Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of ... more Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of physiotherapy treatment for low back pain (LBP). Methods: Sixty-seven patients with LBP \u3c 3 months were randomly allocated to one of three groups - traditional education about US (control group [CG]), inflated education about US (experimental group [EG]) or extra-inflated education about US (extra-experimental group [EEG]). Each patient received the exact same application of US that has shown clinical efficacy for LBP (1.5 Watts/cm Results: Both EG and EEG groups showed a statistically significant improvement for SLR ( Conclusion: The choice of words when applying a treatment in physiotherapy can alter the efficacy of the treatment
Supplemental material, Supplemental_Material for A controlled clinical trial of preoperative pain... more Supplemental material, Supplemental_Material for A controlled clinical trial of preoperative pain neuroscience education for patients about to undergo total knee arthroplasty by Adriaan Louw, Emilio J Puentedura, Jordan Reed, Kory Zimney, Derek Grimm and Merrill R Landers in Clinical Rehabilitation
BACKGROUND: Fear of falling avoidance behavior (FFAB) is common in parkinsonisms and results in p... more BACKGROUND: Fear of falling avoidance behavior (FFAB) is common in parkinsonisms and results in potentially mitigable downstream consequences. OBJECTIVE: Determine the characteristics of individuals with parkinsonisms most associated with FFAB. METHODS: A retrospective, cross-sectional study was conducted from medical records data of 142 patients with parkinsonisms. These data included: demographics (age, sex), disease severity (Movement Disorders Society –Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III), years since diagnosis), fall history (number of fall injuries in previous year), and gait and balance function (five times sit to stand, MiniBESTest, Timed Up and Go (TUG), dual-task TUG, ten-meter walk test (10MWT), observed freezing of gait (FOG) (MDS-UPDRS III item 11)). RESULTS: 10MWT (p < .001) and MDS-UPDRS III item 11 (p < .014) were significantly associated with FFAB above and beyond disease severity, which also contributed significantly to the overall model (ps < .046). Fall history was not associated with FFAB. CONCLUSION: Our findings suggest that the largest portion of variability in FFAB is explained by gait velocity and FOG; however, disease severity also explains a significant portion of the variability of FFAB. Further investigation into factors predictive of FFAB and mitigation of downstream consequences, using more robust designs, is warranted.
Background Postural instability (PI) in Parkinson’s disease (PD) is associated with several negat... more Background Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative downstream consequences. Objective The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance confidence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods A path analysis of cross-sectional data from 55 participants with PD was conducted. The four constructs in the model connected in succession were: 1. PI (principal components analysis (PCA) composite of the Unified Parkinson’s Disease Rating Scale PI and Gait Difficulty score, Timed Up and Go test, and Berg Balance Scale); 2. balance confidence (Activities-Specific Balance Confidence Scale); 3. FOF avoidance behavior (PCA composite of the FOF Avoidance Behavior Questionnaire and average number of steps per day); and, 4. physical conditioning (2-Minute Step Test). Results The path model was an excellent fit to the data, χ2 (7) = 7.910, p = .341, CFI = 0.985, TLI = 0.968, RMSEA = 0.049 (90% CI: 0.000 to 0.179). The moderate to strong and uniformly significant parameter estimates were −0.519, −0.651, −0.653, and −0.570, respectively (ps < 0.01). Conclusions PI directly and inversely predicted balance confidence, which in turn directly and inversely predicted FOF avoidance behavior. Furthermore, FOF avoidance behavior directly and inversely predicted physical conditioning, which directly and inversely predicted PI, thereby closing the cycle. These findings highlight the downstream consequences of PI in PD and support the notion of a vicious cycle of FOF avoidance behavior.
Background. Decreased automaticity is common among individuals with neurodegenerative disease and... more Background. Decreased automaticity is common among individuals with neurodegenerative disease and is often assessed using dual-task (DT) paradigms. However, the best methods for assessing performance changes related to DT demands remain inconclusive. Objective. To investigate the reliability and validity of a novel battery of DT measures (DT Effect—Battery (DTE-B)) encompassing three domains: task-specific interference, task prioritization, and automaticity. Methods. Data for this retrospective cross-sectional study included 125 participants with Parkinson’s disease (PD), 127 participants with Alzheimer’s disease (AD), and 84 healthy older adults. Reliability analyses were conducted using a subset of each population. DTE-B measures were calculated from single and DT performance on the Timed Up and Go test and a serial subtraction task. Construct validity was evaluated via associations within the DTE-B and with theoretically supported measures as well as known-groups validity analyse...
The Journal of Prevention of Alzheimer's Disease, 2022
Preclinical Alzheimer’s disease (AD) provides an opportunity for the study and implementation of ... more Preclinical Alzheimer’s disease (AD) provides an opportunity for the study and implementation of interventions and strategies aimed at delaying, mitigating, and preventing AD. While this preclinical state is an ideal target, it is difficult to identify efficiently and cost-effectively. Recent findings have suggested that cognitive-motor dual task paradigms may provide additional inference. Investigate the relationship between dual task performance and amyloidosis, suggestive of preclinical Alzheimer’s disease and whether dual task performance provides additional information beyond a cognitive composite, to help in the identification of amyloidosis. Cross-sectional. Outpatient specialty brain health clinical research institution in the United States. 52 cognitively healthy adults. The data included demographics, amyloid standardized uptake value ratio obtained via florbetapir-PET, neuropsychological testing, apolipoprotien E genotype, and dual task performance measures. Data were ana...
Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of ... more Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of physiotherapy treatment for low back pain (LBP). Methods: Sixty-seven patients with LBP \u3c 3 months were randomly allocated to one of three groups - traditional education about US (control group [CG]), inflated education about US (experimental group [EG]) or extra-inflated education about US (extra-experimental group [EEG]). Each patient received the exact same application of US that has shown clinical efficacy for LBP (1.5 Watts/cm Results: Both EG and EEG groups showed a statistically significant improvement for SLR ( Conclusion: The choice of words when applying a treatment in physiotherapy can alter the efficacy of the treatment
Supplemental material, Supplemental_Material for A controlled clinical trial of preoperative pain... more Supplemental material, Supplemental_Material for A controlled clinical trial of preoperative pain neuroscience education for patients about to undergo total knee arthroplasty by Adriaan Louw, Emilio J Puentedura, Jordan Reed, Kory Zimney, Derek Grimm and Merrill R Landers in Clinical Rehabilitation
BACKGROUND: Fear of falling avoidance behavior (FFAB) is common in parkinsonisms and results in p... more BACKGROUND: Fear of falling avoidance behavior (FFAB) is common in parkinsonisms and results in potentially mitigable downstream consequences. OBJECTIVE: Determine the characteristics of individuals with parkinsonisms most associated with FFAB. METHODS: A retrospective, cross-sectional study was conducted from medical records data of 142 patients with parkinsonisms. These data included: demographics (age, sex), disease severity (Movement Disorders Society –Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III), years since diagnosis), fall history (number of fall injuries in previous year), and gait and balance function (five times sit to stand, MiniBESTest, Timed Up and Go (TUG), dual-task TUG, ten-meter walk test (10MWT), observed freezing of gait (FOG) (MDS-UPDRS III item 11)). RESULTS: 10MWT (p &lt; .001) and MDS-UPDRS III item 11 (p &lt; .014) were significantly associated with FFAB above and beyond disease severity, which also contributed significantly to the overall model (ps &lt; .046). Fall history was not associated with FFAB. CONCLUSION: Our findings suggest that the largest portion of variability in FFAB is explained by gait velocity and FOG; however, disease severity also explains a significant portion of the variability of FFAB. Further investigation into factors predictive of FFAB and mitigation of downstream consequences, using more robust designs, is warranted.
Background Postural instability (PI) in Parkinson’s disease (PD) is associated with several negat... more Background Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative downstream consequences. Objective The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance confidence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods A path analysis of cross-sectional data from 55 participants with PD was conducted. The four constructs in the model connected in succession were: 1. PI (principal components analysis (PCA) composite of the Unified Parkinson’s Disease Rating Scale PI and Gait Difficulty score, Timed Up and Go test, and Berg Balance Scale); 2. balance confidence (Activities-Specific Balance Confidence Scale); 3. FOF avoidance behavior (PCA composite of the FOF Avoidance Behavior Questionnaire and average number of steps per day); and, 4. physical conditioning (2-Minute Step Test). Results The path model was an excellent fit to the data, χ2 (7) = 7.910, p = .341, CFI = 0.985, TLI = 0.968, RMSEA = 0.049 (90% CI: 0.000 to 0.179). The moderate to strong and uniformly significant parameter estimates were −0.519, −0.651, −0.653, and −0.570, respectively (ps < 0.01). Conclusions PI directly and inversely predicted balance confidence, which in turn directly and inversely predicted FOF avoidance behavior. Furthermore, FOF avoidance behavior directly and inversely predicted physical conditioning, which directly and inversely predicted PI, thereby closing the cycle. These findings highlight the downstream consequences of PI in PD and support the notion of a vicious cycle of FOF avoidance behavior.
Background. Decreased automaticity is common among individuals with neurodegenerative disease and... more Background. Decreased automaticity is common among individuals with neurodegenerative disease and is often assessed using dual-task (DT) paradigms. However, the best methods for assessing performance changes related to DT demands remain inconclusive. Objective. To investigate the reliability and validity of a novel battery of DT measures (DT Effect—Battery (DTE-B)) encompassing three domains: task-specific interference, task prioritization, and automaticity. Methods. Data for this retrospective cross-sectional study included 125 participants with Parkinson’s disease (PD), 127 participants with Alzheimer’s disease (AD), and 84 healthy older adults. Reliability analyses were conducted using a subset of each population. DTE-B measures were calculated from single and DT performance on the Timed Up and Go test and a serial subtraction task. Construct validity was evaluated via associations within the DTE-B and with theoretically supported measures as well as known-groups validity analyse...
The Journal of Prevention of Alzheimer's Disease, 2022
Preclinical Alzheimer’s disease (AD) provides an opportunity for the study and implementation of ... more Preclinical Alzheimer’s disease (AD) provides an opportunity for the study and implementation of interventions and strategies aimed at delaying, mitigating, and preventing AD. While this preclinical state is an ideal target, it is difficult to identify efficiently and cost-effectively. Recent findings have suggested that cognitive-motor dual task paradigms may provide additional inference. Investigate the relationship between dual task performance and amyloidosis, suggestive of preclinical Alzheimer’s disease and whether dual task performance provides additional information beyond a cognitive composite, to help in the identification of amyloidosis. Cross-sectional. Outpatient specialty brain health clinical research institution in the United States. 52 cognitively healthy adults. The data included demographics, amyloid standardized uptake value ratio obtained via florbetapir-PET, neuropsychological testing, apolipoprotien E genotype, and dual task performance measures. Data were ana...
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