Improving the Validity and Reliability of a Health Promotion Survey for Physical Therapists.
Improving the validity and reliability of a health promotion survey for physical therapists.
Cardiopulm Phys Ther J. 2013 Mar; 24(1): 14-23
Stephens JL, Lowman JD, Graham CL, Morris DM, Kohler CL, Waugh JB
Physical therapists (PTs) have a unique opportunity to intervene in the area of health promotion. However, no instrument has been validated to measure PTs’ views on health promotion in physical therapy practice. The purpose of this study was to evaluate the content validity and test-retest reliability of a health promotion survey designed for PTs.An expert panel of PTs assessed the content validity of “The Role of Health Promotion in Physical Therapy Survey” and provided suggestions for revision. Item content validity was assessed using the content validity ratio (CVR) as well as the modified kappa statistic. Therapists then participated in the test-retest reliability assessment of the revised health promotion survey, which was assessed using a weighted kappa statistic.Based on feedback from the expert panelists, significant revisions were made to the original survey. The expert panel reached at least a majority consensus agreement for all items in the revised survey and the survey-CVR improved from 0.44 to 0.66. Only one item on the revised survey had substantial test-retest agreement, with 55% of the items having moderate agreement and 43% poor agreement.All items on the revised health promotion survey demonstrated at least fair validity, but few items had reasonable test-retest reliability. Further modifications should be made to strengthen the validity and improve the reliability of this survey. HubMed – rehab
Insufficiency fracture of the tibial plateau after anterior cruciate ligament reconstructive surgery: a case report and review of the literature.
J Can Chiropr Assoc. 2013 Jun; 57(2): 123-31
Wong JJ, Muir B
Peri-articular fractures after anterior cruciate ligament (ACL) reconstructive surgery are rare. To our knowledge, this case documents the first insufficiency fracture of the tibial plateau after ACL reconstruction, which presented three weeks after the procedure. A 25-year-old female recreational soccer player suffered an insufficiency fracture of the tibial plateau, extending 1.5 mm into the anterior wall of tibial tunnel and medial compartment under the anterior horn of medial meniscus, which presented as a diagnostic challenge. Clinically, the fracture mimicked a low-grade infection of the surgical site, while radiographically, the fracture resembled an avulsion fracture, later confirmed as a tibial tunnel fracture with computed tomography. With the ACL graft integrity not in jeopardy, four weeks of non-weightbearing and a delayed post-operative rehabilitation program was effective in allowing the fracture to heal. Good functional outcome was achieved after conservative management, with minimal loss of terminal knee extension and minimal pain at 22-month follow-up. HubMed – rehab
Knowledge Transfer within the Canadian Chiropractic Community. Part 1: Understanding Evidence-Practice Gaps.
J Can Chiropr Assoc. 2013 Jun; 57(2): 111-5
Kawchuk G, Bruno P, Busse JW, Bussières A, Erwin M, Passmore S, Srbely J
[Stress incontinence after prostatectomy in treatment reality : Results from a rehabilitation clinic.]
Urologe A. 2013 Jun 12;
Lent V, Schultheis HM, Strauß L, Laaser MK, Buntrock S
BACKGROUND: In the current discussion on the operative therapy of prostate cancer, not only”if” but also”how” play a major role. Both questions are closely related as, e.g. a possible excessive therapy will result in additional suffering due to stress incontinence. For the most common, troublesome and expensive consequences of prostatectomy it is of interest to know which factors play a role in treatment reality and which could possibly be avoided. PATIENTS AND METHODS: The hospital records of all patients who underwent follow-up treatment after prostatectomy in 2009 at the clinic in the spa park in Bad Wildungen-Reinhardshausen were evaluated with respect to relevant data on outcome and clinical endpoints. RESULTS: Of the 1,750 patients 405 (23.1?%) were continent on admission and discharge and a further 189 (10.8?%) were continent on discharge so that a total of 594 patients (33.9?%) were continent on discharge. Of the 1,155 patients (66.0?%) who were incontinent on admission and discharge, this remained the same during the rehabilitation period for 727 (62.9?%) who were diurnally incontinent and 659 (57.1?%) who were nocturnally incontinent. For 387 patients (33.5?%) the incontinence decreased during the day and for 370 (32.0?%) during the night, for 34 (3.4?%) the incontinence increased during the day and for 45 (3.9?%) during the night. An age ?70 years was disadvantageous. Retention of nerves showed a significant effect on maintaining continence. Statistically significant differences between the results of operative procedures and the results of the type of clinic (KKP communal, confessional and private or UK university clinic) were not observed. However, the results of maintaining continence (up to termination of rehabilitation treatment) for the 594 patients (33.9?%) was only achieved by 94 (51?%) of all 183 clinics, i.e. 78 (49.7?%) of the KKP clinics and 14 (53.9?%) of UK clinics. For the certified prostate centers of KKP and UK clinics this amounted to 17 (81?%) and 5 (83.3?%), respectively. CONCLUSIONS: In treatment reality of follow-up treatment of patients after prostatectomy in rehabilitation clinics approximately one third (33.9?%) achieved retention of continence up to discharge. An age ?70 years disadvantageous. Bilateral and unilateral retention of nerves significantly improved retention of continence. The operative procedure and type of clinic did not significantly affect the results. However, in approximately one third of patients (33.9?%) retention of continence was achieved by only approximately one half (51.4?%) of all clinics. This shows that in treatment reality, stress incontinence following prostatectomy is avoidably underdeveloped and can be demonstrably increased by suitable operative techniques for sphincter protection. HubMed – rehab