Hong Kong Physiotherapy Journal最新文献

Background: Exergames have gained attention as interactive technologies that combine exercise and gaming to enhance rehabilitation outcomes. Despite their potential, their use in clinical practice remains limited in Saudi Arabia. A validated survey was administered to healthcare practitioners to investigate their familiarity and attitudes (advantages and barriers) towards the utilisation of exergames in rehabilitation settings.

Objective: The objective was to identify the factors influencing the successful implementation of exergames as a therapeutic modality.

Methods: A cross-sectional study design was used to investigate healthcare practitioners' familiarity and attitudes towards exergames in rehabilitation settings in Saudi Arabia. A survey was developed to encompass these three constructs. A conceptual framework for the survey was established through a comprehensive literature review and expert consultation to ensure the content's validity and comprehensiveness.

Results: A total of 244 responses were received, mainly from physiotherapists and occupational therapists. The findings indicated that the use of exergames in rehabilitation was limited, with only 17% of healthcare practitioners ( $n=42$ /244) reporting their use. Despite this, there was an overall positive attitude towards exergames. The most commonly reported advantage of exergames was their ability to increase training motivation ( $n=231$ /244, 95%), while the primary barrier to adoption was the cost associated with purchasing the necessary devices and games ( $n=186$ /244, 76%).

Conclusion: The reported advantages of using exergames significantly outweighed the perceived barriers, suggesting a positive attitude and high acceptance rate among healthcare practitioners in Saudi Arabia towards this technology.

Background: Self-efficacy in pain sufferers includes beliefs about one's capacity to tolerate pain. For usage by Arabic-speaking individuals, the Chronic Pain Self-Efficacy Scale (CPSS), which was initially developed in English, must be translated and modified into the Arabic language.

Objective: To assess the CPSS's psychometric qualities for subjects suffering from chronic pain in Arabic.

Methods: This was a cross-sectional survey that followed Beaton et al.'s guidelines. The CPSS underwent cross-cultural adaptation and Arabic translation in the initial phase. Then, the reliability and validity of the Arabic version of CPSS were examined. A total of 329 patients completed the questionnaire (40.7% males and 59.3% females).

Results: The subscales had good internal consistency, the Cronbach's alpha was 0.870 for subscale 1 (self-efficacy for managing pain), 0.935 for subscale 2 (physical function self-efficacy), and 0.925 for subscale 3 (coping with other symptoms self-efficacy). Test-retest total scores had an acceptable intraclass correlation coefficient (ICC) of 0.743 (95% CI -0.29 to -0.196, $p=0.92$ ). When performing principal component analysis with varimax rotation [exploratory factor analysis $(\text{EFA})>0.4$ ], the test is helpful. Regarding construct validity, the correlation between the total score of Beck depression inventory (BDI) and CPSS subscales and total score have significant moderate negative correlations ( $r=-0.479$ ; $p=0.001$ ) except the pain management subscale has significantly weak negative correlations ( $r=-0.345$ ; $p=0.001$ ).

Conclusion: The Arabic version seems to be a reliable and valid instrument for evaluating a person's self-efficacy in chronic pain among Arabic-speaking individuals making it a good and acceptable instrument.

Background: Patients with stroke experience hemiparesis causing secondary problems like structural changes, malfunction, and low quality of life over time.

Objective: This study aimed to investigate the relationship between shoulder musculoskeletal factors and the upper limb function in patients with stroke.

Methods: Eighteen patients with hemiplegic stroke participated in this study. Acromion-greater tuberosity (AGD) distance and muscle thickness (supraspinatus and deltoid) were measured on both the affected and non-affected sides. Jebsen-Taylor Hand Function Test (JHFT) was undertaken to evaluate the patient's upper limb function. The differences between affected and non-affected shoulder complex parameters, and the correlation between shoulder musculoskeletal factors and upper limb function were analysed.

Results: All parameters were significantly different between the affected and non-affected sides (p < 0.05) except for the AGD. There was a moderate negative correlation between shoulder muscle thickness (supraspinatus and deltoid) and the upper limb function in the chronic hemiplegic stroke.

Conclusion: This study confirmed that there is a relationship between supraspinatus, deltoid muscle, and the upper limb function. These results emphasise the importance of targeted interventions to prevent muscle atrophy and improve shoulder strength and provide valuable insights into the rehabilitation of chronic hemiplegic stroke in a clinical setting.This work was carried out under the Registration KCT0005574.

Background: Achieving community ambulation is a common goal for many patients seeking to improve their quality of life. Rehabilitation professionals are tasked with preparing patients to meet the demands of their environment. In Singapore, rapid infrastructural development over the past two decades could alter these environmental challenges and affect functional community ambulation.

Objectives: This study aims to provide current recommendations of distance, step count and speed requirements for therapists to determine their patients' suitability for community ambulation in Singapore, as well as to deepen understanding of current environmental barriers and enablers.

Methods: A quantitative surveillance data collection was conducted on 510 public housing blocks sampled across the country (North, North-East, Central, East and West sectors) to determine ambulation requirements for accessing five essential amenities of daily living (eatery, clinic, grocery, automated teller machine and public transport). Measurements of distance, step count and number of obstacles encountered en route to each amenity were collected. Walking speed was calculated by measuring the length and time allocated for traffic junction crossings.

Results: The average distance to amenities was found to be 294.3 m, with 441 steps taken. Public transport was the nearest amenity (190.8 m), while grocery stores were the furthest (382.7 m). There was a significant variation in the distance to reach amenities (ranging from 10.0 m to 1611.2 m). The most common obstacles encountered were curbs and stairs. The average walking speed to cross traffic junctions safely was 0.74 m/s.

Conclusion: This study aids rehabilitation professionals in better understanding Singapore's urban landscape and planning realistic rehabilitation goals with their clients to achieve functional community ambulation.

Objective: To investigate the effectiveness of the standardised stroke upper extremity rehabilitation program with stratification using shortened Fugl-Meyer assessment (S-FM).

Methods: A new stroke upper extremity rehabilitation program was designed. Participants were randomly allocated to standardised program group or conventional training group. Both groups received training for 60-90 min/session, 5 sessions/week and 5-20 sessions in total. Outcome measures, including S-FM, functional test for the hemiplegic upper extremity (FTHUE) and modified Barthel index (MBI), were taken before and after training.

Results: Outcomes of 19 participants in standardised program group and 20 participants in conventional training group were analysed. Both groups showed improvements in S-FM, FTHUE and MBI after training but there were no statistically significant interactions between the groups, upper extremity impairment levels and time. In participants with severe upper extremity impairment, the standardised program group showed greater improvements in S-FM and FTHUE compared to the conventional training group, with the change in S-FM exceeding the minimal clinically important difference. However, these differences did not reach statistical significance.

Conclusion: The standardised stroke upper extremity rehabilitation program with S-FM stratification may have slightly better upper extremity functional outcomes in people with stroke having severe upper extremity impairment when compared to the conventional training.Clinical trial registration number: NCT06902948.

Background: Anterior cruciate ligament reconstruction (ACLR) often results in residual strength deficits in knee muscles, which may affect an athlete's return to performance. Isokinetic testing and thigh circumference measurements offer valuable insights into recovery, with thigh circumference potentially serving as a quick indicator of quadriceps strength.

Objectives: To evaluate the isokinetic capability of knee extensors and flexors two years after ACLR and examine the correlation between isokinetic peak torque of knee extensors and thigh circumference of the operated limb.

Methods: Seventeen professional soccer players, two years post-ACLR, participated. Thigh circumference was measured at 10 cm and 20 cm from the patella. The peak torque of knee flexors and extensors was assessed at various speeds. Hamstring-to-quadriceps ratios (H/Qconv and H/Qfunc) were evaluated. Paired-Samples T Test compared peak torque, thigh circumference, H/Qconv, and H/Qfunc between limbs. Pearson Correlation determined the relationship between peak torque of knee extensors and thigh circumference.

Results: Two years post-ACLR, peak torque was significantly reduced for knee extensors at 60^∘/s, 180^∘/s, and 300^∘/s ( $p<0.05$ ) and for knee flexors at 60^∘/s ( $p=0.038$ ). No significant differences were found for H/Qconv and H/Qfunc. Thigh circumference differed significantly at 20 cm from the patella ( $p=0.030$ ) and correlated with the peak torque of knee extensors ( $r=0.770$ -0.863).

Conclusions: Knee extensors and flexors show reduced peak torque two years post-ACLR. A strong correlation exists between peak torque of knee extensors and thigh circumference. Isokinetic evaluation is effective at functional velocities, and thigh circumference measurement is a viable alternative for assessing quadriceps strength.

Background: Stress and sedentary lifestyles negatively impact the physical fitness of overweight and obese female university students. Physical activity has been shown to promote psychological as well as physical wellness. However, the effects of Surya Namaskar (SN) yoga on stress and physical fitness remain unclear.

Objective: This study aimed to compare the physical fitness, anthropometric measures, and perceived stress between the SN yoga training program group and the control group.

Methods: In a randomized controlled study, 44 overweight and obese female university students participated. For 8 weeks, the exercise group received training in SN yoga, whereas the control group was not permitted to participate in any form of exercise. At baseline and after 8 weeks of training, all participants completed the Thai Perceived Stress Scale-10 (T-PSS-10), and assessed the body mass index (BMI), waist-hip ratio, body fat percentage, maximum oxygen consumption (VO₂max), and muscle strength and flexibility. We used the dependent t-test or Wilcoxon sign rank test to examine the differences between the T-PSS-10 and physical fitness within each group. The statistical differences of all parameters between the two groups were compared using an independent t-test or a Mann-Whitney U test. A p- $\text{value}<0.05$ was considered statistically significant.

Results: Compared to the baseline, the SN yoga group's post-training period had a significant increase ( $p<0.05$ ) in forward back flexibility, hand grip strength, leg strength, and VO₂max, while a significant decrease ( $p<0.05$ ) in T-PSS-10 scores and BMI. In addition, we found a significant difference between the both groups in forward back flexibility and T-PSS-10 scores in the post-training period ( $p=0.015$ and $p=0.009$ , respectively).

Conclusion: This study's findings demonstrated that SN yoga is a useful exercise for enhancing overweight and obese female university students' perceived stress scales and physical fitness.

Background: Improvements for knee osteoarthritis (OA) care models are carried out widely. Yet, patient attendance behaviours in present care models are not fully understood, without the readily available localised evidence.

Objective: Hence, we examined the relationships of patient-specific factors with the physiotherapy attendance for patients with knee OA.

Methods: A retrospective, cohort study was conducted. Primary data from a randomised controlled trial of a community-based, individualised, multidisciplinary programme for patients with knee OA was analysed. Patient-specific factors like demographics, medical factors, self-reported knee function, physical function testing, activity levels and psychological factors were considered. We ran multiple ordered logistic models to examine the relationships between these factors and patients' physiotherapy attendance.

Results: We found that factors like gender, BMI, pain during physical function, previous knee injections and psychological symptoms were associated with the physiotherapy attendances of patients with knee OA.

Conclusion: There's evidence to suggest that patient-specific factors are associated with different levels of physiotherapy attendance among the patients with knee OA. Our results further the understanding of physiotherapy attendance patterns of patients with knee OA, and reinforces the need to consider these factors when developing informed treatment strategies that optimises the physiotherapy attendance of these patients.

Ataxia telangiectasia (AT) is a rare neurodegenerative condition with a prevalence of 1 in 40,000 to 1 in 300,000 worldwide. It involves a genetic mutation of chromosome 11q.26. The condition is inherited in an autosomal recessive manner causing atrophy of the cerebellum due to loss of Purkinje fibres. AT presents early in childhood and the clinical features depend on the type of mutation. The study is a case report of a rare genetic disorder of a 9-year-old female who came to the physiotherapy clinic with a diagnosis of AT. The patient was presented with progressively worsening gait problems with frequent falls, with complete dependence on assistance and impaired balance and coordination. The treatment program was 12 months divided into an intense physiotherapy program for two months followed by 10 months of two times per week of physiotherapy sessions. The program was divided into four elements which are: (1) Lifestyle changes, (2) Strengthening exercises, (3) Coordination exercises, and (4) Balance training exercises. The result showed a positive outcome in increasing the patient's independence, increased muscle strength, reduced ataxia symptoms intensity, and the patient can carry out complex activities with the help of accessory orthosis devices.