Advances in Physiotherapy

The purpose of the study was to assess the test–retest reliability of the Swedish versions of Dizziness Handicap Inventory short form (DHIsf) and Dizziness Handicap Inventory Screening version (DHI-S), and to assess correlations with the original Dizziness Handicap Inventory (DHI). Thirty-nine subjects with dizziness and/or disequilibrium were recruited from two Ear, Nose and Throat departments, and completed the three DHI versions during their visit to the clinic. Thirty-one subjects also completed the questionnaires at home the next day. For relative reliability, intraclass correlation values between 0.89 and 0.91 were found. For absolute reliability, the method errors were 6 points for DHI, 1 point for DHIsf and 3 points for DHI-S. The correlation between DHIsf and DHI was r = −0.91 and between DHI-S and DHI r = 0.94. Answers were missing to 0.4% of the questions in DHI, 1.7% in DHIsf and 0.8% in DHI-S. It was concluded that DHIsf and DHI-S showed good test–retest reliability in line with that of DHI, and both short versions were highly correlated with the original version. The DHI-S showed better relative reliability, correlated stronger with DHI and had fewer missing answers compared with the DHIsf. DHI-S is therefore recommended when a short version of the DHI is needed.

Ann-Sofi Kammerlind

Martina Bladström

Kristine Svensson

Test–retest reliability of two short Swedish versions of the Dizziness Handicap Inventory

两种简短瑞典版眩晕障碍量表的重测信度研究

The objective of the study was to determine the relationship between physical comorbidity and outcomes in a cohort of chronic low back pain (LBP) patients (n = 2777). Patients were treated at one of 48 physiotherapy clinics between January 1, 2005 and September 30, 2006. All patients were categorized into either: (i) physical Comorbidity Group (n = 898), or (ii) only Back Pain Group (n = 1879). There were no baseline statistical differences in symptom duration, visual analogue scale, function and medication use between groups. The Comorbidity Group was significantly older by 5 years and more females (p < 0.0001); odds ratios were adjusted for age and sex. Logistic regression analysis revealed no statistically significant differences for change in functional score (OR = 0.996), change in pain rating (OR = 1.013) and total treatment sessions (OR = 0.997), between groups. Those with LBP and a physical comorbidity (coronary artery disease, hypertension, rheumatoid arthritis, diabetes, non-spinal malignancy, chronic obstructive pulmonary disease, or any other non-spinal condition) had no statistically significant differences in outcomes compared with those with LBP only. The clinical approach to chronic low back patients with an associated physical comorbidity may initially seem more intimidating or complex, but the potential for recovery is just as favourable as that for patients with uncomplicated chronic LBP.

Greg McIntosh

Hamilton Hall

Christina Boyle

Outcomes for those with or without physical comorbidity for a specific cohort of chronic low back pain patients in an active rehabilitation approach

特定慢性腰背痛患者群体中，有无身体共病的康复效果：一种积极康复方法的结果

Gunnevi Sundelin

Do we need to pay attention to fatigue in rehabilitation?

我们是否需要关注康复中的疲劳问题？

The aim was to examine the effect on physical activity of a 2-year family-based lifestyle intervention among overweight and obese Swedish children 8–12 years of age; 105 children were randomized to either intervention or control group. The intervention group was offered a 2-year lifestyle programme. Physical activity was measured using SenseWear Pro2 Armband during 4 consecutive days before and after the intervention. When comparing the intervention and control groups, no significant differences were found in the physical activity outcome variables after 2 years of intervention. However, the intervention group decreased their number of steps per day by 13%, p = 0.003 but had an unchanged screen time, whereas the control group had an unchanged number of steps but increased their screen time by 15%, p = 0.02, from baseline to 2-year measurement. There were no significant change in the intervention group, whereas significantly fewer children in the control group achieved the physical activity recommendations at 2-year measurement (88%) compared with at baseline (98%), p = 0.007. Future interventions regarding physical activity among overweight and obese children are of great importance even though the present one showed limited effects. In the continuing work, a greater effect may be received with an extended and more intense intervention regarding physical activity, focusing on reducing sedentary time rather than increasing the physical activity level.

Catharina Bäcklund

Christel Larsson

Effects of a 2-year lifestyle intervention on physical activity in overweight and obese children

2年生活方式干预对超重和肥胖儿童身体活动的影响

Clinical placement is usually seen as the most enjoyable and rewarding aspect of physiotherapy students' education. Clinical supervision is an essential and integral component in the process of developing clinical competence. The aim of this study was to analyse how students experience the impact of supervision on their learning process while in practice. Information was collected through 10 qualitative interviews with interns and third-year students. The interviews were analysed using qualitative content analysis. Two main categories summarize the essence of what the students express as important concerning supervision and impact on their learning: (i) sense of trust and security, and (ii) balance of challenge and support. When the students in our study experience a sense of trust and security and a balance of challenge and support, this is recognized as a positive learning environment that can generate a climate for awareness and discovery. The clinical educator can be defined as a catalyst and mediator of resources who guides the students on by asking for reflection and reasoning. When highlighting significant experiences together with the student, reflecting on these while acknowledging the student's own effort and achievement, the supervisor will lead the student to their own discovery and awareness of the critical essence of the clinical situation.

Unni Vågstøl

Anne Kari Skøien

“A learning climate for discovery and awareness”: Physiotherapy students' perspective on learning and supervision in practice

“发现与意识的学习氛围”：物理治疗学生对实践中的学习和监督的看法

AbstractAim: The objective of this study was to investigate Nigerian physiotherapy teachers’ self-assessment on the attributes of effective clinical teaching and the importance attached to these attributes. Methodology: The McGill Clinical Teacher Evaluation including self-assessment and importance of the attributes of clinical teaching was used to survey 46 clinicians and academicians who teach physiotherapy in five of the seven physiotherapy programs in Nigeria. Descriptive and non-parametric statistics were used to analyze and interpret data. Results: Overall, the Nigerian teachers’ self- and importance rating on McGill clinical teachers’ attributes was high. The teachers rated themselves least on attributes related to challenging content from text and journals and encouraging student to take responsibility for their learning, while customizing clinical teaching to suit the students’ level and occasionally challenging content from texts and journals were the least important attributes. Academic faculty...

Adetoyeje Y. Oyeyemi

Adewale L. Oyeyemi

Babatunde O. Adegoke

Adamu A. Rufai

Physiotherapy clinical teachers’ perceptions on important attributes in teaching – A Nigerian perspective

尼日利亚视角下物理治疗临床教师对教学重要属性的认知

Although palpation is frequently used in physiotherapy examinations, a limited amount of research has been done to clarify this concept. The aim of this study was to describe physiotherapists' experiences of shoulder palpation with the intention of obtaining detailed descriptions of the concept of palpation. Three focus group interviews were conducted, including a total of seven physiotherapists who had experience of patients with shoulder disability built up over a long period. A qualitative content analysis of the interviews was carried out. The findings showed how palpation can be perceived as a skill that could be described from two different perspectives: Manual and technical palpation and Palpation being dependent on the relationship between the physiotherapist and the patient. Palpation requires time, and the knowledge and experience of palpating built up over time. We also found how the two "perspectives" of palpation were inseparable from each other. The ability to perform manual and technical palpation and the relationship between the physiotherapist and the patient can be considered an interactive learning situation where the physiotherapist and the patient develop mutual knowledge of the body.

Lisbeth Eriksson

Lilly Ekenberg

Anita Melander-Wikman

The concept of palpation of the shoulder – A basic element of physiotherapy practice: A focus group study with physiotherapists

肩部触诊的概念——物理治疗实践的基本要素：一项针对物理治疗师的焦点小组研究

Aims: To investigate whether there are associations between the professional assessment of a patient's main clinical problem and the patient's self-reported health among patients with musculoskeletal disorders and/or mental disorders. To investigate differences in self-reported health and work-related measures in patients who were recommended clinical versus work-related interventions. Method: A cross-sectional study, including a convenience sample of 210 patients, visiting occupational health service. Patients answered a questionnaire on demographic variables, dimensions of health, functioning, work ability and working conditions. Patients’ main clinical problem and type of intervention was classified by physiotherapists. Activity limitations were identified using the Patient-Specific Functional Scale. Findings: The main clinical problems were: medical/organic problems (39%), psychosocial problems (46%) and physical work-related problems (15%). The psychosocial group reported more problems in mental functioning and the medical/organic group had worse physical functioning. There were significant differences for the main clinical problem, educational level, work ability, social interaction skills and mobility in patients who were recommended clinical versus work-related interventions. Conclusions: There are associations between the professional biopsychosocial classification and the patient's self-reported health and functioning. Clinical reasoning may be improved by including systematic biopsychosocial assessment of specific health and working conditions, and activity limitations according to Patient-Specific Functional Scale.

Charlotte Wåhlin

Kerstin Ekberg

Birgitta Öberg

Clinical reasoning in occupational health services for individuals with musculoskeletal and mental disorders

职业健康服务中肌肉骨骼和精神障碍患者的临床推理

Purpose: This study describes caregivers’ experiences of person transfer situations involving people with dementia. Method: Qualitative focus group interviews were conducted with a total of 10 caregivers; two groups with five persons each, including two men and eight women. The resulting data were extracted and condensed into meaning units and codes using content analysis. Findings: One main theme was formulated that represents the caregivers’ experiences of person transfer situations involving people with dementia: “Reciprocal struggle in person transfer tasks”. Five categories were formulated: “Becoming familiar and making contact”, “Risking one's own body to protect the resident from injury”, “Focused yet aware of the surroundings”, “Identifying needs to facilitate the person transfer” and “Struggling to be understood”. Conclusion: Person transfer situations involving people with dementia are subject to sudden changes. The ongoing challenge is to ensure a dynamic approach that can be adapted to the needs of the person with dementia at any given time. There is a need for more studies within the field about care and rehabilitation among people with dementia. We suggest that assessment of person transfer situations involving people with dementia and their caregivers is an important issue for further investigation and physiotherapeutic interventions.

Charlotta Thunborg

Petra von Heideken Wågert

Anne Söderlund

Eva Götell

Reciprocal struggling in person transfer tasks – Caregivers’ experiences in dementia care

痴呆症护理中人员转移任务的相互挣扎——护理人员的体验

In this issue of Advances in Physiotherapy, assessment concerning the physical functional capacity of patients with long-term musculoskeletal pain, registration of muscle activity with electromyogr...

Assessments and treatments in physiotherapy

物理治疗中的评估与治疗

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