Physiotherapy Research International最新文献

Introduction: The purpose of this case study was to demonstrate the clinical decision-making process of healthcare professionals within a rehabilitation program during chemoradiotherapy (CHRT) for a high-risk patient diagnosed with stage III non-small cell lung cancer (NSCLC). The course of CHRT and patient's preferences, facilitators, and barriers were considered.

Case-description: The patient was a 69-year-old man with a history of rheumatoid arthritis diagnosed with stage III NSCLC.

Intervention: A home-based, personalized, and partly supervised rehabilitation program during CHRT, including aerobic, resistance, and breathing exercises, as well as nutritional counseling.

Outcomes: The patient suffered from side effects of CHRT, which required adjustments in the context and intensity of the exercises. An important facilitator for the patient was encouraged by his wife in following the home-based rehabilitation program. During home visits, the patient and physiotherapists performed the exercises together to help him to overcome the burden and motivate the patient to adhere to the rehabilitation program.

Conclusion: This case study demonstrates that physical exercise training could be performed by adjusting training intensity and the way in which the physical exercise training was delivered, while the patient experienced side effects from CHRT. In addition, the involvement and support of (in)formal caregivers seems essential for adherence to rehabilitation.

Background: The concept of adherence to exercise for musculoskeletal (MSK) pain is poorly defined and inadequately measured. This study aimed to, (1) conceptualise adherence to exercise therapy for MSK pain, and (2) identify statements most representative of the new conceptualisation that could be developed into items for a new measurement tool.

Methods: Concept mapping methodology was used, which is an integrated mixed methods approach. Focus groups with stakeholders generated statements describing adherence to exercise for MSK pain. Statements were grouped according to themes and rated for importance. Data analysis via multidimensional scaling and hierarchical cluster analysis produced a series of concept maps, which were refined during a further stakeholder workshop to produce the final conceptualisation of exercise adherence. Mean importance ratings established statements most suitable for future development.

Results: Twenty-eight participants produced 100 unique statements concerning adherence, which were sorted and rated. Analysis of the sort data with further participant refinement concluded that adherence to exercise consists of six domains: communication with experts; targets; how exercise is prescribed; patient knowledge and understanding; motivation and support; and psychological approach and attitudes. Fifty-six statements were rated with above average importance for inclusion in a new measure of adherence to exercise for MSK pain.

Conclusion: Adherence to exercise for MSK pain is a complex and multi-dimensional construct represented by six distinct domains. Statements that best represent these domains have been identified by key stakeholders and will inform the development of a new measure of adherence to exercise for MSK pain.

Purpose: The current context of the COVID-19 pandemic has demonstrated the need for home exercise strategies for the relief of neck pain, which, in recent times, has increased. However, there is a gap regarding home exercises that are aimed at reducing neck pain. Therefore, the aim of this study was to develop, validate and culturally adapt a home exercise protocol for neck pain.

Methods: This was an observational study conducted in three stages: (1) Developing an online search of databases for articles on neck pain exercises. (2) Validating a panel of 12 physical therapists, using the Delphi technique, and (3) Cultural adaptation, through face-to-face assessment with individuals aged 18-30 years with neck pain (n = 15). This resulted in the production of a final version of the protocol. Consensus on the protocol items (using the five-point Likert scale) was considered when the percent agreement was equal to or greater than 75%. Individuals were also asked about pain intensity during the last week before and after performing the protocol.

Results: A protocol was developed with the principles of neck and scapular stabilization and upper limb movements, for a period of 4 weeks. Nine physical therapists completed two rounds online, and all items in the second version of the protocol presented an agreement of over 75%. The protocol was culturally adapted by the target population, in which 73% of individuals presented pain reduction with a minimally clinically important difference.

Conclusion: A 4-week home exercise protocol was created based on the best evidence in the literature, was validated by physical therapists and adapted for the population with neck pain. It proved to be an understandable, useful, practical and convenient tool in the treatment of this disorder and demonstrated an improvement in neck pain.

Clinicaltrials: GOV: (NCT04187001).

Background: Telehealth can be an alternative action at a distance that can help as a form of motor intervention, alleviating the deleterious effects arising from social distancing on functional capacity, mental health and quality of life among older people with dementia during the COVID-19 pandemic.

Purpose: We aim to analyze the effects of a telehealth program on functional capacity, mental health and quality of life among older people with dementia and their caregivers.

Methods: seventy-eight individuals with mild and moderate dementia and their caregivers will answer an anamnesis and be evaluated through Clinical Dementia Assessment Score. They will also be evaluated by blinded examiners in terms of functional capacity (Activities of Daily Living Questionnaire and World Health Organization Disability Assessment Schedule 2.0), mental health (Mini-Mental State Examination, Clock Drawing Test, Verbal Fluency test and the Neuropsychiatric Inventor) and quality of life (Quality of Life in Alzheimer's Disease scale). Afterward, the volunteers will be randomized into the telehealth training group and the control group. The TR will perform systematic physical and cognitive exercises in 50-min sessions three times a week with professional monitoring, while the CG will receive non-systematized guidance, both for 12 weeks. Participants will be evaluated at baseline, immediately after the three-month interventions and with a 12-week follow- up.

Discussion: Technological approaches such as telehealth can be a viable alternative in home care service during times of pandemic. We expect that older people with dementia and their caregivers have high adherence to the telehealth program and improve their functional capacity, mental health and quality of life of older people with dementia. Telehealth is an alternative that can contribute to public policies and the development of effective intervention strategies that neutralize adverse outcomes. It can also be presented as an alternative to home care services, which could reduce demands for health resources.

Purpose: Exercise training is the central component in Cardiac Rehabilitation (CR). A baseline assessment of aerobic capacity is paramount for exercise prescription and safety. The Two-Minute Step Test (2MST) has been used to measure aerobic capacity in healthy older adults. However, the reliability and validity of the 2MST in older adults post-coronary revascularisation (CRV) is unknown.

Methods: A prospective observational study was conducted in a single CR centre. Two 2MSTs and one six-minute walk test (6MWT) were completed in a single session. The 2MST measurements were recorded by two raters for each individual. The six-minute walk distance (6MWD) and 2MST steps recorded by both raters were analysed to determine the relationship and agreement between measurements.

Results: Thirty one participants with a median (IQR) age of 66 (62,73) years old were included in the study post CRV. Strong positive correlations were found between steps achieved during the 2MSTs and the 6MWD (r = 0.87, 95% CI 0.82-0.91, p < 0.0001). Excellent inter-rater reliability was demonstrated between raters during the 2MSTs (ICC = 0.999-1.000, p = 0.000). Excellent relative test-retest reliability was demonstrated in both 2MSTs recorded by both raters (ICC = 0.927-0.934, p = 0.000). However, absolute test-retest reliability may have been limited by a learning effect between repeated 2MSTs.

Conclusions: The results of this study indicate that the 2MST may be used as an alternative to the 6MWT as an outcome measure for aerobic capacity in older adults post-CRV. However, a practice trial is recommended at baseline to account for a learning effect.

Background: Cardiorespiratory system involvement and early fatigue observed in stroke patients complicate the rehabilitation process and affect their ability to perform daily activities and functional independence.

Aim: It was aimed to determine the relationship between respiratory functions and respiratory muscle strength with trunk control, functional capacity, and functional independence in hemiplegic patients after stroke.

Materials and methods: Twenty-five volunteers who were diagnosed with post-stroke hemiplegia were included in the study. Sociodemographic and physical characteristics were recorded. Pulmonary function test (PFT), respiratory muscle strength, Trunk Impairment Scale (TIS), Timed-Up and Go Test (TUG), and Barthel Index (BI) were applied.

Results: There was a moderate negative correlation between TUG scores and PFT results (r = 0.413-0.502; p = 0.011-0.04), except for PEF (%) and FEV1/FVC. Also, there were statistically significant correlation between TIS scores and FEV1(%) (r = 0.505; p = 0.012), FVC(%) (r = 0.449; p = 0.024). On the other hand, there was no statistically significant relationship between BI results and any parameter of the PFT (p > 0.05). There was no statistically significant correlation between respiratory muscle strength and TUG, TIS, BI (p > 0.05).

Conclusion: It has been shown that respiratory functions are associated with functional capacity and trunk control. However, it was found that there was no relationship between respiratory muscle strength and functional capacity, trunk control, and functional independence. It is thought that considering these parameters in the assessment of patients will contribute to the creation of individual and effective rehabilitation programs. The respiratory system should be systematically assessed in stroke rehabilitation and considered as part of a holistic approach.

Clinical trial registration: NCT05290649 (retrospectively registered) (clinicaltrials.gov).