Hong Kong Physiotherapy Journal最新文献

Background: IPAQ-LF is a widely used tool for subjective assessment of physical activity. It has been translated, cross-culturally adapted into many languages and tested in many countries around the world. However, no Hindi version of the long-form of this questionnaire exists till date.

Objective: To cross-culturally adapt the IPAQ-LF from English to Hindi language and to evaluate its reliability and validity.

Methods: The guidelines by IPAQ Committee were followed for cross-cultural adaptation process. The Test-retest reliability was assessed on 60 participants by administering Hindi IPAQ-LF twice within two-week time frame. The construct validity was assessed by comparing with seven-day pedometer recording.

Results: Excellent reliability was observed between total physical activity scores on repeated Hindi IPAQ-LF administrations, with interclass correlation coefficient of 0.963 at 95% confidence interval. The ICC for job, transport, Housework and Leisure domain was calculated to be 0.923, 0.839, 0.862 and 0.939, respectively, suggesting excellent reliability. The Cronbach's alpha computed (0.82) suggests good internal consistency. The Hindi Version of IPAQ-LF also demonstrated good construct validity with Spearman correlation coefficient of 0.783. Bland-Altman analyses were performed to evaluate the level of agreement between two constructs.

Conclusion: The study demonstrates that Hindi version of IPAQ-LF is a reliable and valid tool for assessing physical activity levels for Hindi speaking population.

Background: There is a growing evidence on the benefits of exercise for older people living with dementia in developed countries. However, cultural, health-care systems and environmental differences may impact on the uptake of exercise and outcomes in different regions of the world.

Objective: This study synthesised the available evidence examining the effectiveness of exercise interventions on improving physical function and reducing behavioural symptoms in community-dwelling older people living with dementia in Asia, and the impact on their informal carers.

Methods: Six databases were searched to November 2021. Randomised controlled trials (RCTs) or quasi-experimental studies evaluating exercise interventions for community-dwelling older people with dementia living in Asia were included. The Cochrane risk-of-bias tool for randomised trials and Downs and Black checklist had been used to assess methodological quality of the studies. Meta-analyses using a fixed effects model assessed the effects of exercise interventions where sufficient data were available. Mean difference (MD) with 95% confidence interval (CI) was used to pool results.

Results: Nine studies (five RCTs) were included (Hong Kong-4, China-1, South Korea-2, Taiwan-1, Indonesia-1). Exercise improved dynamic balance [Functional Reach (2 studies, $n=111$ people with dementia), $\text{MD}=2.61$, 95% CI (1.55, 3.67)], but not for the Berg Balance Scale ($\text{MD}=1.10$, 95% CI [-2.88, 5.07]), Timed Up and Go ($\text{MD}=-3.47$, 95% CI [-7.27, 0.33]) and 5 times sit to stand tests ($\text{MD}=-1.86$, 95% CI [-5.27, 1.54]). Single studies where data could not be pooled showed no effect of exercise on behavioural symptoms or impact on informal carers.

Conclusion: Exercise appeared to have a beneficial effect on improving balance performance among older people with dementia living in Asia, however, this evidence is limited and inconsistent, and should be interpreted with caution. Further high-quality large RCTs are necessary for advancing the evidence base of exercise interventions for this population.

Background: Hyperkyphosis is frequently found nowadays due to the change in current lifestyles and age-related system decline. A simple hyperkyphosis measurement can be made easily using the perpendicular distance from the landmark to the wall. However, the existing evidence applied two different landmarks [occiput and the seventh cervical vertebra (C7)] and the measurement using rulers was susceptible to error due to their misalignment.

Objective: To assess an appropriate landmark for thoracic kyphosis measurement using distance from the wall (KMD), by comparing between occiput and C7, as measured using rulers and verified using data from a specially developed machine, the so-called infrared-gun kyphosis wall distance tool (IG-KypDisT), and the Cobb angles.

Methods: Community-dwelling individuals with a risk of thoracic hyperkyphosis (age $\ge 10$ years, $n=43$) were cross-sectionally assessed for their thoracic hyperkyphosis using the perpendicular distance from the landmarks, occiput and C7, to the wall using rulers and IG-KypDisT. Then the Cobb angles of these participants were measured within seven days.

Results: The outcomes from both landmarks differed by approximately 0.8 cm ($p=$ 0.084). The outcomes derived from C7 were more reliable (ICCs>0.93, $p<$0.001), with greater concurrent validity with the radiologic data ($r=$ 0.738, $p<$0.001), with the overall variance predicted by the regression models for the Cobb angles being higher than that from the occiput (47-48% from C7 and 38-39% from occiput). The outcomes derived from rulers and IG-KypDisT showed no significant differences.

Conclusion: The present findings support the reliability and validity of KMD assessments at C7 using rulers as a simple standard measure of thoracic hyperkyphosis that can be used in various clinical, community, and research settings.

Background: Knee Osteoarthritis is the most commonly affected joint among Africans. There is a shred of preliminary evidence that a high body mass index (BMI) is associated with high kinesiophobia. Little is known about the relationships of psychosocial factors such as Kinesiophobia, Pain Catastrophizing (PC), Self-Efficacy (SE), and BMI among Nigerians with knee OA.

Objective: This study aims to determine the relationships between BMI and selected psychosocial factors (kinesiophobia, pain catastrophizing, and self-efficacy) among individuals with knee OA in Nigeria.

Methods: Seventy-seven consecutively sampled patients diagnosed with knee OA from three selected public hospitals in Enugu, South-East Nigeria, participated in this cross-sectional survey. Brief Fear of Movement Scale for Osteoarthritis (BFMSO), Pain Catastrophizing Scale (PCS), and Arthritis Self-Efficacy Scale-8 item (ASES-8 item) were used to assess Kinesiophobia, PC, and SE, respectively. Also, a stadiometer and weighing scale were used to determine height and weight respectively. Data were analyzed using Pearson's correlation coefficient at $p<0.05$ and multiple linear regression.

Results: Participants were aged $58.04\pm 12.46$ years. Female participants had a higher BMI ($31.51\pm 6.82$) than the males ($26.86\pm 3.03$). The mean scores for BMI of the right knee, left knee, and bilateral knees were $29.00\pm 5.35$, $24.78\pm 3.74$, and $33.02\pm 6.80$, respectively. Significant positive correlations were found between BMI and PC ($r=0.35$) whereas significant negative correlations existed between BMI and SE ($r=-0.30$). Significant predictive markers of BMI were PC ($\beta =0.21$) and SE ($\beta =-0.89$).

Conclusion: Body mass index, PC, and SE correlate significantly in individuals with knee OA. The results call for the routine integration of psychologically-informed physiotherapy practice in the management of knee OA.

Background: Patients undergoing Coronary Artery Bypass Graft (CABG) surgery often develop pulmonary complications in the early post-operative period as result of decreased lung function and impaired cough. Conventional physiotherapy in early post-operative period aims at increasing lung volumes and airway clearance.

Objective: This study aimed to determine the effectiveness of the addition of Acapella to conventional chest physiotherapy in improving lung volumes and secretion clearance in early post-operative CABG patients.

Methods: Twenty patients of both genders (40-70 years) who had undergone CABG and were in Phase I of Cardiac Rehabilitation were involved in this pilot randomized control trial (9 control, 11 experimental). Post-surgery intervention commenced on post-operative day 2 (POD 2) and continued till POD 6. Patients in the control group were given conventional physiotherapy that included breathing exercises, incentive spirometry and manual techniques. Patient in the experimental group used an Acapella device along with the conventional intervention. Outcome measures considered were pulmonary function parameters (FVC, FEV1 & PEFR) and amount of sputum expectorated.

Results: A significant increase in lung volumes was observed in both the groups on POD 6 as compared to POD 2 ($\text{both}<0.01$). However, the increase was significantly greater on POD 6 in experimental group than the control group [mean difference (95% CI) FVC: 0.44 L (0.24-0.63), FEV1: 0.43 L (0.19-0.66), PEFR: 0.86 L/s (0.57-1.14)]. The amount of sputum expectoration significantly greater in the experimental group as compared to the control group [2.71 mL (0.53-4.90)].

Conclusion: The addition of Acapella enhanced the effect conventional physiotherapy in improving lung volumes and airway clearance in the early post-operative period for CABG patients.

A shortage of physiotherapist (PT) manpower is a barrier for providing better rehabilitation service in Hong Kong. Quality training can benefit patients with better recovery, on the contrary, insufficient training may cause a longer length of stay, readmission, and thus the burden of healthcare system. The estimated cost for PT services in Hospital Authority was HK$7.0 Billion in 2020. A novel Danish robot with a 7-joint robotic arm became popular in Denmark and Germany in the last two years. The robot is designed for lower limb patient rehabilitation. It can enhance the mobility of patients. Based on the experience of a university hospital in Denmark, this robotic rehabilitation was well accepted by both patients and PTs. Function-wise, the robot provides many clinical benefits to patients, especially stroke ones. A physiotherapist's time can be saved when the robot is being used. The cost-effectiveness of ROBERT${}^{\text{®}}$ is better than PT performing repetitive exercises for lower limbs. The robot potentially provides a cost-effective solution to the Hong Kong healthcare system.

Background: Older individuals face a high risk of mobility and body composition decline, which can affect their independence. In light of a current uncertain healthcare situation created by the coronavirus (COVID-19) pandemic, healthcare paradigm has been shifted with increased demand for a practical measure to promote standard home healthcare services for all individuals, including older adults.

Objective: This study explored the feasibility and validity of seated push-up tests (SPUTs) as clinical measures to reflect the body composition, muscle strength, and mobility among community-dwelling older individuals, aged $\ge 65$ years ($n=82$).

Methods: Participants were cross-sectionally assessed using SPUTs with various demanding forms, including the 1-time SPUT (1SPUT) along with its upper limb loading SPUT (ULL-SPUT), 5-time SPUT (5SPUT), 10-time SPUT (10SPUT), and 1-min SPUT (1minSPUT) and standard measures.

Results: Participants who passed and failed a 1SPUT showed significant differences in the outcomes of all standard measures ($p<0.05$). The ULL-SPUT significantly correlated to all body composition, muscle strength, and mobility ($r=0.247$-0.785; $p<0.05$). Outcomes of 1minSPUT significantly correlated with muscle strength and mobility outcomes ($r=0.306$-0.526; $p<0.05$). Participants reported no adverse effects following the SPUTs.

Conclusion: The findings suggest the use of the 1SPUT, ULL-SPUT, and 1minSPUT as practical measures to reflect the body composition, muscle strength, and mobility of older individuals, according to their functional levels. The tests may especially clinically benefit those with lower limb limitations and those in settings with limited space and equipment.

Summary at a glance: The 6-min walk test (6MWT) is a widely used field walking test. This study reports the normative reference values (NRV) of distance walked during 6MWT (6MWD) in healthy Singaporeans (aged 21-80) and updates the 6MWD reference equations. This information may facilitate the interpretation of the 6MWD in clinical populations.

Ethics approval: The Singapore Institute of Technology-Institutional Review Board (SIT-IRB Project Number: 2019099) approved this study to be carried out from June 2019 to January 2021. All participants gave written informed consent before data collection began.

Background: The six-minute walk test (6MWT) is a widely adopted submaximal field-walking test to evaluate functional exercise capacity. This validated test is a reliable, safe, inexpensive, and straightforward assessment tool commonly used as an outcome measure, using the distance walked (6MWD) as the primary outcome. An earlier study has established the normative reference values (NRV) and equation in healthy Singaporeans - however, the small sample size and narrow age range curb adequate representation of the adult population profile.

Objectives: This study aims to update the NRV and reference equations to predict the distance walked during 6MWT (6MWD) for healthy Singaporeans aged 21-80.

Methods: This cross-sectional study recruited community-dwelling healthy subjects aged 21-80 via convenience sampling. Each subject completed two trials of 6MWT according to the standard protocol. Primary outcome measures included 6MWD, pre-and post-test heart rate (HR), oxygen saturation, and blood pressure (BP).

Results: 172 healthy Singaporeans ($\text{females}=90$, $\text{males}=82$) participated. The overall mean 6MWD was $578.00\pm 75.38$ metres. The age-stratified mean 6MWD ranged from $601.3\pm 71.79$ metres (aged 21-39) to $519.02\pm 55.42$ metres (aged 60-80). Age, gender, and percentage maximum HR predicted (%PredHRmax) were the most significant variables ($p<0.001$). 6MWD reference $\text{equation}=288.282(\text{height},\text{m})+27.463\times \text{Gender}$