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Fausett WA, Reid DA, Larmer PJ. Current perspectives of New Zealand physiotherapists on rehabilitation and return to sport following anterior cruciate ligament reconstruction: A survey. Phys Ther Sport 2021; 53:166-172. [PMID: 34711502 DOI: 10.1016/j.ptsp.2021.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the clinical beliefs and practices of New Zealand physiotherapists regarding pre- and post-surgical rehabilitation and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR). DESIGN Online cross-sectional survey. METHODS A survey was adapted from a previously published survey and disseminated to New Zealand physiotherapists who were considered more likely to be involved in post-ACLR rehabilitation. RESULTS The number of completed surveys was 318. Most physiotherapists (85%) preferred to first consult patients within 14 days of ACLR. In the first six weeks following ACLR, 89% of physiotherapists see patients at least once per week. Between 3- and 6-months post-ACLR, 76% of physiotherapists see patients at least once a fortnight. Pre-operative rehabilitation and post-operative rehabilitation exceeding six months are considered essential or important to patient outcomes by over 95% of physiotherapists. While 63% of physiotherapists support RTS 9-12 months after ACLR, 11% permit RTS within 6-9 months of surgery. Common RTS considerations include functional capacity, movement quality during functional tasks, time from ACLR, and knee strength. CONCLUSION The survey revealed variability in the beliefs and practices of NZ physiotherapists regarding post-ACLR rehabilitation, and these beliefs and practices are at times inconsistent with best practice recommendations.
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Affiliation(s)
- Wayne A Fausett
- Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand.
| | - Duncan A Reid
- School of Clinical Sciences, Auckland University of Technology, New Zealand
| | - Peter J Larmer
- School of Clinical Sciences, Auckland University of Technology, New Zealand
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McGruer N, Baldwin JN, Ruakere BT, Larmer PJ. Māori lived experience of osteoarthritis: a qualitative study guided by Kaupapa Māori principles. J Prim Health Care 2020; 11:128-137. [PMID: 32171355 DOI: 10.1071/hc18079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 05/03/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Osteoarthritis adversely affects people's quality of life; however, the effects of osteoarthritis on Māori in New Zealand remain unknown. AIM To explore the Māori lived experience of osteoarthritis. METHODS A qualitative study guided by Kaupapa Māori principles. Māori adults (≥30 years) with clinical knee or hip osteoarthritis took part in semi-structured interviews that were recorded and transcribed. Thematic analysis and a model of Māori health (Te Whare Tapa Whā, outlining four dimensions of wellbeing (taha tinana- physical; taha hinengaro- mental; taha wairua- spiritual; and taha whānau- family)) were used to analyse data. RESULTS Seven Māori females aged 44-71 years participated. Physical manifestations of osteoarthritis, namely pain and limited daily activities, affected mental, spiritual and family wellbeing. Participants experienced whakamā (shame) and frustration. Cultural duties such as attending the marae were impeded, affecting spiritual wellbeing and cultural identity. Participants described drawing on the strength of their ancestors to cope with their impairments. Western medicine was commonly used, although side-effects were prominent and few participants had received information about the condition from health professionals. Both positive and negative experiences of health-care and treatments were reported. DISCUSSION Osteoarthritis inflicts a substantial burden on the physical, mental, spiritual and family wellbeing of Māori women. Primary care practitioners must consider spiritual and family wellbeing when providing care for Māori with osteoarthritis. Culturally sensitive education for patients and their whānau is needed.
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Affiliation(s)
- Nikita McGruer
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Jennifer N Baldwin
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Brian T Ruakere
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Peter J Larmer
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand; and Corresponding author.
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Fausett W, Wilkins F, Reid D, Larmer PJ, Potts G. Physiotherapy treatment and rehabilitation following anterior cruciate ligament injury in New Zealand: Are we doing enough? ACTA ACUST UNITED AC 2019. [DOI: 10.15619/nzjp/47.3.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Baldwin JN, Garrett N, Larmer PJ, Murray C, Evans R, Buchan R, Neville S. Primary care doctor and nurse utilisation rates for billed consultations across the Comprehensive Care Primary Health Organisation. N Z Med J 2019; 132:79-89. [PMID: 31295240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM To examine socio-demographic trends in doctor and nurse utilisation rates for invoiced consultations across Comprehensive Care Primary Health Organisation (PHO). METHOD De-identified enrolled patient information and Service Utilisation Reporting data for invoiced consultations were extracted from all general practices for January 2013-December 2016. Utilisation rates were calculated using the number of enrolled patients as the denominator. RESULTS Data for 3,657,873 invoiced consultations across 66 general practices were analysed, including 2,941,624 doctor and 716,249 nurse consultations. Average utilisation rates were 3.1 visits per patient year for doctors and 0.7 visits for nurses, with considerable variability between practices. Utilisation rates were higher for females (3.3 visits for doctors; 0.8 for nurses), older adults (5.0-6.9; 1.3-1.6 visits) and patients residing in the most socially deprived quintile (3.3; 1.6 visits). European patients had the highest doctor utilisation rates (3.2 visits), while Māori and Pacific patients had the highest nurse utilisation rates (1.1 and 1.3 visits, respectively). CONCLUSION Females, older adults and people residing in socially deprived areas utilise primary care more frequently according to invoiced consultation data. Analysis of all other consultations, including immunisations, Accident Corporation Claims and non-billed services is needed to more accurately capture utilisation rates, particularly for nurses, to better inform national decision-making, workforce planning and funding assumptions.
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Affiliation(s)
- Jennifer N Baldwin
- Postdoctoral Research Fellow, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland
| | - Nick Garrett
- Biostatistician/Senior Research Fellow, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland
| | - Peter J Larmer
- Head of School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland
| | - Craig Murray
- General Manager Operations, Comprehensive Care PHO, Auckland
| | - Rachael Evans
- Director of Nursing, Comprehensive Care PHO, Auckland
| | - Rosey Buchan
- Nurse Leader, Workforce Development, Comprehensive Care PHO, Auckland
| | - Stephen Neville
- Head of Department, Nursing, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland
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Briggs AM, Hinman RS, Darlow B, Bennell KL, Leech M, Pizzari T, Greig AM, MacKay C, Bendrups A, Larmer PJ, Francis-Cracknell A, Houlding E, Desmond LA, Jordan JE, Minaee N, Slater H. Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study. ACR Open Rheumatol 2019; 1:219-235. [PMID: 31777798 PMCID: PMC6857979 DOI: 10.1002/acr2.1032] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. Methods Study design is a multinational (Australia, New Zealand, Canada) cross-sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final-year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high- and low-value care (customized items), attitudes toward exercise/physical activity (free-text responses). Results A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist-nurse analyses were 9.3 [7.7-10.9] for knowledge [scale: 11-55] and 14.6 [12.3-17.0] for skills [scale: 16-80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3-8.4]; scale 10-60) and in medical students compared with physiotherapy students (2.0 [1.3-2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%-19% and 19%-22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%-36% and 35%-44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%-61% and 21%-52%). Most agreed (90%-98% and 92%-97%) that exercise is indicated and strongly supported by qualitative data. Conclusion Workforce capacity building that de-emphasizes biomedical management and promotes high-value first-line care options is needed. Knowledge and skills among physiotherapists support leadership roles in OA care for this discipline.
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Affiliation(s)
- Andrew M Briggs
- School of Physiotherapy and Exercise Science Curtin University Perth Australia
| | - Rana S Hinman
- Department of Physiotherapy University of Melbourne Melbourne Australia
| | - Ben Darlow
- Department of Primary Health Care and General Practice University of Otago Wellington New Zealand
| | - Kim L Bennell
- Department of Physiotherapy University of Melbourne Melbourne Australia
| | - Michelle Leech
- Faculty of Medicine Nursing and Health Sciences Monash University Melbourne Australia
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre La Trobe University Melbourne Australia
| | - Alison M Greig
- Department of Physical Therapy University of British Columbia Vancouver Canada
| | - Crystal MacKay
- Toronto Rehabilitation Institute University Health Network Toronto Canada
| | - Andrea Bendrups
- Department of Medicine (Royal Melbourne Hospital) University of Melbourne Melbourne Australia
| | - Peter J Larmer
- School of Clinical Sciences Auckland University of Technology Auckland New Zealand
| | | | - Elizabeth Houlding
- School of Physiotherapy and Exercise Science Curtin University Perth Australia.,Faculty of Science University of Ottawa Ottawa Canada
| | - Lucy A Desmond
- Department of Medicine Western Health Melbourne Australia
| | | | - Novia Minaee
- School of Physiotherapy and Exercise Science Curtin University Perth Australia
| | - Helen Slater
- School of Physiotherapy and Exercise Science Curtin University Perth Australia
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Nixon GH, Kerse NM, Bagg W, Skinner MA, Larmer PJ, Crampton P. Proposal for a National Interprofessional School of Rural Health. N Z Med J 2018; 131:67-75. [PMID: 30408820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Shortages of health professionals persist in much of rural New Zealand despite a range of targeted university and professional college initiatives. In response to this a collective of universities, professional colleges and sector groups have put a proposal to Government for a National Interprofessional School of Rural Health. If adopted, this proposal would embed rural health professional education and research in rural communities around New Zealand, empowering them to organise the education that occurs in their community, in a coherent and coordinated way. What is being proposed is not a new or separate education provider but rather an 'enabling body' that would lever off the expertise and resources of the existing tertiary institutions, colleges and rural communities. It calls for an 'all of systems' approach that encompasses all the health professions that practise in rural areas, undergraduate education and postgraduate training, and rural health research. Although modelled on successful Australian rural clinical schools, it is a uniquely New Zealand solution that is cognisant of the New Zealand context and resources.
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Affiliation(s)
- Garry H Nixon
- Associate Dean Rural, Division of Health Sciences, University of Otago, Dunedin
| | - Ngaire M Kerse
- Head School of Population Health, General Practice and Primary Health Care, University of Auckland, Auckland
| | - Warwick Bagg
- Head of the Medical Programme, Faculty of Medical and Health Sciences, University of Auckland, Auckland
| | - Margot A Skinner
- Deputy Dean/Senior Lecturer, School of Physiotherapy, University of Otago, Dunedin
| | - Peter J Larmer
- Head, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland
| | - Peter Crampton
- Dean, Otago Medical School, Kōhatu, Centre for Hauora Māori, University of Otago, Dunedin
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Tillson T, Rohan M, Larmer PJ. Use of a functional mobility measure to predict discharge destinations for patients admitted to an older adult rehabilitation ward: A feasibility study. Australas J Ageing 2017; 37:E12-E16. [PMID: 29281171 PMCID: PMC5873393 DOI: 10.1111/ajag.12491] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate whether the discharge destination for older adults can be predicted using functional mobility as measured by the Modified Elderly Mobility Scale (MEMS), associated with demographic and primary reason for admission variables. METHODS A retrospective cohort population audit of 257 patients admitted and discharged from four tertiary older adult rehabilitation wards in a three-month period. A number of predictor variables were considered alongside the discharge destination. RESULTS Multinomial statistical modelling established that MEMS prior to (P < 0.001), MEMS on completion (P = 0.009) of rehabilitation physiotherapy and primary reason for admission (P = 0.002) were significant variables to predict discharge destination. The model correctly predicted 71% of observed patient discharge destinations. CONCLUSION The MEMS in conjunction with primary reason for admission was able to predict discharge destination with 71% accuracy in a heterogeneous population of older adults following rehabilitation.
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Affiliation(s)
| | - Maheswaran Rohan
- Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand
| | - Peter J Larmer
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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Reid DA, Vanweerd RJ, Larmer PJ, Kingstone R. The inter and intra rater reliability of the Netball Movement Screening Tool. J Sci Med Sport 2015; 18:353-7. [DOI: 10.1016/j.jsams.2014.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 05/05/2014] [Accepted: 05/11/2014] [Indexed: 10/25/2022]
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Larmer PJ, Reay ND, Aubert ER, Kersten P. Systematic review of guidelines for the physical management of osteoarthritis. Arch Phys Med Rehabil 2013; 95:375-89. [PMID: 24184307 DOI: 10.1016/j.apmr.2013.10.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/26/2013] [Accepted: 10/08/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To undertake a systematic critical appraisal of guidelines to provide a summary of recommendations for the physical management of osteoarthritis (OA). DATA SOURCES The Cochrane Library, MEDLINE, CINAHL, SPORTDiscus with Full Text, Scopus, ScienceDirect, PEDro, and Google Scholar databases were searched (2000-2013) to identify all guidelines, protocols, and recommendations for the management or treatment of OA. In addition, Internet searches of all relevant arthritis organizations were undertaken. All searches were performed between July 2012 and end of April 2013. Guidelines that included only pharmacological, injection therapy, or surgical interventions were excluded. Guidelines published only in English were retrieved. STUDY SELECTION OA guidelines developed from evidence-based research, consensus, and/or expert opinion were retrieved. There were no restrictions on severity or site of OA, sex, or age. Nineteen guidelines were identified for evaluation. DATA EXTRACTION The quality of all guidelines was critically appraised using the Appraisal of Guidelines for REsearch and Evaluation II instrument. Each guideline was independently reviewed. All relevant recommendations for the physical management of OA were synthesized, graded, and ranked according to available evidence. DATA SYNTHESIS Seventeen guidelines with recommendations on the physical management of OA met the inclusion criteria and underwent a full critical appraisal. There were variations in the interventions, levels of evidence, and strength of recommendations across the guidelines. Forty different interventions were identified. Recommendations were graded from "strongly recommended" to "unsupported." Exercise and education were found to be strongly recommended by most guidelines. CONCLUSIONS Exercise and education were key recommendations supporting the importance of rehabilitation in the physical management of OA. This critical appraisal can assist health care providers who are involved in the management of people with OA.
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Affiliation(s)
- Peter J Larmer
- Faculty of Health and Environmental Sciences, School of Rehabilitation and Occupation Studies, AUT University, Auckland.
| | - Nicholas D Reay
- Faculty of Health and Environmental Sciences, Department of Physiotherapy, AUT University, Auckland
| | - Elizabeth R Aubert
- Faculty of Health and Environmental Sciences, Department of Physiotherapy, AUT University, Auckland
| | - Paula Kersten
- Faculty of Health and Environmental Sciences, Person Centred Research Centre, School of Rehabilitation and Occupation Studies, AUT University, Auckland, New Zealand
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Abstract
Osteoarthritis (OA) of a hip joint, with subsequent total hip joint replacement surgery, is portrayed in the literature in terms of quantitative research studies, where the person living with the hip disappears in objective statistical analyses, or in qualitative studies where one person's story is fragmented within thematic findings. This phenomenological study of a physiotherapist's (Peter) lived experience of OA offers insights relevant to practice. In the initial stages of the disease, Peter was too close to 'see' the possibility of OA as a diagnosis. As the pain limited what he could do, he needed to reinvent ways of retaining his sense of 'self'. The pain worsened; there was nothing that relieved it. The experience became one of endurance, leading to a moment when he decided the time had come to have surgery. Post-surgery, the journey of recovery was one of the feelings vulnerable. He wanted guidance and re-assurance. Paradoxically, recovery showed itself as 'forgetting' the body. The insights call for therapists to listen to the experience of clients and be alongside side them as they struggle with vulnerability. Sharing an understanding of the nature of the experience can bring confidence to clients.
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Affiliation(s)
- Elizabeth Smythe
- Division of Health Care Practice, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
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Larmer PJ, McNair PJ, Smythe L, Williams M. Ankle sprains: patient perceptions of function and performance of physical tasks. A mixed methods approach. Disabil Rehabil 2011; 33:2299-304. [PMID: 21470050 DOI: 10.3109/09638288.2011.568668] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE To investigate patient's perceptions of function and performance of physical tasks after discharge from treatment for an ankle sprain. METHODS Using a mixed methods approach, 40 participants who presented with an acute sprained ankle and their treating clinicians completed two questionnaires related to function at the start and end of a rehabilitation programme. Additionally, participants completed the questionnaires at 6 weeks following discharge at which time they also performed physical tasks that were still perceived as difficult. Ten participants also completed a semi-structured interview. RESULTS There were no significant differences (p > 0.05) in the participant's and clinician's initial assessment of function. However, at discharge participants scored their function significantly (p < 0.05) lower than clinicians. This difference was not apparent 6 weeks later (p > 0.05). However, there was a significant difference (p < 0.05) following actual performance of tasks with an effect size of 1.58. Participant interviews confirmed that patients had a fear of re-injury until they actually performed tasks that were perceived as difficult. CONCLUSIONS Clinicians and participants do not have a similar perception of the recovery of an ankle sprain at discharge. Performing tasks which were perceived as difficult were valuable in assisting participants gain an improved appreciation of their function.
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Affiliation(s)
- Peter J Larmer
- School of Rehabilitation and Occupation Studies, Faculty of Health and Environmental Sciences, AUT University, Auckland, 1142, New Zealand.
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McNair PJ, Simmonds MA, Boocock MG, Larmer PJ. Exercise therapy for the management of osteoarthritis of the hip joint: a systematic review. Arthritis Res Ther 2009; 11:R98. [PMID: 19555502 PMCID: PMC2714154 DOI: 10.1186/ar2743] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Revised: 05/28/2009] [Accepted: 06/25/2009] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Recent guidelines pertaining to exercise for individuals with osteoarthritis have been released. These guidelines have been based primarily on studies of knee-joint osteoarthritis. The current study was focused on the hip joint, which has different biomechanical features and risk factors for osteoarthritis and has received much less attention in the literature. The purpose was to conduct a systematic review of the literature to evaluate the exercise programs used in intervention studies focused solely on hip-joint osteoarthritis, to decide whether their exercise regimens met the new guidelines, and to determine the level of support for exercise-therapy interventions in the management of hip-joint osteoarthritis. METHODS A systematic literature search of 14 electronic databases was undertaken to identify interventions that used exercise therapy as a treatment modality for hip osteoarthritis. The quality of each article was critically appraised and graded according to standardized methodologic approaches. A 'pattern-of-evidence' approach was used to determine the overall level of evidence in support of exercise-therapy interventions for treating hip osteoarthritis. RESULTS More than 4,000 articles were identified, of which 338 were considered suitable for abstract review. Of these, only 6 intervention studies met the inclusion criteria. Few well-designed studies specifically investigated the use of exercise-therapy management on hip-joint osteoarthritis. Insufficient evidence was found to suggest that exercise therapy can be an effective short-term management approach for reducing pain levels, improving joint function and the quality of life. CONCLUSIONS Limited information was available on which conclusions regarding the efficacy of exercise could be clearly based. No studies met the level of exercise recommended for individuals with osteoarthritis. High-quality trials are needed, and further consideration should be given to establishing the optimal exercises and exposure levels necessary for achieving long-term gains in the management of osteoarthritis of the hip.
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Affiliation(s)
- Peter J McNair
- Health and Rehabilitation Research Centre, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
| | - Marion A Simmonds
- Health and Rehabilitation Research Centre, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
| | - Mark G Boocock
- Health and Rehabilitation Research Centre, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
| | - Peter J Larmer
- Health and Rehabilitation Research Centre, Auckland University of Technology, Private Bag 92006, Auckland 1020, New Zealand
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Boocock MG, Collier JM, McNair PJ, Simmonds M, Larmer PJ, Armstrong B. A Framework for the Classification and Diagnosis of Work-Related Upper Extremity Conditions: Systematic Review. Semin Arthritis Rheum 2009; 38:296-311. [DOI: 10.1016/j.semarthrit.2007.10.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2007] [Revised: 10/04/2007] [Accepted: 10/21/2007] [Indexed: 11/28/2022]
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Larmer PJ, Tillson TM, Scown FM, Grant PM, Exton J. Evidence-based recommendations for hand hygiene for health care workers in New Zealand. N Z Med J 2008; 121:69-81. [PMID: 18425156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM The aim of this systematic review is to establish evidence-based recommendations for hand hygiene for health care workers in New Zealand. METHODS Using a systematic approach to literature searching, relevant studies were retrieved and evaluated using a standardised tool. The 23 studies that met the inclusion criteria were categorised into subgroups depending on the type of comparison: hand hygiene product; skin condition; hand drying method. A 'best-evidence synthesis' was utilised for classifying the evidence. RESULTS Included studies provided evidence to support the use of alcohol-based hand rub as the preferred hand hygiene product. There was conflicting evidence for the use of medicated or plain soap, or any particular method to dry hands. CONCLUSIONS Hand hygiene is a crucial component of risk management for both health care workers and their patients. It is important that hand hygiene practice is based on the best current evidence. As a result of a systematic review, evidence-based recommendations for hand hygiene for health care workers are proposed.
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Affiliation(s)
- Peter J Larmer
- School of Physiotherapy, AUT University Private Bag 92006 Auckland 1020, New Zealand.
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Boocock MG, McNair PJ, Larmer PJ, Armstrong B, Collier J, Simmonds M, Garrett N. Interventions for the prevention and management of neck/upper extremity musculoskeletal conditions: a systematic review. Occup Environ Med 2007; 64:291-303. [PMID: 16973739 PMCID: PMC2092555 DOI: 10.1136/oem.2005.025593] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2006] [Indexed: 11/03/2022]
Abstract
Considered from medical, social or economic perspectives, the cost of musculoskeletal injuries experienced in the workplace is substantial, and there is a need to identify the most efficacious interventions for their effective prevention, management and rehabilitation. Previous reviews have highlighted the limited number of studies that focus on upper extremity intervention programmes. The aim of this study was to evaluate the findings of primary, secondary and/or tertiary intervention studies for neck/upper extremity conditions undertaken between 1999 and 2004 and to compare these results with those of previous reviews. Relevant studies were retrieved through the use of a systematic approach to literature searching and evaluated using a standardised tool. Evidence was then classified according to a "pattern of evidence" approach. Studies were categorised into subgroups depending on the type of intervention: mechanical exposure interventions; production systems/organisational culture interventions and modifier interventions. 31 intervention studies met the inclusion criteria. The findings provided evidence to support the use of some mechanical and modifier interventions as approaches for preventing and managing neck/upper extremity musculoskeletal conditions and fibromyalgia. Evidence to support the benefits of production systems/organisational culture interventions was found to be lacking. This review identified no single-dimensional or multi-dimensional strategy for intervention that was considered effective across occupational settings. There is limited information to support the establishment of evidence-based guidelines applicable to a number of industrial sectors.
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Affiliation(s)
- M G Boocock
- Physical Rehabilitation Research Centre, Auckland University of Technology, Auckland, New Zealand.
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