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Biomedical subjects

C Moncur

Publications and source records attributed to C Moncur.

12 recordsLinked to original sources
PubMed1996

Inter-observer reliability of the Spondylitis Functional Index Instrument for assessing spondylarthropathies.

OBJECTIVE: To study the Spondylitis Functional Index (SFI) by having two physical therapists observe patients with spondylitis perform various tasks listed on the instrument. The physical therapists' observations were compared with each other and with the self-reported abilities of the patients. METHODS: Subjects (n = 30) were recruited from a cross-section of patients participating in a prospective randomized, multicenter, double-blind, parallel clinical trial of the efficacy of sulfasalazine on ankylosing spondylitis (n = 13), psoriatic arthritis (n = 13), and Reiter's syndrome (n = 4) conducted at the Veterans Affairs Medical Center in Salt Lake City. Percents of agreement and Cohen's kappa analysis were used to assess the reliability of the observations of the therapists and patients. RESULTS: The overall percent of agreement between the observers on the SFI was 93%. The overall percent of agreement between observer 1 and patients on the SFI was 66% and between observer 2 and patients was 67%. The overall inter-observer reliability measured by the Pearson coefficient was 0.91 and by Cohen's kappa was 0.86. Between observer 1 and the patients the Pearson was r = 0.53 and kappa = 0.39. For observer 2 the Pearson was r = 0.52 and kappa 0.39. CONCLUSIONS: We consider the agreement and reliability between observers to be high. The agreement and inter-observer reliability was poor between observers and patients. The SFI, as enhanced for use in this study to assess change in functional ability of patients with spondylitis, demonstrated high reliability when used by trained observers.

Activities of Daily Living↗
PubMed1995

Rheumatoid arthritis: status of drug therapies.

This article describes the current drug therapies used to manage rheumatoid arthritis (RA). A brief description of the pathology, pathogenesis, and clinical features of RA is presented. The purpose of the article is to increase an awareness among physical therapists regarding the medications their patients might be taking and how these agents might influence the outcome of physical therapy intervention. The general approach to prescribing medication is presented according to the status of the disease. The attributes of nonsteroidal antiinflammatory drugs, corticosteroids, slow-acting antirheumatic drugs, and cytotoxic and experimental drugs used in RA are described. Given the potential benefits, side effects, and adverse reactions of these potentially powerful medications, it is important for the physical therapist to monitor closely what is happening to the patient with respect to the use or nonuse of the medication.

Adrenal Cortex Hormones↗
PubMed1994

Exercise tests as outcome measures.

Outcome assessments of physical fitness attributes such as endurance, strength, and flexibility are not measured routinely in clinical trials or clinical practice in either adults or children with rheumatic diseases. Although physical fitness is not a measure of disease severity, it can be a critical indicator of capacity to function. Adequate fitness is necessary for the performance of positive health behaviors that enhance health status and wellness in spite of chronic disease. The purpose of this paper is to explore the conceptual, methodologic, and analytic issues related to the use of exercise tests as outcome measurements of physical functioning in persons with rheumatic disease.

Adult↗
PubMed1994

The psychologic impact of ostomy surgery on persons 50 years of age and older.

There have been few studies on the psychologic effects and reactions to ostomy creation in persons older than 50 years. Eighty-nine patients with ostomies (42 female, 47 male) were evaluated to see how ostomy creation affected them. Six instruments were used to make these assessments: Surgery Preparedness Inventory, Surgical Adjustment Scale, Social Interaction Inventory, Self-Esteem Inventory, Geriatric Depression Scale, and Life Satisfaction Inventory-A. In addition to these six instruments, the participants in the study were asked to state their greatest concern. Older men and women showed similar patterns in surgical preparedness, adjustment to operation, and level of self-esteem. Men reported lower satisfaction with life than did women. Men also had more difficulty in social interactions than did women. Twice as many men as women reported mild to moderate depression. Older women reported poorer health status; if unmarried, they reported less satisfaction with life than younger or married women. More of those reporting good current health reported a positive adjustment to ostomy creation than did those who reported poor health. Those who did not feel hindered by their ostomies reported higher scores on well-being than did those who felt hindered. The more time that has passed after operation, the better patients felt. Four major concerns were reported: (1) concern with being able to care for themselves; (2) leakage from the pouch, odor, and gas noises; (3) other health problems; and (4) recurrence of cancer. Good current health and a sense of well-being are important to positive adjustment after ostomy creation. These areas would be well worth monitoring and should be promoted by the caregivers.

Activities of Daily Living↗
PubMed1990

Counterpoint: is patient control of treatment always appropriate?

Health care providers often find tension and even conflict between what they consider is important for the patient to do and what the patient wants or decides to do. The current trend among patients is to assume more autonomy and freedom in the process of their care. Yet situations that commonly arise between the provider and the patient prompt the patient to refuse to accept or acquiesce to the provider's wishes or choices that are perceived by the provider to be in the patient's best interest. Under what circumstances should the provider practice beneficence in the form of paternalism at the expense of the patient's autonomy? This article explores justifiable paternalism and beneficence.

Authoritarianism↗
PubMed1988

Cervical spine management in patients with rheumatoid arthritis. Review of the literature.

Rheumatoid arthritis of the cervical spine is a well-recognized source of neck pain. Discussion of the potential effects of various treatment interventions on the tissues of patients with rheumatoid arthritis of the cervical spine, however, has been scarce in the physical therapy literature. Physical therapists should understand the implications of this type of inflammatory arthritis when treating patients with rheumatoid arthritis. The end-stage results of the inflammatory process and the mechanical forces on the cervical spine can cause atlantoaxial subluxation, atlantoaxial impaction, and subaxial subluxation. The purpose of this article is to review the literature on several aspects of rheumatoid arthritis of the cervical spine: 1) pathological anatomy, 2) clinical findings, 3) surgical management, 4) management with cervical orthoses, and 5) physical therapy management.

Arthritis, Rheumatoid↗
PubMed1987

Physiotherapy methods of relieving pain.

Management of pain in the person with arthritis requires interdisciplinary team work with the patient being the final manager. It is important that any health care provider perceive the patient as a person who happens to have arthritis--not as 'an "arthritic".' Defining a person by one's disease process is dehumanizing. The patient has the same aspirations as anyone who is ablebodied--to be free from disease. While the patient may know that a cure is not imminent, there is still the hope for one. Therefore, as the patient comes for physiotherapy, there may be a hidden wish that the moist packs, TENS, or therapeutic pool will be curative. It is important that the patient understand that no equipment in the physiotherapy department has curative powers. This will help avoid unnecessary dependency behaviours on the part of the patient. Careful instruction and supervision of the patient by the physiotherapist, in concert with reinforcement from the physician, can prepare the patient to apply heat, cold, or a variety of treatments at home. Although the patient is given the responsibility for this part of his care, periodic follow-up and reassessment should be completed to determine changes in his physiological, psychological, and functional status. Physiotherapists who have a clear understanding of the physical treatment of pain associated with the rheumatic diseases can be a valuable asset to medical care.

Humans↗
PubMed1987

Perceptions of physical therapy competencies in rheumatology. Physical therapists versus rheumatologists.

The purpose of this article is to report the differences in perceptions among three groups of respondents who assessed the importance of 80 competencies for entry-level physical therapists who treat patients with arthritis. Nonparametric statistics were used to analyze the responses of physical therapists and rheumatologists who completed a questionnaire regarding the competencies. I used the Kruskal-Wallis one-way analysis of variance to make group comparisons and the Mann-Whitney U test to complete pair-wise comparisons. The results revealed significant differences of opinion among the groups (p = .007) for 20 of the 80 competencies. The significant differences in opinion were among physical therapy clinical educators (n = 100), physical therapy arthritis health professionals (n = 108), and rheumatologists (n = 80). Although the results suggested that some groups perceived certain physical therapy competencies in rheumatology to be useful but not essential for the entry-level physical therapist to perform, considerable variability existed within groups. Despite the variance in opinions, teaching of these competencies should be included in the entry-level physical therapy curriculum or in clinical settings.

Arthritis↗
PubMed1985

Physical therapy competencies in rheumatology.

Physical therapists and rheumatologists in the United States were surveyed to determine what they perceived as the necessary competencies in rheumatology for the entry-level physical therapist. Physical therapists in clinical education programs (n = 100), those who belonged to the Arthritis Health Professionals Association (n = 108), and rheumatologists belonging to the American Rheumatism Association (n = 80) responded to a questionnaire consisting of items related to educational variables of interest, professional experience, and 80 competencies. The respondents determined that 35 competencies were absolutely essential, 39 were frequently essential, and 6 were useful but not essential. Identification of these competencies should assist the faculty in physical therapy educational programs to prepare the entry-level physical therapist to be competent to treat arthritis patients.

Arthritis↗