Research Report Abstracts - Gesundheit

WPT2011, Research Report Abstracts eS515
Sabinet, Science Direct, Up-To-Date. The search yielded
10,016 study titles.
Methods: This was a systematic review. The databases
were reviewed by making use of a specified search strategy
customised for each. Keywords used were: physiotherapy/physical
therapy; bronchiolitis and paediatric/pediatric
in combination with percussion, postural drainage and suction.
Studies were chosen from the population of studies using
pre-set inclusion and exclusion criteria. These criteria were
applied to the article title and/or abstract.
Analysis: Appraisal tools from the National Health System
Critical Appraisal Skills Programme (NHS CASP) and
the PEDro scale (for randomised controlled trials) were
used to evaluate and score the sample. Scoring was done
independently by two researchers, and agreement reached
through negotiation. The evidence was synthesised and
graded according to the Sackett hierarchy of evidence. Due
to the heterogeneity of the sample, and the nature of results
reported a meta-analysis was not possible.
Results: Results from this study reveal that there is no
evidence to support routine physiotherapy intervention in
uncomplicated viral bronchiolitis amongst the paediatric
population. Chest physiotherapy does not decrease length
of hospital stay, oxygen requirements or clinical scores
indicating distress/morbidity. However, with secondary bacterial
respiratory infections, physiotherapy may be indicated
depending on the assessment of each individual patient.
Conclusions: Percussion, postural drainage and suctioning
are not effective in the management of bronchiolitis in zero to
24 month old children, except in individually assessed cases
with secondary bacterial infection. In this subset physiotherapy
must be customised to the patient. Routine physiotherapy
is not indicated.
Implications: There is evidence that bronchiolitis hospitalisations
have increased in the past twenty years, and many of
these children develop wheezing at a later stage of their lives.
Using evidence-based practice can assist in improving quality
of care; optimise treatment and use of resources as well
as prevent the development of long-term complications such
as asthma and other related chronic obstructive pulmonary
diseases.
Keywords: Chest physiotherapy; Bronchiolitis; Paediatric
Funding acknowledgements: Unfunded.
Ethics approval: No clinical intervention was done in this
study, therefore permission was not required from an ethics
committee.
Research Report Poster Display
Number: RR-PO-205-11-Tue Tuesday 21 June 13:00
RAI: Exhibit Halls2&3
RELIABILITY OF MEASUREMENTS OF THE
CROSS-SECTIONAL AREA OF THE MEDIAN
NERVE IN THE CARPAL TUNNEL: AN
ULTRASONOGRAPHIC STUDY
Hummelsund S.
Department of Physiotherapy, Faculty of Health and Social
Science, Bergen University College, Bergen, Norway
Purpose: To evaluate the intra- and interrater reliability
of transversal ultrasound imaging in the estimation of the
median nerve cross sectional area at 3 levels (proximal, middle
and distal) in the carpal tunnel.
Relevance: The use of ultrasound imaging in the estimation
of the cross-sectional area of the median nerve in the
carpal tunnel is a promising method in the assessment of
patients suffering from carpal tunnel syndrome. Previous
studies, however; show little or no information of the reliability
of the method in measuring the cross-sectional area of
the median nerve.
Participants: Material: Healthy individuals (n = 29). 20
women and 9 men. Average age is 44 years.
Methods: Two physiotherapists made in total 597 measurements
on ultrasound images of the cross sectional area of
the median nerve. In the assessment of intrarater reliability
both raters did a test–retest assessment and an assessment of
repeated measurements on their own images. The analysis
of interrater reliability was done on the basis of the raters
repeated measurements on the same ultrasound images and
on a test–retest assessment.
Analysis: Outcome measures were Intraclass Correlation
Coefficient ICC (1.1) and ±1.96 × within subject
standard deviation (±1.96 × Sw). I have graded the
reliability scores into 3 categories: (1) very good
reliability = ± 1.96 × Sw ≤ 0.020 cm 2 . (2) good reliability
= ± 1.96 × Sw ≥ 0.021 cm 2 and ≤0.030 cm 2 . (3) poor
reliability = ± 1.96 × Sw ≥0.031 cm 2 .
Results: At the proximal level the absolute reliability was
very good on all reliability assessments. ICC (1.1) had an
average score of 0.81 (range: 0.69–0.89). At the middle level
the reliability was very good on 5 occasion and good on 2
occasions. ICC (1.1) had an average score of 0.74 (range:
0.55–0.89). At the distal level the reliability was very good on
1 reliability assessment, good on 4 reliability assessments and
poor on 2 reliability assessments. ICC (1.1) had an average
score of 0.62 (range 0.35–0.91).
Conclusions: The reliability of transversal ultrasound imaging
in the estimation of the cross-sectional area of the median
nerve in the carpal tunnel is very god at the proximal level.
At the middle level the reliability is very good or good. The
variability at the distal level is highest.
Implications: The use of ultrasound imaging in the estimation
of the cross-sectional area of the median nerve in the