collections personnelles. Résultats : les données extraites ont été synthétisées par consensus des auteurs en vue de dresser des recommandations sur l'optimisation des paramètres et des techniques d'application de la stimulation dans le traitement de déficits musculaires associés aux affections suivantes: accident vasculaire cérébral (extrémité inférieure ou supérieure; aigu ou chronique), reconstruction du ligament croisé antérieur, syndrome fémoro-rotulien douloureux, arthrose du genou et arthroplastie totale du genou, ainsi que des maladies graves et en stade avancé. Les auteurs fournissent également un résumé des éléments clés de chaque étude incluse dans la revue. Enfin, ils recommandent une nomenclature de l'électrothérapie et présentent des conseils pour l'utilisation sécuritaire et efficace de la SENM. Conclusion : ce document constitue pour les physiothérapeutes une ressource permettant d'appuyer leur utilisation de la SENM sur des données probantes.

An introduction to teamwork: findings from an evaluation of an interprofessional education experience for 1000 first-year health science students.

Effective interprofessional collaboration is an important factor in addressing health care needs and priorities. Educators and health care practitioners have argued that interprofessional education (IPE) is necessary to equip students with the knowledge, skills, attitudes, and behaviors to work collaboratively and ultimately deliver enhanced patient/client care. The University of Toronto has implemented an introductory IPE session for approximately 1000 health science students that focuses on teamwork. This session provides students with an opportunity to be sensitized to the client's perspective and become familiar with roles and perspectives of different professions. A mixed method pre/post research design was developed to examine changes in students' perceptions and attitudes regarding IPE following their participation in this session. This study also endeavored to explore the pedagogic effectiveness of this large-scale IPE session. Students completed pre and post surveys based on the Interprofessional Attitudes Questionnaire and the Interdisciplinary Education Perception Scale. A total of 399 surveys were matched for pre/post analysis, and 25 students participated in follow-up focus group interviews. Findings from this study reveal that a significant shift in many indicators occurred after this single intervention. Despite the large numbers of students, which meant a complex range of logistical factors to negotiate, our findings indicated that it is feasible to deliver a successful IPE session to a large cohort of first-year students. We suggest that the findings presented in this report can be of value to other interprofessional groups of course developers.

Reviews.

A PRESCRIBER'S GUIDE TO DRESSINGS AND WOUND MANAGEMENT MATERIALS CLAYTON'S ELECTROTHERAPY 10th edition.