Search

Systematic scoping review. Many factors are potentially associated with successful work-related transitions following hand injury. There is no current, comprehensive review of the literature to guide clinical practice. To comprehensively identify the current body of research evidence supporting return to work (RTW) after hand injury and identify gaps. A systematic search identified relevant, peer-reviewed, full text, English language primary qualitative or quantitative literature published since 2006. All authors independently determined whether studies should be included, assigned them to a hierarchy of evidence and extracted data. Decisions were defended and disagreements resolved in team meetings. Literature was summarized into key themes using common intent and constructs. Of 259 potentially-relevant articles, 38 were relevant. Study designs included prospective observational, cross-sectional, and retrospective (n=9 each), mixed methods (n=3), qualitative (n=4), and opinion pieces (n=4). There were no experimental studies. The most commonly-reported key themes were prognostic factors for RTW (25 papers) and assessment tools (18 papers). Remaining themes of impact of injury on the individual, patient perspectives, other stakeholder perspectives, healthcare provider education, and treatment were reported in fewer than 10 papers each. There was little commonality in how research was conducted or reported. Gaps included lack of information on effective interventions, which prognostic factors should be routinely measured, and which assessment and outcome items to routinely use in practice. Despite the impact of hand injury on capacity to RTW, there is limited evidence to inform successful work-related transitions. • Factors influencing successful return to work after hand injury are complex and inter-connected. • Higher hierarchy studies are required to test effectiveness of work-related transitions. • Consensus on a core data set is needed to enable comparison across studies. • Comprehensive packages for early work-related transitions after hand injury are essential. • International collaborations are important to build the evidence-base in this area. [ABSTRACT FROM AUTHOR]

This paper describes adolescent low back pain and tests its associations with environmental features of backpack load, time spent carrying loads, time sitting, and time playing sport, using data from 1269 adolescents in twelve volunteer high schools in Adelaide, South Australia. Backpacks were the preferred method of load carrying, two-thirds of wearers preferring to carry the load over two shoulders. The average load weighed 5.3 kg (approximating 10% of body weight). The youngest students carried approximately the same amount as the oldest students. Girls were more likely than boys to report recent low back pain, and there were gender- and age-specific associations between recent low back pain, the amount of time spent sitting, the backpack load and time spent carrying it, and time playing sport. Body mass was not a confounder of any association. These findings support ongoing concerns regarding environmental contributions to adolescent low back pain. Keywords: Adolescents; Low back pain; Backpacks

Chemical restraint (CR) is emergency drug management for acute behavioural disturbances in people with mental illness, provided with the aim of rapid calming and de-escalating potentially dangerous situations. To describe a systematic review of Randomised Controlled Trials (RCTs) reporting on short-term safety and effectiveness of drugs used for CR, administered to non-consenting adults with mental health conditions, who require emergency management of acute behavioural disturbances. A meta-analysis was conducted of those RCTs with comparable interventions, outcome measures and measurement timeframes. Academic databases were searched for RCTs published between 1 January 1996 and 20th April 2020. Relevant RCTs were critically appraised using the 13-item JBI checklist. All RCTs were described, and step-wise filters were applied to identify studies suitable for meta-analysis. For these, forest and funnel plots were constructed, and Q and I2 statistics guided interpretation of pooled findings, tested using MedCalc Version 19.1. Of 23 relevant RCTs, 18 (78.2% total) had excellent methodological quality scores (at least 90%). Eight RCTs were potentially relevant for meta-analysis (six of excellent quality), reporting 20 drug arms in total. Adverse events for 6–36% patients were reported in all 20 drug arms. Four drug arms from two homogenous studies of N = 697 people were meta-analysed. These RCTs tested two antipsychotic drugs (droperidol, olanzapine) delivered intravenously in either 5 mgs or 10 mg doses, with outcomes of time to calm, percentage calm within five or 10 min, and adverse events. There were no significant differences between drug arms for either measure of calm. However, 5 mg olanzapine incurred significantly lower risk of adverse events than 10 mg olanzapine (OR 0.4 (95%CI 0.2−0.8)), although no dose differences were found for droperidol. 5 mg intravenous olanzapine is recommended for quick, safe emergency management of people with acute behavioural disturbances associated with mental illness. [ABSTRACT FROM AUTHOR]

Background Improved techniques of measuring sitting posture have not led to a more comprehensive understanding of poor posture, nor its association with pain. There is also an evidence gap regarding critical thresholds of sitting postural change over time related to pain production. This paper describes postural angle changes over a 12-month period, and describes the process of placing defensible cut-points in the angle change data, to better understand associations between posture change over time, and onset of upper quadrant musculoskeletal pain (UQMP). Methods This paper reports on data captured at baseline and 12-month follow-up, in adolescents in school using computers. Four sitting postural angles, head flexion (HF), neck flexion (NF), craniocervical angle (CCA) and trunk flexion (TF), and self-reported seated UQMP in the previous month were captured at each time-point. Research questions were: 1) What is the magnitude and direction of change in each postural angle over 12 months? 2) What are best cut-points in the continuous posture change distribution to most sensitively test the association between posture change and UQMP? 3) Is gender-specific cut-points required? The 12-month posture angle change data was divided into quintiles (0–20th%; 21-40 th %, 41-60 th %, 61-80 th %, >80 th %), and the odds of UQMP occurring in each posture change quintile were calculated using logistic regression models. Results Two hundred and eleven students participated at baseline, of which 153 were followed-up at one year. Both males and females with postural change into extension (which represents lesser flexion range) were more at risk for the development of UQMP, than any other group. The best cut-point for HF was 40 th % (≤−3.9°), NF was 20th% (≤−2.9°) and TF was 40 th % (≤−1.1°). For CCA however, change at or beyond 40 th % for extension or beyond 60% for flexion was associated with UQMP. Conclusions Identification of critical postural angle change cut-points assists in considering the pain-producing mechanisms for adolescents using desk top computers. [ABSTRACT FROM AUTHOR]

Background There is no consensus in the English-language literature regarding the best types or dosages of stretching to maximise muscle strength and functional performance. It is possible that primary research published in non-English languages provides different insights, and could add to the body of international knowledge. Purpose This systematic review aimed to identify and evaluate Japanese-language randomised controlled trials (RCTs) investigating acute effects of stretching on maximal strength and functional performance. Methods Three Japanese databases and five English databases were searched from inception to 24 March 2015. Only Japanese-language RCTs examining acute effects of stretching on maximal strength and/or functional performance were included. Risk of bias in included studies was assessed using Physiotherapy Evidence Database scale. GRADE (Grading of Recommendation Assessment, Development and Evaluation) approach was applied to evaluate the quality of evidence. Descriptive synthesis was attempted. Results Seven RCTs with variable methodological quality were included. No two studies were the same, thus meta-analysis was not possible. Descriptively, because of heterogeneity of interventions and outcome measures, it was not possible to identify consensus on the benefits of stretching. GRADE approach indicated low to very low quality evidence for this topic. Conclusion This review of Japanese-language RCTs provided no additional information to strengthen or challenge the current English-language evidence base on acute effects of stretching on maximal strength and performance. Future Japanese-language studies should address methodological flaws exposed in this review and incorporate functional outcome measures to strengthen the international evidence base. [ABSTRACT FROM AUTHOR]

Background There is evidence that consistent sitting for prolonged periods is associated with upper quadrant musculoskeletal pain (UQMP). It is unclear whether postural alignment is a significant risk factor. Objective and design The aim of the prospective study (2010–2011) was to ascertain if three-dimensional sitting postural angles, measured in a real-life school computer classroom setting, predict seated-related UQMP. Method Asymptomatic Grade 10 high-school students, aged 15–17 years, undertaking Computer Application Technology, were eligible to participate. Using the 3D Posture Analysis Tool, sitting posture was measured while students used desk-top computers. Posture was reported as five upper quadrant angles (Head flexion, Neck flexion; Craniocervical angle, Trunk flexion and Head lateral bending). The Computer Usage Questionnaire measured seated-related UQMP and hours of computer use. The Beck Depression Inventory and the Multidimensional Anxiety Scale for Children assessed psychosocial factors. Sitting posture, computer use and psychosocial factors were measured at baseline. UQMP was measured at six months and one-year follow-up. Results 211, 190 and 153 students participated at baseline, six months and one-year follow-up respectively. 34.2% students complained of seated-related UQMP during the follow-up period. Increased head flexion (HF) predicted seated-related UQMP developing over time for a small group of students with pain scores greater than the 90th pain percentile, adjusted for age, gender, BMI, computer use and psychosocial factors (p = 0.003). The pain score increased 0.22 points per 1° increase in HF. Conclusions Classroom ergonomics and postural hygiene should therefore focus on reducing large HF angles among computing adolescents. [ABSTRACT FROM AUTHOR]

Abstract: Physiotherapists should be proactive in preparing themselves to participate in innovative models of health care, which are emerging from the healthcare workforce reforms in Australia. One challenging outcome of workforce change is physiotherapy (non-medical) prescribing (NMP), which is part of the extension of scope of physiotherapy practice. This paper summarises the current evidence base for Australian physiotherapists seeking to obtain prescribing rights. A targeted literature review was undertaken through EBSCO Host, Cochrane, Medline, SportsDiscus, Cinahl, Healthsource and Google.com using broad search terms to identify peer-reviewed and grey literature pertaining to NMP by physiotherapists, nationally and internationally. No critical appraisal was undertaken however literature was structured into the NHMRC hierarchy of evidence. Themes raised in the included literature were reported descriptively. There were six relevant peer-reviewed articles, of hierarchy levels III_3 and IV. There was however, comprehensive and recent grey literature to inform Australian physiotherapy NMP initiatives. Themes included the need for standard National action in relation to legislative and regulatory/registration issues, appropriate education, credentialing and supervisory requirements for physiotherapy prescribing. Many lessons can be learnt from the literature, including the importance of planned, uniform National action (rather than piecemeal state-by-state initiatives). Essential elements include appropriate training and skills-based recognition within the discipline and the broader health team, and the need to overtly demonstrate effectiveness and safety. Regularly-evaluated service-delivery models which support NMP by physiotherapists are further required, to demonstrate efficiency, timeliness, patient centredness and equity. [Copyright &y& Elsevier]

Abstract: Objective: The objective was to test if a neuromuscular exercise programme would improve jump-shot landing technique of male adolescent basketball players. Design: A non-equivalent pre-test–post-test control group experimental design was used. Setting: Intervention (a 6-week neuromuscular exercise programme) took place at club practise venues and motion analysis at a biomechanics laboratory. Participants: Five case and five matched control subjects participated. Main outcome measures: Six high-speed (120Hz), Oxford Metrics Vicon 370 cameras (Oxford Metrics, Oxford, UK) and a strain gauge AMTI force plate (AMTI Inc., Newton, MA, USA) synchronised were used to analyse three-dimensional (3-D) knee kinetics and kinematics of a jump-shot landing. Vertical ground reaction force, knee joint angles and negative work were calculated. Results: Repeated ANOVA tests were used to compare the peak vertical ground reaction force, knee flexion, and total negative work prior to and following the exercise intervention. There was an overall significant difference for time of testing (pre-and-post intervention) and group allocation (case or control) for peak ground reaction force, knee flexion and negative working when landing from a jump-shot. Conclusion: The improvements noted in the performance of case subjects suggest that neuromuscular exercises could aid in the reduction of injury rate or severity of knee injuries sustained during game play. [Copyright &y& Elsevier]

A single, complete, ovine knee was imaged using conventional MRI then dissected allowing comprehensive dimensional measurement of the intra-articular structures. A three-dimensional (3-D) computer model of the knee was generated from the MR sections. Thirty-two individual structural measures were recorded from the image output for which there was an available surgical measure for direct comparison. The results of Pearson''s correlation testing show a rounded score of 1.00, suggesting an exceptional linear correlation between direct anatomical measurement and the 3-D image output. Further analysis of the data revealed an average error of measurement of 0.2 mm across the 32 measures. The findings of this preliminary study suggest that 3-D reconstruction from MR data may be an appropriate, and accurate, means for making dimensional measurements of the bony and soft tissue structures of the ovine knee. It is unlikely that the measurement error would be of any great clinical significance. There is evidence in the literature to suggest that an ovine knee may be considered an acceptable model for substitution for the human knee in diagnostic assessment studies. Therefore, such findings may be considered clinically relevant in the field of human knee assessment. [Copyright &y& Elsevier]

Antiretroviral therapy (ART) has had a major impact on life expectancy from HIV as many people now live with it as a chronic disease. Chronic HIV has been associated with a range of comorbid disabilities and health conditions, one of which is hearing loss. Undiagnosed and untreated hearing loss, particularly in children, has been linked to poorer spoken language skills, with subsequent effects on academic performance. This systematic scoping review aimed to summarize the available peer-reviewed literature on hearing loss in HIV-infected children, specifically to describe its extent and nature. The review followed the framework proposed by Arksey and O'Malley. Key search terms included hearing loss (and synonyms), child (and synonyms), and HIV. Electronic databases (EBSCOhost Research Platform, PubMed, Web of Science and Scopus databases) were searched for any relevant articles published from January 1, 2000 to June 30, 2019. Reference lists of included articles were pearled for additional relevant articles not already identified. Each stage of the selection process was conducted independently by two authors. The results were then collated by a third author who also resolved any discrepancies. Extracted data included sample descriptors, audiologic tests, hearing loss prevalence, hearing loss descripts, and factors associated with hearing loss. Seventeen articles were included; 10 from Africa, four from South America, two from North America and the remaining article from Asia. Although most of the articles reported on pure tone audiometry, the samples as well as the cut-off criteria for normal hearing were heterogenous. Prevalence of hearing loss varied across articles (from 6% to 84%). Conductive hearing loss occurred more frequently than sensorineural or mixed hearing loss. ART use and ear infection were reported as significant in three of five articles that reported on significant associates of HIV-related hearing loss. There was a modest volume of research from a limited number of countries. Heterogeneity in sampling and audiometric methods precluded a clear understanding of potential associations between chronic HIV-related hearing loss and contributing factors. • Conductive hearing loss occurs more frequently than sensorineural or mixed hearing loss. • Antiretroviral treatment and ear infections are associated with hearing loss in children living with HIV. • Heterogeneity in sampling and audiometric methods need to be addressed to make study results comparable. [ABSTRACT FROM AUTHOR]