Andrea Greisberger - Academia.edu (original) (raw)
Papers by Andrea Greisberger
Pervasive Computing Technologies for Healthcare, 2024
Scientific Reports, Jan 15, 2024
In gait analysis, knowledge on validity and reliability of instruments and influences caused by t... more In gait analysis, knowledge on validity and reliability of instruments and influences caused by the examiner's performance is of crucial interest. These measurement properties are not yet known for commonly used, low-cost two-dimensional (2D) video-based systems. The purpose of this study was to assess the concurrent validity of a video-based 2D system against a three-dimensional (3D) reference standard, as well as the inter-rater reliability, and test-retest reliability of 3D marker application. Level walking was captured simultaneously by a 2D and a 3D system. Reflective markers were applied independently by three raters and repeated by one rater on a second day. We assessed the agreement between the two systems, as well as reproducibility, and inter-rater agreement of derived spatio-temporal parameters and sagittal kinematics. Nineteen healthy participants completed this study. 2D gait analysis provides a possibility to accurately assess parameters such as stride time, stride length, gait velocity, and knee RoM. Interrater and test-retest reliability of 3D gait analysis are generally acceptable, except for the parameters toe-off and pelvic RoM. This is the first study to publish measurement properties of a commercially available 2D video-based gait analysis system, which can support interpretation of gait pattern near the sagittal plane. The quality and accuracy of instrumented gait analysis in level walking depends on the nature of gait dysfunction and the measurement technology used 1-5. The influence of rater performance on the reliability of outcomes has been assessed for highly instrumented methods like 3D optoelectronic systems 1 , as well as for observational ratings 6. Inter-rater reliability of gait parameters was shown to be an important metric in a team of raters performing gait analysis 7. Test-retest reliability is considered a quality benchmark in the analysis of longitudinal changes in level walking 8. However, compared to the number of studies on level walking, few papers have been published on inter-rater and test-retest reliability, which also serves as a standardization basis for the respective gait labs. To optimize observational gait analysis, some institutions have implemented standardized instrumental threedimensional gait analysis (3DGA) by means of optoelectronic movement analysis systems to assess level walking. 3DGA is a widely accepted reference standard for assessing gait parameters if applied by a rater following marker placement training 9. However, for reasons of cost and space, 3DGA is not yet very common and cannot easily be used in extramural settings. For assessing spatio-temporal parameters, pressure distribution platforms 10,11 , LED bars, and inductive walkway systems 12 are available and were tested for reliability with partly excellent results. To obtain additional 3D kinematic parameters, systems based on inertial measurement units were introduced 13. Low-cost and mobile depth-finding camera-equipped game consoles may not accurately obtain lower body kinematic data, but show potential for spatio-temporal assessments 14,15. Overall, it was concluded that validation studies on some of these technologies are of limited quality, but reliability was better investigated than concurrent validity, and spatio-temporal gait parameters consistently outperformed planar joint angle data 16. To our knowledge, only four commercially available video-based movement analysis systems have been assessed for their accuracy in level walking 5. Considering the advantages of two-dimensional (2D) video-based kinematic analyses with marker tracking, which are inexpensive, commonly available, and highly mobile, the number of studies using this method is astonishingly small. Although a 2D analysis system can only serve for gait patterns with strides close to the sagittal plane in the walking direction 17 , there are still various indications for its use in preventive and rehabilitative settings with a need for assessing kinematic and spatio-temporal parameters of level walking in the sagittal
transcript Verlag eBooks, Dec 30, 2023
NeuroRehabilitation
BACKGROUND: A contextual transferability analysis identified group-based circuit training (GCT) a... more BACKGROUND: A contextual transferability analysis identified group-based circuit training (GCT) as an optimal intervention in German and Austrian outpatient physical therapy to improve mobility post-stroke. GCT incorporates task-oriented, high-repetitive, balance, aerobic and strength training and allows for increased therapy time without increasing personnel. OBJECTIVE: To determine the extent to which German and Austrian physical therapists (PTs) use GCT and its components in the outpatient treatment of stroke-related mobility deficits and to identify factors associated with using GCT components. METHODS: A cross-sectional online survey was conducted. Data were analyzed descriptively and using ordinal regression. RESULTS: Ninety-three PTs participated. None reported using GCT moderately to frequently (4–10/10 patients). The percentage of PTs reporting frequent use (7–10/10 patients) of task-oriented, balance, strength, aerobic, and high-repetitive training was 45.2%, 43.0%, 26.9%,...
Wiener Medizinische Wochenschrift
Zusammenfassung Hintergrund/Ziel Die Scale for the Assessment and Rating of Ataxia (SARA) ist ein... more Zusammenfassung Hintergrund/Ziel Die Scale for the Assessment and Rating of Ataxia (SARA) ist ein praxistaugliches Assessment für die Einschätzung des Schweregrades einer Ataxie und für die Evaluierung von Therapiemaßnahmen. Um im deutschsprachigen Raum über eine entsprechend internationalen Vorgaben übersetzte Version zu verfügen, war das Ziel dieser Arbeit, die SARA ins Deutsche zu übersetzen und für den deutschsprachigen Raum kulturell anzupassen. Methode Der Übersetzungsprozess beinhaltete 6 Schritte. Dabei wurde die Verständlichkeit der Übersetzung in Interviews mit den späteren Nutzer*innen überprüft. Ergebnisse Neun Physiotherapeut*innen und sechs Ärzt*innen mit unterschiedlichen Arbeitsumgebungen wurden interviewt. Sieben Personen waren in Deutschland und je vier in Österreich bzw. der Schweiz tätig. Die Interviews führten zu einer Präzisierung der übersetzten Version. Im länderspezifischen Vergleich wurden keine Auffälligkeiten der Verständlichkeit festgestellt. Schlussfolg...
International Journal of Health Professions
Ziel Leitlinienbasiertes Arbeiten hat Vorteile für Patient*innen und das Gesundheitssystem. Trotz... more Ziel Leitlinienbasiertes Arbeiten hat Vorteile für Patient*innen und das Gesundheitssystem. Trotz dieser Vorteile arbeiteten in der Vergangenheit nur ca. 10 % der österreichischen Physiotherapeut*innen leitlinienbasiert. Zur Behandlung von Mobilitätseinschränkungen nach Schlaganfall empfehlen aktuelle, internationale Leitlinien aufgabenorientiertes Training sowie den Einsatz standardisierter Assessments. Das Ziel dieser Studie ist es, die Arbeitsweise von in der ambulanten Schlaganfallversorgung tätigen Physiotherapeut*innen in Österreich bezüglich dieser Leitlinienempfehlungen darzustellen. Methode Ein bereits in einer Umfrage in Deutschland verwendeter Fragebogen wurde an den österreichischen Kontext adaptiert. Der Fragebogen beinhaltete ein Fallbeispiel, anhand dessen je drei Untersuchungsmethoden und Behandlungsmaßnahmen genannt und begründet werden sollen. Eingeschlossen wurden Physiotherapeut*innen, die mindestens drei Personen nach Schlaganfall pro Jahr behandeln. Die Datenan...
Hintergrund/Fragestellung: Für Menschen mit einem Schlaganfall sind Einschränkungen der Gehfähigk... more Hintergrund/Fragestellung: Für Menschen mit einem Schlaganfall sind Einschränkungen der Gehfähigkeit und Mobilität von zentraler Bedeutung. Zur Verbesserung der Mobilität empfehlen aktuelle Leitlinien intensive Physiotherapie, die sich auf neurowissenschaftliche Erkenntnisse[zum vollständigen Text gelangen Sie über die oben angegebene URL]
Journal of rehabilitation medicine, Jan 28, 2016
To evaluate the evidence for, and clinical relevance of, immediate and long-term effects of trunk... more To evaluate the evidence for, and clinical relevance of, immediate and long-term effects of trunk restraint during reach-to-grasp training poststroke on movement patterns and functional abilities within the framework of the International Classification of Functioning, Disability and Health. PubMed, Web of Science, CINAHL, Embase, PEDro, Cochrane Library (publication dates January 1985 to March 2015). Randomized controlled trials comparing training using trunk restraint with any other exercise training. Data were extracted by one researcher and checked by two other researchers. The Cochrane Collaboration's tool for assessing risk of bias and the Physiotherapy Evidence Database scale were used by two researchers to assess study quality and risk of bias. Eight studies met the inclusion criteria. Five studies found better recovery of movement patterns (trunk displacement, elbow extension, and/or shoulder flexion - body function/structure) at post-test in the experimental compared wi...
BACKGROUND: Recently, the Austrian professional association of physiotherapists has published a p... more BACKGROUND: Recently, the Austrian professional association of physiotherapists has published a position statement on entry-level competencies assigned to various roles of physiotherapists. The role of a “physiotherapy expert” is mainly characterised by competencies concerning the clinical reasoning process around individual patients. Our network (Öesterreichisches Hochschulnetzwerk Physiotherapie in der Neurologie ÖHPN) specified these competencies for neurological physiotherapy education. However, specific learning content to achieve these competencies, e.g. regarding particular medical diagnoses has not been developed yet. Furthermore, although crucial for enhancing the competency of establishing diagnoses and evaluating therapy effects, particular standardised assessments already taught on a regular basis remain so far unknown. Therefore, the aim of this project is to present the current situation of neurological physiotherapy education in Austria. METHODS: Based on current curr...
International Journal of Health Professions, 2021
Objective Guidelines recommend task-oriented training and the use of standardized assessments to ... more Objective Guidelines recommend task-oriented training and the use of standardized assessments to improve stroke-related mobility deficits. However, the German outpatient physical therapy prescription catalogue does not include these recommendations resulting in a possible gap between guideline recommendations and clinical practice. Therefore, the purpose of this study was to describe physical therapy practice patterns of stroke-related mobility deficits in the outpatient setting exemplified by the states Baden-Württemberg and Thuringia. Methods Using an online survey, physical therapists treating people with stroke in outpatient settings in Baden-Württemberg and Thuringia were recruited. The questionnaire was developed using a multi-step procedure. Using a case vignette and open-ended questions, preferred evaluation and treatment methods were assessed. Data were analyzed using content analysis and descriptive statistics. Results Data from 63 physical therapists were included in the ...
Physical Therapy
People with stroke cite mobility deficits as one of the most burdensome limitations. National and... more People with stroke cite mobility deficits as one of the most burdensome limitations. National and international stroke guidelines recommend physical therapy based on task-oriented practice, with high numbers of repetitions to improve mobility. In the outpatient setting in Germany and Austria, these principles have not yet been established. The purpose of this study was to identify an evidence-based intervention that could help reduce this research-practice gap. A stepwise approach proposed by Voigt-Radloff and colleagues and Cochrane Germany was used. First, the specific health service problem in the German and Austrian physical therapy outpatient context was identified. Second, a promising intervention was identified using a systematic search in the Cochrane Library and by grading the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation. Finally, the transferability of the promising intervention into the local context was evaluated usi...
Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
Journal of Manipulative and Physiological Therapeutics
International Journal of Health Professions, Nov 30, 2017
Blended learning is characterised as a combination of face-to-face teaching and e-learning in ter... more Blended learning is characterised as a combination of face-to-face teaching and e-learning in terms of knowledge transfer, students' learning activities and reduced presence at the teaching facility. The present cohort study investigated long-term effects of blended learning regarding cognitive outcomes as well as self-indicated estimates of immediate learning effects on the affective domain in the inter-professional field of occupational medicine. Physiotherapy students (bachelor degree) at FH Campus Wien-University of Applied Sciences completed the course Occupational Medicine/Prevention either in a traditional teaching-learning setting entirely taught face-to-face (control-group, n=94), or with a blended learning model (intervention-group, n=93). Long-term effects (1.5 year follow-up) on the cognitive learning outcomes were assessed according to four levels of Bloom's learning objectives. In addition, students estimated potential benefits resulting from blended learning based on four Krathwohl's learning objectives for the affective domain by means of a six-option Likert scale (n=282). Concerning cognitive outcomes, significant results favouring both groups were found with effect sizes from small to medium. The traditional teaching-learning setting resulted in significantly better results in the upmost aspired learning objective (analysis) at the long-term (p<0,01; r=-0,33). In contrast, the intervention group resulted in significantly better long-term results on learning objective levels 1 (knowledge) and 2 (understanding) (p=0,01; r=-0,20 and, p=0,02; r=-0,17, respectively). Hence, no general recommendation favouring either the classical setting or blending learning can be drawn regarding the cognitive domain. However, students' self-indications on the affective domain give preference to blended learning, particularly if inter-professional teamwork is a course objective. Blended learning-learning outcome-e-learning-occupational medicine-prevention-affective domain-cognitive domain
Archives of Physical Medicine and Rehabilitation, 2015
To investigate the perception of muscular effort in individuals with multiple sclerosis (MS) and ... more To investigate the perception of muscular effort in individuals with multiple sclerosis (MS) and healthy controls during dynamic contractions. Case-control study. MS day care center. Individuals with MS (n=28) and controls (n=28) (N=56). Not applicable. Perceived muscular effort during dynamic elbow extensions was rated at 9 different weight intensities (10%-90% of 1-repetition maximum) in a single-blind, randomized order using the OMNI-Resistance Exercise Scale. Muscle activity of the triceps brachii muscle (lateral head) was measured via surface electromyography and normalized to maximal voluntary excitation. According to OMNI-level ratings, significant main effects were found for the diagnostic condition (F=27.33, P&amp;lt;.001, η(2)=.11), indicating 0.7 (95% confidence interval [CI], 0.3-1.1) lower mean OMNI-level ratings for MS, and for the intensity level (F=46.81, P&amp;lt;.001, η(2)=.46), showing increased OMNI-level ratings for increased intensity levels for both groups. Furthermore, significant main effects were found for the diagnostic condition (F=16.52, P&amp;lt;.001, η(2)=.07), indicating 7.1% (95% CI, -8.6 to 22.8) higher maximal voluntary excitation values for MS, and for the intensity level (F=33.09, P&amp;lt;.001, η(2)=.36), showing higher relative muscle activities for increasing intensity levels in both groups. Similar to controls, individuals with MS were able to differentiate between different intensities of weight during dynamic elbow extensions when provided in a single-blind, randomized order. Therefore, perceived muscular effort might be considered to control resistance training intensities in individuals with MS. However, training intensity for individuals with MS should be chosen at approximately 1 OMNI level lower than recommended, at least for dynamic elbow extension exercises.
Journal of the Neurological Sciences, 2013
A 58-year old white female with multiple sclerosis was treated with antiretroviral therapy (ART) ... more A 58-year old white female with multiple sclerosis was treated with antiretroviral therapy (ART) of raltegravir and lamividine. Over two years prior to the commencement of ART the patient reported progressive worsening of weakness in right arm and legs requiring use of a walking stick, burning sensations in limbs and persistent fatigue. MRI showed areas of demyelination in the spine but without involvement of the brain. CSF analysis showed oligoclonal IgG bands. The patient was treated with interferon beta for seven years but it was stopped due to disease progression. No other disease modifying therapy had been used. Methods: Neurological examination, EDSS, Multiple Sclerosis Functional Composite (MSFC), Multiple Sclerosis Quality of Life Inventory (MSQLI) and blood safety parameters were performed at baseline then monthly over six months of treatment. Z-scores for MSFC and MSQLI were calculated and adjusted to reference population. Results: There was no significant change from baseline in the EDSS, MSFC and MSQLI scores. There were no side effects of ART reported by patient or detected by blood safety parameters. The patient reported marked improvement in fatigue during the first two months of treatment. Conclusions: ART in this patient was safe and may have stabilising impact on disease progression and quality of life. A possible mode of action of ART in MS includes suppressive effect on MS-associated Human Endogenous Retrovirus and herpes viruses triggering MS. This is the first case of patient with MS receiving antiretroviral therapy with formal evaluation of disease progression and safety.
Journal of rehabilitation medicine, Jan 28, 2016
To evaluate the evidence for, and clinical relevance of, immediate and long-term effects of trunk... more To evaluate the evidence for, and clinical relevance of, immediate and long-term effects of trunk restraint during reach-to-grasp training poststroke on movement patterns and functional abilities within the framework of the International Classification of Functioning, Disability and Health. PubMed, Web of Science, CINAHL, Embase, PEDro, Cochrane Library (publication dates January 1985 to March 2015). Randomized controlled trials comparing training using trunk restraint with any other exercise training. Data were extracted by one researcher and checked by two other researchers. The Cochrane Collaboration's tool for assessing risk of bias and the Physiotherapy Evidence Database scale were used by two researchers to assess study quality and risk of bias. Eight studies met the inclusion criteria. Five studies found better recovery of movement patterns (trunk displacement, elbow extension, and/or shoulder flexion - body function/structure) at post-test in the experimental compared wi...
Pervasive Computing Technologies for Healthcare, 2024
Scientific Reports, Jan 15, 2024
In gait analysis, knowledge on validity and reliability of instruments and influences caused by t... more In gait analysis, knowledge on validity and reliability of instruments and influences caused by the examiner's performance is of crucial interest. These measurement properties are not yet known for commonly used, low-cost two-dimensional (2D) video-based systems. The purpose of this study was to assess the concurrent validity of a video-based 2D system against a three-dimensional (3D) reference standard, as well as the inter-rater reliability, and test-retest reliability of 3D marker application. Level walking was captured simultaneously by a 2D and a 3D system. Reflective markers were applied independently by three raters and repeated by one rater on a second day. We assessed the agreement between the two systems, as well as reproducibility, and inter-rater agreement of derived spatio-temporal parameters and sagittal kinematics. Nineteen healthy participants completed this study. 2D gait analysis provides a possibility to accurately assess parameters such as stride time, stride length, gait velocity, and knee RoM. Interrater and test-retest reliability of 3D gait analysis are generally acceptable, except for the parameters toe-off and pelvic RoM. This is the first study to publish measurement properties of a commercially available 2D video-based gait analysis system, which can support interpretation of gait pattern near the sagittal plane. The quality and accuracy of instrumented gait analysis in level walking depends on the nature of gait dysfunction and the measurement technology used 1-5. The influence of rater performance on the reliability of outcomes has been assessed for highly instrumented methods like 3D optoelectronic systems 1 , as well as for observational ratings 6. Inter-rater reliability of gait parameters was shown to be an important metric in a team of raters performing gait analysis 7. Test-retest reliability is considered a quality benchmark in the analysis of longitudinal changes in level walking 8. However, compared to the number of studies on level walking, few papers have been published on inter-rater and test-retest reliability, which also serves as a standardization basis for the respective gait labs. To optimize observational gait analysis, some institutions have implemented standardized instrumental threedimensional gait analysis (3DGA) by means of optoelectronic movement analysis systems to assess level walking. 3DGA is a widely accepted reference standard for assessing gait parameters if applied by a rater following marker placement training 9. However, for reasons of cost and space, 3DGA is not yet very common and cannot easily be used in extramural settings. For assessing spatio-temporal parameters, pressure distribution platforms 10,11 , LED bars, and inductive walkway systems 12 are available and were tested for reliability with partly excellent results. To obtain additional 3D kinematic parameters, systems based on inertial measurement units were introduced 13. Low-cost and mobile depth-finding camera-equipped game consoles may not accurately obtain lower body kinematic data, but show potential for spatio-temporal assessments 14,15. Overall, it was concluded that validation studies on some of these technologies are of limited quality, but reliability was better investigated than concurrent validity, and spatio-temporal gait parameters consistently outperformed planar joint angle data 16. To our knowledge, only four commercially available video-based movement analysis systems have been assessed for their accuracy in level walking 5. Considering the advantages of two-dimensional (2D) video-based kinematic analyses with marker tracking, which are inexpensive, commonly available, and highly mobile, the number of studies using this method is astonishingly small. Although a 2D analysis system can only serve for gait patterns with strides close to the sagittal plane in the walking direction 17 , there are still various indications for its use in preventive and rehabilitative settings with a need for assessing kinematic and spatio-temporal parameters of level walking in the sagittal
transcript Verlag eBooks, Dec 30, 2023
NeuroRehabilitation
BACKGROUND: A contextual transferability analysis identified group-based circuit training (GCT) a... more BACKGROUND: A contextual transferability analysis identified group-based circuit training (GCT) as an optimal intervention in German and Austrian outpatient physical therapy to improve mobility post-stroke. GCT incorporates task-oriented, high-repetitive, balance, aerobic and strength training and allows for increased therapy time without increasing personnel. OBJECTIVE: To determine the extent to which German and Austrian physical therapists (PTs) use GCT and its components in the outpatient treatment of stroke-related mobility deficits and to identify factors associated with using GCT components. METHODS: A cross-sectional online survey was conducted. Data were analyzed descriptively and using ordinal regression. RESULTS: Ninety-three PTs participated. None reported using GCT moderately to frequently (4–10/10 patients). The percentage of PTs reporting frequent use (7–10/10 patients) of task-oriented, balance, strength, aerobic, and high-repetitive training was 45.2%, 43.0%, 26.9%,...
Wiener Medizinische Wochenschrift
Zusammenfassung Hintergrund/Ziel Die Scale for the Assessment and Rating of Ataxia (SARA) ist ein... more Zusammenfassung Hintergrund/Ziel Die Scale for the Assessment and Rating of Ataxia (SARA) ist ein praxistaugliches Assessment für die Einschätzung des Schweregrades einer Ataxie und für die Evaluierung von Therapiemaßnahmen. Um im deutschsprachigen Raum über eine entsprechend internationalen Vorgaben übersetzte Version zu verfügen, war das Ziel dieser Arbeit, die SARA ins Deutsche zu übersetzen und für den deutschsprachigen Raum kulturell anzupassen. Methode Der Übersetzungsprozess beinhaltete 6 Schritte. Dabei wurde die Verständlichkeit der Übersetzung in Interviews mit den späteren Nutzer*innen überprüft. Ergebnisse Neun Physiotherapeut*innen und sechs Ärzt*innen mit unterschiedlichen Arbeitsumgebungen wurden interviewt. Sieben Personen waren in Deutschland und je vier in Österreich bzw. der Schweiz tätig. Die Interviews führten zu einer Präzisierung der übersetzten Version. Im länderspezifischen Vergleich wurden keine Auffälligkeiten der Verständlichkeit festgestellt. Schlussfolg...
International Journal of Health Professions
Ziel Leitlinienbasiertes Arbeiten hat Vorteile für Patient*innen und das Gesundheitssystem. Trotz... more Ziel Leitlinienbasiertes Arbeiten hat Vorteile für Patient*innen und das Gesundheitssystem. Trotz dieser Vorteile arbeiteten in der Vergangenheit nur ca. 10 % der österreichischen Physiotherapeut*innen leitlinienbasiert. Zur Behandlung von Mobilitätseinschränkungen nach Schlaganfall empfehlen aktuelle, internationale Leitlinien aufgabenorientiertes Training sowie den Einsatz standardisierter Assessments. Das Ziel dieser Studie ist es, die Arbeitsweise von in der ambulanten Schlaganfallversorgung tätigen Physiotherapeut*innen in Österreich bezüglich dieser Leitlinienempfehlungen darzustellen. Methode Ein bereits in einer Umfrage in Deutschland verwendeter Fragebogen wurde an den österreichischen Kontext adaptiert. Der Fragebogen beinhaltete ein Fallbeispiel, anhand dessen je drei Untersuchungsmethoden und Behandlungsmaßnahmen genannt und begründet werden sollen. Eingeschlossen wurden Physiotherapeut*innen, die mindestens drei Personen nach Schlaganfall pro Jahr behandeln. Die Datenan...
Hintergrund/Fragestellung: Für Menschen mit einem Schlaganfall sind Einschränkungen der Gehfähigk... more Hintergrund/Fragestellung: Für Menschen mit einem Schlaganfall sind Einschränkungen der Gehfähigkeit und Mobilität von zentraler Bedeutung. Zur Verbesserung der Mobilität empfehlen aktuelle Leitlinien intensive Physiotherapie, die sich auf neurowissenschaftliche Erkenntnisse[zum vollständigen Text gelangen Sie über die oben angegebene URL]
Journal of rehabilitation medicine, Jan 28, 2016
To evaluate the evidence for, and clinical relevance of, immediate and long-term effects of trunk... more To evaluate the evidence for, and clinical relevance of, immediate and long-term effects of trunk restraint during reach-to-grasp training poststroke on movement patterns and functional abilities within the framework of the International Classification of Functioning, Disability and Health. PubMed, Web of Science, CINAHL, Embase, PEDro, Cochrane Library (publication dates January 1985 to March 2015). Randomized controlled trials comparing training using trunk restraint with any other exercise training. Data were extracted by one researcher and checked by two other researchers. The Cochrane Collaboration's tool for assessing risk of bias and the Physiotherapy Evidence Database scale were used by two researchers to assess study quality and risk of bias. Eight studies met the inclusion criteria. Five studies found better recovery of movement patterns (trunk displacement, elbow extension, and/or shoulder flexion - body function/structure) at post-test in the experimental compared wi...
BACKGROUND: Recently, the Austrian professional association of physiotherapists has published a p... more BACKGROUND: Recently, the Austrian professional association of physiotherapists has published a position statement on entry-level competencies assigned to various roles of physiotherapists. The role of a “physiotherapy expert” is mainly characterised by competencies concerning the clinical reasoning process around individual patients. Our network (Öesterreichisches Hochschulnetzwerk Physiotherapie in der Neurologie ÖHPN) specified these competencies for neurological physiotherapy education. However, specific learning content to achieve these competencies, e.g. regarding particular medical diagnoses has not been developed yet. Furthermore, although crucial for enhancing the competency of establishing diagnoses and evaluating therapy effects, particular standardised assessments already taught on a regular basis remain so far unknown. Therefore, the aim of this project is to present the current situation of neurological physiotherapy education in Austria. METHODS: Based on current curr...
International Journal of Health Professions, 2021
Objective Guidelines recommend task-oriented training and the use of standardized assessments to ... more Objective Guidelines recommend task-oriented training and the use of standardized assessments to improve stroke-related mobility deficits. However, the German outpatient physical therapy prescription catalogue does not include these recommendations resulting in a possible gap between guideline recommendations and clinical practice. Therefore, the purpose of this study was to describe physical therapy practice patterns of stroke-related mobility deficits in the outpatient setting exemplified by the states Baden-Württemberg and Thuringia. Methods Using an online survey, physical therapists treating people with stroke in outpatient settings in Baden-Württemberg and Thuringia were recruited. The questionnaire was developed using a multi-step procedure. Using a case vignette and open-ended questions, preferred evaluation and treatment methods were assessed. Data were analyzed using content analysis and descriptive statistics. Results Data from 63 physical therapists were included in the ...
Physical Therapy
People with stroke cite mobility deficits as one of the most burdensome limitations. National and... more People with stroke cite mobility deficits as one of the most burdensome limitations. National and international stroke guidelines recommend physical therapy based on task-oriented practice, with high numbers of repetitions to improve mobility. In the outpatient setting in Germany and Austria, these principles have not yet been established. The purpose of this study was to identify an evidence-based intervention that could help reduce this research-practice gap. A stepwise approach proposed by Voigt-Radloff and colleagues and Cochrane Germany was used. First, the specific health service problem in the German and Austrian physical therapy outpatient context was identified. Second, a promising intervention was identified using a systematic search in the Cochrane Library and by grading the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation. Finally, the transferability of the promising intervention into the local context was evaluated usi...
Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
Journal of Manipulative and Physiological Therapeutics
International Journal of Health Professions, Nov 30, 2017
Blended learning is characterised as a combination of face-to-face teaching and e-learning in ter... more Blended learning is characterised as a combination of face-to-face teaching and e-learning in terms of knowledge transfer, students' learning activities and reduced presence at the teaching facility. The present cohort study investigated long-term effects of blended learning regarding cognitive outcomes as well as self-indicated estimates of immediate learning effects on the affective domain in the inter-professional field of occupational medicine. Physiotherapy students (bachelor degree) at FH Campus Wien-University of Applied Sciences completed the course Occupational Medicine/Prevention either in a traditional teaching-learning setting entirely taught face-to-face (control-group, n=94), or with a blended learning model (intervention-group, n=93). Long-term effects (1.5 year follow-up) on the cognitive learning outcomes were assessed according to four levels of Bloom's learning objectives. In addition, students estimated potential benefits resulting from blended learning based on four Krathwohl's learning objectives for the affective domain by means of a six-option Likert scale (n=282). Concerning cognitive outcomes, significant results favouring both groups were found with effect sizes from small to medium. The traditional teaching-learning setting resulted in significantly better results in the upmost aspired learning objective (analysis) at the long-term (p<0,01; r=-0,33). In contrast, the intervention group resulted in significantly better long-term results on learning objective levels 1 (knowledge) and 2 (understanding) (p=0,01; r=-0,20 and, p=0,02; r=-0,17, respectively). Hence, no general recommendation favouring either the classical setting or blending learning can be drawn regarding the cognitive domain. However, students' self-indications on the affective domain give preference to blended learning, particularly if inter-professional teamwork is a course objective. Blended learning-learning outcome-e-learning-occupational medicine-prevention-affective domain-cognitive domain
Archives of Physical Medicine and Rehabilitation, 2015
To investigate the perception of muscular effort in individuals with multiple sclerosis (MS) and ... more To investigate the perception of muscular effort in individuals with multiple sclerosis (MS) and healthy controls during dynamic contractions. Case-control study. MS day care center. Individuals with MS (n=28) and controls (n=28) (N=56). Not applicable. Perceived muscular effort during dynamic elbow extensions was rated at 9 different weight intensities (10%-90% of 1-repetition maximum) in a single-blind, randomized order using the OMNI-Resistance Exercise Scale. Muscle activity of the triceps brachii muscle (lateral head) was measured via surface electromyography and normalized to maximal voluntary excitation. According to OMNI-level ratings, significant main effects were found for the diagnostic condition (F=27.33, P&amp;lt;.001, η(2)=.11), indicating 0.7 (95% confidence interval [CI], 0.3-1.1) lower mean OMNI-level ratings for MS, and for the intensity level (F=46.81, P&amp;lt;.001, η(2)=.46), showing increased OMNI-level ratings for increased intensity levels for both groups. Furthermore, significant main effects were found for the diagnostic condition (F=16.52, P&amp;lt;.001, η(2)=.07), indicating 7.1% (95% CI, -8.6 to 22.8) higher maximal voluntary excitation values for MS, and for the intensity level (F=33.09, P&amp;lt;.001, η(2)=.36), showing higher relative muscle activities for increasing intensity levels in both groups. Similar to controls, individuals with MS were able to differentiate between different intensities of weight during dynamic elbow extensions when provided in a single-blind, randomized order. Therefore, perceived muscular effort might be considered to control resistance training intensities in individuals with MS. However, training intensity for individuals with MS should be chosen at approximately 1 OMNI level lower than recommended, at least for dynamic elbow extension exercises.
Journal of the Neurological Sciences, 2013
A 58-year old white female with multiple sclerosis was treated with antiretroviral therapy (ART) ... more A 58-year old white female with multiple sclerosis was treated with antiretroviral therapy (ART) of raltegravir and lamividine. Over two years prior to the commencement of ART the patient reported progressive worsening of weakness in right arm and legs requiring use of a walking stick, burning sensations in limbs and persistent fatigue. MRI showed areas of demyelination in the spine but without involvement of the brain. CSF analysis showed oligoclonal IgG bands. The patient was treated with interferon beta for seven years but it was stopped due to disease progression. No other disease modifying therapy had been used. Methods: Neurological examination, EDSS, Multiple Sclerosis Functional Composite (MSFC), Multiple Sclerosis Quality of Life Inventory (MSQLI) and blood safety parameters were performed at baseline then monthly over six months of treatment. Z-scores for MSFC and MSQLI were calculated and adjusted to reference population. Results: There was no significant change from baseline in the EDSS, MSFC and MSQLI scores. There were no side effects of ART reported by patient or detected by blood safety parameters. The patient reported marked improvement in fatigue during the first two months of treatment. Conclusions: ART in this patient was safe and may have stabilising impact on disease progression and quality of life. A possible mode of action of ART in MS includes suppressive effect on MS-associated Human Endogenous Retrovirus and herpes viruses triggering MS. This is the first case of patient with MS receiving antiretroviral therapy with formal evaluation of disease progression and safety.
Journal of rehabilitation medicine, Jan 28, 2016
To evaluate the evidence for, and clinical relevance of, immediate and long-term effects of trunk... more To evaluate the evidence for, and clinical relevance of, immediate and long-term effects of trunk restraint during reach-to-grasp training poststroke on movement patterns and functional abilities within the framework of the International Classification of Functioning, Disability and Health. PubMed, Web of Science, CINAHL, Embase, PEDro, Cochrane Library (publication dates January 1985 to March 2015). Randomized controlled trials comparing training using trunk restraint with any other exercise training. Data were extracted by one researcher and checked by two other researchers. The Cochrane Collaboration's tool for assessing risk of bias and the Physiotherapy Evidence Database scale were used by two researchers to assess study quality and risk of bias. Eight studies met the inclusion criteria. Five studies found better recovery of movement patterns (trunk displacement, elbow extension, and/or shoulder flexion - body function/structure) at post-test in the experimental compared wi...