Design: A randomized controlled trial.

Setting: The outpatient and inpatient departments of three hospitals.

Subjects: One hundred and twenty patients with clinically diagnosed schizophrenia with predominantly negative symptoms were included in the study.

Intervention: All 120 patients were randomly assigned to double-blind treatment with WSKY group (n = 60) or placebo group (n = 60) added to risperidone for eight weeks.

Main measure: The efficacy measures included the World Health Organization Quality of Life Scale (WHOQOL-100), the Positive and Negative Syndrome Scale (PANSS), the Social Disability Screening Schedule and the Hamilton Rating Scale for Depression. Safety and tolerability were assessed throughout the trial.

Results: The scores of quality of life in the WSKY group showed statistically significant improvement at the end-point of treatment compared with those in the placebo group (WSKY, increasing 40.5 (29.4); placebo, increasing 14.4 (27.1); F =24.900, P<0.001), while the scores of social function and depression symptoms also showed statistically significant improvement. The response rates for the WHOQOL-100 total scores were 50.0% for the WSKY group versus 31.7% for placebo group ( ² = 4.172, P=0.041). There were no significant differences in the safety/tolerability measures between the WSKY group and the placebo group during treatment.

Conclusions: The results suggest that WSKY added to risperidone significantly improved the quality of life, social function, depression symptom compared with placebo added to risperidone.

Design: This study was a randomized controlled trial with blinded outcomes assessment and a six-month follow-up.

Subjects and setting: Participants were older adults (>65 years) using a mobility aid discharged from a tertiary hospital in Brisbane, Australia, without referral for community-based rehabilitation services.

Intervention: A digital video disk-based programme encompassing six exercise types each with six levels of difficulty. A home visit from a project physiotherapist was conducted to ensure patient safety. Control group patients received usual care.

Main measures: Falls, health-related quality of life, participation in activities of daily living, physical capacity and fear of falling.

Results: Study participants (n = 53, 19 intervention, 34 control) experienced decreasing health-related quality of life, several falls (72), and lower levels of participation in activities of daily living over the six-month follow-up. The intervention group did not differ significantly from the control group in terms of the outcomes examined, though a non-significant reduction in the rate of falls was observed. Intervention group participants complied with the exercise programme well during the first two weeks following discharge from hospital but then reduced their compliance levels thereafter.

Conclusions: The intervention may be beneficial for reducing the rate of falls in this patient population though further research with a larger sample size is indicated.

Design: Randomized controlled study.

Setting: Residential cardiac rehabilitation centre and community hospital. Intervention: One month of intensive exercise and risk reduction therapy including educational sessions, a low-fat diet, and 2 hours of individually prescribed exercise daily. Control subjects received usual care. Subjects were evaluated at baseline, after completing the one-month residential programme and six years later.

Subjects: From an original study group of 50, 16 patients (8 exercise, 8 controls) with chronic heart failure were alive and available for evaluation after six years.

Main measures: Cardiopulmonary exercise test responses and ventricular size and function using MRI.

Results: Peak Vo₂ was 20.0 and 12.4% higher after the rehabilitation programme and six years later, respectively, whereas minimal changes were observed among controls. Left ventricular mass and volumes tended to decrease among subjects in the exercise group, whereas left ventricular mass and volumes tended to increase among control subjects after six years. Ejection fraction increased approximately 20% in both groups.

Conclusion: Six years after participation in a concentrated residential rehabilitation programme, exercise capacity was preserved and no significant changes were observed in ventricular size or function. These findings provide further support for exercise rehabilitation in chronic heart failure.

Design: A controlled trial.

Setting: Cardiac rehabilitation service of a provincial hospital.

Subjects: Eighty men 2—3 weeks after an acute coronary syndrome, with good exercise tolerance.

Interventions: Three-week, inpatient cardiac rehabilitation programme (control group) supplemented with Nordic Walking (Nordic Walking group), or with traditional walking training (walking training group).

Main measures: Exercise capacity was assessed as peak energy cost (in metabolic equivalents) in symptom-limited treadmill exercise test, and physical fitness with the Fullerton Functional Fitness Test.

Results: Exercise capacity after the rehabilitation programme was higher in the Nordic Walking group than in the control group (10.8 ± 1.8 versus 9.2 ± 2.2 metabolic equivalents, P =0.025). The improvement in exercise capacity in the Nordic Walking group was higher than in the control group (1.8 ± 1.5 versus 0.7 ± 1.4 metabolic equivalents, P =0.002). In contrast to the control group, the results of all components of the Fullerton test improved in the Nordic Walking and walking training groups. After the programme, lower body endurance, and dynamic balance were significantly better in the Nordic Walking group in comparison with the walking training and control groups, and upper body endurance was significantly better in the Nordic Walking and walking training groups than in the control group.

Conclusions: Nordic Walking may improve exercise capacity, lower body endurance and coordination of movements in patients with good exercise tolerance participating in early, short-term rehabilitation after an acute coronary syndrome.

Design: Pilot randomized controlled trial.

Methods: Thirty physiotherapists involved in stroke management were randomized into two groups and participated in five tutor-guided educational sessions (the Physiotherapists’ Educational Programme on Clinimetrics in Stroke, PEPCiS). Groups differed from each other with respect to tutors: one experienced and one inexperienced in stroke care. Primary outcome was ‘actual use’ (the frequencies of data of seven recommended outcome measures in the patient records of the participating physiotherapists).

Results: The actual use of instruments shifted from a median of 3 to 6 in the expert tutor group and from 3 to 4 in the non-expert tutor group (P = 0.07). Physiotherapists educated by the expert tutor used a broader variety of instruments and appreciated the educational programme, their own knowledge gain and all three scales of tutor style aspects significantly more than their colleagues of the non-expert tutor group (all P<0.05). Univariate analysis on the entire set of data revealed eight factors, including tutors’ performance, that were associated with a change score of the use of two or more outcome measures by individual physiotherapists after the educational programme.

Conclusion: In this pilot trial it was not proven that tutor expertise in stroke care influences the actual use of outcome measures, but it warrants a future study with sufficient power to investigate the influence of the tutor.

Data sources: MEDLINE, CINAHL, EMBASE, PEDro and AMED.

Review methods: Independent reviewers selected and extracted data from articles that assessed the reliability, validity, sensitivity to change or clinical utility of measures of walking and mobility in adult neurological conditions. Measures with ‘good’ psychometrics and 9/10 clinical utility scores were recommended.

Results: Seventeen measures were selected. Of these, the 5-m and 10-m walk tests, six-minute walk test, High Level Mobility Assessment Tool (HiMAT) and the Rivermead Mobility Index (RMI) reached the required standards and are usable in clinical practice. None of the recommended measures assessed wheelchair mobility. The least frequently assessed property was sensitivity to change. Further measures could be recommended if the minimal detectable change were demonstrated.

Conclusion: The 5-m, 10-m and six-minute walk test, High Level Mobility Assessment Tool and the Rivermead Mobility Index are psychometrically robust measures of walking and mobility and are feasible for use in clinical practice.

Setting: Outpatient physiotherapy department in a local hospital and a local rehabilitation clinic.

Participants: One hundred and twenty patients with chronic pain in physiotherapy treatment.

Methods: Each participant was asked to complete the Chinese version of the Pain Self-Efficacy Questionnaire, visual analogue scale (VAS), modified Roland Morris Disability Questionnaire, and Short Form Health Survey (SF-36). The test structure of the Pain Self-Efficacy Questionnaire was evaluated by confirmatory factor analysis. Highly correlated paths were added onto the initial structure for improving the final construct for the Pain Self-Efficacy Questionnaire. The correlations between the Chinese Pain Self-Efficacy Questionnaire and related measurements were computed using Pearson product-moment correlation coefficients.

Results: Confirmatory factor analysis indicated that the one-factor model provided the best fit between the model and data, with the chi-square of the respecified model computed to be 36.79 (33, N = 120), the goodness-of-fit index 0.940, cumulative fit index 0.996, and the root mean square error of approximation 0.031. The item-total correlations ranged from 0.70 to 0.85. Cronbach’s alpha of the Chinese version of the Pain Self-Efficacy Questionnaire was computed to be 0.94. The total scores also correlated significantly with the modified Roland Morris Disability Questionnaire and six subscales of SF-36.

Conclusion: A single-factor model confirmed the unidimensionality of the Chinese version of the Pain Self-Efficacy Questionnaire in a sample of Chinese patients with chronic pain. It demonstrated good internal consistency reliability and construct-related validity.

Design: A quantitative questionnaire study with two time points: at the beginning of rehabilitation and at six-month follow-up. Multiple regression analyses were used to determine the contribution of demographic/amputation factors versus psychosocial factors to adjustment outcomes.

Setting: A regional outpatient specialist mobility and rehabilitation centre in the UK.

Subjects: Participants were recruited as a consecutive sample of new referrals with lower limb amputation.

Main measures: Age, gender, level and cause of amputation were recorded. The following measures were used: Hope Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Trinity Amputation and Prosthetic Experiences Scale (TAPES) pain subscale initially and the Positive and Negative Affect Scale (PANAS) and full TAPES at six-month follow up. The measures were administered by two specialist nurses.

Results: Ninety-nine patients provided data at both time points. Hope at the beginning of rehabilitation was related to positive mood (P<0.001) and hope and social support were related to general adjustment (P<0.01, P<0.001) at follow-up. Demographic and amputation factors were not related to psychological adjustment outcomes in this study.

Conclusions: The findings demonstrate prospectively the importance of psychosocial variables in the prediction of positive adjustment to lower limb amputation.

Design: Stroke physiotherapists recorded the interventions used to treat postural control and mobility during treatment sessions. They recorded five sessions for at least five patients each. Descriptive statistics assessed the frequency with which the interventions were used.

Setting: Hospital-based acute stroke care.

Subjects: Thirty-six acute stroke physiotherapists recorded 2374 interventions in 364 treatment sessions for 76 patients.

Main measures: The Stroke Physiotherapy Intervention Recording Tool.

Results: Facilitation techniques were the most frequently used interventions (n = 1258, 53%) with exercise (n = 115, 5%), teaching others how to help the patient (n = 99, 4%) and provision of equipment (n = 63, 3%) the least frequently used.

Conclusions: Acute stroke physiotherapists primarily use therapist-led ‘hands-on’ interventions to treat postural control and mobility problems. Interventions to promote activity or practice outside the treatment session are infrequently used.