Hong Kong Physiotherapy Journal最新文献

Background: Peripheral artery disease (PAD) receives little attention despite its clinical consequences. Intermittent claudication is the most disturbing symptom of the disease resulting in marked limitations to functional walking performance. Treadmill walking exercise is the first-line non-pharmacological treatment in PAD; however, older patients may be unable to exercise because of the functional disability of the disease itself or deconditioning.

Objective: In an attempt to seek an alternative intervention, this study aimed to assess the effect of laser acupuncture on patient-reported claudication symptoms and walk performance in PAD.

Methods: Thirty male patients with PAD were assigned randomly to a control group ( $n_1=15$ , $64.5\pm 3.5$ years old, $25.9\pm 2.6$ kg/m²) or a study group ( $n_2=15$ , $65.6\pm 3.3$ years old, $25.44\pm 3.1$ kg/m²). Inclusion criteria were mild-to-moderate PAD, Fontaine stage II, unilateral or bilateral claudications, and older men. Exclusion criteria were asymptomatic PAD, resting pain, severe or critical limb ischemia, ischemic ulcers, and patients contraindicated for laser therapy. Both groups received pharmacological treatment, but only the study group received gallium aluminum arsenide (GaAlAs) laser therapy at nine acupuncture points, namely, Liver 2 (LV2), Stomach 41 (ST41), Urinary bladder 40 (UB40), UB60, UB61, Gall bladder 30 (GB30), GB34, GB38, and GB40 for 2 days/week and five consecutive weeks. A pen-type laser device was used at a wavelength of $654.7\pm 2$ nm, with a power output of $41\pm 3.65$ mW, a spot size of 0.08 cm², and an energy density of 2 J/cm², for 60 s/point. The Edinburgh Claudication Questionnaire (ECQ) and the 6-min walk distance (6-MWD) were the endpoints of the study. The McNemar-Bowker Test and Generalized Estimating Equations Ordinal Logistic Regression Model were used for the within- and between-group statistical analyses of the categorical data of ECQ, respectively; and a mixed model MANOVA was used for the within- and between-group analyses of the 6-MWD data.

Results: There was a significant improvement in patients' response to ECQ only in the study group compared to the baseline ( $p=0.002$

Background: Various factors, inherited and acquired, are associated with habitual spinal postures.

Objective: The purpose of this study was to identify the relationships between trunk muscle endurance, anthropometry and physical activity/inactivity and the sagittal standing lumbopelvic posture in pain-free young participants.

Methods: In this study, 112 healthy young adults (66 females), with median (IQR) age of 20 years (18.2-22 years), without low back pain, injury or trauma were included. Lumbar curve (LC) and sacral slope (SS) angles were measured in standing with a mobile phone application (iHandy level). Anthropometric, physical activity/inactivity levels (leisure-time sport involvement and sitting hours/day) and abdominal (plank prone bridge test) and paraspinal (Sorensen test) isometric muscle endurance measures were collected.

Results: LC and SS angles correlated significantly ( $r=0.80$ , $p<0.001$ ). Statistically significant differences for both LC ( $p=0.023$ ) and SS ( $p=0.013$ ) angles were identified between the male and female participants. A significant negative correlation was identified between the abdominal endurance time and LC ( $r=-0.27$ , $p=0.004$ ); however, the power of this result (56%) was not sufficiently high. The correlation between abdominal endurance and SS was non-significant ( $r=-0.17$ , $p=0.08$ ). In addition, no significant associations were identified between either of the sagittal lumbopelvic angles (LC-SS) in standing and the participants' body mass index (BMI), paraspinal endurance, leisure-time sport involvement or sitting hours/day.

Conclusion: The potential role of preventive exercise in controlling lumbar lordosis via enhancement of the abdominal muscle endurance characteristics requires further confirmation. A subsequent study, performed in a larger population of more diverse occupational involvement and leisure-time physical activity levels, is proposed.

Background: The Shoulder Pain and Disability Index (SPADI) is the most commonly used self-administered questionnaire which is a valid and reliable instrument to assess the proportion of pain and disability in shoulder disorders. There is no evidence of SPADI questionnaire being translated into regional Indian language (Marathi).

Objective: This study aims to translate and culturally adapt and validate the Marathi version of the SPADI questionnaire. This was done as per the AAOS outcomes committee guidelines.

Methods: Cross-cultural adaptation and psychometric testing of SPADI was done in the Outpatient Physiotherapy Department of Tertiary Care Hospital, Ahmednagar, India.

Results: The internal consistency was assessed by calculating Cronbach alpha value for the pain score (0.908), disability score (0.959), and total SPADI (0.969) which were all high. The Test-retest reliability was assessed using the intraclass correlation coefficient (ICC) values for the pain score (0.993), disability score (0.997), and total SPADI (0.997) which showed excellent reliability. The criterion validity was assessed using Pearson correlation coefficient. In Males, weak to strong negative correlation was observed except for shoulder extension and in females, moderate negative correlation was observed between baseline shoulder range of motion and initial total SPADI scores and individual pain and disability except for shoulder internal rotation. The internal consistency of the Marathi SPADI (Cronbach's alpha $>$ 0.99) was higher than the original English version. The reliability of the total Marathi SPADI and its subscale (Intraclass correlation coefficient $>$ 0.90) were found to be higher than that of the English SPADI and were consistent with the German, Brazilian, Slovene and Greek versions.

Conclusion: The translated and culturally adapted Marathi version of the SPADI questionnaire is a reliable and valid tool for the assessment of pain and disability in Marathi population.

Objectives: (1) To assess the effects of a conventional, delayed physiotherapy protocol used by Ischemic Stroke (IS) and Hemorrhagic Stroke (HS) post-stroke patients, in their electromyographic activation patterns during hemiparetic gait; and (2) to study whether this protocol may improve the functional abilities in this population.

Methods: This is an observational, descriptive, and analytical quasi-experimental trial. Forty patients with unilateral IS ( $n=25$ ) and HS ( $n=15$ ) stroke were recruited; the stroke involved the motor cortex or sub-cortical areas, and the patients were able to walk independently. Interventions with standard protocols of physiotherapy were carried out. Evaluations (clinical and gait assessment) were performed at the time of admission and at the end of the protocol. Outcome measures include Stroke Impact Scale, Timed Up and Go Test, and gait electromyographic evaluation.

Results: Only IS patients (with an average of $124.4\pm 45.4$ months delayed access to physiotherapy rehabilitation) had improvements in Timed Up and Go Test (change in $\text{speed}=-8.0$ seg $p<0.05$ ) and presented an anticipation of the onset in Upper leg muscles after the intervention. BF ( $p=0.05$ ), ST ( $p=0.001$ ), and RF ( $p=0.024$ ), started their recruitment (onset) earlier at the swing phase of the gait cycle, which is more similar to the normal pattern (grey shadow). IS and HS ( $120.4\pm 28.4$ months since last stroke) patients presented higher electromyographic activation, after physiotherapy, of the posterior leg muscles (gastrocnemius, semitendinosus and biceps femoris) during stance phase ( $p<0.05$ ).

Conclusion: IS patients had improvements after delayed conventional physiotherapy. For HS limited response to intervention was observed.

Objective: The aim of this study was to compare the role of a chest physiotherapy (CP) intervention to no intervention on the respiratory status of children under two years of age, with mild-to-moderate bronchiolitis.

Methods: Out of 80 eligible children observed in the Emergency Room, 45 children completed the study with 28 randomized to the intervention group and 17 to the control group. The intervention protocol, applied in an ambulatory setting, consisted of combined techniques of passive prolonged slow expiration, rhinopharyngeal clearance and provoked cough. The control group was assessed with no chest physiotherapy intervention. The efficacy of chest physiotherapy was assessed using the Kristjansson Respiratory Score at the admission and discharge of the visit to the Emergency Room and during clinical visits at day 7 and day 15.

Results: There was a significant improvement in the Kristjansson Respiratory Score in the intervention group compared to the control group at day 15 [1.2 (1.5) versus 0.3 (0.5); $p$ -value $=0.005$ , in the control and intervention groups, respectively], with a mean difference (95% CI) of $-0.9$ ( $-1.6$ to $-0.3$ ).

Conclusion: Chest physiotherapy had a positive impact on the respiratory status of children with mild-to-moderate bronchiolitis.

Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT04260919.

Objective: To evaluate the new service model of additional weekend and holiday physiotherapy (PT) by comparing functional outcomes and hospital length of stay between a group of geriatric patients with hip fracture receiving daily PT training and a group of geriatric patients with hip fracture receiving weekdays PT training.

Methods: A retrospective case-historical control chart review was conducted and a total of 355 patients were identified. Between-group comparisons were done on functional outcomes including Modified Functional Ambulation Classification (MFAC), Elderly Mobility Scale (EMS), Modified Barthel Index (MBI) and process outcome in terms of length of stay (LOS) in hospitals.

Results: With similar characteristics, patients who received weekend and holiday PT training had a significant higher percentage of MFAC Category III and a significant lower percentage of MFAC Category II ( $p=0.015$ ) and significant higher MBI scores ( $\text{mean}\pm \text{standard}$ deviation, median; Study group: $47.4\pm 19.6$ points, 51 points; Control group: $43.0\pm 20.0$ points, 43 points; $p=0.042$ ) upon admission to rehabilitation hospital. A similar trend in EMS scores (Study group: $8.2\pm 5.5$ points, 7 points; Control group: $8.4\pm 6.1$ points, 6 points; $p=0.998$ ) and MBI scores (Study group: $63.0\pm 23.4$ points, 68 points; Control group: $61.2\pm 26.1$ points, 64 points; $p=0.743$ ) were observed upon discharge from the rehabilitation hospital. The average LOS in acute hospitals remained static (Study group: $7.7\pm 3.9$ days, 7 days; Control group: $7.4\pm 5.0$ days, 6 days; $p=0.192$ ). The average LOS in rehabilitation hospital (Study group: $20.0\pm 5.5$ days, 20 days; Control group: $24.3\pm 9.9$ days, 23 days;