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 Summer 2010, Volume 1, Issue 4
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In This Issue
New Topics

  • Biofeedback
  • Foot Pain, Acute: Unspecified Site
  • Hypertension in Older Adults
  • Hypertension Overview
  • Myofascial Pain Syndrome
  • Restless Legs Syndrome
  • Williams Syndrome: Speech Therapy
  • And much more!

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    Rehabilitation Reference Center Peer Review
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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. S is a patient being seen for physical therapy for balance training. Mr. S sustained an incomplete spinal cord injury (SCI) 5 years ago.

    The physical therapist wants to find some information on incomplete SCI. She consults Rehabilitation Reference Center, keying in incomplete spinal cord injury. She consults the clinical review, "Spinal Cord Injury: Incomplete Injuries."

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

    She refers to the handouts on exercises and goes over them with Mr. S.

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

    Caring for Patients with Diabetes Mellitus, Type I


    Diabetes mellitus (DM) type I is a disorder in which the body does not produce insulin.


    Patients with DM type I may present with poor glycemic control, and decreased patient knowledge, strength and cardiopulmonary endurance. Goals of physical therapy treatment include improved strength and cardiopulmonary endurance, improved glycemic control, and independence with home exercise program.


    The treatment for DM type I includes strengthening exercise, cardiovascular exercise, and patient education. Desired outcomes of physical therapy treatment include normalized age-appropriate muscle strength and cardiovascular endurance, and patient satisfaction. Outcome measures include manual muscle testing, estimated VO2max, random capillary blood glucose, and reduced episodes of exercise-related hypoglycemia.


    You can read the Clinical Review on "Diabetes Mellitus, Type 1, and Exercise" by logging into your subscription of Rehabilitation Reference Center.
    Evidence-based Content Update
    Recently, the clinical reviews Ankle Replacement and Achilles Tendon Rupture were revised following review under the systematic literature surveillance program.

    Information of value to physical therapy practice regarding ankle replacement were two recent research studies. The first was a study of 10 individuals who underwent total ankle replacement (TAR). Gait analysis revealed statistically significant improvements in cycle duration, velocity, and the arc of dorsiflexion-plantarflexion ROM (primarily increased dorsiflexion) following the TAR. The second was a study of 20 individuals who underwent a three-component TAR. The individuals had reduced energy expenditure during gait following the TAR.

    Information of value to physical therapy practice regarding Achilles tendon rupture was a systematic literature review of 14 trials involving 894 patients. Open operative treatment was associated with a lower risk of re-rupture but a higher risk of infection, adhesions, and disturbed skin sensibility compared with nonoperative treatment (4 trials, 356 patients). Moreover, postoperative splinting in a functional brace appears to reduce hospital stay, time off work and sports, and may lower the overall complication rate.