Repeatable measures are essential for clinicians and researchers alike. Both need baseline measures that are reliable, as intervention effects cannot be accurately identified without consistent measures. The intrarater and interrater reliability of the new Foot Posture Index and current podiatric measures of foot position were assessed using a same-subject, repeated-measures study design across three age groups. The Foot Posture Index total score showed moderate reliability overall, demonstrating better reliability than most other current measures, although navicular height (normalized for foot length) was the single most reliable measure in adults. None of the tested measures exhibited adequate reliability in young children, and, with less-than-desirable reliability being demonstrated, most measures need to be interpreted accordingly when repeated measures are involved.

The 6-min walk test (6MWT) is increasingly being used as a measure of 'functional ability' in young people with cerebral palsy, despite a lack of published evidence that it is reliable for this population. This study aimed to determine the test-retest reliability of the 6MWT for ambulant 11-17-year-old adolescents with cerebral palsy. Adolescents with cerebral palsy were invited to participate in a single testing session. They performed the 6MWT twice under controlled conditions (standardized 10 m course layout, standardized instructions and encouragement), with a 30-min rest. Forty-one participants (response rate 36.6%) were recruited (26 males, 15 females; mean age 13.6+/-1.6 years). No significant difference was found between the 6-min walk distance in trials 1 and 2 for the whole group (448.7+/-96.9 m vs. 449.5+/-102.1 m; P=0.81) or by sex and gross motor function subsets. The test-retest intraclass correlation coefficient was 0.98. Bland-Altman analyses revealed a bias of only -0.9 m, and that in 95% of cases, the second 6-min walk distance would fall within +/-43.1 m of the first 6-min walk distance. All participants successfully managed the testing procedure, appeared to understand what was expected of them, and experienced no ill effects from the 6MWT. These results indicate that, when carried out according to American Thoracic Society guidelines, the 6MWT is a reliable test for young ambulant people with cerebral palsy.

A prospective, blinded, randomised controlled trial investigated the effectiveness of quadriceps exercises following anterior cruciate ligament reconstruction. A treatment group (Quadriceps exercise group) performed straight leg raises and isometric quadriceps contractions throughout the first two postoperative weeks, and a second group (No quadriceps exercise group) did not. A battery of outcome measures assessed subjects postoperatively at day one, two weeks, and one, three and six months. A total of 103 patients (Quadriceps exercise n = 48, No quadriceps exercise n = 55) commenced the study with 91 subjects available at final follow up (Quadriceps exercise n = 47, No quadriceps exercise n = 44). Performance of quadriceps exercises significantly improved a number of knee flexion and extension range of motion measurements (p = 0.01 to 0.04). No significant differences were found between the two groups at any postoperative period for quadriceps lag (p = 0.36), functional hop testing (p = 0.49 to 0.51), isokinetic quadriceps strength (p = 0.70 to 0.72), the majority of numerical analogue scores (p = 0.1 to 0.94) and Cincinnati scores (p = 0.10 to 0.84). Subjects performing quadriceps exercises reported significantly higher pain scores with exercise on the first postoperative day (p = 0.02). At six months postoperatively, the Quadriceps exercise subjects reported significantly more favourable Cincinnati scores for symptoms (p = 0.005) and problems with sport (p = 0.05). While average knee laxity was not significantly different between treatment groups over time (p = 0.27 to 0.94), quadriceps exercise performance was associated with a significantly lower incidence of abnormal knee laxity. Isometric quadriceps exercises and straight leg raises can be safely prescribed during the first two postoperative weeks and confer advantages for faster recovery of knee range of motion and stability. It remains to be proven whether the magnitude of differences between groups is clinically significant.

Background: Respiratory muscle training has been shown to improve both its strength and endurance. The effect of these improvements on whole-body exercise performance remains controversial. Objective: To assess the effect of a 10 week inspiratory resistive loading (IRL) intervention on respiratory muscle performance and whole-body exercise endurance. Methods: Fifteen apparently healthy subjects (10 men, 5 women) were randomly allocated to one of three groups. One group underwent IRL set at 80% of maximum inspiratory pressure with ever decreasing work/rest ratios until task failure, for three days a week for 10 weeks (IRL group). A second placebo group performed the same training procedure but with a minimal resistance (PLA group). IRL and placebo training were performed at rest. The remaining five control subjects performed no IRL during the 10 week study period (CON group). Cycling endurance capacity at 75% V O 2 peak was measured before and after the intervention. Results: After the 10 week IRL intervention, respiratory muscle strength (maximum inspiratory pressure) and endurance (sum of sustained maximum inspiratory pressure) had significantly improved (by 34% and 38% respectively). An increase in diaphragm thickness was also observed. These improvements translated into a 36% increase in cycling time to exhaustion at 75% V O 2 peak. During cycling trials, heart rate, ventilation, and rating of perceived exertion were attenuated in the IRL group. No changes were observed for the PLA or CON group either in the time to exhaustion or cardiorespiratory response to the same intensity of exercise. Conclusion: Ten weeks of IRL attenuated the heart rate, ventilatory, and perceptual response to constant workload exercise, and improved the cycling time to exhaustion. Familiarisation was not a factor and the placebo effect was minimal.

Electrophysical agents (EPAs) are a core part of physiotherapy practice and entry level education. With the increase in the number of EPAs over time, their availability and use in contemporary physiotherapy practice is an important consideration when determining entry level curricula. Thus, the aim of the study was to ascertain the current availability and usage of EPAs in Australian physiotherapy practice. A purpose-designed questionnaire was mailed to all registered physiotherapists in Australia. A response rate of 27% was obtained (n=3,538). Nonresponder analyses indicated that the results were representative of the total population of Australian physiotherapists. Over 70% of respondents had access to ultrasound, cold packs/ice, heat packs, electrical stimulation for sensory stimulation, and interferential therapy. Two main groups of EPAs were used relatively frequently. The first group was used daily or monthly by 60% of respondents (ultrasound, hot packs, and cold packs/ice), and a second group (electromyographic and pressure biofeedback, interferential therapy, and electrical stimulation for sensory stimulation) was used on a daily or monthly basis by between 30% and 45% of the sample. A group of EPAs, including ultraviolet light, microwave, and shortwave diathermy, was not used by over 90% of the sample. The study has provided contemporary national data on EPA availability and use in Australia.