1,721,085 research outputs found
Discrimination of the neutral low back sitting posture in people with and without low back pain, before and after a shift of work
No full textBackground: The "neutral" lumbar posture is considered the position least likely to cause low back pain, with errors as little as 2° from the neutral spinal posture substantially decreasing the axial compressive load capacity of the spine. Accurate sensory feedback from, and activation of, appropriate trunk muscles is essential for appreciation and maintenance of the neutral spinal posture. If these muscles are dysfunctional due to low back pain and/or workrelated activity and fatigue, this might impair people’s ability to discriminate the neutral spinal posture. This study investigated whether LBP or a shift ofwork alters people’s ability to discriminate the neutral low back sitting posture.Methods: Sixty one subjects with, and forty subjects without, a history of LBP were recruited. Each subject’s spinal position sense was assessed before and after a shift of work by an electro-goniometer placed over the lumbar sacral spine. Subjects were blindfolded and instructed to actively locate the neutral low back sitting posture – the "test" position. They were then asked to flex or extend their low back and stop at a random position for 3 seconds, before returning to the neutral low back sitting position; the position they returned to was the "reproduced" position. This procedure was repeated 20 times in total. The absolute error between the "test" position and each "reproduced" position was calculated in degrees. The average mean error was then calculated and compared between the two groups using an independent-samples t test.Results: Data was not normally distributed and therefore log-transformed before analysis. Anti-logged (returning data to original scale) values are also presented. LBP subjects had slightly higher average mean error values before work, showing that they found it more difficult than NLBP subjects to discriminate the neutral low back sitting posture, but the difference was nonsignificant. Conclusions: The ability of people with and without LBP to appreciate the neutral low back sitting posture was similar, both before and after a shift of work
Disabled people and professionals differ in their perceptions of rehabilitation needs
No full textBackground. This study set out to explore whether there are systematic differences in unmet needs for rehabilitation services and resources as identified by disabled people and nominated key professionals.Method. A cross-sectional interview survey of 87 pairs of community-dwelling disabled people (aged 16-65) and their nominated key professionals was conducted in southern England. The Southampton Needs Assessment Questionnaire (SNAQ) was used to examine unmet needs and the Office of Population Censuses and Surveys (OPCS) Disability and Severity Scale to Examine level of disability.Results. Eighty-seven pairs of disabled people and their nominated key professionals participated. People were severely disabled (median OPCS score 8; interquartile range 6-9). Disabled participants reported significantly more unmet needs than did professionals. There was zero concordance on identified unmet needs between disabled participants and professionals in 56 per cent of cases. Concordance between disabled participants and professionals was significantly better if the disabled participant had reported more unmet needs. There was a trend for general practitioners to be poorer at reporting disabled participants' needs than other professionals. There was fair agreement between disabled participants and professionals in five areas of unmet need only (in descending order): adaptations, physiotherapy, equipment, assistance with 'non-care' activities and the use of a day centre. In all the other areas of unmet need the agreement was poor.Conclusion. Needs for rehabilitation services and resources (for disabled people) are perceived differently by disabled people and professionals. Until we know who is right about rehabilitation needs, it is important to determine both users' and providers' views when planning and commissioning services
Recording of vital signs in a district general hospital emergency department
No full textAim: to examine and explore factors that may influence the recording of vital signs in adult patients within the initial 15 min and again within 60 min of arrival in the “resuscitation” and “major” areas of the emergency department (ED). Methods: a retrospective analysis of recording of vital signs was performed on 400 consecutive sets of notes from adult patients presenting to the “major” or “resuscitation” areas of a district general hospital ED. The effect of staffing levels, triage category and attendances on the recording of vital signs was examined using logistic regression. The main outcome measures were the proportion of patients with all vital signs recorded within 15 min of arrival, the proportion of patients with all vital signs repeated within 60 min of arrival and the outcomes of logistic regression analysis. Results: only 223/387 patients (58%) had all vital signs recorded within 15 min of arrival and only 29/387 (7%) had all vital signs repeated at 60 min. There was a significant relationship between the failure to record vital signs and lower triage categories. There was no evidence that staffing levels or number of attendances predicted the recording of vital signs within 15 min of arrival. Conclusion: recording of vital signs was poor and unrelated to staffing levels or numbers of patients attending the ED. Failure to record patients’ vital signs undermines strategies to detect and manage ill patients. <br/
Effects of acupuncture as a treatment for hyperventilation syndrome: a pilot, randomized crossover trial
No full textBACKGROUND: Sustained and subtle hyperventilation can result in a wide variety of symptoms, leading to a chronic condition that has been termed hyperventilation syndrome (HVS). Treatment options include physiotherapy, in the form of breathing retraining (BR), but additional approaches aim to reduce the anxiety that is recognized as being a frequent component of this condition. OBJECTIVES: The aim of this study was to evaluate whether acupuncture is an appropriate treatment for HVS to reduce anxiety, and whether a crossover trial is an appropriate study design to evaluate acupuncture in this condition. DESIGN: A single-blind crossover trial was carried out comparing the effects of 4 weeks (30 minutes twice weekly) acupuncture and BR on patients with HVS. SUBJECTS: Ten (10) patients diagnosed with HVS were recruited to the trial and randomized into two groups. Both groups received acupuncture and BR with a washout period of 1 week. OUTCOME MEASURES: The primary outcome measure used was the Hospital Anxiety and Depression (HAD) Scale. Other outcome measures used were the Nijmegen questionnaire and Medical Research Council Dyspnea scale. RESULTS: The results showed statistically significant treatment differences between acupuncture and breathing retraining, in favor of acupuncture. Reductions were found in the HAD A (anxiety) (p = 0.02) and Nijmegen (symptoms) (p = 0.03) scores. There was no statistical evidence of any carryover effects. However, when graphically examining individual anxiety scores, in those who received acupuncture first, there was a reduction in anxiety levels which persisted through the washout period, suggesting that there may have been some carryover effect from this treatment. CONCLUSIONS: This study suggests that acupuncture may be beneficial in the management of HVS in terms of reducing anxiety levels and symptom severity. However, there may be some carryover effect, after acupuncture treatment, which went undetected because the small sample size. This preliminary study provides the basis for a larger, sufficiently powered and methodologically sound trial
SNIFS – Steam inhalation and nasal irrigation For recurrent sinusitis
No full textTo assess the effectiveness of nasal irrigation, steam inhalation or a combination of these treatments in the prevention of sinusitis symptoms
SNIFS – steam inhalation and nasal irrigation For recurrent sinusitis
No full textTo assess the effectiveness of nasal irrigation, steam inhalation or a combination of these treatments in the prevention of sinusitis symptoms
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