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   Winter 2010, Volume 1, Issue 2
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In This Issue
New Topics

  • Bone Marrow Transplantation in Children
  • Diabetes, Type 1, and Exercise
  • Dysphagia Overview
  • Larynx, Artificial
  • Rheumatoid Arthritis: Wrist and Hand
  • Running Shoes and Foot Type
  • Schizophrenia: Speech  Therapy
  • Spinal Cord Injury: Incomplete Injuries

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    Welcome!
    Welcome back to 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 in Daily Practice
    Mr. M is a patient with a history of asthma who would like to start an exercise program.

    The physical therapist wants to find some information on exercise for people with asthma. She consults Rehabilitation Reference Center, keying in "adult asthma." She consults the Clinical Review "Asthma in Adults."

    She reads about asthma, including presentation, signs/symptoms, and contraindications. Then, she reviews the examination of a person with asthma. After completing the physical and subjective examination, she goes on to read about the treatment of people with asthma and the precautions to take.

    She refers to the handouts on exercises and reviews them with Mr. M.

    Note: The above referenced Clinical Review is freely accessible to all readers of the Rehabilitation Reference Center Update.
    Quick Overview

    Caring for Patients with Sciatica


    Sciatica is low back pain that radiates to lumbosacral (L4, L5, S1) dermatomes, from buttock to posterior calf or foot, as a result of irritation to the sciatic nerve or L4, L5, or S1 nerve roots.


    Patients with sciatica may present with decreased lower extremity and trunk strength, gait disturbances, functional decline, and impaired postural control. Goals of physical therapy treatment include independence with self-management of pain, and improved strength, ROM, functional mobility and postural control.


    The treatment for sciatica includes therapeutic exercise (including McKenzie positioning), modalities and patient education.


    Desired outcomes of physical therapy treatment include centralization of pain, symmetry of ROM and muscle strength, reduced disability with return to prior functional status, and patient satisfaction. Outcome measures include VAS, goniometry, manual muscle testing, and increased score on the 12-item Short-Form Health Survey questionnaire. You can read the Clinical Review on "Sciatica" by logging into your subscription of Rehabilitation Reference Center.
    Evidence-based Content Update
    Each week the Rehabilitation Reference Center Editorial Team reviews and evaluates thousands of articles for inclusion within our evidence-based content to deliver the best available evidence at the point-of-care. Recently, two clinical reviews were revised following review under the systematic literature surveillance (SLS) program. The topics were Complex Regional Pain Syndrome (CRPS) and Ergonomics Assessment and Intervention. You can read both of these clinical reviews in Rehabilitation Reference Center by logging into your subscription.

    Information of value to physical therapy practice regarding CRPS was a systematic review that included five randomized controlled trials, one comparative study, and five case series. The authors concluded that graded motor imagery decreases pain in adult patients with CRPS type I and that there is insufficient evidence for the use of stress loading therapy (Daly).

    Information of value to physical therapy practice regarding ergonomics assessment and intervention included one research study and one case study. In a prospective cohort study of 3,052 patients, three significant risk factors for the non-completion of a functional restoration program were identified. A protracted timeframe in which the disability has been present (onset of injury to entering program) when compared against other participants increased the risk of non-completion, as did opioid dependency and personality disorders (Howard). A case study of a 26-year-old female reported that ergonomic intervention significantly improved the patient's pain level beyond what traditional physical therapy was able to accomplish alone (Fabrizio).