Quadratus femoris: an EMG investigation during walking and running

Dysfunction of hip stabilizing muscles such as quadratus femoris (QF) is identified as a potential source of lower extremity injury during functional tasks like running. Despite these assumptions, there are currently no electromyography (EMG) data that establish the burst activity profile of QF during any functional task like walking or running. The objectives of this study were to characterize and compare the EMG activity profile of QF while walking and running (primary aim) and describe the direction specific action of QF (secondary aim). A bipolar fine-wire intramuscular electrode was inserted via ultrasound guidance into the QF of 10 healthy participants (4 females). Ensemble curves were generated from four walking and running trials, and normalized to maximum voluntary isometric contractions (MVICs). Paired t-tests compared the temporal and amplitude EMG variables. The relative activity of QF in the MVICs was calculated. The QF displayed moderate to high amplitude activity in the stance phase of walking and very high activity during stance in running. During swing, there was minimal QF activity recorded during walking and high amplitudes were present while running (run vs walk effect size = 4.23,

“…like you’re pushing the snowball back up hill”—the experiences of Australian physiotherapists promoting non-treatment physical activity: A qualitative study

Participating in physical activity is important for maintaining general health. When physiotherapists promote physical activity for the purposes of maintaining or improving a patient‟s general health, they are promoting non-treatment physical activity. Physiotherapists have a responsibility to promote non-treatment physical activity to their patients while also providing the patient with treatment for their presenting complaint. This qualitative study explored the experiences of Australian physiotherapists promoting non-treatment physical activity to patients with musculoskeletal conditions. Ten Australian physiotherapists treating patients with musculoskeletal conditions in private practice and outpatient settings were recruited using a social media campaign and snowballing. All interviewees received one $AU20 gift card for participating. Sixty-minute semi-structured interviews were conducted and were transcribed verbatim. Interpretative phenomenological analysis was used to design the interview guide and analyse data. Transcripts were used to identify emergent and superordinate themes. Most interviewees were female, aged between 25–34 years, physically active and reported promoting NTPA. The superordinate themes that emerged from the transcripts included: Internal and external influences on NTPA promotion, approach taken by the physiotherapist towards NTPA promotion, challenges experienced when promoting NTPA, and skills and training. In conclusion, physiotherapists reported they were well-placed to promote NTPA, but they face many challenges. The perceived inability to motivate patients to become physically active and the need to prioritise patient expectations of hands-on therapy made NTPA promotion difficult. Workplace specific factors, such as having an open-plan clinic environment and having other staff who promote NTPA, were perceived to make NTPA promotion easier. Using effective marketing strategies that portray the physiotherapy clinic as a physically active environment might see patients expect NTPA promotion, making NTPA promotion easier for Australian physiotherapists in the future

Changing prescribing behaviours with educational outreach:An overview of evidence and practice

BACKGROUND: General practitioners (GPs), or family practitioners, are tasked with prescribing medications that can be harmful to the community if they are inappropriately prescribed or used (e.g. opioids). Educational programs, such as educational outreach (EO), are designed to change the behaviour of health professionals. The purpose of this study was to identify the efficacy of EO programs at changing the prescribing behaviour of GPs. METHODS: This study included an evidence and practice review, comprising a rapid review supplemented by interviews with people who are familiar with EO implementation for regulation purposes. Seven databases were searched using terms related to health professionals and prescribing. Systematic and narrative reviews published in English after 2007 were included. Non-statistical analysis was used to report intervention efficacy. Three government representatives participated in semi-structured interviews to aid in understanding the relevance of review findings to the Victorian context. Interviews were transcribed verbatim and thematically analysed for emerging themes. RESULTS: Fourteen reviews were identified for the evidence review. Isolated (e.g. EO program delivered by itself) and multifaceted (e.g. EO program supplemented by other interventions) programs were found to change prescribing behaviours. However, limited evidence suggests that EO can successfully change prescribing behaviours specific to GPs. Isolated EO can successfully change health professional prescribing behaviours, although cheaper alternatives such as letters might be just as effective. Multifaceted EO can also successfully change health professional prescribing behaviours, especially in older adults, but it remains unclear as to what combination of interventions works best. Success factors for EO reported by government representatives included programs having practical rather than didactic foci; making EO compulsory; focussing EO on preventing adverse events; using monetary or professional development incentives; and in-person delivery. CONCLUSIONS: Educational outreach can successfully change prescribing behaviours but evidence specific to GPs is lacking. Key characteristics of EO that could optimise success include ensuring the EO program is tailored, involves practical learning and uses incentives that are meaningful to clinicians

Subsequent injuries are more common than injury recurrences: an analysis of 1 season of prospectively collected injuries in professional Australian football

BACKGROUND: It is known that some people can, and do, sustain >1 injury over a playing season. However, there is currently little high-quality epidemiological evidence about the risk of, and relationships between, multiple and subsequent injuries. PURPOSE: To describe the subsequent injuries sustained by Australian Football League (AFL) players over 1 season, including their most common injury diagnoses. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Within-player linked injury data on all date-ordered match-loss injuries sustained by AFL players during 1 full season were obtained. The total number of injuries per player was determined, and in those with >1 injury, the Subsequent Injury Classification (SIC) model was used to code all subsequent injuries based on their Orchard Sports Injury Classification System (OSICS) codes and the dates of injury. RESULTS: There were 860 newly recorded injuries in 543 players; 247 players (45.5%) sustained >/=1 subsequent injuries after an earlier injury, with 317 subsequent injuries (36.9% of all injuries) recorded overall. A subsequent injury generally occurred to a different body region and was therefore superficially unrelated to an index injury. However, 32.2% of all subsequent injuries were related to a previous injury in the same season. Hamstring injuries were the most common subsequent injury. The mean time between injuries decreased with an increasing number of subsequent injuries. CONCLUSION: When relationships between injuries are taken into account, there is a high level of subsequent (and multiple) injuries leading to missed games in an elite athlete group

The behaviour change techniques used by Australian physiotherapists to promote non-treatment physical activity to patients with musculoskeletal conditions

OBJECTIVES: To determine: (i) the behaviour change techniques used by a sample of Australian physiotherapists to promote non-treatment physical activity; and (ii) whether those behaviour change techniques are different to the techniques used to encourage adherence to rehabilitation exercises. DESIGN: Cross-sectional survey. METHOD: An online self-report survey was advertised to private practice and outpatient physiotherapists treating patients with musculoskeletal conditions. The use of 50 behaviour change techniques were measured using five-point Likert-type scale questions. RESULTS: Four-hundred and eighty-six physiotherapists responded to the survey, with 216 surveys fully completed. Most respondents (85.1%) promoted non-treatment physical activity often or all of the time. Respondents frequently used 29 behaviour change techniques to promote non-treatment physical activity or encourage adherence to rehabilitation exercises. A similar number of behaviour change techniques was frequently used to encourage adherence to rehabilitation exercises (n=28) and promote non-treatment physical activity (n=26). Half of the behaviour change techniques included in the survey were frequently used for both promoting non-treatment physical activity and encouraging adherence to rehabilitation exercises (n=25). Graded tasks was the most, and punishment was the least, frequently reported technique used to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. CONCLUSIONS: Respondents reported using similar behaviour change techniques to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. The variability in behaviour change technique use suggests the behaviour the physiotherapist is promoting influences their behaviour change technique choice. Including the frequently-used behaviour change techniques in non-treatment physical activity promotion interventions might improve their efficacy

The self-reported factors that influence Australian physiotherapists\u27 choice to promote non-treatment physical activity to patients with musculoskeletal conditions

OBJECTIVES: To determine the factors that influence physiotherapists\u27 choice to promote non-treatment physical activity to patients with musculoskeletal conditions. DESIGN: Cross sectional survey. METHODS: A national, online self report survey was targeted at Australian registered physiotherapists primarily treating patients with musculoskeletal conditions in private practice and outpatient settings. Likert scale questions were used to measure the factors influencing non-treatment physical activity promotion by physiotherapists. RESULTS: Two hundred and sixteen full responses were received. Most (56.6%) respondents irregularly promoted non-treatment physical activity, whereas 43.4% always promoted non-treatment physical activity. Promotion of non-treatment physical activity was bivariately associated with respondents\u27 own physical activity level (x CONCLUSIONS: The majority of surveyed Australian physiotherapists irregularly promoted non-treatment physical activity. Lack of knowledge of how to promote non-treatment physical activity, prioritising other patient problems before non-treatment physical activity promotion and using promotion methods that are not compatible with current practice might reduce non-treatment physical activity promotion frequency by physiotherapists

Physiotherapists use a small number of behaviour change techniques when promoting physical activity:A systematic review comparing experimental and observational studies

Objectives: Physiotherapists promote physical activity as part of their practice. This study reviewed the behaviour change techniques physiotherapists use when promoting physical activity in experimental and observational studies. Design: Systematic review of experimental and observational studies. Methods: Twelve databases were searched using terms related to physiotherapy and physical activity. We included experimental studies evaluating the efficacy of physiotherapist-led physical activity interventions delivered to adults in clinic-based private practice and outpatient settings to individuals with, or at risk of, non-communicable diseases. Observational studies reporting the techniques physiotherapists use when promoting physical activity were also included. The behaviour change techniques used in all studies were identified using the Behaviour Change Technique Taxonomy. The behaviour change techniques appearing in efficacious and inefficacious experimental interventions were compared using a narrative approach. Results: Twelve studies (nine experimental and three observational) were retained from the initial search yield of 4141. Risk of bias ranged from low to high. Physiotherapists used seven behaviour change techniques in the observational studies, compared to 30 behaviour change techniques in the experimental studies. Social support (unspecified) was the most frequently identified behaviour change technique across both settings. Efficacious experimental interventions used more behaviour change techniques (n = 29) and functioned in more ways (n = 6) than did inefficacious experimental interventions (behaviour change techniques = 10 and functions = 1). Conclusions: Physiotherapists use a small number of behaviour change techniques. Less behaviour change techniques were identified in observational studies compared to experimental studies, suggesting physiotherapists use less BCTs clinically than experimentally