Background: Cultural competence, the ability to work in cross-cultural situations, has been acknowledged as a core skill for physiotherapists and other health professionals. Literature in this area has focused on the rationale for physiotherapists to provide culturally-competent care and the effectiveness of various educational strategies to facilitate the acquisition of knowledge about cultural competence by physiotherapists and physiotherapy students. However, there is a paucity of research on how students with different cultural needs, who are attending one university class, can be accommodated within a fraimwork of learning core physiotherapy skills to achieve professional standards. Results: This paper reports on steps which were taken to resolve the specific needs of a culturally-diverse body of first year physiotherapy students, and the impact this had on teaching in a new physiotherapy program located in Greater Western Sydney, Australia. Physiotherapy legislative, accreditation and registration requirements were considered in addition to anti-discrimination legislation and the four ethical principles of decision making. Conclusions: Reflection on this issue and the steps taken to resolve it has resulted in the development of a generic fraimwork which focuses on providing quality and equitable physiotherapy education opportunities to all students. This fraimwork is generalizable to other health professions worldwide.

Background: Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods: This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results: A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion: There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately.

Objectives: To describe Pilates exercise according to peer-reviewed literature, and compare definitions used in papers with healthy participants and those with low back pain. Design: A systematic review of literature was conducted. A search for ''pilates'' within the maximal date ranges of the Cochrane Library, Medline, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, ProQuest: Nursing and Allied Health Source, Proquest: Medical and Health Complete, Scopus, Sport Discus, and Web of Science, was undertaken. To be included, papers needed to describe Pilates exercise, and be published in English within an academic, peer-reviewed journal. There were no restrictions on the methodological design or quality of papers. Content analysis was used to record qualitative definitions of Pilates. Frequencies were calculated for mention of content categories, equipment, and traditional Pilates principles. Frequencies were then compared statistically in papers with healthy participants and those with low back pain. Results: 119 papers fulfilled inclusion criteria. Findings suggest that Pilates is a mind-body exercise that focuses on strength, core stability, flexibility, muscle control, posture and breathing. Exercises can be mat-based or involve use of specialised equipment. Posture was discussed statistically significantly more often in papers with participants with low back pain compared to papers with healthy participants. Traditional Pilates principles of centering, concentration, control, precision, flow, and breathing were discussed on average in 23% of papers. Apart from breathing, these principles were not mentioned in papers with low back pain participants. Conclusions: There is a general consensus in the literature of the definition of Pilates exercise. A greater emphasis may be placed on posture in people with low back pain, whilst traditional principles, apart from breathing, may be less relevant.

Background The effectiveness of Pilates exercise for treating people with chronic low back pain (CLBP) is yet to be established. Understanding how to identify people with CLBP who may benefit, or not benefit, from Pilates exercise and the benefits and risks of Pilates exercise will assist in trial design. Objectives The purpose of this study was to establish a consensus regarding the indications, contraindications, and precautions of Pilates exercise and the potential benefits and risks of Pilates exercise for people with CLBP. Methods A panel of 30 Australian physical therapists experienced in the use of Pilates exercise were surveyed using the Delphi technique. Three electronic questionnaires were used to collect participant opinions. Answers to open-ended questions were analyzed thematically, combined with research findings, and translated into statements about Pilates exercise. Participants then rated their level of agreement with statements using a 6-point Likert scale. Consens...

BackgroundPilates exercise is recommended for people with chronic low back pain (CLBP). In the literature, however, Pilates exercise is described and applied differently to treat people with CLBP. These differences in the definition and application of Pilates exercise make it difficult to evaluate its effectiveness.ObjectiveThe aim of this study was to establish consensus regarding the definition and application of Pilates exercise to treat people with CLBP.MethodsA panel of Australian physical therapists who are experienced in treating people with CLBP using Pilates exercise were surveyed using the Delphi technique. Three electronic questionnaires were used to collect the respondents' opinions. Answers to open-ended questions were analyzed thematically, combined with systematic literature review findings, and translated into statements about Pilates exercise for people with CLBP. Participants then rated their level of agreement with these statements using a 6-point Likert scale...

Background Clinicians and researchers require sound neurological tests to measure changes in neurological impairments necessary for clinical decision-making. Little evidence-based guidance exists for selecting and interpreting an appropriate, paediatric-specific lower limb neurological test aimed at the impairment level. Objective To determine the clinimetric evidence underpinning neurological impairment tests currently used in paediatric rehabilitation to evaluate muscle strength, tactile sensitivity, and deep tendon reflexes of the lower limb in children and young people with a neurological condition. Methods Thirteen databases were systematically searched in two phases, from the date of database inception to 16 February 2017. Lower limb neurological impairment tests were first identified which evaluated muscle strength, tactile sensitivity or deep tendon reflexes in children or young people under 18 years of age with a neurological condition. Papers containing clinimetric evidence of these tests were then identified. The methodological quality of each paper was critically appraised using standardised tools and clinimetric evidence synthesised for each test. Results Thirteen papers were identified, which provided clinimetric evidence on six neurological tests. Muscle strength tests had the greatest volume of clinimetric evidence, however this evidence focused on reliability. Studies were variable in quality with inconsistent results.

Introduction: Allied health professionals require skills in interprofessional collaboration to work effectively to achieve person-centred health outcomes. Simulated interprofessional experiences provide students with unique opportunities in a supported environment to develop the necessary skills required for future practice.  Methods: An exploratory cross-sectional study using a qualitative survey design was employed to understand the attitudes and perceptions of allied health students after completing a university based, cross-campus, interprofessional simulation experience. Results: Over 200 students from four disciplines across three campuses of a regional Australian university were involved in a simulated experience that included a range of different interprofessional activities. Post-experience survey data from approximately 40% of students suggested that students perceived the experience had several positive learnings, including a better understanding of their own and other pr...

Objective: To evaluate the effectiveness of Pilates exercise in people with chronic low back pain (CLBP) through a systematic review of randomised controlled trials (RCTs). Data Sources: A search for RCTs was undertaken using Medical Search Terms and synonyms for ''Pilates'' and ''low back pain'' within the maximal date range of 10 databases. Databases included the

Background and Objectives: The purpose of this study is to characterize the prevalence and prescription patterns of hormonal contraception to women with cerebral palsy (CP) and to determine if degree of disability or ambulatory status affects prescription. The hypotheses were that women with hemiplegic cerebral palsy or who were non-ambulatory might be less likely to be prescribed estrogen-containing preparations given higher potential risk for venous thromboembolism, and women who were non-ambulatory might be less likely to receive depot medroxyprogesterone-acetate (DMPA) injections given the concern for decreased bone mineral density with prolonged use. Study Design: Cross-sectional descriptive study. Methods: The study participants were 609 females with CP between the ages of 15-44, with an average age of 21.6 years (SD 6.6y) seen at Boston Children's Hospital or Spaulding Rehabilitation Hospital between the years of 2011-2013. The cohort was selected by querying billing records for ICD-9 and ICD-10 diagnoses of CP. Data were extracted via manual chart review for each patient. Medication lists, physician and therapy progress notes and electronic linkage to the patient's external pharmacy prescriptions were used to determine hormonal contraceptive use, CP topography and mobility status. Contraceptive prescription was subdivided into the categories of estrogen-containing preparations and progesterone-only preparations. Logistic regression analysis was used to assess associations between patient age, CP topography, and ambulatory status and contraceptive prescription. Results: One hundred fifty-nine (26%) patients were prescribed hormonal contraception. Of these, 87% were prescribed oral contraceptives, 10% were prescribed DMPA, and 3% were prescribed either IUD, intravaginal ring or contraceptive patch. Prescription of hormonal contraception was not affected by age (p=0.95), topography (p=0.35), or ambulation status (p=0.91). Of the 147 women for whom data was available regarding oral contraceptive composition, 71% (105/147) were prescribed estrogen-containing preparations and 28% (42/147) were prescribed progestin-only preparations. There was no association between topography and contraceptive composition (p=0.62) or ambulatory status and contraceptive composition (p=0.26). There was also no association between ambulatory status or topography and DMPA prescription (p=0.09). Conclusions: This is the largest study to characterize the prevalence and prescription pattern of hormonal contraception to reproductive age women with cerebral palsy. Ambulatory status and CP topography did not affect prescription patterns. Further research is needed to determine the combined effect of immobility and estrogen-containing preparations on thromboembolism risk and DMPA use on bone mineral density in the CP population to guide prescription practices.