Background: Achilles tendon disorders are among the most common maladies encountered in sports medicine. Increased tendon thickness is considered to be a risk factor for Achilles tendon disorders. Ultrasonography is currently the modality of choice that best demonstrate the Achilles tendon abnormalities. This study investigated Intra-rater reliability of ultrasound in Achilles tendon thickness measurements among asymptomatic’-s, performed by a qualified physiotherapist with limited ultrasound training.

Method: A test retest reliability design was used. 25 healthy participants were recruited from Sheffield Hallam University. Achilles tendon thickness measurements were performed on two occasions, approximately 30 minutes apart; by the same rater, under same testing conditions.

Results: The Intraclass correlation coefficient (ICC) for intra-rater reliability was found be excellent (ICC =0.935; 95% confidence interval, 0.88-0.96).
Implications: Ultrasound can be used in the field of physiotherapy as a clinical tool for prevention, assessment and monitoring rehabilitation of athletes.

Conclusion: Ultrasound evaluation of Achilles tendon thickness can be reliably performed by a qualified physiotherapist with limited ultrasound training. Further research is required to investigate inter rater reliability and among different patient populations with proper US training.

As new theories emerge and new exercises, movements and techniques are taken up by the hands and mind of a physiotherapist, our profession is continuously developing. This paper discusses the development of ethical concerns within the profession, specifically in relation to autonomy and welfare of the patients.

There is much debate in the UK about proposed changes to the National Health Service (NHS) which will lead to a much stronger market orientation for aspects of the service. Although the changes are ‘proposed’ in the current Government’s Department of Health bill (2011) and previous white paper (Department of Health 2010), various initiatives to develop services into new forms of social enterprise were already being implemented under the previous administration, and allied health professionals (AHPs) were being encouraged to establish themselves in these forms of organization. This discussion paper will explore some of the issues and the background to this development, particularly with regard to the implications for occupational therapy services.

The International Journal of Physical Therapy and Rehabilitation (IJPTR) is an open access journal dedicated to the development of research and education in the field of therapeutic rehabilitation. It is aimed at all health professionals with an allied health background including nursing. It is important that healthcare is based on sound evidence from well conducted [...]

This letter raises a number of issues which appear to relate to two main areas of concern for Senthil Kumar. Firstly he critiques the paper by Marwaha et al (2010) and secondly he critiques the editorial processes employed by IJPTR. These will be dealt with in order. Critique of Marwaha et al (2010) We would [...]

Whilst there has been a plethora of books related to special tests in musculoskeletal examination, a compilation of the evaluation and testing procedures of other physiological systems of the body has been long overdue. O’Connell et al (2011) have recently published a handy volume on the special tests of the cardiopulmonary, vascular and gastrointestinal systems. [...]

Healthcare practitioners who want to write for publication for the first time can waste time and energy by relying on writing behaviour learned in educational settings, characterised in this article as the gatherer style of writing. The gatherer style is suitable for authors who are preparing literature reviews and similar types of publication.

A hunter style of writing is more appropriate when an author wants to describe work carried out, whether research, a quality improvement study, a clinical audit, a service evaluation or another project. In the hunter style, an author works through a systematic thought process and makes key decisions about the work the author wants to describe, before starting to write. The thought process includes defining what journal readers want to read about, answering key questions about the subject being written about and organising the ideas into a logical structure. Practical points about writing clearly also are provided.

Background – Rehabilitation of chronic musculoskeletal conditions usually involves long-term home-based exercise programmes. Exercises have been shown to alleviate pain, improve joint mobility and stability, allow faster return to work and prevent progression of chronic conditions. Non-adherence of patients to unsupervised long-term exercise is a major problem that affects treatment outcome. This study explores UK physiotherapists’ perceptions of exercise adherence and their interventions to tackle it in clinical practice.

Method – A convenience sample of five experienced physiotherapists from Sheffield Hallam University were interviewed. Interviews were transcribed and analysed. Interpretative Phenomenological Analysis (IPA) was used to analyse data transcriptions.

Results – The identified themes revolved around issues of patient-therapist collaboration in chronic rehabilitation. The subordinate themes were: negotiating ownership and self management, education and pain, professional power and patient attitudes and communication.

Conclusion – Experienced physiotherapists recognised barriers and often critically viewed their practice. They undertook necessary interventions in their practice but persisting non-adherence made them question the patient’s role in the partnership.

Background – Back disability measures are considered important by stake-holders as they offer a means of evaluating the effect of low back pain. The Quebec Back Pain Disability Scale (QDS) is a commonly-used measure of back disability, but it has only been adapted into four languages.

Method – Using a combination of cross-cultural adaptation guidelines for self-reported measures, health professionals, methodologists and Arabic linguists voluntarily participated in cross cultural adaptation of the QDS. At least three different participants were included in each of four stages.

Results – A pre-final version of the Arabic QDS was developed. The equivalence of the adapted measure to the original QDS version was agreed by examining it from four perspectives: idiomatic, experiential, conceptual and semantic.

Implications – The pre-final version is ready to be tested in almost any Arabic speaking population. This will give the opportunity to gather data in the third most widely spoken language worldwide, representing a target population of more than 500 million people.

Conclusion – The QDS can be cross-culturally adapted into Arabic without losing any concepts of the original scale; this adapted scale is ready for further testing.

This case report describes successful outpatient physical therapy intervention (including High Velocity Low Amplitude Thrust (HVLAT) spinal manipulation) of a 43 year-old female patient with neck pain who did not fit ideal clinical prediction rule criteria for thoracic or cervical manipulation following an initial unsuccessful course of physical therapy. Following patient report of “0% improvement” in a physical therapy clinic that did not include HVLAT, patient care was transferred to a different clinic and the patient received physical therapy care that included HVLAT for 10 sessions. During that time, neck disability index scores decreased from 76% to 18%, meeting previously established criteria for minimally detectable change as well as clinically meaningful change. Cranio-cervical flexion test abilities improved from 18mmHg to 28mmHg, active cervical rotation improved from 45 degrees bilaterally to 85 degrees bilaterally, and neck pain had decreased from 7/10 to 0/10 on a Numeric Pain Rating Scale. Functionally, the patient re-acquired the ability to work an 8 hour shift of manual labor, to turn her head and back out of the driveway with her car, and to sleep through the night without waking in pain. The potential relative importance of non-clinical psychosocial factors in the prediction of outcome in patients who do not ideally fit clinical prediction rules is discussed.