Jean Wessel

Evaluation of a Community Fitness Program for Adolescents with Cerebral Palsy

A community fitness program for adolescents with cerebral palsy was evaluated. Twenty-three subjects (mean age, 14.2 yr) completed a program of aerobics, strength training, and stretching three times a week for 10 weeks. They were tested three times before training, once at the end of the training,

Isometric strength measurements in children with arthritis: Reliability and relation to function

OBJECTIVE To examine the reliability of testing strength in children with juvenile arthritis (JA), and to determine the relationship between strength and function. METHODS Children with JA were tested for grip and pinch strength (n = 32). Isometric force produced by hip abductors and knee extensors was tested with a hand-held dynamometer (n = 29). Two therapists both performed each of the tests twice so that intrarater and interrater reliability could be examined. Function was measured by means of the Childhood Health Assessment Questionnaire (CHAQ) and performance on a 50-meter run. Reliability was examined with intraclass correlations (ICC). The relationships of strength and function were determined with Pearson and Spearman correlations. RESULTS All measures demonstrated good intrarater (ICC = 0.92-0.97) and interrater (ICC = 0.80-0.95) reliability. Grip strength and pinch were correlated with the CHAQ (r = -0.45 and -0.33, respectively), while hip abduction and knee extension torque were correlated with rankings on the 50-meter run (rho = -0.34 and -0.38, respectively). CONCLUSION Isometric strength can be reliably measured in children with arthritis in a clinical setting.

Lower extremity kinematics of females with patellofemoral pain syndrome while stair stepping.

STUDY DESIGN Cross-sectional case-control design. BACKGROUND Although the etiology of patellofemoral pain syndrome (PFPS) is not completely understood, there is some evidence to suggest that hip position during weight-bearing activities contributes to the disorder. OBJECTIVE To compare the knee and hip motions (and their coordination) during stair stepping in female athletes with and without PFPS. METHODS Two groups of female recreational athletes, 1 group with PFPS (n = 10) and a control group without PFPS (n = 10), were tested. All participants ascended and descended stairs (condition) at 2 speeds (self-selected comfortable and taxing [defined as 20% faster than the comfortable speed]), while the knee and hip angles were measured with a magnetic-based kinematic data acquisition system. Angle-angle diagrams were used to examine the relationship between flexion/extension of the knee and flexion/extension, adduction/abduction, and internal/external rotation of the hip. The angle of the knee and the 3 angles of the hip at foot contact on the third step were compared between groups by means of 3-way analyses of variance (ANOVA), with repeated measures on speed and condition. RESULTS Group-by-speed interaction for knee angle was significant, with knee flexion being greater for the PFPS group for stair ascent and descent at a comfortable speed. Both the angle-angle diagrams and ANOVA demonstrated greater adduction and internal rotation of the hip in the individuals with PFPS compared to control participants during stair descent. CONCLUSION Compared to control participants, females with PFPS descend stairs with the knee in a more flexed position and have the hip in a more adducted and internally rotated position at foot contact during stair stepping at a comfortable speed.

Critical thinking and learning styles of students in a problem-based, master's entry-level physical therapy program

The purpose of this study was to compare critical thinking ability and critical thinking disposition of physical therapy students in year 1 and year 2 of an entry-level Masters program, and determine the association between critical thinking and preferred learning styles. Fifty year 1 and 44 year 2 students were tested for critical thinking ability on the California Critical Thinking Skills Test (CCTST), critical thinking disposition on the California Critical Thinking Disposition Inventory (CCTDI), and learning style on the Kolb Learning Style Inventory (LSI). Repeat testing of the critical thinking tests was done 8 months later. Two-way repeated measures analyses of variance (ANOVA) were used to compare students between years and times. Associations between variables were determined by means of Pearsons or Spearmans correlations. The mean scores of the CCTST (year 1: 20.7 ± 3.96, year 2: 20.2 ± 3.08) and total CCTDI (year 1: 314.6 ± 22.57, year 2: 315.2 ± 23.37) were not significantly different between years, and did not change over time. The ANOVA revealed significant effects for three subscales of the CCTDI: truth-seeking—year 2 greater than year 1, self-confidence—significant time effect, and systematicity—significant year × group interaction effect. None of the CCTDI scores was significantly correlated with CCTST. Critical thinking scores were not different among the four LSI categories. LSI scores did not predict change in critical thinking. Masters entry-level physical therapy students did not have major changes in their critical thinking ability or disposition during the program.

The factor validity of the Western Ontario Rotator Cuff Index

BackgroundThe Western Ontario Rotator Cuff Index (WORC) is a self-report questionnaire developed specifically to evaluate disability in persons with pathology of the rotator cuff of the shoulder. The authors created items in 5 categories based on a model of quality of life, but never validated this structure. The purpose of this study was to examine the validity of the original 5-domain model of the WORC by performing factor analysis.MethodsThree hundred twenty nine subjects (age, mean: 52, SD: 12) were tested prior to undergoing surgery for rotator cuff pathologies. They completed the WORC, a self-report questionnaire, which has 21 items on the effect of the rotator cuff problem on symptoms, activities and emotions. Statistical calculations included correlations between items, Cronbachs alpha of the total scale and subscales, and principal component factor analysis with oblique rotation.ResultsCorrelations ranged from .09 to .70 between all the items, from .29 to .70 between items within a subscale, and from .53 to .72 between subscale scores. Cronbachs alpha was .93 for the total scale, and .72 to .82 for the subscales. The factor analysis produced 3 factors that explained 57% of the variance. The first factor included symptoms and emotional items, the second included strength items and the third included daily activities.ConclusionThe results of this study did not support the 5-domain model of the WORC.

Longitudinal Study of Emotional Intelligence, Leadership, and Caring in Undergraduate Nursing Students

This study describes the development of emotional intelligence (EI), leadership, and caring in undergraduate nursing students throughout their educational program. A correlational, repeated measures study design was used. Fifty-two nursing students completed four self-report questionnaires on three occasions (T1, T2, T3): BarOn Emotional Quotient Inventory: Short (EQ-i:S), Self-Assessment Leadership Instrument (SALI), Caring Ability Inventory (CAI), and Caring Dimensions Inventory (CDI). Mean scores for Total EI did not change significantly over time (T1, 100.1 ± 13.8; T2, 103.1 ± 13.8; T3, 101.6 ± 14.7). However, EI adaptability was higher at T2 (101.6 ± 13.1) and T3 (101.8 ± 14.1) than at T1 (97.0 ± 12.5; p = 0.03), as was CAI Courage (64.2 ± 9.5, 66.7 ± 9.5, 66.9 ± 8.7; p = 0.04) and the CDI (96.8 ± 18.1, 103.0 ± 7.3, 102.0 ± 10.9; p = 0.02). Changes in EI were positively correlated (r > 0.50, p < 0.001) with changes in SALI, CAI Knowing, and CAI Courage. During the undergraduate program, significant increases occurred in caring and EI adaptability but not in overall EI or leadership.

Inter-rater reliability of formally trained and self-trained raters using the Edmonton Functional Assessment Tool

The primary objective of this study was to determine the inter-rater reliability of the revised version of the Edmonton Functional Assessment Tool (EFAT-2). A second objective was to determine whether both formally trained and self-trained therapists had an acceptable level of inter-rater reliability. The EFAT-2 was administered to consenting palliative care patients by one of two independent physical therapist rater pairs; one pair self-trained (R1, R2) and the other formally trained (R3, R4). The intraclass correlation [ICC (1,1)] for R1, R2 was 0.97 [95% confidence interval (CI) 0.94–0.99] and for R3, R4 was 0.95 (95% CI 0.90–0.98). The standard error of measurement was 1.09 and 1.44, respectively. The Kappa statistic for the rater pairs on individual EFAT items ranged from 0.17 to 0.96. The results suggest that both formally trained and self-trained therapists obtain an acceptable level of inter-rater reliability when using the EFAT-2.

Women's perceptions of home-based exercise performed during adjuvant chemotherapy for breast cancer

PURPOSE To describe womens perceptions of a home-based exercise intervention in which they participated while receiving adjuvant chemotherapy for breast cancer. METHODS AND SAMPLE Participants were 8 women who were involved in a home-based exercise program while receiving 24 weeks of adjuvant chemotherapy for breast cancer. They were asked about their exercise program every 2 weeks by telephone, and completed a feasibility and acceptability questionnaire at the end of the study. The two principal investigators performed a content analysis on the resulting data. KEY RESULTS Participants highly valued the exercise program. The content analysis resulted in two major categories: exercise challenges and exercise facilitators and strategies. The most common exercise challenges were side effects of chemotherapy, particularly fatigue and pain. The women overcame challenges in many ways, most notably adapting the routine, internal motivation and external support. Their comprehension of breast cancer and its treatment, reinforced by expert advice and resources on exercise, helped them develop successful strategies to maintain the exercise program. CONCLUSIONS In spite of challenges, women in this study perceived that a customized, flexible, home-based exercise program was beneficial while they were undergoing adjuvant chemotherapy for breast cancer. Resource material and regular guidance helped them implement strategies to maintain the exercise program.

Construct validity of the AIMS-2 upper limb function scales as a measure of disability in individuals with osteoarthritis of the hand.

This study aimed to validate the use of the Arthritis Impact Measurement Scales 2 (AIMS-2) Hand and Finger Function and Arm Function scales for assessing disability in persons with osteoarthritis (OA) of the hand. Ninety-nine subjects with hand OA completed the AIMS-2 scales, grip strength testing, and timed manipulation tasks. Confirmatory factor analyses determined that the ten items comprising the scales separated out into hand and arm limitations. Spearman correlations revealed the appropriate associations between Hand and Finger Function scale scores and grip strength (r = −0.37) and dexterity (r = 0.36). Arm Function scale scores discriminated individuals with additional upper limb involvement from those without (Mann–Whitney test, p < 0.01). Thus, convergent construct validity of the Hand and Finger Function scale and known-group validity of the Arm Function scale were shown. These AIMS-2 scales are valid and distinct measures of disability in individuals with hand OA.

Muscle activation during hand dexterity tasks in women with hand osteoarthritis and control subjects.

STUDY DESIGN Descriptive cross-sectional study. INTRODUCTION Hand osteoarthritis (OA) is a condition that results in hand pain and disability. It is important to understand how muscle function impairments contribute to impaired dexterity. PURPOSE OF THE STUDY To compare muscle activation in women with and without hand OA and determine if the activation relates to measures of impairment and disability. METHODS Electromyography (EMG) was recorded from four muscles of the hand/forearm while subjects threaded (assembly) and unthreaded (disassembly) a small bolt. The groups were compared on the integrated EMG (IEMG) of four muscles using two-way repeated-measures analyses of covariance for the assembly and disassembly tasks. RESULTS No differences were found in muscle activation between groups when IEMG values were normalized by time (p>0.05). CONCLUSIONS Patients with OA have some indicators of altered muscle function. It is unclear whether these are adaptive or predisposing changes. When controlling for the time to perform a task, there were no significant IEMG differences between women with hand OA and control subjects. LEVEL OF EVIDENCE 2b.