Passive Movements Do not Appear to Prevent or Reduce Joint Stiffness in Medium to Long-Stay ICU Patients: A Randomized, Controlled, Within-Participant Trial.

Objectives: ICU patients have an increased risk of joint stiffness because of their critical illness and reduced mobility. There is a paucity of evidence evaluating the efficacy of passive movements (PMs). We investigated whether PMs prevent or reduce joint stiffness in ICU patients.

Exercise and Airway Clearance Techniques in Cystic Fibrosis.

Exercise and airway clearance techniques (ACTs) have been a cornerstone of treatment for people with cystic fibrosis (pwCF) for many decades. Exercise may confer both respiratory and nonrespiratory benefits for pwCF, with greater exercise capacity associated with improved survival. A wide variety of exercise interventions for pwCF have been investigated.

Exercise as a substitute for traditional airway clearance in cystic fibrosis: a systematic review.

Background: Exercise and traditional airway clearance techniques (ACTs) are both routinely recommended for people with cystic fibrosis (CF), with some people using exercise as a substitute for traditional ACTs. The effectiveness of this is unclear. We systematically reviewed the evidence for using exercise as a substitute for traditional ACTs in people with CF.

Development of a device to measure adherence and pressure characteristics of positive expiratory pressure therapies used by adults with cystic fibrosis.

Introduction: Positive expiratory pressure (PEP) and oscillating positive expiratory pressure (OscPEP) therapies are often used by people with cystic fibrosis (CF) to facilitate airway clearance. However, suboptimal adherence and poor technique may reduce their effectiveness.

Objective: To develop a device (PEPtrac) to accurately measure and provide preliminary clinical data of adherence and technique characteristics when airway clearance is performed using PEP/OscPEP devices.

Exercise as a therapeutic intervention for people with cystic fibrosis.

The complex multisystem nature of cystic fibrosis (CF) commonly results in reduced exercise tolerance, which is independently associated with poor clinical outcomes. Exercise is routinely recommended as part of the therapeutic regimen in CF to improve both respiratory and non-respiratory impairments. Areas covered: This article summarises the most recent evidence regarding the use of exercise as a therapeutic intervention in CF and discusses some of the practical considerations for exercise prescription in this setting.

Exercise is commonly used as a substitute for traditional airway clearance techniques by adults with cystic fibrosis in Australia: a survey.

Questions: What airway clearance techniques and exercise regimens are used by adults with cystic fibrosis (CF) in Australia when well or unwell? What proportion of these adults believe that exercise can be used as a substitute for traditional airway clearance techniques, and how have they come to this belief? What type of exercise is used as a substitute for traditional airway clearance techniques?

Design: Cross-sectional survey at 13 CF centres in Australia, using a purpose-designed questionnaire.

Participants: Six hundred and ninety-two adults with CF completed the questionnaire.

Outcome Measures: The questionnaire included questions about: the participants' current use of traditional airway clearance techniques and exercise, when well and unwell; and beliefs regarding the use of exercise as a substitute for traditional airway clearance techniques.

Airway clearance by exercising in mild cystic fibrosis (ACE-CF): A feasibility study.

Background: People with cystic fibrosis (CF) are encouraged to perform airway clearance techniques on a daily basis. Whilst several short-term studies support a potential role for exercise as an airway clearance technique, to date no medium to longer term studies have investigated the use of exercise as a stand-alone airway clearance technique.

Objective: To determine the feasibility of a protocol investigating the use of exercise as a stand-alone form of airway clearance in adults with CF.

Increased allied health services to general and acute medical units decreases length of stay: comparison with a historical cohort.

Objective The present study evaluated the effect of an initiative to fund increased allied health (AH) services, enabling increased days and both volume and scope of AH services, for general medical in-patients in the Central Adelaide Local Health Network for a 6-month trial period. Methods A quasi-experimental mixed-methods study was undertaken involving general medical in-patients at two acute tertiary-referral public hospitals with a prospective (December 2015-May 2016) and historical comparison (December 2014-May 2015) cohort. Outcome measures compared between the two cohorts included hospital length of stay (LOS), occupied bed-days, adverse events and AH service data.

Inspiratory muscle training is feasible and safe for patients with acute spinal cord injury.

Objective: To investigate the feasibility and safety and, to a lesser extent efficacy, of inspiratory muscle training (IMT) for patients with acute complete cervical or thoracic spinal cord injury (SCI).

Design: Prospective, observational pilot study comprising a series of case reports.

Setting: Tertiary care, public hospital.

Dietetic and educational interventions improve clinical outcomes of diabetic and obese clients with mental impairment.

Aim: The aim of this study was to evaluate the effect of dietetic and educational interventions provided to clients with type 2 diabetes (with or without obesity) or obesity-only residing in supported residential facilities and characterised by mental impairment.

Methods: A retrospective audit involving the retrieval of information from medical records and databases was undertaken to evaluate the effect of dietetic and educational interventions. Clinical outcomes were weight, body mass index and glycosylated haemoglobin (HbA1c) levels.

The psychometric properties of the Leicester Cough Questionnaire and Respiratory Symptoms in CF tool in cystic fibrosis: A preliminary study.

Background: There are few tools to quantify the impact of cough in cystic fibrosis (CF). The psychometric properties of the Leicester Cough Questionnaire (LCQ) and Respiratory Symptoms in CF (ReS-CF) tool were investigated in adults with CF.

Methods: Validity and reliability were assessed in clinically stable participants who completed the questionnaires twice, along with the Cystic Fibrosis Questionnaire - Revised (CFQ-R).

Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults.

Introduction: The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients.

Methods: A systematic literature review was followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilization of mechanically ventilated patients.

Results: Safety considerations were summarized in four categories: respiratory, cardiovascular, neurological and other.

Orthopedic inpatients’ ability to accurately reproduce partial weight bearing orders.

Partial weight bearing is often prescribed for patients with orthopedic injuries. Patients’ ability to accurately reproduce partial weight bearing orders is variable, and its impact on clinical outcomes is unknown. This observational study measured patients’ ability to reproduce partial weight bearing orders, factors influencing this, patients’ and physiotherapists’ ability to gauge partial weight bearing accuracy, and the effect of partial weight bearing accuracy on long-term clinical outcomes.

Physiotherapy in intensive care: an updated systematic review.

Background: Although physiotherapy is frequently provided to patients in the ICU, its role has been questioned. The purpose of this systematic literature review, an update of one published in 2000, was to examine the evidence concerning the effectiveness of physiotherapy for adult, intubated patients who are mechanically ventilated in the ICU.

Methods: The main literature search was undertaken on PubMed, with secondary searches of MEDLINE, CINAHL, Embase, the Cochrane Library, and the Physiotherapy Evidence Database.

Physical activity levels of patients with cystic fibrosis hospitalised with an acute respiratory exacerbation.

Background: The physical activity levels of adult patients with cystic fibrosis hospitalised for an acute respiratory exacerbation is unknown.

Methods: A prospective observational study was undertaken. Physical activity levels were measured for a 24-h period using an activity monitor (SenseWear(®) Pro 3) during hospitalisation for an acute respiratory exacerbation and one month post-discharge.

Physical and quality of life outcomes of patients with isolated hand burns--a prospective audit.

Hand burns can have major implications on function, appearance, and quality of life. Our clinical practice has changed over the last 10 years, with a steady increase in the proportion of hand burns receiving early and aggressive surgical management using Biobrane® sheets/gloves and a concomitant fall in the proportion requiring excision and split skin grafting. The aim of this study was to measure a comprehensive range of outcomes for patients admitted with isolated hand burns to review our outcomes and provide us with the "expected" patterns of recovery.

Outcome measurement tools currently used to assess pediatric burn patients: an occupational therapy and physiotherapy perspective.

Given the high incidence of burn injuries in children, it is important that all clinicians involved in the care of these patients, including occupational therapists and physiotherapists, are able to assess patients with valid, sensitive, and reliable measurement tools to optimize outcomes and clinical management. The aims of this study were to identify therapist- relevant outcome measurement tools that have been previously used with pediatric burn patients and to ascertain the outcome measurement tools currently used by occupational therapists and physiotherapists working in pediatric burns units. A literature review was undertaken to identify therapist-relevant outcome measurement tools that have been used in the pediatric burn population.

A physiotherapy service to an emergency extended care unit does not decrease admission rates to hospital: a randomised trial.

Background: One of the reasons physiotherapy services are provided to emergency departments (EDs) and emergency extended care units (EECUs) is to review patients' mobility to ensure they are safe to be discharged home.

Aim: To investigate whether a physiotherapy service to an EECU altered the rate of hospital admission, rate of re-presentation to the ED, visits to community healthcare practitioners, return to usual work/home/leisure activities and patient satisfaction.

Methods: A randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis was undertaken in an EECU.

Comparison of the pressure redistribution qualities of two air-filled wheelchair cushions for people with spinal cord injuries.

Background/aim: People with spinal cord injuries are at high risk of developing pressure ulcers. Wheelchair cushions that redistribute pressure are one prevention strategy to reduce the risk of pressure ulcers in this population. Currently, therapists have only limited evidence concerning the pressure redistribution qualities of wheelchair cushions to guide their cushion selection in clinical practice.

A postoperative shoulder exercise program improves function and decreases pain following open thoracotomy: a randomised trial.

Question: Does a postoperative physiotherapy exercise program incorporating shoulder exercises improve shoulder function, pain, range of motion, muscle strength, and health-related quality of life in patients undergoing elective pulmonary resection via open thoracotomy?

Design: Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.

Participants: 76 patients who underwent pulmonary resection via open thoracotomy.

Intervention: All participants received standard medical and nursing care involving a clinical pathway.

Does physiotherapy reduce the incidence of postoperative pulmonary complications following pulmonary resection via open thoracotomy? A preliminary randomised single-blind clinical trial.

Objective: This study investigates whether targeted postoperative respiratory physiotherapy decreased the incidence of postoperative pulmonary complications and length of stay for patients undergoing elective pulmonary resection via open thoracotomy.

Methods: Seventy-six patients participated in a prospective, single-blind, parallel-group, randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis. Treatment group participants received daily respiratory physiotherapy interventions until discharge.

An evaluation of the level of satisfaction with a dedicated inpatient venepuncture service at a rehabilitation centre.

The purpose of this prospective observational study was to determine the levels of satisfaction of the three main 'customers' of a dedicated inpatient venepuncture service at a rehabilitation centre, namely the patients, medical staff and nursing staff. The venepuncture service was delivered by two part-time nurses. One hundred and six patients, 14 medical staff and 35 nurses participated in the study.

Passive limb movements for patients in an intensive care unit: a survey of physiotherapy practice in Australia.

Purpose: This study aimed to investigate physiotherapists' clinical practice regarding passive limb movements for adult patients in Australian intensive care units (ICUs).

Materials And Methods: A prospective survey using a purpose-designed questionnaire was mailed to the senior physiotherapist working in each Australian level 3 (tertiary) adult ICU.

Results: Of 65 questionnaires sent, 51 (78%) were returned.