Physiotherapy Research International最新文献

Background and purpose: Anticipatory postural adjustments (APA) and compensatory postural adjustments (CPA) have played a vital role in postural control since early childhood, which is critical to accomplishing activities in daily life. However, literature indicated dissimilarities and inconsistencies in APA and CPA analysis in sitting and standing positions in children with Cerebral Palsy (CP). Thus, this study analyzed the changes in postural control (APA and CPA) through the postural muscles [rectus abdominis (RA) and erector spinae (ES)] in both standing and sitting positions during functional activities (grasping a ball) in children with CP.

Methods: Children with CP [N = 21] aged 5-13 years having GMFCS levels I (n = 12) and II (n = 9) participated. Surface electromyography (EMG) was performed for postural muscles (ES and RA) to measure the APA and CPA with two types of loads (heavy and light) in both sitting and standing positions.

Results: Children with CP showed increased EMG amplitude for APA and CPA with a heavier load than light load in sitting and standing positions. The EMG amplitude of CPA in sitting and standing for both load conditions was significantly higher than that of APA.

Discussion: The findings suggest rehabilitation programs should enhance APA and CPA through targeted exercises and load management strategies. These insights have the potential to inform clinical practices, improve postural stability, and ultimately strengthen the ability of children with CP to perform daily activities with greater ease and confidence, thereby significantly impacting the quality of life.

Background and purpose: Goal setting is a key aspect of patient-centered physiotherapy, helping to motivate patients, align healthcare efforts, prevent oversight, and stop ineffective interventions. This study aims to identify facilitators and barriers for physiotherapists in hospitals to set and document patient treatment goals.

Methods: An explanatory sequential mixed-methods approach was used. The survey, informed by systematic reviews of factors influencing shared decision-making and the theoretical domains framework (TDF), included 25 statements to be rated. Two focus groups (n = 8) discussed (1) factors from the survey, (2) the goal-setting processes, and (3) brainstormed facilitators and barriers for documenting physiotherapy goals.

Results: Survey findings showed mixed opinions but agreement on two factors, which indicate that the goal influences the therapeutic interventions and motivates the therapists. The focus group identified four themes: "Goal," "Physiotherapeutic Self-Conception," "Interprofessionality", and "Hospital Setting." Issues included limited space and poor placement in documentation systems, mental rather than written goal conceptualization, and a perceived lack of interest from interprofessional team members, leading to deprioritization by physiotherapists. Finally, joint goal setting was deemed impractical for certain patients.

Discussion: Hospital physiotherapists set treatment goals with their patients. The process is influenced by various factors, including interprofessional dynamics and the hospital setting. The identified themes align with existing literature. Effective documentation of patient-centered physiotherapy goals in hospitals requires well-designed tools and interprofessional collaboration. Further, it is crucial to understand professional self-conception and acknowledge situations where physiotherapists need to set goals independently.

Background: Proprioceptive deficits are common among stroke survivors and can negatively impact their balance and postural control. However, there has been little evaluation of the change in proprioceptive deficits in the lower limbs over time after stroke. This study aimed to examine proprioceptive deficits over time after stroke in both the affected and "unaffected" lower limbs.

Methods: This cross-sectional study included sixty first-time unilateral stroke survivors and twenty age-matched healthy individuals. Participants after stroke were divided into three subgroups based on different time points after stroke. The generally accepted clinical time points after stroke are the first 4 weeks-the acute stage; 5-24 weeks-the subacute stage; over 24 weeks-the chronic stage. The active movement extent discrimination apparatus (AMEDA) was used to quantify ankle proprioception in plantarflexion and inversion directions, on both the affected and "unaffected" sides.

Results: Lower limb proprioception scores decreased linearly over time after stroke on both the affected and "unaffected" sides (p < 0.001). Overall, proprioception scores for the stroke groups were significantly lower than those for the healthy age-matched group (p < 0.01), with the only exception being ankle plantarflexion and inversion scores on the unaffected side in the acute stroke group, which were not significantly different from their healthy counterparts.

Conclusion: Ankle proprioception in both lower limbs decreased over time after a unilateral stroke, with proprioceptive acuity on the "unaffected" side diminishing linearly in the same way as that on the affected side. These observed continuing deficits in lower limb proprioception among stroke survivors raise implications for clinical neurorehabilitation.

Background: The International Classification of Functioning, Disability and Health (ICF) is the worldwide terminology system for measuring health and disability at both individual and population levels. However, the underlying challenges remain in achieving widespread adoption and implementation of ICF within healthcare contexts, including the unequal interval scale of the ICF Likert-type qualifier system ranging from 0 to 4, a lack of consensus on conceptualization and grading criteria of ICF items, and an excessive number of ICF items associated with each disease. The utilization of item response theory (IRT) for ICF studies demonstrated potential benefits in addressing these issues. Here, a review attempted to provide clarification of two predominant needs (sufficiency and efficiency) and two dimensions of scoring principles (stratification and assignment principles) in the ICF.

Methods: A literature search was conducted on the PubMed database, and 44 relative articles were selected. On this basis, this review was undertaken to track the research progress of the ICF based on the parameter IRT method, typically the Rasch model.

Results: This review outlined the classification of Item response model (IRM) for ICF studies and summarized existing IRT-based ICF research paradigms. Moreover, this review identified blind spots regarding assignment principles and the difficulty parameter in current ICF-based IRT studies. The Mokken scale analysis (MSA), as a non-parametric IRT method, was introduced as a data shaping tool for parametric IRM. The pipeline of the ICF-based MSA-Rasch modeling might advance the understanding of ICF clinical application and shed light on a new paradigm of questionnaire design.

Conclusion: The advent of ICF-oriented IRM algorithms may advance the comprehension of ICF clinical application and pave the way for a new paradigm for IRT-derived ICF questionnaires, namely the parsimonious ICF core set. Additionally, the Wright map holds promise in facilitating insight into rehabilitation trajectories and personalizing rehabilitation goals.

Background and purpose: Cancer is one of the most prevalent diseases in the general population, and is one of the main causes of changes in the population's illness profile. In this study, we assessed changes in the functional status and quality of life of patients in the first months of chemotherapy treatment.

Method: A prospective cohort study was carried out, collecting data from cancer patients seen at an outpatient clinic in the Midwest of Santa Catarina who had breast, lung, colon and rectum, prostate and head and neck cancer. Patients were assessed at four different times, the first at diagnosis and the following at 1-month intervals after the previous assessment. The assessment included the sociodemographic profile, weight, Functional Independence Measure (FIM), Timed Up & Go test (TUG test), Karnofsky Performance Status Scale and the EORTC Quality of Life Questionnaire. Statistical analyses were carried out using the IBM SPSS program, considering statistical significance p < 0.05.

Results: In a sample of 145 patients, there was no statistically significant reduction in the functional independence and weight of the patients followed up despite the treatment instituted; moreover, they did not show significant changes in their mobility capacity. The Karnofsky Scale was directly impacted by tumor staging.

Discussion: These results showed that patients with different tumors and staging at diagnosis, despite different degrees of disability, did not suffer significant changes in quality of life and self-sufficiency in the first 4 months of treatment.

Background and purpose: Premenstrual syndrome (PMS) affects physical, psychological, and behavioral symptoms in women. Obesity may worsen PMS, but the impact of caloric restriction and aerobic exercise on PMS in obese women is unclear. This study examines their effects on PMS, anthropometric, and hormonal parameters in obese females.

Methods: This randomized controlled trial involved 40 obese females with PMS. They were randomly divided into two groups of 20 each. The control group (A) received medical treatment in the form of Brufen 400 mg: one tablet daily for 5 days before menstruation and two tablets daily during menstruation for 12 weeks. The study group (B) received the same medical treatment and additionally engaged in a program of caloric restriction and aerobic exercise for 12 weeks. Outcome measures included the premenstrual syndrome scale (PMSS), weight, body mass index (BMI), waist and hip circumferences, waist-hip (W/H) ratio, and serum levels of progesterone and cortisol.

Results: At baseline, no significant between-group differences were observed in PMSS scores, anthropometric measures (weight, BMI, waist and hip circumferences, W/H ratio), or hormonal parameters (serum cortisol and progesterone). Post-treatment, the study group (B) demonstrated significantly greater improvements compared to the control group (A), including reductions in PMSS scores, weight, BMI, waist and hip circumferences, W/H ratio, and serum cortisol, along with significantly higher serum progesterone levels (p < 0.05).

Discussion: A 12-week program of caloric restriction and aerobic exercise resulted in substantial improvements in PMS symptoms, anthropometric parameters, cortisol levels, and progesterone levels in obese females with PMS.

Background and purpose: To examine the respiratory and functional benefits of manual diaphragmatic release for Cleaning-Laborers Exposed to Occupational Hazards.

Methods: A randomized controlled trial of 36 participants aged 35-45 years was randomly allocated into two groups. The experimental group (n = 18); received manual diaphragm release along with respiratory training exercises, and the control group (n = 18); received respiratory training exercises only. Three times/week for 12 consecutive weeks. The serum immunoglobulin E level, pulmonary functions [forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), FEV₁/FVC, and peak expiratory flow (PEF) rate (PEF)], chest wall mobility, and 6 min walk-test performance were assessed pre- and post-intervention.

Results: There was a greater decline in serum immunoglobulin levels (p = 0.003; Partial η² = 0.23) and enhancement in pulmonary functions [FEV₁ (p = 0.025, Partial η2 = 0.14), FVC (p = 0.017, Partial η² = 0.16), FEV₁/FVC (p = 0.028, Partial η² = 0.13), and PEF (p = 0.012, Partial η2 = 0.17) in the experimental group. Further, there was a greater increase in chest mobility at the xiphoid level (p = 0.002, Partial η² = 0.25) in the experimental group, but this was not the case at the axillary level (p = 0.29, Partial η² = 0.03). Still, the 6 min walk-test performance improved more significantly in the experimental group (p = 0.002, Partial η² = 0.24).

Conclusion: The diaphragmatic release technique may offer a promising approach for mitigating distressing respiratory symptoms, enhancing immune function, and improving 6 min walk-test performance among cleaning laborers with work-related respiratory hazards.

Trial registration: The study was retrospectively registered at XXX (ID: NCT05802355).

Introduction: Center-based rehabilitation is limited by COVID-19 infectivity and social distancing policy. We hypothesized that discharged patients benefit from 8-week home-based tele-rehabilitation (tele-PR) using mobile phones and low-cost instruments.

Methods: The TERCOV (Tele-rehabilitation in COVID-19 survivors) is an investigator-initiated, prospective, multi-center, real-world study. After proper assessment, 186 discharge patients received tele-PR by smartphone, including breathing exercise, respiratory muscle training, aerobic exercise, and resistance training. Physicians, physiotherapists, and nurses provided guidance through smartphone applications. The primary outcome was six-minute walk distance (6MWD). The secondary outcomes included hand grip, short physical performance battery, maximal inspiratory pressure, maximal expiratory pressure, self-rating anxiety/depression scale (SAS/SDS), 36-item short-form health survey (SF-36) and international physical activity questionnaire.

Results: Dyspnea subgroups were more functionally impaired. After tele-PR, improvements were observed in exercise capacity(∆6MWD: 16.80 m, 95% CI 1.18-32.42, p < 0.0001), limb muscle function (∆SPPB 0.25 points, 95% CI 0.05-0.46), respiratory muscle strength (∆MIP 16.50 cm H2O, 95% CI 9.22-23.78, p < 0.0001; ∆MEP: 12.09 cm H2O, 95% CI 3.48-20.70, p = 0.0002), health-related quality of life (∆SF-36 49.85, 95% CI: 21.01-78.69, p < 0.0001), physical activity(∆HEPA 13.01%, p = 0.0029). Anxiety reduced in patients with mMRC ≥ 2 (∆SAS = -4.19 points, CI -8.16 to -0.22, p = 0.03). Greater change was seen in dyspnea patients.

Implications on physiotherapy practice: Supervised/semi-supervised tele-PR is a promising option during the pandemic. Patients with Dyspnea benefit more.

Background: Stress Urinary incontinence (SUI) is a common condition among women of all ages. The point prevalence of SUI among young adult Jordanian women is less explored.

Objectives: To examine the point prevalence of SUI among this sample based on activity level, and whether the affected women have shared their complaints with healthcare providers and/or received education related to UI.

Methods: This was a cross-sectional survey-based study. Participants with diseases that affect the control of micturition were excluded. The International Consultation on Incontinence Questionnaire-UI Short-Form was used to calculate the point prevalence of UI. The Tegner activity scale was used to classify participants based on their physical activity levels. The participants reported whether they shared their complaints with a healthcare provider or received education about this health problem.

Results: Five hundred women (median age = 20 years, BMI = 22) participated (118 competitive athletes, 192 recreational, and 190 sedentary). The overall point prevalence of SUI was 14% (n = 61). A chi-square test of independence showed a significant difference in the point prevalence of SUI between women with different activity levels, χ2 (12) = 12.07, p < 0.01. The point prevalence of SUI among competitive athletes, recreational women, and sedentary women was 21%, 8%, and 11%, respectively. None of those with SUI have shared their complaints with healthcare providers or received education related to SUI.

Conclusion: SUI is prevalent among young adult Jordanian women, with the highest prevalence observed in those engaged in competitive athletic activities. The affected women refrain from disclosing their SUI-related concerns to healthcare practitioners and lack sufficient knowledge about this health issue.

Background and purpose: Enhancing physical function and quality of life in older adults at higher risk of falls is challenging because of the lack of established interventions. This study examines the impact of a 6-week balance training program using the shuttle balance device on gait speed, postural control, and quality of life in older men.

Methods: This single-blinded randomized controlled trial was conducted in a research laboratory. Thirty-two participants aged ≥60 years were randomly assigned to either an experimental group (EG; n = 16) or a control group (CG; n = 14). The EG participated in a 6-week shuttle balance exercise program, while the CG maintained regular physical activity routines. The main outcome measures included gait speed (assessed via the timed up and go test), postural control (assessed via center of pressure data on a force plate), and quality of life (evaluated using the SF-36 questionnaire).

Results: Post-intervention, the EG showed significant improvements compared with the CG (p < 0.05). The 95% confidence intervals for the differences between groups were as follows: closed eyes (CE) mean velocity (-39.07, -0.13), CE sway area (-48.86, -0.18), SF-36 total score (9.01, 16.81), SF-36 physical functioning (7.00, 24.81), SF-36 physical role functioning (1.80, 27.57), SF-36 pain (15.01, 36.82), SF-36 general health state (7.48, 26.08), SF-36 vitality (5.60, 28.35), and SF-36 mental health (0.21, 21.12).

Discussion: A 6-week shuttle balance training program significantly improves postural control and quality of life in older males. These findings suggest the potential effectiveness of shuttle balance exercises in enhancing physical function and well-being in this population. Further research is needed to validate these findings and explore the long-term effects with larger sample sizes.