Monday, June 17, 2013

The Osteoporosis Exercise Book

by Sherri R Betz PT. self published 2008.

I usually reserve the blog for pelvic PT but this is a good reference.  This is a simple complete patient education reference.  My most common complaint about patient education books is that they try to cover every situation for every patients - too much information makes for confusion for the patient.  This book has the exact amount of depth without confusion.  Exercises are divided into beginner, intermediate and advanced with one exercise per page, large clear pictures.  There are many to choose from and all the basics are covered.  A short section on fall prevention and body mechanics is also included.  Sherri does a good job.  She has a few other products that might be good to look at also.  Check it out on Amazon. 

Friday, June 14, 2013

Tuesday, June 11, 2013

Adherence to Behavioral interventions for stress incontinence: rates, barriers, and predictors. Borello-France D, et al. PTJ 2013;93(6):757-773.

This one year follow up investigated many different adherence barriers and found the most common variable associated with adherence was "trouble remembering" to do the exercises.  At three months after randomization weaker PFM was associated with drop out.  Understanding barriers to adherence can help in addressing them when they occur and asking patients about them especially the ability to remember to do the exercises.  There are many phone apps which help with reminder indicators.  Check out this blog for more details. 

Friday, June 7, 2013

Activity restrictions after gynecological surgery: is there evidence? Nygaard IE, Hamad NM, Shaw JM. Int Urogynecol J (2013) 24:719-724.

eth Shelly PT, DPT, WCS, BCB PMD
6/5/13 Pelvic PT Distance Journal Club

Points made in general
·         controlled early resumption of activities promotes restoration of function
·         physical activities may be incorrectly blamed for post op failures (carrying is not causative to LBP)
·         prolonged bed rest causes complications

Wound healing
·         Collagen begins to appear in wound on day 2
·         Abdominal fascia (lab tests)

o   regains 51-80% of its strength at 6 weeks

o   regains 73-93% of its strength at 20 weeks

o    never achieves full pre-op strength

Measuring outcomes in urogynecological surgery: "perspective is everything". Parker-Autry CY, Barber MD, Kenton K, Richter HE. Int Urogynecol J (2013) 24:15-25.

Beth Shelly, PT, DPT, WCS, BCB PMD
6/5/13 Pelvic PT Distance Journal Club

This article is important to read cover to cover.  It does a great job at summarizing the history of outcomes and how you can change outcome results by using a different outcome measure.  Outcomes are very important and we must be able to choose the correct one for the job.

Definitions - taken from many sources  - Outcomes should be reliable and valid
·         Reliability - (Interclass correlation ICC) the extent to which a measurement is consistent and free from error - statically calculated
o   Inter-rater reliability - assesses the degree to which test scores are consistent when measurements are taken by different people using the same methods.
o   Test-retest reliability / intra-rater reliability - assesses the degree to which test scores are consistent when measurements are gathered from a single rater who uses the same methods or instruments and the same testing conditions.
·         Validity - ability of a measure to detect or measure what is indented. Validity is measured in a specific patient population.  Measure should be performed according to how it was validated (patient fills out versus therapist asks the questions)
·         Reproducibility - appears to be the same as reliability.  There is no way to statistically calculate reproducibility. 
·         Responsiveness - ability to detect change
·         Minimally clinically important difference - the smallest change in a measure that a patient or clinician would care about

Sunday, June 2, 2013

Bladder Apps for Android and IPhone

Technology can be so helpful but which one to pick.  This post is a follow up to the post of February 11, 2013

Hope this information is helpful.  Please send your favorite apps.

Urological professional apps for IPad and IPhone
Some target patients and some are for the professional (like Draw MD urology which has images for patient education).