Updates: sharing the latest evidence.

Can you list the appropriate tests to identify a patient with unilateral neglect following a stroke? (1) Can you describe the most common characteristics of children with developmental coordination disorders? (2) Can you discuss the latest data about the growing obesity epidemic?(3) You could--if you had read the Updates published this year in Physical Therapy.

An Update is a brief and credible review of a topic that is important to physical therapists. This review is meant to be reader friendly and is not meant to be an exhaustive, or "exhausting," review. The typical Update submission is generally 12 double-spaced typed pages. It's intended to provide meaningful information to physical therapists who are unfamiliar with the topic. Although Updates aren't exhaustive, they have to be credible, summarizing the most important and recent data on the topic.

Because of the intended wide audience, "experts" in the given area may be bored with an Update. In fact, our content experts sometimes can be overly critical when reviewing an Update because they rightly believe that it does not push the given field forward. But Updates are not intended to push research forward. Updates are intended to bring the latest evidence, in a reader-friendly manner, to busy readers and clinicians who can use the information.

With this goal in mind, air Update includes only data or information that have been previously published. You won't see descriptions about a new patient; our Case Reports fulfill that need. Likewise, you won't find data from a new experiment; our Research Reports do this job. You won't find new perspectives or opinions in an Update, either; established authors can contact the Editor in Chief and submit their opinions as a clinical or professional Perspective. Again, the purpose of an Update is simply to report important peer-reviewed evidence that already has been published elsewhere.

The results of our 1999 readership survey (a sample of 2,500 members with a 67% return rate) suggested that you, the Journal readers, would also like to see more Updates. The Update category had the highest rank in "interest" of all manuscript categories: 86% of readers were either interested or very interested. We publish about 4 or 5 Updates per year, but we'd like to receive, and publish, more.

What is an appropriate topic for an Update? Anything that is important to physical therapy is "fair game" for an Update topic. A review of previously published Updates (www.ptjournal.org/info/updates/updates_titles.cfm) shows the wide range of potential topics. We have published Updates reviewing basic science and physiological issues related to muscle,(4) appropriate components of a clinical examination for the sacroiliac joint region, (5) and criteria for making appropriate diagnoses. (1, 6, 7) An almost infinite number of topics remain to be addressed. What topic do you think is important to share with your physical therapy colleagues? Here are just a few possibilities:

* Effects of exercise on a specific problem, such as manual therapy for osteoarthritis of the knee, appropriate exercise for patients with osteoporosis, increased activity for prevention of type 2 diabetes, aerobic exercise for patients with rheumatoid arthritis, and pelvic floor muscle exercise in the management of patients with incontinence.

* Descriptions of tests, reliability and validity of measurements obtained with those tests, and appropriate uses of tests. From the Sickness Impact Profile (SIP), to the Physical Performance Test, to the Oswestry tests, to the Functional Independence Measure (FIM), to the SF-36--Updates are needed on almost every test used by physical therapists!

* Effects of pharmacological agents, such as beta blockers for patients during cardiac rehabilitation, current medications to manage increased reflex activity (spasticity), and glucosamine for osteoarthritis.

* Effects of orthotic or prosthetic devices for a specific problem, such as splints for carpal tunnel syndrome, foot orthoses for patients with knee pain, braces to prevent anterior cruciate ligament injury, braces and taping to prevent ankle sprains, and braces for scoliosis. Other topics could include comparison of energy-storing feet for patients with transtibial amputation and the current status of osteointegration for patients with transfemoral amputation.

* Descriptions of statistical analyses, such as odds ratios, risk ratios, confidence intervals, and magnitude scaling.

* Effects of modalities on a specific problem, such as ultrasound for integumentary repair and electrical stimulation to augment muscle force production.

* Descriptions of specific classification systems, staging criteria for Parkinson disease, and classification systems for wounds.

Who can write Updates? We welcome clear and credible Updates from new or experienced authors. Some of our best Updates have been submitted by graduate students and new faculty members. Without exception, these graduate students and new faculty members have had mentoring from an experienced author. Writing an Update is not as complex as writing a Research Report, but publishing any article in a peer-reviewed journal goes well beyond English 101, and most authors benefit from a mentor who can help them focus on a topic and select the most critical evidence. We recommend that all prospective authors review previously published Updates to understand the expectations for a successful Update better.

Experienced authors also should consider submitting an Update. Are you a physical therapist who typically conducts your research in other fields and publishes your work in other journals? If so, the Update provides a good opportunity for you to share your relevant findings with the 65,000-plus universe of Physical Therapy subscribers. Or perhaps you have an exceptional graduate student who needs more practice in scientific writing. An Update is an excellent mechanism to engage students in scholarly activity through submission to and publication in a peer-reviewed journal.

Updates are designed to be useful and meaningful to you, the readers and authors of Physical Therapy. If you are a busy clinician, we want the Update to provide you with credible information that will help you manage your patients as an evidence-based practitioner. If you are an author, new or experienced, we want Updates to provide you with a mechanism for sharing your work or your interest through a brief review.

Our profession can thrive and grow only when its members have access to the latest credible information. The Update category is just one way for the Journal to provide that access--and one more way for you to participate in your profession's growth.

Michael J Mueller, PT, PhD Editor--Updates

References

(1) Plummer P, Morris ME, Dunai J. Assessment of unilateral neglect. Phys Ther. 2003;83:732-740.

(2) Barnhart RC, Davenport MJ, Epps SB, Nordquist VM. Developmental coordination disorder. Phys Ther. 2003;83:722-731.

(3) Racette SB, Deusinger SS, Deusinger RH. Obesity: overview of prevalence, etiology, and treatment. Phys Ther. 2003;83:276-288.

(4) Scott W, Stevens J, Binder-Macleod SA. Human skeletal muscle fiber type classifications. Phys Ther. 2001;81:1810-1816.

(5) Freburger JK, Riddle DL. Using published evidence to guide the examination of the sacroiliac joint region. Phys Ther, 2001:81:1135-1143.

(6) Russek LN. Hypermobility syndrome. Phys Ther. 1999;79:591-599.

(7) Krsnich-Shriwise S. Fibromyalgia syndrome: an overview. Phys Ther. 1997;77:68-75.