Physiotherapy Research International最新文献

Background and purpose: Erectile dysfunctions (ED) are highly prevalent in men with chronic kidney diseases and undergoing haemodialysis (HD). The current pilot randomised controlled trial (RCT) aimed to study the effect of intradialytic aerobic exercises on ED and related outcomes in men undergoing HD.

Methods: The participants were randomly allocated to either the exercise or control group. Participants in the exercise group received intradialytic cycling exercises three times weekly for 12 weeks, and no intervention in the control group. The International Index of Erectile Function- Five Items (IIEF-5) was the primary outcome. The secondary outcomes assessed self-esteem, loneliness, depression, and stress. Independent sample t-test, Cohen d effect size, and analysis of covariance were adopted at the level of 95% confidence interval (CI).

Results: The IIEF-5 was improved significantly in favour of the intradialytic exercises (p < 0.01, Cohen d = 1.1). The mean difference in IIEF-5 was 2.65 points, with 95% CI ranging between 1.8 and 3.4 points. All secondary outcomes showed significant improvements in the intervention group compared with controls (p < 0.001). Haemoglobin level at the baseline was the significant covariate (t = -2.49, p = 0.019) for the change in the IIEF-5. No adverse events or side effects were observed in the exercise group.

Discussion: This RCT provides initial evidence supporting intradialytic aerobic exercises as an effective and safe intervention for ED and associated outcomes in HD. Early incorporation of intradialytic aerobic exercises in HD management may improve the efficacy of interventions targeting sexual outcomes such as pharmacological interventions among HD populations. Future research, including objective outcomes and biomarkers at long-term follow-up, is required to confirm the beneficial effects of the exercises.

Background and purpose: Tuberculosis primarily affects the lungs, and many patients experience sequelae, including loss of lung function and a decline in health-related quality of life (HRQoL), despite bacteriological cure. Although post-tuberculosis lung disease (PTLD) is a growing concern worldwide due to poor physical functioning, little is known about peripheral muscle dysfunction. Therefore, the objective of this study was to evaluate patient performance during the Glittre Activities of Daily Living Test (TGlittre) and assess its association with muscle function, lung function, and HRQoL.

Methods: This cross-sectional study included 47 patients with PTLD who underwent the TGlittre. We also assessed patients for respiratory muscle strength, handgrip strength (HGS), quadriceps muscle strength (QMS), and HRQoL using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).

Results: HGS and QMS were reduced in 34% and 25.5% of participants, respectively. Spirometry showed an obstructive pattern, a restrictive pattern, and a normal pattern in 46.8%, 31.9% and 21.3% of participants, respectively, while 42.6% of them had reduced diffusion capacity of lung for carbon monoxide (DLCO). The median TGlittre time was 4.43 (3.48-4.96) minutes, about 15% longer than the expected time to complete it. There was a significant correlation between TGlittre time and DLCO (r_s = -0.532, p < 0.0002), maximum inspiratory pressure (r_s = -0.407, p = 0.005), maximum expiratory pressure (r_s = -0.382, p = 0.008), HGS (r_s = -0.327, p = 0.024), QMS (r_s = -0.314, p = 0.031), and various SF-36 domains. In the regression analysis, DLCO, QMS, and HGS explained 39% of the variability in TGlittre time.

Discussion: PTLD significantly impacts functional capacity, as determined by TGlittre. These patients have muscle dysfunction, deteriorated HRQoL, and impaired lung function. Impaired lung diffusion and reduced peripheral muscle strength (PMS) are independently associated with lower functional capacity. Therefore, rehabilitative strategies are crucial for improving care for this group of patients. This is the first study using the TGlittre to explore PMS in PTLD.

Trial registration: The protocol was registered on ClinicalTrials.gov with the identifier NCT06127641.

Background and purpose: Stroke is among the most prevalent medical conditions and often leads to persistent complications within the central nervous system. It results in both physical and cognitive impairments that can substantially affect individuals' ability to perform activities of daily living (ADL). Conventional rehabilitation exercises are frequently lengthy, repetitive, and unengaging, which may reduce adherence and limit therapeutic outcomes. Therefore, there is a pressing need to explore innovative approaches that enhance motivation, increase the frequency and duration of exercises, and improve patient satisfaction.

Methods: This protocol describes a randomized, two-blind controlled trial with blinded outcome assessment. The study will be conducted at a physiotherapy clinic in Tabriz and will compare standard rehabilitation with an intervention combining standard rehabilitation and a virtual reality (VR)-based serious game.

Results: A VR-based serious game is an innovative technology incorporating advanced user-computer interaction to deliver simulation and engagement through visual and auditory feedback. Due to the ongoing debate about the effectiveness of VR-based serious gaming interventions and the limited availability of high-quality clinical trials, further research is warranted. To date, no studies have examined the integration of VR with conventional treatments or compared it with standard physiotherapy practices.

Discussion: The aim of this study is to investigate the effect of a VR-based serious game on promoting cognitive-motor rehabilitation in stroke patients, with a focus on improving performance in daily life activities. This protocol outlines the methodology for a prospective randomized controlled trial designed to generate evidence supporting the use of VR technologies in stroke rehabilitation.

Background: Developmental delays in children pose significant challenges, necessitating effective intervention strategies to promote optimal development. Reflex integration therapy, which involves structured movement exercises to encourage reflex maturation, has emerged as a promising approach to address developmental delays, yet its efficacy remains underexplored in clinical settings.

Aim: This study aimed to evaluate the effectiveness of reflex integration therapy in a one-year-and-six-month-old female child diagnosed with developmental delay, focusing on integrating the asymmetric tonic neck reflex (ATNR) and enhancing gross motor function.

Case description: The subject, Baby Dhanvi, presented with persistent ATNR and failure to achieve age-appropriate milestones despite her age. Treatment interventions included reflex integration therapy, exercises targeting motor skills, vestibular stimulation, and verbal and visual stimulation. The therapy sessions spanned a period of 20 days, with assessments conducted pre- and post-treatment.

Results: After 20 days of therapy, significant improvements were observed in ATNR integration, as measured by the Sally Goddard Reflex Rating Scale. Additionally, Baby Dhanvi exhibited moderate enhancement in gross motor function, leading to the attainment of previously unmet milestones, as evidenced by the Trivandrum Development Screening Chart.

Conclusion: This case study provides compelling evidence supporting the efficacy of reflex integration therapy in addressing developmental delay, particularly in integrating ATNR and enhancing gross motor function. The findings underscore the potential of reflex integration approaches in clinical settings, emphasizing the importance of further research and application to optimize outcomes for children with developmental delays.

Background and purpose: Stress urinary incontinence (SUI) is characterized by the involuntary leakage of urine on physical activities or sneezing or coughing. Despite a considerable number of studies on physiotherapy for female SUI have been published, a bibliometric analysis that comprehensively quantifies and summarizes these studies is still lacking. Thus, the aim of this study is to summarize the current state of this area based on bibliometrics and to suggest future research trends.

Methods: We searched literature in the Web of Science database from the inception to 11 August 2024 and extracted the information of countries, institutions, authors, journals, references and keywords. CiteSpace v 6.2.4, VOSviewer v 1.6.19, and Origin 2024 were used for analysis and visualization.

Results: A total of 447 papers, published between 1986 and 2024, were included. The annual publication number has increased on average. The United States ranked first in the publication numbers, but the New Zealand had the highest average article citations. The University of Otago and the International Urogynecology Journal published the highest number of literature. The author of Bo, K ranked first in terms of scientific productions. While, the paper with the highest citation numbers was published by Dumoulin, C (2018). The keywords "stress urinary incontinence," "women," and "pelvic floor muscle training" ranked in the top three on occurrence frequency. In trend topics analysis, the frontier topics may be identified as "sexual function," "laser therapy," and "internet-based treatment."

Conclusions: This bibliometric analysis highlights the increasing research output on female SUI. Key research areas include pelvic floor muscle training, while emerging trends such as sexual function, laser therapy, and interest-based treatments suggest the need for future studies to explore innovative and patient-centered approaches to female SUI management.

Background and purpose: Pregnancy is a unique life stage for women and is also an independent risk factor for pelvic floor disorders (PFD). Physiological changes during pregnancy can weaken pelvic floor support, potentially leading to common pelvic floor dysfunctions such as urinary incontinence, fecal incontinence, chronic pelvic pain, sexual dysfunction, rectus diastasis, and pelvic organ prolapse if left unaddressed. Early preventive interventions are recommended to reduce the overall incidence of PFD. This review aims to summarize various preventive health care strategies for pelvic floor health during pregnancy.

Methods: A comprehensive review of the literature was conducted, focusing on studies related to pelvic floor health care during pregnancy. Relevant articles were selected based on their contributions to understanding preventive measures and interventions aimed at maintaining pelvic floor health.

Results: The research findings outline effective methods for pelvic floor health care during pregnancy, including health education, breathing exercises, pelvic floor muscle training, weight management, perineal massage, and holistic exercise programs. The literature search spanned six electronic databases (PubMed, Cochrane Library, Web of Science, CNKI, Wanfang, and Weipu) with 60 studies meeting inclusion criteria. Given the profound impact of pelvic floor dysfunction on women's quality of life, these strategies can specifically alleviate pelvic floor strain during pregnancy, improve delivery outcomes, promote postpartum recovery, and reduce the risk of PFD, thereby playing a significant role in supporting the overall health of mothers.

Discussion: Emphasizing early management of pelvic floor health is crucial for the recovery of pelvic floor tissues in pregnant women and should be widely implemented in clinical practice. Healthcare providers should consider each pregnant woman's individual health status, physical abilities, and maternal-fetal safety to develop personalized exercise plans, employing appropriate strategies for early intervention against the pelvic floor during pregnancy which may successfully prevent pelvic floor disorders in women.

Background and purpose: Deteriorated upper extremity function is a leading cause of potential disability and functional decline in breast cancer survivors (BCS) not only during their active treatment but also in their survivorship continuum. Fatigue and decreased muscle strength are the prominent ones that can account for decreased upper extremity function. Therefore, this study aimed to explore the potential contributors to the upper extremity function of BCS.

Methods: A total of 100 BCS were included. Handgrip strength (HGS) was assessed with a dynamometer while fatigue and self-reported upper extremity function were assessed with the Fatigue Severity Scale (FSS), Disabilities of Arm, Shoulder, and Hand Questionnaire (DASH), respectively. To control the potential confounding effect of the handedness, the mean value of HGS was used in the regression model.

Results: HGS was found to be significantly higher on the right side compared to the left side (22.71 ± 3.51 kg vs. 21.45 ± 3.66 kg, t = 5.328, p < 0.001). The mean scores of DASH and FSS were found 21.97 ± 15.62, and 39.62 ± 12.16, respectively. The multivariate linear regression analysis showed that a total of 26.9% of the cumulative variance in DASH is explained by the mean HGS, FSS, and body mass index (BMI) (F (4,95) = 11.793, p < 0.001, R² = 0.269, Cohen's f²:0.54). There were no significant effects and/or interactions of any clinical features of BCS on DASH. FSS and DASH also significantly correlated with each other (r = 0.49, p < 0.001).

Discussion: This study showed that HGS shows itself as a significant outcome measure to predict upper extremity function in BCS. Because BCS can experience fatigue even years after the completion of primary treatment, it is noteworthy to consider it when evaluating the function of BCS.

Trial registration: ClinicalTrials.gov Identifier: NCT04245657.

Background: Smartphones and tablets can be used by clinicians to measure 2D joint and segment kinematics, which helps inform important treatment decisions. However, whether 2D kinematic measures obtained with these devices are reliable is unknown.

Objective: This study examined the inter- and intrarater reliability of 2D kinematic measures obtained using handheld devices.

Methods: CINAHL, Embase, PubMed, and SPORTDiscus database searches were performed using Medical Subject Heading terms, keywords, and text words related to reliability, handheld device, 2-dimensions, video analysis, application, kinematics, and functional movement. The initial search resulted in 407 potentially relevant titles. Following title, abstract, and full-text screening, 8 studies were included in this review. To be included, studies must have examined the inter- or intrarater reliability of 2D joint or segment kinematics measured using digital video on either a smartphone or tablet. Study quality was evaluated using the Quality Appraisal of Reliability Studies (QAREL) tool.

Results: Inter- and intrarater reliability intraclass correlation values varied considerably between and within studies. These varied reliability findings can be attributed to differences in testing protocol and equipment, activity examined, the discrete point of interest during an activity (e.g., time of initial contact or peak knee flexion), and joint(s) or segment(s) of interest.

Conclusion: Using smartphones and tablets to measure 2D joint and segment kinematics clinically is promising as it can be performed reliably. However, clinicians should be aware of the potential impact of their methodological decisions on the reliability of joint or segment kinematics obtained using these handheld devices.

Trial registration: This study was registered with PROSPERO on May 12, 2022 (CRD42022330137).

Background: Aspiration is the most severe complication of dysphagia in patients with poststroke dysphagia (PSD). However, the risk factors associated with aspiration remain inadequately understood.

Objective: To determine the associated risk factors for aspiration in patients with PSD.

Methods: A total of 321 dysphagia patients with first-ever stroke were retrospectively enrolled. We differentiated patients with aspiration from those without aspiration via swallowing function screening, clinical swallowing function examinations, and videofluoroscopic swallowing studies. We conducted a comparative analysis of the basic demographic data, disease-related information, and clinical characteristics between the two groups via multivariate logistic regression.

Results: Multivariate logistic regression analysis revealed that age ≥ 65 years (OR = 3.596, 95% CI: 1.251-10.335), history of pneumonia (OR = 3.617, 95% CI: 1.174-11.148), severe dysarthria (OR = 7.331, 95% CI: 1.314-40.889), number of chronic diseases > 2 (OR = 4.814, 95% CI: 1.61-14.397), bilateral brain injury (OR = 6.673, 95% CI: 1.926-23.115), a lesion location in the brainstem (OR = 4.581, 95% CI: 1.05-19.987), and a higher water swallowing test score (OR = 1.806, 95% CI: 1.113-2.93) were risk factors for aspiration. Conversely, a high Montreal Cognitive Assessment (MoCA) score (OR = 0.919, 95% CI: 0.849-0.995) and a high cut-off value of the repetitive saliva swallowing test (RSST) (OR = 0.149, 95% CI: 0.067-0.332) were identified as protective factors.

Discussion: Timely diagnosis and intervention for aspiration should prioritise patient populations aged 65 years and older, individuals with a history of pneumonia, those exhibiting severe dysarthria, patients with multiple chronic conditions, individuals with bilateral brain injuries, patients with lesions situated in the brainstem, and those exhibiting higher WST scores.

Trial registration: This study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2500097142).

Background and purpose: Thoracic hyperkyphosis is characterised by an increase in the normal angle of the thoracic kyphosis. Several factors make adolescents and young adults a potential risk group for postural hyperkyphosis. Among the treatment options, therapeutic exercise allows patients to take an active role, providing a number of beneficial effects. The aim of this systematic review was to evaluate the scientific evidence on the efficacy of therapeutic exercise for hyperkyphosis in adolescents and young adults.

Methods: A search in six databases (PubMed, Medline, PEDro, Scopus, SPORTDiscus and ENFISPO) was performed during January and February 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).

Results: Nine randomised clinical trials were analysed. Regarding methodological quality, four studies were of fair quality and five were of good quality. In all studies, a significant improvement in thoracic kyphosis angle was obtained. In addition, improvements were found in different aspects related to hyperkyphosis, such as lumbar lordosis angle, balance, quality of life and pain, among others.

Conclusions: Therapeutic exercise appears to be effective in the management of hyperkyphosis in adolescents and young adults. However, many variables related to hyperkyphosis are not subject to primary evaluation and the quality of the evidence found is fair to good.