Physiotherapy Research International最新文献

Aim: To examine if a novel reactive balance training program (ReacStep) designed for clinical settings is acceptable to clinicians prescribing balance and mobility training.

Methods: ReacStep consists of tether-release reactive step training, volitional trip and slip training, and functional strength training. An open survey comprising 11-point visual analog scale items (0 = strongly disagree to 10 = strongly agree) based on the Theoretical Framework of Acceptability was sent to clinicians working in balance and mobility training. Items evaluated the acceptability of ReacStep across seven domains (intervention coherence, perceived efficacy, self-efficacy, ethicality, affective attitude, burden and opportunity cost).

Results: Two hundred and seven clinicians (169 Physiotherapists, 22 Exercise Physiologists, 11 Occupational Therapists and five others) completed the survey. Respondents considered ReacStep to have good overall acceptability, intervention coherence, effectiveness, ethicality and self-efficacy (mean acceptability scores >7). However, respondent's ratings of ReacStep's affective attitude, burden and opportunity cost were more variable (mean acceptability scores 2-8) due to concerns about client anxiety, the need for a safety harness and staffing and training requirements. Respondents considered that ReacStep would be more effective and safer to conduct in geriatrics clients compared with neurological clients, and that it would be more appropriate for rehabilitation and private practice settings compared to home settings.

Conclusions: ReacStep was generally acceptable from the perspective of clinicians who prescribe balance and mobility training in various clinical settings, and was deemed more effective and safer for older clients without neurological conditions, and beneficial in outpatient rehabilitation and private practice settings.

Background and purpose: To our knowledge, there is currently no research on telerehabilitation concerning artists. This study aims to assess the feasibility, acceptability, and effectiveness of utilizing video-based telerehabilitation in physiotherapy among artists during the COVID-19 pandemic.

Methods: Fifty-one artists who accessed virtual physiotherapy between November 2020 and February 2022 at a healthcare center that provides specialized healthcare services to artists of all disciplines who reside or work in Ontario, Canada were asked to complete a 26-item online questionnaire about their experience with virtual physiotherapy.

Results: The 51 respondents were from a range of artistic disciplines, with the largest portion being musicians (n = 22; 43%). Of the respondents, 86% (n = 44) felt the virtual physiotherapy met their expectations in therapeutic benefits, 78% (n = 40) were confident in performing all the exercises that the physiotherapist demonstrated on the virtual platform, 80% (n = 41) did not run into many technological challenges when booking or attending virtual sessions, and 54% (n = 20) reported similar treatment outcomes between virtual and in-person sessions. Although artists liked the convenience of accessing physiotherapy from home, 53% (n = 17) of respondents rated the lack of physical contact as a major limitation in telerehabilitation.

Conclusion: Telerehabilitation for artists during the COVID-19 pandemic has shown potential to be an effective and viable alternative to in-person physiotherapy, as demonstrated by high satisfaction levels and comparable treatment outcomes, especially when public health restrictions were in place. Future research can explore hybrid models (mix of in-person and virtual sessions) in physiotherapy to meet the needs for physical contact during sessions.

Background: Balance while seated and the capacity to conduct selective trunk movements are significant predictors of functional outcomes following stroke. Patients with inappropriate muscle activation and inadequate movement control in the trunk muscles cause mobility and daily function difficulties. Stroke patients have weak leg muscles and decreased balance, resulting in compensatory changes. Functional postural strategy training is necessary to restore balance in these patients. Few studies have examined the effect of physical therapy trunk exercises with hip strategy training on improving balance and increasing independence after stroke.

Purpose: This study aimed to explore the effect of selective trunk exercises (STE) with hip strategy training in improving balance in patients with stroke as well as independence levels.

Method: A multicenter inpatient stroke treatment randomized pre- and post-test control trial. Forty-six stroke survivors were randomly allocated to experimental or control groups (n = 23 each). The experimental group received hip strategy training and trunk exercises. All groups received Neuro-Developmental Treatment (NDT)-based physical therapy four times a week for 6 weeks. Trunk impairment scale, Berg Balance Scale (BBS), and functional independence measure (FIM) measured static and dynamic seated balance, functional balance, and trunk movement coordination pre- and post-therapy.

Results: The experimental group's post-therapeutic measures were substantially higher than the control group. The experimental group's TIS score, and subscale improved more than the control group. The experimental group considerably increased the BBS score. The experimental group also showed greater FIM gains.

Conclusions: This study demonstrated that adding STE in conjunction with hip strategy training to patients after has a positive impact on trunk control while maintaining static and dynamic sitting balance, functional balance, and independence levels which are effective in stroke rehabilitation.

Background: Cognitive decline is a debilitating symptom in Parkinson's disease (PD). Cognitive impairment in PD has a significant impact on many aspects of an individual's life, social interactions, and overall quality of life (QOL). It is also associated with a faster disease progression and an increased risk of developing dementia. A biopsychosocial approach is likely to address not only the underlying biological mechanisms of cognitive impairment in PD but also the psychological and social factors that can contribute to cognitive decline and influence treatment outcomes.

Method: This experimental study was conducted on 60 older adults with PD at Saveetha medical college and hospital. Participants who met the inclusion criteria were randomly allocated into two groups of Biopsychosocial (n = 30) and conventional (n = 30). Participants in the intervention group received the multiple interventions based on the biopsychosocial approach with a duration of 60 min per session. Pre and post-test evaluation conducted using Scales for Outcomes in PD-cognition (SCOPA-cog) and Parkinson disease QOL Questionnaire (PDQ-8).

Result: The results of the study showed that there is a statistically significant difference in the median scores within the Groups for the outcome measures SCOPA-cog and PDQ-8 (p < 0.001). For SCOPA-cog, the BPS group median score increased from 30 to 36, while the Conventional group median score increased from 31 to 33. For PDQ-8, the BPS group median reduced from 27 to 14, compared to the Conventional group's reduced from 30 to 24. On comparison between the post-test values, the biopsychosocial approach group showed more improvement in cognition and QOL with (p < 0.001).

Conclusion: The findings of this study concluded that the biopsychosocial approach is effective in improving cognition and QOL among the Parkinson population.

Background: Primary dysmenorrhea leads to significant gynecological consultations, school absenteeism, disrupted daily activities, and adversely affects overall quality of life (QOL).

Purpose: This study compared the effects of aquatic exercise versus aerobic exercise on primary dysmenorrhea and QOL in adolescent females.

Subjects and methods: Sixty adolescent females suffering from primary dysmenorrhea with moderate to severe intensity were distributed randomly and equally into two groups was registered at ClinicalTrials.gov (NCT06129708) the Registration Date, November 13, 2023; group A was treated by aquatic exercise for 12 weeks, while group B was treated by aerobic exercise for 12 weeks. Assessment of both groups before and after treatment involved evaluating dysmenorrhea severity using the WaLIDD Score, measuring pain intensity with the numeric pain rating scale (NPRS), determining pressure pain threshold (PPT) with an algometry, and evaluating the QOL using EuroQol-5 Dimension-3 Level (EQ-5D-3L) and EuroQol-visual analog scale (EQ-VAS).

Results: Both groups, A and B, experienced significant reductions in the WaLIDD score, NPRS, and all domains of EQ-5D-3L (p < 0.05), coupled with significant increases in PPT and EQ-VAS (p < 0.05). Posttreatment comparisons between the groups showed insignificant differences in WaLIDD score, NPRS, and PPT (p > 0.05). However, there was a significant decrease in EQ-5D-3L and a significant increase in EQ-VAS, favoring group A (p < 0.05).

Conclusion: Both aquatic and aerobic exercises are effective methods in primary dysmenorrhea management and QOL improvement in adolescent females, with a better effect of aquatic exercise in enhancing QOL.

Introduction: Long COVID occurs when numerous symptoms begin 3 weeks after acute infection and last for 12 months or more. High-definition transcranial direct current stimulation (HD-tDCS) has been tested in patients with COVID-19; however, previous studies did not investigate the HD-tDCS use combined with inspiratory muscle training (IMT) for respiratory sequelae of long COVID.

Case presentation: Six individuals (four women and two men) aged between 29 and 71 years and presenting with respiratory sequelae of long COVID were included. They were submitted to an intervention that comprised HD-tDCS combined with IMT twice a week for 5 weeks. Lung function and respiratory muscle assessments were performed at baseline and after 5 weeks of intervention.

Implications on physiotherapy practice: HD-tDCS may enhance the IMT effects by increasing respiratory muscle strength, efficiency, and lung function of individuals with long COVID.

Background and objectives: Dysphagia is a common complication following stroke. It corresponds to the development of pneumonia, which is always associated with bad prognosis, longer hospital stays and increased mortality. The aim of the study was to assess the impact of physical therapy intervention of dysphagia on preventing pneumonia in acute stroke patients.

Methods: A single-blind randomized controlled trial was carried out on 70 ischemic stroke patients with oropharyngeal dysphagia, age ranged from 49 to 65 years. They were randomly assigned to two groups (control and study) of equal number. Patients in the control group received oral care and nasogastric tube feeding, while patients in the study group received the same program in addition to the designed physical therapy program (exercises and neuromuscular electrical stimulation). The intervention program was applied for 40 min/session, 1 session/day, and 5 days/week for 4 weeks. Gugging swallowing screen (GUSS), and stroke associated pneumonia (SAP) control and prevention criteria were used to assess dysphagia and incidence of pneumonia at baseline, after two and 4 weeks of intervention for both groups.

Results: Before treatment, all patients were susceptible to pneumonia after two and 4 weeks of intervention; there were a significant increase in GUSS score in both groups with more improvement in favor of the study group (p < 0.05) and a statistically significant increase in incidence of SAP after 2 weeks of intervention only in the control group (p < 0.05). The results also showed a significant negative correlation between GUSS score and SAP (r = - 0.3662, p = 0.0018) IMPLICATIONS FOR PHYSIOTHERAPY PRACTICE: adding physical therapy (exercise therapy and neuromuscular electrical stimulation) to oral care and nasogastric tube feeding is effective in improving oropharyngeal dysphagia and decreasing the incidence of aspiration pneumonia in acute ischemic stroke patients.

Background: Aberrant movement in chronic low back pain (CLBP) is associated with a deficit in the lumbar multifidus (LM) and changes in cortical topography. Anodal transcranial direct current stimulation (a-tDCS) can be used to enhance cortical excitability by priming the neuromuscular system for motor control exercise (MCE), thereby enhancing LM activation and movement control. This study aimed to determine the effects of a 6-week MCE program combined with a-tDCS on cortical topography, LM activation, movement patterns, and clinical outcomes in individuals with CLBP.

Methods: Twenty-two individuals with CLBP were randomly allocated to the a-tDCS group (a-tDCS; n = 12) or sham-tDCS group (s-tDCS; n = 10). Both groups received 20 min of tDCS followed by 30 min of MCE. The LM and erector spinae (ES) cortical topography, LM activation, movement control battery tests, and clinical outcomes (disability and quality of life) were measured pre- and post-intervention.

Results: Significant interaction (group × time; p < 0.01) was found in the distance between LM and ES cortical locations. The a-tDCS group demonstrated significantly fewer discrete peaks (p < 0.05) in both ES and LM and significant improvements (p < 0.05) in clinical outcomes post-intervention. The s-tDCS group demonstrated a significant increase (p < 0.05) in the number of discrete peaks in the LM cortical topography. No significant changes (p > 0.05) in LM activation were observed in either group; however, both groups demonstrated improved movement patterns.

Discussion: Our findings suggest that combined a-tDCS with MCE can separate LM and ES locations over time while s-tDCS (MCE alone) reduces the distance. Our study did not find superior benefits of adding a-tDCS before MCE for LM activation, movement patterns, or clinical outcomes.

Background: Diabetic peripheral neuropathy (DPN) occurs in >50% of diabetic patients and is a high risk-factor of balance problems and risk of falls. Impaired balance can lead to reduced function, which has a detrimental effect on patients' quality of life. Structured strength and balance training can result in sustained improvements in muscle strength, coordination, balance, functional status and quality of life.

Objective: To determine the combined effects of strength and balance training versus aerobic training on balance, severity of symptoms of DPN, and quality of life in patients with DPN.

Methods: This double blinded, two arm parallel design Randomized Clinical Trial. The study was conducted from March to December 2020 in the AIMS diabetic center Peshawar, Pakistan. Participants were selected through convenience sampling technique and randomly allocated into strength plus balance and aerobic training groups. Type 2 diabetic patients of both sexes, aged 40 to 80 years, with a Toronto neuropathy score ≥6 recruited, while patients with ulceration/infection of feet, medical/Surgical conditions, and non-ambulatory patients were excluded from this study. Intervention was applied 3 days a week for 8 weeks. The Toronto clinical neuropathy system was used to assess neuropathy severity, SF-36 to assess quality of life and the Berg balance scale was used for assessment of balance. Assessment was done at the baseline and after 8 weeks of intervention using SPSS. Version 22 was used for analysis.

Results: The mean age of the participants was 60.80 ± 9.73. Between group analysis, which showed were statistically insignificant for neuropathy severity, balance and all domains of quality of life (p-value >0.05) except SF-36 General Health Perception Score, with Mean ± SD of 62.50 ± 7.54 in group A versus Mean ± SD of in group B 60.00 ± 15.98 (p-value = 0.05). Within group analysis showed statistically significant results for neuropathy severity, balance and all domains of quality of life (p-value<0.05).

Conclusion: This study concluded that there is a statistically significant effect of structured balance and strength training and aerobic training on severity of DPN, balance and quality of life. But there was no statistically significant difference in improvement between the two intervention groups.

Background and purpose: Evidence regarding whether reducing sedentary behavior and increasing physical activity levels to prevent stroke recurrence is insufficient. Therefore, this study preliminarily investigated whether post-discharge sedentary behavior and physical activity levels in patients with minor ischemic stroke were associated with stroke recurrence.

Methods: This retrospective observational study included 73 patients (aged 72.0 years) with minor ischemic stroke from a previous study. The outcome was recurrent stroke 2 years after stroke onset, assessed using medical records. Exposure factors including sedentary behavior and physical activity levels 6 months post-discharge were measured using accelerometers; patients were classified into the recurrence or non-recurrence groups. Logistic regression analyses were then conducted to determine whether sedentary behavior and physical activity 6 months after discharge were associated with stroke recurrence.

Results: Six patients experienced stroke recurrence (recurrence rate, 8.2%). The recurrence group showed greater sedentary behavior (recurrence group 68.0%, non-recurrence group 52.0%, p = 0.007) and less light-intensity physical activity (LPA) (recurrence group 21.0%, non-recurrence group 37.0%, p = 0.002) than in the non-recurrence group. Logistic regression analysis showed that sedentary behavior (odds ratio = 1.083, 95% confidence interval = 1.007-1.165, p = 0.032) and LPA (odds ratio = 0.874, 95% confidence interval = 0.785-0.975, p = 0.015) were independent factors for recurrence of stroke.

Discussion: Post-discharge sedentary behavior and LPA in patients with minor ischemic stroke were associated with stroke recurrence. Results suggest that reducing post-discharge sedentary behavior and increasing LPA may be crucial for reducing the risk of stroke recurrence in patients with minor ischemic stroke.