Physiotherapist observation of cervical alignment in a sitting position
Leanne Passier
Objectives of Professional Activity
The objective of this project is to complete data analysis and prepare for publication the results of the research project entitled ‘Physiotherapist observation of cervical alignment in a sitting position’. This is a sub study of the Acute Brain Injury Physiotherapy Assessment (ABIPA) project which aimed to examine the concurrent validity of visual observation compared to a gold standard and inter-rater reliability of physiotherapist classifications of head and neck positions according to the ABIPA alignment subscale. In determining the validity and reliability of the ABIPA instrument as a whole, individual components of the assessment tool should demonstrate good to excellent clinometric properties individually. Data collection for this study was completed in June 2006, however due to the clinical demands of the investigators further progress has been limited. This funding will provide for time off line to write the paper for publication. One team member is a research fellow who will complete data analysis and provide guidance in the interpretation of results.
Specialist rehabilitation services are provided by Princess Alexandra Hospital for patients with brain injury in the Brain Injury Rehabilitation unit and acutely in the Neurosurgical Unit. These patients have a long period of recovery. In the initial phase correct alignment and positioning of body segments influences muscle length, joint range, tonal presentation and overall function. Head alignment is shown to influence overall body postures and is an important initial treatment point. Physiotherapists need to be able to quickly and accurately assess the alignment of head position in order to implement appropriate intervention. In addition to investigating the ABIPA tool this study will provide information about the validity of visual assessment, which is utilised broadly by neurological physiotherapists.
Lay Description of Professional Activity
The Acute Brain Injury Physiotherapy Assessment (ABIPA) is a quantitative assessment tool for patients with severe brain injury. ‘Physiotherapist observation of cervical alignment in a sitting position’ is a sub study which tested one component of the ABIPA, the physiotherapists’ ability to visually assess if a patient’s head is in a neutral position or malaligned in any plane of movement. Previous studies have investigated the accuracy and validity of tools for measuring cervical range of movement however; in acute severe brain injury overall head alignment is more clinically relevant than exact measures. The ability to visually assess head alignment is of significant clinical relevance to therapists, particularly in the areas of neurology and musculoskeletal physiotherapy. This project will complete the data analysis and prepare for the results for publication.
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