New Topics
Charge Syndrome
Cystic Fibrosis
Epilepsy
Fracture, Hip
Kyphosis
Mallet Finger
Metatarsalgia
Morton's Neuroma
Scoliosis |
|
|
Rehabilitation Reference Center Peer Review
|
We are seeking peer reviewers for all clinical areas.
|
|
Get the RRC Update Newsletter!
|
 |
|
|
|
Welcome!
|
This is the first issue of our free evidence-based Rehabilitation Reference Center Update. You are receiving this newsletter because you are a subscriber of CINAHL and/or Rehabilitation Reference Center. We will periodically send news on the latest evidence in rehabilitation. Please share this with your colleagues, students, practitioners and others who would appreciate awareness of this information.
Rehabilitation Reference Center™ (RRC) is an evidence-based
clinical reference tool for use by rehabilitation clinicians at the
point-of-care. RRC provides physical therapists, occupational
therapists, speech therapists and rehabilitation students with the best
available evidence to provide the highest quality care and improve patient outcomes.
|
|
Rehabilitation Reference Center Systematic Literature Surveillance
|
| Each
week the Rehabilitation Reference Center Editorial Team reviews and evaluates
thousands of articles for inclusion within our evidence-based content
to deliver to you the best available evidence at the point-of-care.
|
| Evidence-based Content Update |
Recently two clinical reviews were revised following review under the systematic literature surveillance program. The topics were Achilles Tendinopathy and Shoulder Instability, Multidirectional.
Information of value to physical therapy practice regarding achilles tendinopathy included two randomized controlled trials. In a trial of 25 patients it was found that eccentric loading combined with conservative management (i.e. deep friction massage, therapeutic ultrasound, and stretching exercises) is more effective than conservative management alone to improve function. Based on another trial of 118 patients it was found that the addition of an AirHeel™ Brace to an eccentric training protocol for achilles tendinopathy does not provide any additional functional advantages over eccentric exercises alone.
Information of value to physical therapy practice regarding multidirectional shoulder instability included one research study. In a study of 285 patients status, post shoulder surgery, it was found that no single shoulder outcome assessment tools offered better measurement characteristics than the others. Shoulder outcome assessment tools evaluated included the Short Form-36, University of California, Los Angeles shoulder score, American Shoulder and Elbow Surgeons shoulder evaluation form, Constant score, Simple Shoulder Test, and Western Ontario Shoulder Instability Index.
|
Rehabilitation Reference Center in Daily Practice
|
Mr. Smith is a patient who only has the active use of one upper extremity. He is worried about using a walker when returning home after discharge.
The physical therapist wants to find some information on the use of walkers. She consults Rehabilitation Reference Center, searching on assistive devices. She consults the clinical review "Ambulatory Assistive Devices."
She reads about ambulatory assistive devices, including walkers, crutches, and canes. Then, she reviews the different types of walkers and their attachments and modifications. After deciding which walker may be the most appropriate she goes on to read about the guidelines for the use of the device and the precautions to take.
She refers to the handouts on exercises and walkers and goes over them with both Mr. and Mrs. Smith.
|
| Caring for Patients with Lymphedema |
Lymphedema occurs in an extremity when lymph flow is impaired usually due to developmental abnormalities or surgery.The edema begins with pitting edema and progresses to nonpitting edema. Primary lymphedema is caused by the absence of lymphatic valves. Secondary lymphedema is caused by obstruction of the lymphatic system often due to surgery for the management of malignant tumors.
Patients with lymphedema may present with hard, thick, and leathery skin; paresthesias; fatigue, heaviness, or tightness in the affected area; impaired wound healing; increased girth of the affected extremity; decreased strength and ROM; and impaired sensation, cardiovascular endurance, and function. Goals of physical therapy treatment include independence with self-management of lymphedema, reduction of circumference measurement of involved extremity, and improved strength, ROM, scar mobility, aerobic capacity and endurance.
The most effective treatment for lymphedema is complete decongestive physiotherapy. The first phase involves manual lymphatic drainage techniques to reduce the size of the extremity. The second phase involves patient self-care activities including self massage, appropriate skin care, exercise and the use of compression garments.
Desired outcomes of physical therapy treatment include edema reduction, and improved functional mobility, ROM, and strength. Outcome measures include girth measurements, and Shoulder Pain and Disability Index (SPADI).
| |
|
|
|
