Hong Kong Physiotherapy Journal最新文献_第4页

Effectiveness of robotic-assisted gait training in stroke rehabilitation: A retrospective matched control study 机器人辅助步态训练在中风康复中的有效性:一项回顾性匹配对照研究

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2017-06-01 DOI: 10.1016/j.hkpj.2016.09.001

Bryan Ping Ho Chung MSc in Health Care

Objective

This study aimed to evaluate the effectiveness of robotic-assisted gait training (RAGT) in improving functional outcomes among stroke patients.

Design

This was a retrospective matched control study.

Setting

This study was conducted in an extended inpatient rehabilitation centre.

Patients and intervention

There were 14 patients with subacute stroke (4–31 days after stroke) in the RAGT group. Apart from traditional physiotherapy, the RAGT group received RAGT. The number of sessions for RAGT ranged from five to 33, and the frequency was three to five sessions per week, with each session lasting for 15–30 minutes. In the control group, there were 27 subacute stroke patients who were matched with the RAGT group in terms of age, days since stroke, premorbid ambulatory level, functional outcomes at admission, length of training, and number of physiotherapy sessions received. The control group received traditional physiotherapy but not RAGT.

Outcome measures

Modified Functional Ambulation Category (MFAC), Modified Rivermead Mobility Index (MRMI), Berg's Balance Scale (BBS), and Modified Barthel Index (MBI) to measure ambulation, mobility, balance, and activities of daily living, respectively.

Results

Both RAGT and control groups had significant within-group improvement in MFAC, MRMI, BBS, and MBI. However, the RAGT group had higher gain in MFAC, MRMI, BBS, and MBI than the control group. In addition, there were significant between-group differences in MFAC, MRMI, and BBS gains (p = 0.026, p = 0.010, and p = 0.042, respectively). There was no significant between-group difference (p = 0.597) in MBI gain (p = 0.597).

Conclusion

The results suggested that RAGT can provide stroke patients extra benefits in terms of ambulation, mobility, and balance. However, in the aspect of basic activities of daily living, the effect of RAGT on stroke patients is similar to that of traditional physiotherapy.

目的本研究旨在评估机器人辅助步态训练(RAGT)在改善脑卒中患者功能预后方面的有效性。这是一项回顾性匹配对照研究。本研究在一个扩展的住院康复中心进行。患者与干预RAGT组有14例亚急性脑卒中患者(脑卒中后4-31天)。在传统物理治疗的基础上，RAGT组给予RAGT治疗。RAGT的次数从5到33次不等，频率为每周3到5次，每次持续15-30分钟。在对照组中，有27例亚急性卒中患者在年龄、卒中后天数、发病前活动水平、入院时功能结局、训练时间和接受物理治疗次数方面与RAGT组相匹配。对照组采用传统物理治疗，不采用RAGT治疗。结果测量:改良功能行走类别(MFAC)、改良Rivermead活动指数(MRMI)、Berg平衡量表(BBS)和改良Barthel指数(MBI)分别测量行走、活动、平衡和日常生活活动。结果RAGT组和对照组在MFAC、MRMI、BBS和MBI方面均有组内显著改善。然而，RAGT组在MFAC、MRMI、BBS和MBI方面的增益高于对照组。此外，MFAC、MRMI和BBS增益组间差异显著(p = 0.026、p = 0.010和p = 0.042)。MBI增加(p = 0.597)组间无显著差异(p = 0.597)。结论RAGT对脑卒中患者在行走、活动和平衡方面有额外的益处。然而，在日常生活的基本活动方面，RAGT对脑卒中患者的作用与传统物理治疗相似。

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引用次数: 18

Australian critical care nursing professionals' attitudes towards the use of traditional “chest physiotherapy” techniques 澳大利亚重症护理专业人员对使用传统“胸部物理治疗”技术的态度

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2017-06-01 DOI: 10.1016/j.hkpj.2016.08.001

Clint J. Newstead BPhysio (Hons), Jack A. Seaton BPhysio (Hons), Catherine L. Johnston PhD, MAppSc (Cardiopulmonary Physiotherapy), BAppSc (Physiotherapy)

Background

Chest physiotherapy techniques, such as percussion, postural drainage, and expiratory vibrations, may be employed in a critical care setting. Physiotherapists are primarily responsible for their provision; however, nurses have also traditionally implemented these treatments. It is unclear whether nurses consider chest physiotherapy to be a part of their role, or how they perceive their knowledge and confidence pertaining to these techniques.

Objective

To investigate the attitudes of nurses towards traditional chest physiotherapy techniques.

Method

A total of 1222 members of the Australian College of Critical Care Nurses were invited to participate in an anonymous online survey.

Results

There were 142 respondents (12%) with the majority (n = 132, 93%) having performed chest physiotherapy techniques in clinical practice. Most of them considered that the provision of chest physiotherapy was a part of nurse's role. Commonly cited factors influencing nurses' use of chest physiotherapy techniques were the availability of physiotherapy services, adequacy of nursing staff training and skill, and perceptions of professional roles.

Conclusions

Nurses working in critical care commonly utilised traditional chest physiotherapy techniques. Further research is required to investigate the reasons why nursing professionals might assume responsibility for the provision of chest physiotherapy techniques, and if their application of these techniques is consistent with evidence-based recommendations.

背景:胸部物理治疗技术，如打击、体位引流和呼气振动，可用于重症监护环境。物理治疗师主要负责提供这些服务;然而，护士也传统地实施这些治疗。目前尚不清楚护士是否认为胸部物理治疗是他们职责的一部分，或者他们如何看待他们对这些技术的知识和信心。目的了解护士对传统胸部物理治疗技术的态度。方法澳大利亚重症监护护士学院共邀请1222名成员参加了一项匿名在线调查。结果142例(12%)受访患者在临床实践中使用过胸部物理治疗技术，其中多数(n = 132, 93%)。他们大多认为提供胸部物理治疗是护士职责的一部分。影响护士使用胸部物理治疗技术的常见因素是物理治疗服务的可获得性、护理人员的培训和技能的充足性以及对专业角色的认识。结论危重病护理人员普遍采用传统的胸部物理治疗方法。需要进一步的研究来调查为什么护理专业人员可能承担提供胸部物理治疗技术的责任，以及他们对这些技术的应用是否符合循证建议。

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引用次数: 11

Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial 肌肉能量技术和静态拉伸对机械性颈痛患者疼痛和功能障碍的影响:一项随机对照试验

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2016-12-01 DOI: 10.1016/j.hkpj.2015.12.002

Apoorva Phadke MPT , Nilima Bedekar PhD , Ashok Shyam MS (Ortho) , Parag Sancheti MS (Ortho)

Background

Mechanical neck pain is one of the common musculoskeletal disorders. Muscle energy technique (MET) may be a useful intervention for treating such disorder.

Objective

The aim of this study was to compare the effect of MET with passive stretching on pain and functional disability in people with mechanical neck pain.

Methods

A randomized controlled trial was undertaken. Sixty patients with mechanical neck pain were randomly allocated to either the MET group or control group. The former group received MET, and the latter group received static stretching. Both groups received conventional therapy. Treatment was given once a day for 6 days. A visual analogue scale (VAS) was used to measure the intensity of pain, and functional disability was assessed using the neck disability index (NDI) was immediately before treatment and again on the 6^th day.

Results

VAS and NDI scores showed a significant improvement in both MET and stretching groups on the 6^th day postintervention (p < 0.05). However, both VAS and NDI scores showed better improvement in the MET group as compared to the stretching group (p < 0.025).

Conclusion

Muscle energy technique was better than stretching technique in improving pain and functional disability in people with mechanical neck pain.

背景:机械性颈痛是常见的肌肉骨骼疾病之一。肌肉能量技术(MET)可能是治疗这种疾病的有效干预手段。目的本研究的目的是比较MET和被动拉伸对机械性颈痛患者疼痛和功能障碍的影响。方法采用随机对照试验。60例机械性颈痛患者随机分为MET组和对照组。前一组接受MET，后一组接受静态拉伸。两组均接受常规治疗。每日1次，连用6天。采用视觉模拟评分法(visual analogue scale, VAS)评估疼痛程度，并在治疗前及第6天分别采用颈部残疾指数(neck disability index, NDI)评估功能障碍。结果MET组和拉伸组在干预后第6天的vas和NDI评分均有显著改善(p <0.05)。然而，与拉伸组相比，MET组的VAS和NDI评分均有更好的改善(p <0.025)。结论肌能技术在改善机械性颈痛患者疼痛和功能障碍方面优于拉伸技术。

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引用次数: 67

A validation study of a smartphone application for functional mobility assessment of the elderly 老年人功能活动能力评估智能手机应用程序的验证研究

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2016-12-01 DOI: 10.1016/j.hkpj.2015.11.001

Matthew H.M. Chan MPT, Donald T.F. Keung MPT, Steve Y.T. Lui MPT, Roy T.H. Cheung PhD

Background

To minimize the reaction time and position judgment error using stopwatch-timed measures, we developed a smartphone application to measure performance in the five-time sit-to-stand (FTSTS) and timed up-and-go (TUG) tests.

Objective

This study aimed to validate this smartphone application by comparing its measurement with a laboratory-based reference condition.

Methods

Thirty-two healthy elderly people were asked to perform the FTSTS and TUG tests in a randomized sequence. During the tests, their performance was concurrently measured by the smartphone application and a force sensor installed in the backrest of a chair. The intraclass correlation coefficient [ICC_(2,1)] and Bland–Altman analysis were used to calculate the measurement consistency and agreement, respectively, between these two methods.

Results

The smartphone application demonstrated excellent measurement consistency with the lab-based reference condition for the FTSTS test [ICC_(2,1) = 0.988] and TUG test [ICC_(2,1) = 0.946]. We observed a positive bias of 0.27 seconds (95% limits of agreement, −1.22 to 1.76 seconds) for the FTSTS test and 0.48 seconds (95% limits of agreement, −1.66 to 2.63 seconds) for the TUG test.

Conclusion

We cross-validated the newly developed smartphone application with the laboratory-based reference condition during the examination of FTSTS and TUG test performance in healthy elderly.

为了最大限度地减少使用秒表计时测量的反应时间和位置判断误差，我们开发了一款智能手机应用程序来测量五次坐立(FTSTS)和计时站起(TUG)测试中的表现。目的通过将智能手机应用程序的测量结果与实验室基准条件进行比较，验证该应用程序的有效性。方法随机抽取32名健康老年人进行FTSTS和TUG测试。在测试过程中，他们的表现由智能手机应用程序和安装在椅子靠背上的力传感器同时测量。采用类内相关系数[ICC(2,1)]和Bland-Altman分析分别计算两种方法的测量一致性和一致性。结果该智能手机应用程序与FTSTS测试[ICC(2,1) = 0.988]和TUG测试[ICC(2,1) = 0.946]的实验室参考条件具有良好的测量一致性。我们观察到FTSTS测试的正偏差为0.27秒(95%一致限度，- 1.22至1.76秒)，TUG测试的正偏差为0.48秒(95%一致限度，- 1.66至2.63秒)。结论我们将新开发的智能手机应用程序与实验室基准条件进行交叉验证，以检测健康老年人的FTSTS和TUG测试成绩。

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引用次数: 10

Validity and reliability of a thoracic kyphotic assessment tool measuring distance of the seventh cervical vertebra from the wall 胸椎后凸评估工具测量第七颈椎距壁距离的有效性和可靠性

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2016-12-01 DOI: 10.1016/j.hkpj.2016.05.001

Pipatana Amatachaya PhD , Sawitree Wongsa MSc , Thanat Sooknuan M. Eng. , Thiwabhorn Thaweewannakij PhD , Maneepan Laophosri MSc , Nuttaset Manimanakorn MD, PhD , Sugalya Amatachaya PhD

Background

In primary healthcare (PHC) service, community residents, village health volunteers (VHVs), and healthcare professionals need to work in partnership to facilitate universal and equitable healthcare services. However, these partnerships may need an appropriate tool helping them to execute an effective health-related activity.

Objectives

To investigate the reliability and validity of a simple kyphosis measure using a perpendicular distance from the seventh cervical vertebra (C7) to the wall (C₇WD).

Methods

Elderly people with different degrees of kyphosis (n = 179) were cross-sectionally investigated for the intra- and interrater reliability of the measurement by a physical therapist (PT), VHV, and caregiver. The validity was assessed in terms of concurrent validity as compared with the Flexicurve, and discriminative validity for functional deterioration in participants with mild, moderate, and severe kyphosis.

Results

The method showed excellent reliability among PT, VHV, and caregivers (ICC > 0.90, p < 0.001), and excellent correlation to the data from the Flexicurve. Results of the assessment were greater than a level of minimal detectable change and could clearly discriminate functional deterioration in participants with different severity of kyphosis (p < 0.001).

Conclusion

C₇WD is valid and reliable, thus it can be used to promote the standardisation of kyphosis measures among PHC members.

在初级卫生保健(PHC)服务中，社区居民、乡村卫生志愿者(VHVs)和卫生保健专业人员需要携手合作，促进普及和公平的卫生保健服务。然而，这些伙伴关系可能需要一种适当的工具来帮助它们有效地开展与健康有关的活动。目的探讨采用第七颈椎(C7)与颈壁垂直距离(C7WD)测量简单后凸的信度和效度。方法通过物理治疗师(PT)、VHV和护理人员对179例不同程度后凸的老年人进行横断面调查，研究测量结果的内部和内部信度。效度是根据与flexiccurve相比较的并发效度和轻度、中度和重度后凸参与者的功能恶化的判别效度来评估的。结果该方法在PT、VHV和护理人员(ICC >0.90, p <0.001)，并且与flexiccurve的数据有很好的相关性。评估的结果大于最小可检测变化的水平，并且可以清楚地区分不同程度后凸的参与者的功能恶化(p <0.001)。结论c7wd有效可靠，可用于促进PHC成员间脊柱后凸措施的规范化。

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引用次数: 13

Exercise training and postural correction improve upper extremity symptoms among touchscreen smartphone users 运动训练和姿势矫正可以改善触摸屏智能手机用户的上肢症状。

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2016-12-01 DOI: 10.1016/j.hkpj.2016.06.001

Abeer Ahmed Abdelhameed , Amr Almaz Abdel-aziem

Background

Repetitive movements and poor posture are associated with over-use of smartphones when texting or playing games and significantly contribute to the symptoms of pain and discomfort in the upper extremities.

Objective

This study investigated the effect of exercise training and postural correction on disabilities of the arm, shoulder, and hand (DASH), hand grip and key pinch strength among smartphone users.

Methods

One hundred university students were randomly divided into two groups; the experimental group participated in a 12-week programme of exercise training and postural corrections. The control group were instructed to follow their usual routine for smartphone utilization. Measurements of DASH scores, hand grip strength, and key pinch grip strength were conducted before and after 12 weeks for both groups.

Results

There were no significant differences between the start values of both groups for DASH scores, hand grip strength, and key pinch strength (p > 0.05). However, there was a significant improvement in all outcomes measured in the experimental group (p < 0.05), with significant changes in the outcomes of the control group.

Conclusion

Postural correction combined with a selected exercise training programme improved the hand grip, key pinch grip strength, and upper extremity disability and symptoms associated with smartphone use among university students.

背景：在发短信或玩游戏时，重复的动作和不良的姿势与过度使用智能手机有关，并显著导致上肢疼痛和不适的症状。目的：本研究调查了运动训练和姿势矫正对智能手机用户手臂、肩膀和手部残疾（DASH）、握力和按键握力的影响。方法：将100名大学生随机分为两组；实验组参加了为期12周的运动训练和姿势矫正计划。对照组被要求按照他们的常规使用智能手机。两组在12周前和12周后分别测量DASH评分、握力和握力。结果：两组的DASH评分、握力和按键握力的起始值之间没有显著差异（p>0.05）。然而，实验组的所有结果都有显著改善（p<0.05），对照组的结果也有显著变化。结论：姿势矫正结合选择的运动训练计划改善了大学生的握力、握力、上肢残疾和与使用智能手机相关的症状。

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引用次数: 19

Authorship and Conflict statement 作者身份和冲突声明

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2016-12-01 DOI: 10.1016/S1013-7025(16)30086-0

引用次数: 0

Promotion of healthy nutrition in clinical practice: A cross-sectional survey of practices and barriers among physiotherapists in southeast Nigeria 在临床实践中促进健康营养:尼日利亚东南部物理治疗师的实践和障碍的横断面调查

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2016-12-01 DOI: 10.1016/j.hkpj.2016.05.002

Ukachukwu Okoroafor Abaraogu BMR(PT), MSc, PhD Candidate , Mary O. Ogaga BMR(PT) , Eric Odidika BMR(PT) , Jose Frantz PT PhD

Background

Healthy diet counselling is an important concept in health promotion. Physiotherapists are well positioned to initiate or support healthy nutrition in addition to physical activity counselling, in routine patient consultation.

Objective

To determine the practices about and barriers to diet counselling practices among physiotherapists in Southeast Nigeria.

Methods

In this cross-sectional survey, a total of 140 questionnaires were distributed among physiotherapists.

Results

Overall, 103 physiotherapists responded. Physiotherapists are confident and consider the incorporation of dietary counselling very important and of high priority in their daily clinical work. They, however, assessed and counselled on dietary status opportunistically in patients. Notwithstanding, physiotherapists believed that the diet counselling they give could be effective in helping patients change their unhealthy dieting practices. Patients were also amenable to physiotherapists advocating on diet issues as part of their consultation. Several barriers to incorporating diet counselling into physiotherapy practice were identified, including lack of access to a dietician/health promotion staff/counsellors, lack of proper patient education materials, lack of expertise in relation to dietary risk factors' assessment and management, and uncertainty about what dietary services to provide.

Conclusion

Although physiotherapists consider it important to incorporate diet counselling in their daily clinical practice, development and implementation of strategies to improve physiotherapists' diet counselling knowledge, competence, skills, and practice are warranted.

健康饮食咨询是健康促进中的一个重要概念。物理治疗师在常规患者咨询中，除了提供身体活动咨询外，还能很好地发起或支持健康营养。目的了解尼日利亚东南部地区物理治疗师饮食咨询的做法和障碍。方法采用横断面调查法，对物理治疗师进行问卷调查，共发放问卷140份。结果总共有103名物理治疗师做出了回应。物理治疗师很有信心，他们认为在日常临床工作中结合饮食咨询是非常重要和高度优先的。然而，他们对患者的饮食状况进行了评估和咨询。尽管如此，物理治疗师相信他们提供的饮食咨询可以有效地帮助病人改变他们不健康的饮食习惯。患者也愿意接受理疗师的建议，将饮食问题作为咨询的一部分。确定了将饮食咨询纳入物理治疗实践的几个障碍，包括无法获得营养师/健康促进工作人员/顾问，缺乏适当的患者教育材料，缺乏与饮食风险因素评估和管理有关的专业知识，以及不确定提供何种饮食服务。结论尽管物理治疗师认为将饮食咨询纳入其日常临床实践很重要，但制定和实施策略以提高物理治疗师的饮食咨询知识、能力、技能和实践是必要的。

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引用次数: 10

Systematic review of published studies on aquatic exercise for balance in patients with multiple sclerosis, Parkinson's disease, and hemiplegia 对已发表的关于水上运动对多发性硬化症、帕金森病和偏瘫患者平衡的研究进行系统综述

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2016-12-01 DOI: 10.1016/j.hkpj.2016.03.002

Pichanan Methajarunon MSc, PT , Chachris Eitivipart MSc, PT , Claire J. Diver PhD, Grad Dip Phys, MCSP, PG Cert Res , Anchalee Foongchomcheay PhD, PT

Background

Multiple sclerosis, Parkinson's disease, and hemiplegia are common disorders that directly cause impairment of balance and gait. Aquatic exercises are used for neurological rehabilitation. It is suggested that the contributing factors of the water setting such as buoyancy, viscosity, and hydrostatic pressure offer an ideal environment for rehabilitative programmes.

Objective

To conduct a systematic review of studies that assess the effect of aquatic exercises on balance in neurological patients (i.e., patients with multiple sclerosis, Parkinson's disease, and hemiplegia).

Methods

A systematic literature search of six databases (MEDLINE, PEDro, AMED, CINAHL, Embase, SPORTDiscus) for randomized controlled trials and quasi-experimental trials on aquatic exercises in three different neurological disorders, namely, multiple sclerosis, Parkinson's disease, and hemiplegia, was performed. Reference lists from identified studies were manually searched for additional studies. Methodological quality was assessed using the Downs and Black checklist. The data were analyzed and synthesized by two independent reviewers. Disagreements in extracted data were resolved by discussion among the reviewers.

Results

The methodological quality of eight studies included in this review ranged from fair to good. The findings illustrated that there were statistically significant improvements in static and dynamic balance in patients with multiple sclerosis and hemiplegia. The statistically significant improvements in gait ability were only found in the studies conducted on multiple sclerosis. No conclusions can be drawn in Parkinson's populations as only two trials conducted with a small sample size were available.

Conclusion

Aquatic exercises may be effective at improving balance impairment in patients with hemiplegia and multiple sclerosis. There is a need for further research investigating its effect on Parkinson's disease before encouraging the use of aquatic exercises.

背景:多发性硬化症、帕金森氏症和偏瘫是直接导致平衡和步态障碍的常见疾病。水上运动用于神经康复。研究表明，水环境的浮力、粘度和静水压力等因素为修复方案提供了理想的环境。目的对评估水上运动对神经系统患者(即多发性硬化症、帕金森病和偏瘫患者)平衡能力影响的研究进行系统综述。方法系统检索MEDLINE、PEDro、AMED、CINAHL、Embase、SPORTDiscus等6个数据库，对水上运动治疗多发性硬化症、帕金森病和偏瘫3种不同神经系统疾病的随机对照试验和准实验试验进行文献检索。从确定的研究中手动检索参考列表以查找其他研究。使用Downs和Black检查表评估方法学质量。数据由两名独立审稿人进行分析和综合。对提取数据的分歧通过审稿人之间的讨论来解决。结果本综述纳入的8项研究的方法学质量从一般到良好不等。研究结果表明，多发性硬化症和偏瘫患者在静态和动态平衡方面有统计学上显著的改善。步态能力的统计学显著改善仅在多发性硬化症的研究中发现。在帕金森氏症人群中没有得出结论，因为只有两个小样本量的试验。结论水上运动可有效改善偏瘫合并多发性硬化症患者的平衡功能障碍。在鼓励使用水上运动之前，需要进一步研究其对帕金森病的影响。

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引用次数: 36

Checklist 检查表

IF 1.5 Q4 REHABILITATION

Hong Kong Physiotherapy Journal

Pub Date : 2016-12-01 DOI: 10.1016/S1013-7025(16)30085-9

引用次数: 0