Identifying High-Attenuating and Low-Attenuating Muscle Using Computerized Tomography and Exploring Its Impact on Physical Function and Muscle Strength in Obese Critically Ill Patients.

Background: Computed tomography (CT) methods to estimate sarcopenia in obesity do not differentiate high-attenuating from low-attenuating muscle. The primary purpose of this study was to determine agreement between a CT method using general workstation-derived total and high-attenuating psoas muscle cross-sectional area (CSA) and a commercially available segmentation software-derived value. Secondary purpose was to explore the relationship between quantity of high-attenuating muscle to physical functioning in a pilot cohort of obese medical intensive care unit (MICU) patients.

Role of Physical Therapists in the Management of Individuals at Risk for or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline.

The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular & Pulmonary and Acute Care sections of APTA, have developed this clinical practice guideline to assist physical therapists in their decision-making process when treating patients at risk for venous thromboembolism (VTE) or diagnosed with a lower extremity deep vein thrombosis (LE DVT). No matter the practice setting, physical therapists work with patients who are at risk for or have a history of VTE. This document will guide physical therapist practice in the prevention of, screening for, and treatment of patients at risk for or diagnosed with LE DVT.

Restoring functional status: a long-term case report of severe lung and ventilatory muscle pump dysfunction involving recurrent bacterial pneumonias.

Background And Purpose: Prolonged mechanical ventilation contributes to immobility and deconditioning making efforts to safely discontinue ventilator support desirable. This case report documents how implementing physical therapy treatment interventions, based on the Guide to Physical Therapist Practice, can help to restore a person's functional status even after multiple years of mechanical ventilation dependency.

Case Description: A patient (female; aged 63 years) with severe restrictive and obstructive ventilatory impairment has survived 34 recurrent pneumonias involving 6 bacterial pathogens while being mechanically ventilated at home.

Perspective paper: assessing air quality as part of a physical therapy plan of care.

Purpose: The purposes of this clinical perspective paper are (1) to expand physical therapists' awareness to the topic of air quality as a health priority when providing professional services; and (2) to provide templates for screening the indoor clinical environments and patient profiles to avert respiratory exacerbations, especially in persons with asthma.

Summary Of Key Points: The location where a physical therapist practices determines the air quality indices to which a person is exposed. Poor indoor air quality can expose a person to even greater compromise of respiration (ie, Sick Building Syndrome) than outdoor air quality secondary to an array of factors like building materials, the ventilation exchange rate of an enclosed space, chemicals used in cleaning, and humidity.

Functional and oximetric assessment of patients after lung reduction surgery.

Objective: The goal of this study was to clarify the issue of functional oxygen requirement by regimented exercise oximetry in patients undergoing lung reduction surgery.

Methods: Thirty-seven patients underwent lung reduction surgery and were followed up for at least 3 months. Patients routinely completed a 6-week program of cardiopulmonary rehabilitation.

Self-selected walking velocity for functional ambulation in patients with end-stage emphysema.

Purpose: Considerable attention has been given to ambulation and dyspnea in the population with chronic obstructive pulmonary disease; however, previous studies leave the question of what constitutes functional ambulation in this population unanswered. This article examines ambulation for functional independence in the community for patients with-end-stage emphysema based on their self-selected walking velocity (SSWV) during a 6-minute walk (6 MW) and a timed get up and go (GUG) test.

Methods: Fifty-nine patients (28 women, 31 men; mean age of 65.

The lennie test for measuring scapular position in healthy young adult females: a reliability and validity study.

Normal scapular rest position is neither adequately described nor agreed upon by authorities. The purpose of this study was to devise and describe a reliable and valid test (the Lennie Test) to measure scapular position, including normal scapular rest position. Fifteen healthy females (age 19-21 years) participated in the study.

An electromyographic analysis of hip abductor muscle activity when subjects are carrying loads in one or both hands.

Forces produced at the hip joint as a result of hip abductor muscle contractions while carrying loads reach several times body weight (BW). Physical therapists often advise patients with hip osteoarthritis in ways to minimize these forces as a means of reducing the pain associated with carrying loads. The purpose of this study was to use surface electromyography (EMG) to quantify the relative demands placed on the hip abductors while carrying loads in one hand or in both hands.

An electromyographic analysis of the hip abductor muscles during a standing work task.

Research data strongly suggest that osteoarthritis of the hip occurs statistically more often on the right side. A possible contributing factor to this right-sided bias in frequency may be that the articular cartilage on the right hip is subjected to relatively higher muscular-based forces throughout a lifetime. As an initial attempt to study this possibility, this research examined healthy persons to determine the existence of a "dominant" hip similar to that expressed for handedness.

Spinal effects of head-down tilting. Part 1--Low back contour changes.

The purpose of this study was to compare the effects of two methods of inversion therapy and four common exercise positions on the shape of the low back. We studied 25 healthy subjects in six exercise positions: 1) inverted with lower limbs extended (ILLE), 2) standing, 3) supine, 4) inverted with lower limbs flexed (ILLF), 5) sitting, and 6) hooklying. A manual measurement system was used to determine low back contours (LBCs) from S2 upward for 19 cm at 1-cm intervals.

Providing resistive breathing exercise to the inspiratory muscles using the PFLEX device. Suggestion from the field.

This report describes a 6-step process for prescribing resistive inspiratory exercise using the PFLEX device, which is an inexpensive and effective method of enhancing the performance of the vital muscles of respiration. Until further clinical validation of minimal threshold guidelines for prescribing PEPs is achieved, the clinical judgment of the physical therapist remains the most important element in the prescription process.

Influence of aerobic fitness on cardiovascular responses during slow head-down tilting.

This study examined the influence of cardiorespiratory fitness (CRF) on mean heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) responses to slow head-down tilting. Twenty-four young, healthy volunteers were tilted randomly from the horizontal plane to -30, -60, and -90 degrees with lower limbs extended or flexed. A multivariate analysis of variance between three independent variables (level of CRF, tilt angle, and lower limb position) and three dependent variables (mean HR, SBP, and DBP) was performed on the cardiovascular changes from an initial horizontal baseline value (absolute change) and from a horizontal value that immediately preceded tilting angles (relative change).

Resources for vocational planning applied to the job title of PHYSICAL THERAPIST.

Industrial rehabilitation is a rapidly developing area of health care. As a result, physical therapists need to become functionally familiar with common vocational planning processes and resources. Therefore, the purpose of this article is to describe a process called Vocational Diagnosis and Assessment of Residual Employability (VDARE), which is based on the Dictionary of Occupational Titles (DOT) and Classification of Jobs (COJ) resources.

Physical fitness of physical therapy students.

Physical fitness norms do not exist for physical therapists or physical therapy students. This lack, in part, reflects the complexity of physical fitness and the scarcity of data reported on physical fitness norms of other populations. This report describes the methods used and the results obtained for 16 physical fitness factors of 98 female and 13 male physical therapy upperclassmen and discusses the implications of physical fitness in the practice of physical therapy.