Research Report Abstracts - Gesundheit

WPT2011, Research Report Abstracts eS579
a leadership role in establishing that not only is health education
a physical therapy competency, but one that needs to
be integrated into the daily practice and care of both adults
and children. The degree to which physical therapists have
been shown to be effective lifestyle health educators was of
interest, as well as how health education can be judiciously
integrated into physical therapy management.
Participants: Physical therapists and clients.
Methods: Based on keywords and subject headings, MED-
LINE, EMBASE, CINAHL, PsycINFO and The Cochrane
Database of Systematic Reviews were searched from 1950
to August 2010. The “International Journal of Behavioral
Nutrition and Physical Activity” (2000–2010), “Fysiopraxis”
(2007–2010) and the “Nederlandse Tijdschrift voor Fysiotherapie”
(2007–2010) were hand searched. Studies were
limited to English, Dutch and German.
Analysis: The evaluation of the methodological quality was
conducted by two reviewers applying the Downs and Black
tool for randomized as well as non-randomized studies. A
narrative synthesis was conducted in which the target populations,
types and periods of interventions, outcome measures
and significant results were cross-analyzed.
Results: The initial search yielded 1925 studies. Further
screening eliminated duplicates, unpublished findings, inappropriate
study designs, and patient groups not meeting
specific inclusion and exclusion criteria. This resulted in full
text screening of 29 articles which after another detailed
screening yielded 7 source studies; 3 evaluated counselling
solely provided by physical therapists and 4 evaluated counselling
with the participation of physical therapists in a
multiprofessional team. The methodological quality ranged
from 11 to 21 points on the Downs and Black tool (possible
range: low = 0; high = 28). Two of the 7 studies were based on
an effect size calculation and had sufficient power to detect a
clinically important effect.
Conclusions: Physical therapists can effectively educate
patients with respect to lifestyle behavior change (specifically,
increasing physical activity, reducing body weight,
and improving cognitive-behavioral outcomes), at least in
the short-term.
Implications: Given this review’s stringent methodology,
our findings support that physical therapists can be effective
health educators alone or supporting health education
initiated by other healthcare team members. Future studies
will help refine this competency in the physical therapy context,
and the parameters of health education interventions
needed to augment health outcomes in the long- as well as
the short-term.
Keywords: Health behavior change; Lifestyle-related conditions;
Physical therapists
Funding acknowledgements: Unfunded.
Ethics approval: N/A.
Research Report Poster Display
Number: RR-PO-205-17-Wed Wednesday 22 June 12:00
RAI: Exhibit Halls2&3
THE ROLE OF LUMBAR LORDSIS IN THE TRUNK
MOVEMENT OF HEMIPLEGIC GAIT
Kamono A. 1,2
1Showa University, School of Nursing and Rehabilitation,
Kanagawa, Japan, 2Nakaizu Rehabilitation Center, Department
of Rehabilitaion, Shizuoka, Japan
Purpose: The purpose of this study was to clarify the relationship
between the attitudes of lumbo-pelvic complex and
the trunk movement of hemiplegic gait. I hypothesized that
hemiplegic patients were divided into two models; the one
model was the solid model that does not permit movement
between pelvis and thorax, and another was the lumbar lordsis
model that permit the normal trunk movements.
Relevance: The results of this study contribute the effective
training that improve the gait performance of hemiplegic
patients.
Participants: The ten stroke patients included in this study
were 40–68 years of age, had suffered first unilateral cerebrovascular
accidents, were able to walk independently, and
gave informed concent.
Methods: In order to obtain kinematic and electromyographic
data of hemiplegic gait, three-dimensional displacement
and muscular activities of trunk were studied, in
addition to stride length and speed. Retro-reflective markers
were mounted on upper trunk and pelvis, and were recorded
using motion capture system, VICON (VICON Inc., UK) at
120 Hz. Surface electrodes were mounted on belly of bilateral
erector spinae (ES), rectus abdominis (RA) and external
oblique (EO). EMG data were collected using EMG measurement
system (4Assist Inc., JAPAN) with portable data
logger and preamplifier electrodes. EMG data were sampled
at 1000 Hz. The instructions were to walk as ‘naturally’
as possible. The participants were allowed to use walking
aids such as T-cane and ankle-foot-orthosis. The data were
sampled for at least ten gait cycles.
Analysis: Eular angles of pelvis and thorax were calculated
and data processing was performed using Butterworth
second order double pass low-pass filtering with a 6 Hz cutoff
frequency, time normalization (0–100% gait cycle), and
ensemble averaging per subject. Each waveforms of gait
cycle were fitted into sinusoidal waveform. Phase differences
between pelvic and thoracic rotations were calculated. The
pelvic anterior tilting angle during quiet standing was calculated.
EMG data were band-pass filtered at 50–350 Hz to
remove movement artifact, full-wave rectified, and low pass
filtered at 10 Hz with Butterworth second order double pass
filter. Muscle activity rate of each muscle was defined as
the Root-Mean-Square (RMS) value during double support
phase divided by RMS value during residual phase.
Results: Correlation analyses showed significant correlation
between pelvic anterior tilting angle during quiet standing,