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Objective: To explore the outcome domains and measurement instruments reported across randomized trials of any interventions for various shoulder disorders.Methods: We searched for shoulder trials included in Cochrane reviews published up to Issue 10, 2015, or indexed in PubMed between 2006 and 2015. Trials were eligible for inclusion if they focused on any intervention for rotator cuff disease, adhesive capsulitis, shoulder instability, glenohumeral or acromioclavicular osteoarthritis, shoulder dislocation, proximal humeral or humeral head fractures, or unspecified shoulder pain. Two authors independently selected trials for inclusion and extracted information on the domains and measurement instruments reported, with consensus discussion among all authors where required.Results: We included 409 trials, published between 1954 and 2015. Across the trials, we identified 319 different instruments that were classified into 32 domains. Most trials reported a measure of pain (90%), range of motion (78%), and physical function (71%). The recording of adverse events was reported in only 31% of the trials. Muscle strength was reported in 44% of the trials and imaging outcomes in 21%. Other patient-reported outcome measures, such as global assessment of treatment success, health-related quality of life, work ability, and psychological functioning, were each reported in ≤15% of the trials. Most of the domains were reported at similar frequencies across different shoulder disorders.Conclusion: The domains and measurement instruments reported were widely diverse. Our results provide a foundation for the development of a core outcome set for use in future trials across all shoulder disorders. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Evidence-based medicine (EBM) has gained widespread acceptance in physical therapy. However, because little is known about the attitudes, knowledge and behaviour of physical therapists towards EBM, and their participation in research to generate EBM, we explored these aspects among physical therapy students, teachers, supervisors and practising physical therapists. Methods This is a cross-sectional survey in which participants completed a web-based questionnaire to determine their attitudes, knowledge and behaviour regarding EBM, and their participation in research. Results Questionnaires were sent to 814 participants of which 165 were returned. The overall mean score for attitude was 4.3 [standard deviation (SD) 1.0; range 1-7], which indicates a weak positive attitude. Teachers scored the highest (4.9, SD 1.2) and students the lowest (4.1, SD 0.8). Although most participants had some understanding of the technical terms used in EBM, only teachers felt able to explain these terms to others. Of the students, 45% rated their perceived EBM knowledge as bad and 45% as average, whereas 78% of the teachers considered that they had good knowledge. To answer clinical questions, most students generally use textbooks (96%) and the opinion of their supervisors (87.7%). Conclusions There is a weak positive attitude of physical therapists, teachers, supervisors and students towards participating in research in general practice, but there is a lack of knowledge and active behaviour regarding EBM, especially among physical therapy students. [ABSTRACT FROM AUTHOR]

Aim: To study the prognosis of disability of community-dwelling older people with mild disability at baseline. Methods: We used data from the Rotterdam Study: a community-based prospective cohort study of community-dwelling older people. We evaluated sociodemographic factors, lifestyle variables, health conditions and disability status at baseline and follow-up after 6 years. Disability was defined as a score on the Health Assessment Questionnaire. Results: At baseline the population consisted of 1166 older people with mild disability with a mean age of 69.7 (55-93) years. At follow-up 18% of the study population recovered from mild disability, 20% stayed mildly disabled, 31% became severely disabled, while 32% were deceased. At follow-up relatively more men died while more women had a worsened disability. Age and income were predictors of disability decrease. Alcohol use seemed to be significantly protective against death. Conclusion: Just a few prognostic factors appeared to be related to disability 6 years later. [ABSTRACT FROM AUTHOR]

To assess the efficacy of behavioral treatments in patients with tension headache. Medline, Cinahl, EMBASE, and the Cochrane library were searched from inception to October 2007 and reference lists were checked. We selected randomized trials evaluating behavioral treatments (e.g., relaxation, electromyographic [EMG] biofeedback, and cognitive behavioral training) in patients with tension-type headache (TTH). We assessed the risk of bias using the Delphi list and extracted data from the original reports. A qualitative analysis was carried out. We found 44 trials (2618 patients), which were included in this review, of which only 5 studies (11.4%) were considered to have low risk of bias. Most trials lacked adequate power to show statistical significant differences, but frequently, recovery/improvement rates did not reach clinical relevance. In 8 studies, relaxation treatment was compared with waiting list conditions, and in 11 studies, biofeedback was compared with waiting list conditions, both showing inconsistent results. On the basis of the available literature, we found no indications that relaxation, EMG biofeedback, or cognitive behavioral treatment is better than no treatment, waiting list, or placebo controls. [ABSTRACT FROM AUTHOR]

Abstract: Chronic neck pain is a common complaint in the Netherlands with a point prevalence of 14.3%. Patients with chronic neck pain are often referred to physiotherapy and, nowadays, are mostly treated with exercise therapy. It is, however, unclear which type of exercise therapy is to be preferred. Therefore, this study evaluates the effectiveness of behaviour graded activity (BGA) compared with conventional exercise (CE) for patients with chronic neck pain. Eligible patients with non-specific chronic neck were randomly allocated to either BGA or CE. Primary treatment outcome is the patient’s global perceived effect concerning recovery from complaint and daily functioning. Outcome assessment was performed at baseline, and at 4, 9, 26, and 52 weeks after randomization. Effectiveness was examined with general estimating equations analyses. Baseline demographics and patient characteristics were well balanced between the two groups. Mean age was 45.7 (SD 12.4) years and the median duration of complaints was 60 months. The mean number of treatments was 6.6 (SD 3.0) in BGA and 11.2 (SD 4.1) in CE. No significant differences between treatments were found in their effectiveness of managing patients with chronic neck pain. In both BGA and CE some patients reported recovery from complaints and daily function but the proportion of recovered patients did not exceed 50% during the 12-month follow-up period. Both groups showed clinically relevant improvements in physical secondary outcomes. International Standard Randomised Controlled Trial Number: ISRCTN88733332. [Copyright &y& Elsevier]

OBJECTIVES: To evaluate the effectiveness of Tai Chi Chuan in fall prevention in elderly people living at home with a high risk of falling. DESIGN: Randomized controlled trial. SETTING: Two industrial towns in the western part of the Netherlands. PARTICIPANTS: Two hundred sixty-nine elderly people (average age 77) living at home with a high risk of falling. INTERVENTIONS: The intervention group received Tai Chi Chuan training for 1 hour twice a week for 13 weeks; the control group received usual care. Both groups received a brochure containing general information on how to prevent fall incidents. MEASUREMENTS: Primary outcome was the number of falls over 12 months. Secondary outcomes were balance, fear of falling, blood pressure, heart rate at rest, forced expiratory volume during the first second, peak expiratory flow, physical activity, and functional status. RESULTS: After 12 months, no lower fall risk in the Tai Chi Chuan group was observed than in the control group (adjusted hazard ratio=1.16; 95% confidence interval=0.84–1.60), and there were no significant intervention effects on the secondary outcome measures. CONCLUSION: These results suggest that Tai Chi Chuan may not be effective in elderly people at a high risk of falling who live at home. [ABSTRACT FROM AUTHOR]

Study design. A follow-up study of women with pelvic pain during pregnancy. Objectives. To evaluate prognostic factors for pelvic pain. Methods. Out of a cohort of 870 pelvic pain patients, 598 women, who delivered less than 42 months prior to the follow-up measurement, were selected for follow-up. Results. Data of 430 women were available for analysis with a mean follow-up duration of 18 months postpartum. Forty-three women still experienced moderate or severe pain and were seriously hindered in more than one activity. At intake symptomatic women experienced a higher overall severity of complaints, more walking deficiencies, and mentioned prepregnancy back pain more often and reported labor lasting longer than 18 h 2.5 times more often than asymptomatic women. Explained variance of these factors is small. Conclusions. Mean 18 months postpartum a small group had moderate or severe pain. Prepregnancy back pain, severity of complaints, and number of walking deficiencies at primary referral as well as duration of labor showed a significant relation with symptoms. [ABSTRACT FROM AUTHOR]