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Abstract: There is a long-held belief that physical activities such as lifting with a flexed spine is generally harmful for the back and can cause low back pain (LBP), potentially reinforcing fear-avoidance beliefs underlying pain-related fear. In patients with chronic LBP, pain-related fear has been shown to be associated with reduced lumbar range of motion during lifting, suggesting a protective response to pain. However, despite short-term beneficial effects for tissue health, recent evidence suggests that maintaining a protective trunk movement strategy may also pose a risk for (persistent) LBP due to possible pronociceptive consequences of altered spinal motion, potentially leading to increased loading on lumbar tissues. Yet, it is unknown if similar protective movement strategies already exist in pain-free individuals, which would yield potential insights into the role of fear-avoidance beliefs in motor behavior in the absence of pain. Therefore, the aim of this study is to test whether fear-avoidance beliefs influence spinal motion during lifting in a healthy cohort of pain-free adults without a history of chronic pain. The study subjects (N = 57) filled out several pain-related fear questionnaires and were asked to perform a lifting task (5kg-box). High-resolution spinal kinematics were assessed using an optical motion capturing system. Time-sensitive analyses were performed based on statistical parametric mapping. The results demonstrated time-specific and negative relationships between self-report measures of pain-related fear and lumbar spine flexion angles during lifting, indicating potential unfavorable interactions between psychological factors and spinal motion during lifting in pain-free subjects. [ABSTRACT FROM AUTHOR]

This cross-sectional study evaluated the intrasession reliability and concurrent validity of trunk accelerometry (with force plate measurements) for vertical ground reaction force and external mechanical power recorded during a standardized heel-rise (HR) test in 54 elderly subjects (mean +/- standard deviation age 81.2 +/- 6.4 yr). Peak force as well as peak and average power revealed intraclass correlation coefficients of >0.75 and low standard errors of measurement for both the force plate- and the accelerometer-based curves. Correlation coefficients for these variables ranged from 0.95 to 0.98. The accelerometry-derived variables indicated significantly lower absolute values. Trunk accelerometry can be used as a reliable and valid tool for the quantification of the HR test in the elderly population. However, due to several limitations in the protocol, the use of this tool can currently only be recommended in a test-retest manner. Therefore, more research is needed to fully validate this tool for clinical use. [ABSTRACT FROM AUTHOR]

Background and purpose Research priorities, defined by multiple stakeholders, can proximally facilitate the coordination of research projects and national and international cooperation and distally further improve the quality of physiotherapy practice. The aim of this study was therefore to establish physiotherapy research priorities in Switzerland considering multiple stakeholders' opinions. Methods A mixed methods design was chosen. For a qualitative identification of physiotherapy research topics, 18 focus group discussions and 23 semi-structured interviews/written commentaries were conducted. For the quantitative analysis, 420 participants prioritized research topics using a two-round Delphi questionnaire survey. The following stakeholder groups were surveyed in the German-speaking, French-speaking and Italian-speaking regions of Switzerland: physiotherapy researchers, practitioners and educators, representatives of patient organizations, public health organizations, health insurers, physicians, nurses, occupational therapists and other health professionals, as well as physical educators. Results The top five overall physiotherapy research priorities identified were as follows: physiotherapy treatment, physiotherapy assessment and diagnosis, prevention, physiotherapist-patient interaction and physiotherapy professional education at the bachelor level. With regard to diagnostic groups, the highest priorities were placed on musculoskeletal disorders, neurology, orthopaedics, geriatrics and ergonomics/occupational health. Consensus was moderate to high, and only few differences between stakeholder groups were revealed. Discussion Research directly related to physiotherapy treatment is of highest priority. It should focus on diagnostic groups related to chronicity in anticipation of demographic changes. Multidisciplinary networks for research and practice, alongside sound coordination of research projects, should increase the impact of physiotherapy research. An accurate dissemination of research priorities, defined and supported by multiple stakeholder groups, might strengthen their impact on research and practice. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Non-invasive pulse spectrophotometry to measure indocyanine green (ICG) elimination correlates well with the conventional invasive ICG clearance test. Nevertheless, the precision of this method remains unclear for any application, including small-for-size liver remnants. We therefore measured ICG plasma disappearance rate (PDR) during the anhepatic phase of orthotopic liver transplantation using pulse spectrophotometry. Measurements were done in 24 patients. The median PDR after exclusion of two outliers and two patients with inconstant signal was 1.55%/min (95% confidence interval [CI]=0.8-2.2). No correlation with patient age, gender, body mass, blood loss, administration of fresh frozen plasma, norepinephrine dose, postoperative albumin (serum), or difference in pre and post transplant body weight was detected. In conclusion, we found an ICG-PDR different from zero in the anhepatic phase, an overestimation that may arise in particular from a redistribution into the interstitial space. If ICG pulse spectrophotometry is used to measure functional hepatic reserve, the verified average difference from zero (1.55%/min) determined in our study needs to be taken into account. [ABSTRACT FROM AUTHOR]

Background: Skin marker-based analysis of functional spinal movement is a promising method for quantifying longitudinal effects of treatment interventions in patients with spinal pathologies. However, observed day-to-day changes might not necessarily be due to a treatment intervention, but can result from errors related to soft tissue artifacts, marker placement inaccuracies or biological day-to-day variability.Research Question: How reliable are skin marker-derived three-dimensional spinal kinematics during functional activities between two separate measurement sessions?Methods: Twenty healthy adults (11 females/9 males) were invited to a movement analysis laboratory for two visits separated by 7-10 days. At each visit, they performed various functional activities (i.e. sitting, standing, walking, running, chair rising, box lifting and vertical jumping), while marker trajectories were recorded using a skin marker-based 10-camera optical motion capture system and used to calculate sagittal and frontal plane spinal curvature angles as well as transverse plane segmental rotational angles in the lumbar and thoracic regions. Between-session reliability for continuous data and discrete parameters was determined by analyzing systematic errors using one sample T-tests as well as by calculating intraclass correlation coefficients (ICCs) and minimal detectable changes (MDCs).Results and Significance: The analysis indicated high relative consistency for sagittal plane curvature angles during all activities, but not for frontal and transverse plane angles during walking and running. MDCs were mostly below 15°, with relative values ranging between 10 % and 750 %. This study provides important information that can serve as a basis for researchers and clinicians aiming at investigating longitudinal effects of treatment interventions on spinal motion behavior in patients with spinal pathologies. [ABSTRACT FROM AUTHOR]

Background: Structural leg length discrepancy (LLD) is a common phenomenon. However, its effect on spinal gait kinematics remains unclear.Research Question: How does LLD affect spinal gait kinematics in patients with structural LLD and what is the immediate effect of a shoe lift?.Methods: 10 adolescents with structural LLD (20-60 mm) and 14 healthy controls were included. All of whom were fitted with a trunk marker set and requested to walk barefoot as well as with an orthotic shoe lift (only patients). Data were collected using a 12-camera motion capture system. Group comparisons were conducted using one-dimensional Statistical Parametric Mapping (SPM).Results: Patients with LLD showed statistically significant increased frontal plane lumbar bending angles to the longer side (p = 0.007), increased pelvic drop on the shorter side (p < 0.001) and increased hip adduction angles on the longer leg (p < 0.001) compared to the healthy controls. In the sagittal plane, patients demonstrated changed knee (shorter leg) and ankle joint (longer leg) motion. All gait deviations observed in patients with LLD could immediately be altered by correcting the LLD using a shoe lift.Significance: Due to the LLD, patients showed a lateral pelvic drop on the shorter side, which appeared to be compensated for by a contralateral bending in the lumbar spine and a lateral shift of the pelvis towards the longer side. In addition, the use of an orthotic correction seems to be a suitable option to instantly normalize gait kinematics in patients with mild to moderate LLD. [ABSTRACT FROM AUTHOR]

Introduction: It is important to assess and quantify gait in order to determine the severity of impairments during gait and to evaluate therapeutic interventions. However, laboratory gait assessment is expensive and time consuming and there is a lack of an easily applicable tool for the quantification of gait in clinical practice. The aim of this study was to validate a smartphone-based measurement tool for the quantification of level walking.Methods: Vertical center of mass displacement and step duration of 22 healthy young adults were assessed by a smartphone application and a motion capture system. Intra-session reliability was evaluated by repeated-measures ANOVA, intraclass correlation coefficient (ICC), and standard error of measurement. In order to evaluate the concurrent validity of the smartphone application, smartphone- and motion capture-derived values were compared by Pearson correlation coefficient and Bland-Altman limits of agreement.Results: Six out of eight variables derived by the smartphone application showed an excellent reliability (ICC≥0.75) and all variables correlated significantly with measurements of the motion capture system with moderate to strong correlations ranging from 0.61 to 0.92.Conclusion: The results showed a great potential of the smartphone application to be a user-friendly and valid tool for the assessment of gait in clinical practice. Further research needs to investigate whether the smartphone application is able to detect differences in gait patterns following therapeutic or orthopedic interventions and whether it is valid for the quantification of gait in people with movement disorders. [ABSTRACT FROM AUTHOR]

Background Since 2002, the professional education for Swiss physiotherapists has been upgraded to a tertiary educational level. With this change, the need for research related to professional practice has become more salient. The elaboration of research priorities is seen as a possible way to determine the profession's needs, to help coordinate research collaborations and to address expectations regarding physiotherapy. There is still limited evidence about stakeholders' views with regard to physiotherapy research. The objective of this study was to investigate key stakeholders' opinions about research in physiotherapy in Switzerland. Methods Focus groups with patients, health professionals, researchers and representatives of public health organizations were conducted, and semi-structured interviews were conducted with politicians, health insurers and medical doctors from three linguistic regions in Switzerland. An interview guide was elaborated. Data were transcribed and analysed using inductive content analysis (Atlas-ti 6®). Results Eighteen focus groups and 23 interviews/written commentaries included 134 participants with various research experiences and from different settings. Fourteen categories were defined reflecting three themes: identity, interdisciplinarity and visibility. Stakeholders had positive views about the profession and perceived physiotherapists' important role now and in the future. Yet, they also felt that physiotherapy was not sufficiently recognized in society and not visible enough. A stronger professional identity would be key to enhancing interdisciplinary work. Conclusions Results of this qualitative study provide insights into key aspects for moving the physiotherapy profession forward. Identity is at the heart of physiotherapy, not necessarily in terms of research priorities but in the definition of domains of competence and future positioning. Identity is also tightly connected to Interdisciplinarity as this might threaten the existence of the profession. Stakeholders outside the profession insist on the importance of visibility. The results of this study can help stakeholders reflect on the future of physiotherapy and elaborate research priorities. © 2013 The Authors. Physiotherapy Research International published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]