Perceptions of the clinical efficacy of laser therapy

Adoption of therapeutic lasers has been widespread throughout Australia in recent years. A questionnaire survey was conducted amongst therapists in Victoria who were believed to have purchased this apparatus. The study sought to determine the extent of laser use in Victoria; the indications, techniques, dosage, expectations and outcomes; and the background knowledge about lasers possessed by the respondents.The elbow and shoulder were the most commonly treated regions; tendonitis and ligamentous lesions the most frequently treated disorders; pain relief and wound healing the most commonly expected effects; and 30mm the average expected penetration. Although 57.9 per cent of respondents attended one or more seminars prior to purchasing lasers, journals and other reading were given as the most valuable source of knowledge

Early Results From the ‘Diggers to Veterans’ Longitudinal Study of Australian Men who Served in the First World War. Short- and Long-Term Mortality of Early Enlisters

As the world marks the centenaries of the First World War, we still know remarkably little about the life course effects of military service. This paper reports on the first iteration of a cradle-to-grave dataset of men who enlisted and served overseas in the First World War from the state of Victoria, Australia. It examines mortality during military service and in civilian life and finds that mortality in both cases was strongly correlated with individual characteristics. Tall men and young single men were more likely to die in the war. In civilian life, mortality followed closely the pattern for Australian men, and was again highly correlated with individual characteristics and social class

Reliability and Precision of Sonography of the Lumbar Multifidus and Transversus Abdominis During Dynamic Activities

Objective: To determine the intra-rater reliability and precision of measurement of lumbar multifidus (LM) and transversus abdominis (TrA) thickness using freehand ultrasound imaging (USI) in a range of static and dynamic conditions. Methods: Fifteen asymptomatic participants performed a range of exercises whilst USI was used to measure absolute muscle thickness and change in muscle thickness from rest. Exercise conditions included the abdominal drawing in manoeuvre (ADIM), active straight leg raise (ASLR), contralateral arm lift, both unloaded (CAL) and loaded (LCAL), treadmill walking (WALK) and using the Functional Re-adaptive Exercise Device (FRED). Intra- and inter-day reliability was assessed using intraclass correlation coefficients (ICC), and standard error of measurement was used to assess measurement precision. Results: Good to excellent reliability was achieved for TrA and LM absolute thickness in all conditions. Measurement precision for absolute LM thickness was ≤2.8mm for CAL, ≤1.8mm for LCAL, ≤3.1mm for WALK and ≤3.8mm for FRED, and for absolute TrA thickness was ≤0.6mm for ADIM, ≤0.5mm for ASLR, ≤0.7mm for WALK and ≤0.5mm for FRED. Good to excellent reliability was achieved for TrA and LM relative muscle thickness in all conditions. Measurement precision for relative LM thickness was ≤3.7% for CAL, ≤3.8% for LCAL, ≤6.3% for WALK and ≤7.6% for FRED, and for relative TrA thickness was ≤13.6% for ADIM, ≤6.9% for ASLR, ≤11.1% for WALK and ≤7.2% for FRED. Conclusions: Acceptable reliability and precision of measurement is achieved for absolute and relative measures of deep spinal muscle thickness using freehand USI in relatively static and dynamic exercises

A System for the Synchronized Recording of Sonomyography, Electromyography and Joint Angle

Ultrasound and electromyography (EMG) are two of the most commonly used diagnostic tools for the assessment of muscles. Recently, many studies reported the simultaneous collection of EMG signals and ultrasound images, which were normally amplified and digitized by different devices. However, there is lack of a systematic method to synchronize them and no study has reported the effects of ultrasound gel to the EMG signal collection during the simultaneous data collection. In this paper, we introduced a new method to synchronize ultrasound B-scan images, EMG signals, joint angles and other related signals (e.g. force and velocity signals) in real-time. The B-mode ultrasound images were simultaneously captured by the PC together with the surface EMG (SEMG) and the joint angle signal. The deformations of the forearm muscles induced by wrist motions were extracted from a sequence of ultrasound images, named as Sonomyography (SMG). Preliminary experiments demonstrated that the proposed method could reliably collect the synchronized ultrasound images, SEMG signals and joint angle signals in real-time. In addition, the effect of ultrasound gel on the SEMG signals when the EMG electrodes were close to the ultrasound probe was studied. It was found that the SEMG signals were not significantly affected by the amount of the ultrasound gel. The system is being used for the study of contractions of various muscles as well as the muscle fatigue

Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>People with Multiple Sclerosis (MS) frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK) provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect.</p> <p>This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of:</p> <p>1 Establishing the effectiveness of core stability training</p> <p>2 Comparing core stability training with standardised physiotherapy exercise</p> <p>3 Exploring underlying mechanisms of change associated with this intervention</p> <p>Methods</p> <p>This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control). All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12), the Functional Reach (forwards and lateral), a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC) Scale. In addition, ultrasound imaging of the abdominal muscles will be performed before and after intervention to assess changes in abdominal musculature at one of the four centres (Plymouth).</p> <p>Discussion</p> <p>This pragmatic trial will assess the effect of these exercise programmes on ambulatory people with MS. It may not be possible to extrapolate the conclusions to those who are non-ambulatory.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01414725">NCT01414725</a></p

Individual student characteristics and attainment in pre-registration physiotherapy : a retrospective multi-site cohort study

Introduction: Worldwide there is a desire to diversify the physiotherapy workforce. However, limited research indicates that some student characteristics linked to under-representation in pre-registration physiotherapy education have lower attainment and greater attrition. This study explored the relationship between individual characteristics and success of students in pre-registration physiotherapy education within South East England. Design: A retrospective multi-site cohort study including pre-registration physiotherapy programmes in the South East of England. Anonymised data included background information (age, gender, ethnicity, socio-economic status) and outcomes (assessment marks, type of award and classification of degree). Analysis involved Bayesian regression models and ordinal logistic regression to examine the association of student characteristics on outcomes. Results: Data from 1851 student records were collected from four institutions. There were significantly lower assessment scores for Asian (-11.1% 95% CI: -13.1 to -9.2), Black (-7.1%, 95% CI: -9.7 to -4.5) and Other/Mixed ethnicity groups (-4.7%, 95% CI: -7.1 to -2.4), most notable in clinical and observed assessments, compared to their White British colleagues. All BME groups also demonstrated worse odds for a one step lower overall award or no award (Black OR: 3.35, Asian OR: 3.97, Other OR: 2.03). Associations of learning disability, age and non-traditional entry routes with assessment scores and/or degree classification were also noted. Conclusion: These findings suggest significant attainment gaps in pre-registration physiotherapy education in this specific geographical region, particularly for non-White ethnic and disability groups. The association with assessment type challenges educators to look beyond a purely student deficit model to explore all factors that may lead to inequality. © 2017 The Authors.Health Education North West London (HENWL) grant (P063)

Theorizing construction industry practice within a disaster risk reduction setting: is it a panacea or an illusion?

Construction industry practice is strongly influenced by the culture surrounding its operations and, with the prevailing emphasis on achieving efficiency, there is a strong focus on outcome metrics such as profitability and employee productivity. With the recent increases in natural hazard events worldwide, and the likelihood that this will worsen still further with anticipated climate changes, the industry is increasingly contributing to building resilience within disaster-affected communities. Existing industry expertise, its educational approaches and the related theoretical frameworks, however, all require adjustment if these changing needs are to be fully addressed. Most importantly, an agenda shift is required from the philosophical side and a more pragmatic approach is needed if community resilience goals and objectives are to be met, rather than the narrower focus of the current metrics-driven management system. A synthesis of the current literature is therefore presented, along with relevant case histories illustrating how such an agenda shift within a disaster management context may influence the development of appropriate theory, as well as impacting upon grass-roots educational requirements. The research concludes by discussing how the ‘mainstreaming’ of disaster management within construction industry practice could drive forward developments in theorizing expertise and educational provisions across the constituent discipline