Overactive Bladder Symptoms in Female Health Profession Students: Bladder Diary Characteristics and Impact of Symptoms on Health-Related Quality of Life.

INTRODUCTION: There is limited information on overactive bladder (OAB) symptoms, their association with bladder irritants, or the effect of OAB on health-related quality of life (HRQoL) in young women. We evaluated these issues in a group of young female health profession students. METHODS: All female students (n = 964) attending a university in the Pacific Northwest were recruited via email or an in-person informational meeting to participate in this descriptive cross-sectional study. Outcome measures included the OAB-questionnaire, a 4-day bladder diary, and a demographic questionnaire. OAB was diagnosed if a participant reported an average of at least one episode of urgency per day on the bladder diary. Participant characteristics, bladder diary results, and HRQoL were compared using chi square, Fisher's exact test, and t-tests. RESULTS: With a response rate of 21.2%, the average participant age was 25.5 years and 21.7% of participants were identified as having OAB. Participants with OAB consumed more caffeine (mean [standard deviation [SD] 2.0 [1.5] vs. 1.5 [1.2], p = 0.016), more carbonated beverages (mean [SD] 0.5 [0.6] vs. 0.3 [0.5], p = 0.047), more total units of bladder irritants (mean [SD] 3.1 [2.0] vs. 2.1 [1.6], p = 0.002), and had significantly worse HRQoL (p = 0.001) than those without OAB. No differences were found for other parameters measured. CONCLUSION: Participants with OAB consumed more bladder irritants than participants without OAB. Future research should address larger groups of young women from different backgrounds, as well as other factors or characteristics that could be associated with OAB.

Criterion validity, reliability and clinical responsiveness of the CareConnections Functional Index.

This study established the criterion validity, test-retest reliability and responsiveness of the CareConnections Functional Index (CCFI). The CCFI is composed of four body-region specific subscales, measuring functional ability. Reference standards included the Neck Disability Index; Modified Oswestry Disability Index; Quick Disabilities of the Arm, Shoulder and Hand and the Lower Extremity Functional Scale. One hundred subjects per body region were enrolled. Subject's rated their perceived improvement based on the 15-point Global Rating of Change questionnaire. Minimal clinically important differences (MCID) were calculated via receiver operator characteristic curve. Test-retest reliability coefficients were good to excellent. Validity correlations with the reference standard measures were acceptable (r > 0.7) for all subscales. MCID for the cervical subscale = 7 points, lumbar = 8 points, upper extremity = 16 points and lower extremity = 11 points. The results of this study support the use of the CCFI in outpatient physical therapy practice as a responsive tool with good reliability and validity. The results also indicate that future work should focus on the impact of baseline patient factors that may affect future outcome.

Are scores on the physical performance test useful in determination of risk of future falls in individuals with dementia?

BACKGROUND AND PURPOSE: Presence of dementia influences postural control and increases fall risk. The 7-item physical performance test (PPT) is a valid measure of balance in older adults; however, its validity has not been established in people with dementia. The purpose of this research was to establish predictive validity of the PPT for falls in people with dementia. METHODS: Subjects with dementia (N=34, mean MMSE score 18.4 + 3.3) were tested with the PPT and then followed for four months for fall occurrences. DATA ANALYSIS: A stepwise logistic regression (variables of age, previous history of a fall, and PPT score) determined predictors of a fall. Sensitivity, specificity, and likelihood ratios for each of the significant measures were calculated. RESULTS: Twelve subjects (35%) reported at least one fall in the four months. History of a fall in the previous six months was the only significant predictor of a subsequent fall (p=.044), increasing the odds by almost five times. Calculated sensitivity and specificity for history of a fall were 58% and 77% respectively and positive and negative likelihood ratios were 2.52 and .58 respectively. DISCUSSION: A fall in the previous six months was the strongest predictor of a fall in the subsequent four months in people with dementia. Score on the PPT was not a significant predictor of falls. Further research is warranted, however, since 8 of the 13 subjects falsely identified as a faller by their PPT score (false positives) had other strong indicators of postural control dysfunction.

Self-reported musculoskeletal pain in Latino vineyard workers.

The agricultural economy in the United States is dependent on millions of Latino migratory workers. Despite the health risks associated with this line of work, many agricultural workers lack health insurance or access to health care services. The purpose of this study was to collect demographic data and investigate the musculoskeletal health of Latino migratory vineyard workers. A physical therapy team collected demographic data at health clinics held at vineyards in Oregon. Nearly half (48.4%) of all vineyard workers reported experiencing musculoskeletal symptoms (MSS) in at least one region of the body. The primary region of reported MSS was the back (32% of all men and 43.7% of all women). In most cases, those who reported MSS were significantly older than those who did not report MSS. Future research is necessary to identify personal and work related injury risk factors in order to develop prevention programs.

In-season rehabilitation of a division III female wrestler after a glenohumeral dislocation.

OBJECTIVE: Wrestling is a popular sport in the United States at both the high school and collegiate levels. Traditionally a men's sport, participation by female athletes in wrestling is increasing. There exists a paucity of literature regarding injury incidence in women's wrestling. This lack of information challenges the ability of sports medicine and strength training professionals to design optimal injury prevention programs, training routines, and rehabilitation strategies. The objective of this report is to detail the successful conservative rehabilitation of a female wrestler after an initial glenohumeral dislocation. DESIGN: Case report. CASE DESCRIPTION: A 20-year-old female wrestling student-athlete presented to the university's sports medicine team after sustaining an anteriorly dislocated right shoulder. The patient had the goal to return back to competition in time for the National Championships. An evidenced-supported, non-traumatic glenohumeral instability rehabilitation protocol combined with weight-bearing exercises simulating functional sport positions was implemented with the goal of returning the injured collegiate female wrestler back to sport. RESULTS: At the end of the rehabilitation program the athlete demonstrated full active range of motion, good strength in the right shoulder, and reported her pain rating at a 1/10. The conservative rehabilitation strategy utilized in this case enabled the patient to return to wrestling and successfully compete at the National Championships.

Comprehensive Sports Medicine Treatment of an Athlete Who Runs Cross-Country and is Iron Deficient.

BACKGROUND: Optimal athletic performance may be dependent upon an athlete maintaining adequate iron levels through the consumption of dietary forms of iron and subsequent metabolism. Endurance athletes, especially female distance runners, have been identified as being at risk for developing iron deficiency. While iron deficiency is treatable, early diagnosis may be delayed if an adequate medical history and evaluation is not conducted. OBJECTIVE: To describe the evaluation, diagnosis, and comprehensive sports medicine treatment of a collegiate cross-country athlete with a medical diagnosis of iron deficiency with anemia and sports-related musculoskeletal pain. CASE DESCRIPTION: A 21-year-old female collegiate cross-country athlete experienced a decline in her running performance beginning her freshman year of school. She continued to experience degradation in sports performance despite medical intervention. Two-and-a-half years after initially seeking medical attention she was diagnosed with iron deficiency with anemia by a primary care medical doctor. Additionally, the subject required rehabilitation due to the onset of sports-related musculoskeletal symptoms. OUTCOMES: Comprehensive treatment for this patient consisted of iron supplementation, therapeutic exercises, manual therapy, and modalities. The athlete was able to compete during her entire cross-country season and earn All-American status at the Division-III level. DISCUSSION: Sports medicine professionals must consider iron deficiency as a possible differential diagnosis when evaluating endurance athletes. Subtle signs of iron deficiency may, unfortunately, be overlooked ultimately delaying treatment.