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Objective: This systematic review critically evaluated the literature on the subjective and physical characteristics of TMD-related headache, a symptom secondary to the syndrome temporomandibular disorders (TMD). The specific research question is: 'what are the diagnostic criteria that confirm temporomandibular involvement in headache presentations?' Method: Electronic searches were conducted for MEDLINE, PubMed, and CINAHL from 1966 to September 2007. Hand searches for retrieved articles were also conducted to collect the data for this review. After applying inclusion criteria, 15 articles on TMD-related headache were found. Results: The symptoms of TMD-related headache are frequently unilateral and often present in the pre-auricular, temple and retro-orbital regions of the head. The principal physical characteristics include tenderness of the ipsilateral masticatory muscles and reduced jaw opening, often with mandibular deviation. Conclusion: Despite methodological problems such as low subject numbers and poorly documented sampling methods and inclusion criteria, the literature showed that TMD-related headache has identifiable diagnostic characteristics. This information could be used to develop guidelines to assist the identification of headaches which emanate from the temporomandibular structures. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review was to evaluate the literature on the effectiveness of physiotherapy exercises in reducing chronic low back pain (CLBP). A systematic search of the medical databases was performed, with 64 articles retrieved. After the exclusion criteria were applied, 15 randomised controlled trials (RCTs) evaluating physiotherapy delivered exercise programmes to patients with CLBP remained. A methodological quality assessment was performed, showing the included studies to have medium to high quality. Prescribed physiotherapy exercises included general fitness and aerobic exercises, flexibility regimes, stretches, muscle strengthening and spinal stabilising exercises. These interventions were compared with each other as well as surgical stabilisation, yoga, hydrotherapy, back care education booklets and placebo groups. Overall, physiotherapy prescribed exercise programmes were found to be effective in reducing pain in patients with CLBP. However, there was no consensus on a specific technique or exercise format being consistently superior to other interventions. [ABSTRACT FROM AUTHOR]

The level of agreement between clinicians' ratings of gait patterns in children with spastic hemiplegia was investigated using the Winters, Gage, and Hicks (WGH) classification scale. Sixteen clinicians (nine physiotherapists, seven orthopaedic surgeons) from six gait laboratories in five different countries rated gait patterns in 34 children with spastic hemiplegia (22 males, 12 females; mean age 10y [SD 3y], range 6-18y). Archived three-dimensional gait reports (kinematic and video data) and videos (video clips only) were rated for each child. Agreement between clinicians was substantial for reports (weighted kappa [wkappa] 0.77, range 0.62-0.89). Agreement was lower for videos (wkappa 0.63, range 0.39-0.97) and for clinicians' agreement between reports and corresponding videos (wkappa 0.62, range 0.47-0.76). Exact agreement was unacceptable for some gait patterns using reports (mean 65%, range 32-74%) and videos (mean 53%, range 35-94%). Not all gait patterns could be rated using the original WGH categories. It was concluded that: (1) agreement is acceptable using the WGH tool; (2) kinematic data from 3D instrumented gait analysis and video should be used together when using the WGH scale; and (3) further refinement of this classification is required. [ABSTRACT FROM AUTHOR]

PURPOSE: It is not known how clinicians characterise unilateral neglect (ULN) or whether they consider the different types of ULN during their evaluation and management of patients with this condition. The purpose of this study was to gain insight into physiotherapists' understanding of ULN and to identify the terminology used by clinicians to characterise neglect behaviour. METHOD: Qualitative research design employing focus groups and one-to-one interviews. Thirty-three experienced neurological and novice physiotherapists from one Australian state were asked to discuss how they characterise ULN and to explain what they meant by the terms they used. Data analysis involved preparation of verbatim transcripts followed by coding, data reduction, and identification of major themes. Data management was facilitated using NVivo computer software. FINDINGS: Terms such as sensory neglect, visual neglect, extinction, inattention, and functional neglect were used to characterise neglect behaviour but there was considerable confusion between many of these terms. Motor neglect was an unfamiliar concept to many participants. Functional implications of ULN were considered important. Characterisations of neglect according to the spatial distribution of the behaviour were uncommon. CONCLUSIONS: Despite awareness of many types of neglect, the physiotherapists in this study did not have a clear understanding of how to accurately characterise the different types of ULN. Education to address the issue is required. [ABSTRACT FROM AUTHOR]

BACKGROUND AND PURPOSE: The Timed 'Up & Go' Test (TUG) is used to measure the ability of patients to perform sequential locomotor tasks that incorporate walking and turning. This study investigated the retest reliability, interrater reliability, and sensitivity of scores obtained with the TUG in detecting changes in mobility in subjects with idiopathic Parkinson disease (PD). SUBJECTS: The performance of 12 people with PD was compared with that of 12 age-matched comparison subjects without PD. METHODS: The subjects with PD completed 5 trials of the TUG after withdrawal of levodopa for 12 hours ('off' phase of the medication cycle) as well as an additional 5 trials 1 hour after levodopa was administered ('on' phase of the medication cycle). They were scored on the Modified Webster Scale at both sessions. The comparison subjects also performed 5 TUG trials. All trials were videotaped and timed by 2 experienced raters. The videotape was later rated by 3 experienced clinicians and 3 inexperienced clinicians. RESULTS: For the subjects with PD, within-session performance was highly consistent, with correlations (r) ranging from.80 to.98 for the 'off' phase and from.73 to.99 for the 'on' phase. The performance of the comparison subjects across the 5 trials was also highly consistent (r=.90-.97). Comparisons showed differences between trials 1 and 2 on the TUG for both groups. Removal of data for trial 1 (the practice trial) further enhanced retest reliability. There was close agreement in TUG scores among raters despite different levels of experience (intraclass correlation coefficient [3,1]=.87-.99). Mean TUG scores were different between the 'on' and 'off' phases of the levodopa cycle and between subjects with PD and comparison subjects during the 'on' phase. CONCLUSION AND DISCUSSION: Retest reliability and interrater reliability of the TUG measurements were high, and the measurements reflected changes in performance according to levodopa use. The TUG can also be used to detect differences in performance between people with PD and elderly people without PD. [ABSTRACT FROM AUTHOR]

BACKGROUND AND PURPOSE. Evaluation of physical therapy for gait disorders in patients with Parkinson's disease (PD) requires an understanding of how the patients' medication cycle affects function. Four experiments were conducted to investigate stability of gait variables. METHODS AND RESULTS. In experiment 1, 15 subjects with idiopathic PD and 15 subjects without PD performed two sets of gait trials spaced 30 minutes apart, with the initial trial conducted with the subjects at a peak dose of medication. Strong correlations, as determined by intraclass correlation coefficients (ICC[2,1]), occurred between repeat measures of speed (ICC = .92), cadence (ICC = .92), stride length (ICC = .94), and time spent in double support (DS) (ICC = .93). In experiment 2, 16 subjects with PD were tested at the same time on two consecutive days. There was good repeatability for speed (ICC = .88), cadence (ICC = .85), stride length (ICC = .84), and DS (ICC = .80). When we assessed the repeatability of measurements taken at peak dose and at end of dose, there were low correlations for speed (ICC = -.54), cadence (ICC = -.07), stride length (ICC = -.35), and DS (ICC = -.38). In a final experiment on 16 subjects with PD, we used time-series analysis to examine the stability of measurements taken every 15 minutes for 2 1/2 hours. Slopes of regression models, standard deviations, and residual autocorrelations were negligible, indicating that the measurements were stable. CONCLUSION AND DISCUSSION. The parkinsonian gait pattern is reproducible across either brief time intervals or 24 hours when peak medication prevails. At the end of dose, however, marked changes in gait occur, apparently related to depletion of medication. [ABSTRACT FROM AUTHOR]

Background: The current investigation examined the inter- and intra-tester reliability of knee joint angle measurements using a flexible Penny and Giles Biometric electrogoniometer. The clinical utility of electrogoniometry was also addressed.Methods: The first study examined the inter- and intra-tester reliability of measurements of knee joint angles in supine, sitting and standing in 35 healthy adults. The second study evaluated inter-tester and intra-tester reliability of knee joint angle measurements in standing and after walking 10 metres in 20 healthy adults, using an enhanced measurement protocol with a more detailed electrogoniometer attachment procedure. Both inter-tester reliability studies involved two testers.Results: In the first study, inter-tester reliability (ICC[2,10]) ranged from 0.58-0.71 in supine, 0.68-0.79 in sitting and 0.57-0.80 in standing. The standard error of measurement between testers was less than 3.55 degrees and the limits of agreement ranged from -12.51 degrees to 12.21 degrees . Reliability coefficients for intra-tester reliability (ICC[3,10]) ranged from 0.75-0.76 in supine, 0.86-0.87 in sitting and 0.87-0.88 in standing. The standard error of measurement for repeated measures by the same tester was less than 1.7 degrees and the limits of agreement ranged from -8.13 degrees to 7.90 degrees . The second study showed that using a more detailed electrogoniometer attachment protocol reduced the error of measurement between testers to 0.5 degrees .Conclusion: Using a standardised protocol, reliable measures of knee joint angles can be gained in standing, supine and sitting by using a flexible goniometer. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to investigate tendon pain in abnormal patellar tendons with and without neovascularization. STUDY DESIGN: Comparative design. SETTING: Multidisciplinary tendon study group at a competitive volleyball venue. PARTICIPANTS: One hundred eleven volleyball players volunteered to participate in the study. MAIN OUTCOME MEASURES: Subjects' patellar tendons were imaged with ultrasound, with and without Doppler. Tendons that were imaging abnormal were categorized according the presence of tendon neovascularization. Subjects completed 3 pain scales that examined function (Victorian Institute of Sport Assessment score, 100-point maximum), pain with tendon load (decline squat, visual analogue scale, 100-mm maximum), and maximum pain for the previous week (visual analogue scale, 100-mm maximum). A 1-tailed Mann-Whitney U test compared pain scores in abnormal tendons without neovascularization to abnormal tendons with neovascularization. RESULTS: Functional scores were lower (Victorian Institute of Sport score, median, 78; P = 0.045) and pain scores under tendon load were greater (decline squat pain, median, 19; P = 0.048) in subjects with abnormal tendons with neovascularization than subjects with abnormal tendons without neovascularization (Victorian Institute of Sport Assessment score, median, 87; decline squat pain, median, 0). CONCLUSIONS: This study indicates that the presence of neovascularization in abnormal patellar tendons is associated with greater tendon pain compared with abnormal tendons without neovascularization in active jumping athletes. [ABSTRACT FROM AUTHOR]