1,720,989 research outputs found
Electromyographic activity of the serratus anterior muscle in anterior glenohumeral instability pre and post surgical stabilisation
No full textFacilitating learning and retention of practical motor skills in a neuromusculoskeletal physiotherapy module
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Characterizing speed of physical and cognitive performance in individuals with chronic low back pain
No full textCan digital rectal examination be used to detect cauda equina compression in people presenting with acute cauda equina syndrome? A systematic review and meta-analysis of diagnostic test accuracy studies
No full textBackground: digital rectal examination (DRE) is a commonly used test to help identify people with cauda equina compression (CEC). Objective: To determine the diagnostic accuracy of DRE in assessment of anal tone, squeeze, sensation and reflexes, as predictors of CEC. Design: a systematic review to investigate the diagnostic accuracy of DRE to detect CEC compared with lumbar Magnetic Resonance Imaging (MRI). Method: Six electronic databases were searched from inception to 6 July 2020 for studies published in English. Two assessors independently performed screening, data extraction and risk of bias assessment (QUADAS-2). Meta-analysis was performed using STATA-16. Results: six studies were included (n = 741). The sensitivity of anal tone was low across all studies (range: 0.23 to 0.53) with moderate quality evidence against the use of DRE of anal tone. One study on anal sensation found no correlation with CEC using Kendall's tau test: p = 0.102 and another found sensation had low test accuracy. One study identified sensitivity: 0.29 and specificity: 0.96 for anal squeeze, while another identified sensitivity: 0.38 and specificity: 0.6 for anal reflexes. Conclusion: the diagnostic accuracy of DRE of anal tone to detect CEC is low and carries a high risk of false reassurance. It is therefore not recommended in any clinical setting. More research is needed to determine the diagnostic accuracy of DRE of anal squeeze, sensation and reflexes and if done the results should be interpreted with caution.</p
Limited pharmaceuticalisation: a qualitative case study of physiotherapist prescribing practices in an NHS Trust in England following the expansion of non-medical prescribing in the UK
No full textImprégner la réadaptation de recherches et d’études fondamentales critiques: Un appel à l’action
No full textGoverning healthcare: finding meaning in a clinical practice guideline for the management of non-specific low back pain.
No full textClinical practice guidelines produced by NICE - the National Institute for Health and Care Excellence - are seen as key mechanisms to regulate and standardise UK healthcare practice, but their development is known to be problematic, and their adoption and uptake variable. Examining what a guideline or health policy means to different audiences, and how it means something to those communities, provides new insight about interpretive discourses. In this paper we present a micro-analysis of the response of healthcare professionals to publication of a single NICE guideline in 2009 which proposed a re-organisation of professional services for chronic non-specific low back pain. Adopting an interpretive approach, we seek to understand both the meaning of the guideline and the socio-political events associated with it. Drawing on archived policy documents related to the development and publication of the guideline, texts published in professional journals and on web-sites, and semi-structured interview data from professionals associated with the debate, we identify a key discourse that positions the management of chronic non-specific low back pain within physician jurisdiction. We examine the emergence of this discourse through policy-related symbolic artifacts taking the form of specific languages, objects and acts. This discourse effectively resisted and displaced the service reorganisation proposed by the guideline and, in so doing, ensured medical hegemony within practice and professional organisations concerned with the management of non-specific low back pain
What factors do people with joint pain feel are important in designing and developing community information-based self-management approaches? A patient and public engagement report
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