Physiotherapy Research International最新文献

Background and aim: Nocturnal enuresis (NE) is prevalent in children and adolescents and affects their social life later. Therefore, the objective of this study was to ascertain laser acupuncture (LA) therapy's effect on NE in adolescent females.

Methods: Sixty adolescent females diagnosed with chronic monosymptomatic nocturnal enuresis (MNE) were randomly divided into two equal groups: The intervention group (received LA and desmopressin) and the control group (received desmopressin only) (n = 30 each). Treatment was delivered and LA was used three times a week for 12 successive weeks. Abdominal ultrasonography and voiding calendar were used to assess bladder capacity and maximum voiding volume (MVV), respectively. The frequency of bed wetness was assessed throughout the trial period in a diary.

Results: Statistically significant differences were reported in the intervention group. Bladder capacity significantly increased in the intervention group (LA and desmopressin) than in the control group.

Conclusions: The results of this study suggest the beneficial influences of LA on MNE, despite the very poor quality of the literature's available evidence.

Background: Work and health are a national priority in Norway, and leading health authorities call for treatment approaches that incorporate these perspectives. We have little knowledge of how physiotherapists in private practice integrate the work perspective during the treatment of patients with musculoskeletal disorders. Thus, the purpose of this study was to gain more insight into the way physiotherapists in Norway integrate the aspect of work.

Methods: In 2021, all 2650 privately practising members of the Norwegian Physiotherapist Association received a web-based survey that was answered by 514 physiotherapists. The survey included questions about treatment approaches, competencies, and collaboration with other health professionals in the context of promoting work participation.

Results: 91% of the physiotherapists reported that they play an important role in assessing work ability. 75% were confident in assessing the patients' work ability, while 25% stated that they have little or some competence. 49% of the physiotherapists often contacted the general practitioner (GP) to discuss patients' ability to work, and 19% were often contacted by the GP. Only 14% stated that they were invited to participate in dialogue meetings with the Norwegian Labour and Welfare Administration. 28% of the physiotherapists reported that insufficient knowledge about social security issues was an obstacle in promoting the patient's work participation. The physiotherapists believed that increased use of standardised assessment tools, better knowledge of social security issues, and closer collaboration with other professionals may strengthen their role in promoting work participation.

Discussion and conclusion: Although physiotherapists promote work participation when treating patients on sick leave, limited communication with the stakeholders, and inadequate knowledge of social security issues pose an obstacle. To strengthen the physiotherapist's role in the return-to-work facilitation, work and health should become a separate subject in basic and advanced education programmes for physiotherapists.

Background: Tendinopathy is caused by repetitive motion, excessive stress on the tendon, overstretch, and motion past the critical angle of rotation or translation. There are various treatment options available for tendinitis, including those affecting both the upper and lower limbs and those of calcific and non-calcific types.

Hypothesis/purpose: Few reviews have analyzed the efficacy of Extracorporeal Shockwave Therapy (ESWT) in treating upper and lower limb tendinopathies while considering calcific and non-calcific-type tendinitis. This paper provides a review and meta-analysis on Randomized Controlled Trials (RCTs), which compared results from a group undergoing ESWT treatment to another group under different treatments.

Study design: Systematic review and meta-analysis.

Methods: A systematic search was conducted on PubMed, Web of Science, Embase, the Cochrane Central Register of Control Trials (CENTRAL), and Physiotherapy Evidence Database (PEDro) databases for articles published up to January 2022. The reference lists of identified articles were further scanned. Twenty-two studies were included in the meta-analysis.

Results: Meta-analysis showed no difference in pain reduction in ESWT when compared with a comparison group at 4 (p = 0.26) and 12 weeks (p = 0.33). There were no differences in DASH scores at 12 months between the two groups (p = 0.32).

Conclusion: Extracorporeal Shockwave Therapy (ESWT) is effective when used to treat lower limb and calcific tendinitis. It does not yield any better results than other treatment options in managing upper limb tendinopathies and non-calcific tendinopathies.

Objective: To evaluate and compare performance in the modified shuttle walk test (MSWT) with cardiorespiratory parameters and respiratory muscle strength in children with cystic fibrosis (CF) and healthy controls.

Methods: A cross-sectional study with children divided into the CF group (CFG) and healthy control group (HCG). Two MSWTs were performed and the data from the test with the longest distance walked and its cardiorespiratory parameters (blood pressure, respiratory rate, heart rate (HR), oxygen saturation, and dyspnea sensation) were considered, the last three every 4 levels. Respiratory muscle strength was evaluated using a manometer. The Wilcoxon test was used to compare the parameters before and after the MSWT, and the Mann-Whitney and independent t-tests were applied to compare the data between the groups. The distance walked and its association with the variation in cardiorespiratory parameters and respiratory muscle strength were analyzed by Spearman's correlation.

Results: Sixty-two children (31 in each group) participated, with an average age of 10.2 (2.1) years. Children with CF had poorer performance in the average distance walked (CFG 716.7 (274.3)) when compared to the HCG (948.0 (202.8)). Both groups exhibited an increase in all the cardiorespiratory parameters at the end of the test, but the CFG displayed less variation in some parameters. Children with CF presented a positive correlation between distance walked and respiratory muscle strength, HR variation, and systolic blood pressure.

Conclusions: There was no difference in respiratory muscle strength between the groups. In the CFG, the greater the respiratory muscle strength, the better the performance in the MSWT. The CFG exhibited less variation in cardiorespiratory parameters than the HCG.

Background and purpose: Weight-bearing exercises can help improve physical function; however, they may be difficult to perform in patients with neurological issues or lower limb fractures. The purpose of this study was to evaluate the activity of the leg muscles during squatting when using a new exercise aid designed to help patients with difficulty in performing squats, termed the sliding tilt table, at different knee angles and to estimate the squat level for each angle.

Methods: This study was a cross-sectional, observational study performed in the general community. Participants comprised 30 healthy adult men. Squats were performed by setting the knee joints at 30, 60, and 90° and the tilt table angles to 15, 30, and 45°. The muscle activity of the vastus medialis, tibialis anterior, and gastrocnemius was measured using surface electromyography.

Results: As the tilt table and knee joint angle increased, the %maximal voluntary isometric contraction increased. Similar patterns were found in both legs.

Conclusions: Weight-bearing exercises, such as squats, are important exercise elements in patients who require lower limb rehabilitation. Therefore, it is necessary to provide efficient lower limb rehabilitation exercises by adjusting the squat level according to the patient's ability, which can be achieved using a sliding tilt table.

Objective: This study examined the effectiveness of neuromuscular electrical stimulation (NMES) added to the exercise or superimposed on voluntary contractions on patient-reported outcomes measures (PROMs) in people with knee osteoarthritis (OA).

Methods: This systematic review was described according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) were obtained from a systematic literature search in five electronic databases (PubMed, PEDro, LILACS, EMBASE, and SPORTDiscus) in April 2022. We described the effects of intervention according to each PROMs (scores for Pain; Self-reported functional ability; Symptoms (hear clicking, swelling, catching, restricted range of motion, and stiffness); Daily living function; Sports function; and Quality of life) and used a random-effect model to examine the impact of NMES plus exercise on pain compared with exercise in people with knee OA.

Results: Six RCTs (n = 367) were included. In the qualitative synthesis, the systematic literature analysis showed improvement in pain after NMES plus exercise compared with exercise alone in three studies. The other three studies revealed no difference between groups in pain, although similar improvement after treatments. In the meta-analysis, NMES at a specific joint angle combined with exercise was not superior to exercise alone in pain management (standardized mean difference = -0.33, 95% CI = -1.05 to 0.39, p = 0.37). There was no additional effect of NMES on exercise on self-reported functional ability, stiffness, and physical function compared with exercise alone. In only one study, symptoms, activities of daily living, sports function, and quality of life improved after whole-body electrostimulation combined with exercise.

Conclusion: This review found insufficient evidence for the effectiveness of NMES combined with exercise in treating knee OA considering PROMs. While pain relief was observed in some studies, more high-quality clinical trials are needed to support the use of NMES added to the exercise in clinical practice. Electrical stimulation in a whole-body configuration combined with exercise shows promise as an alternative treatment option.

Background: Impairment in unimanual upper limb function is frequent among children with unilateral cerebral palsy (UCP), which affects their ability to perform functional activities.

Aim: To assess the efficacy of plyometric exercises on the function of upper extremity, selective motor control (SMC) and hand grip strength (HGS) in children with UCP.

Design: This was a double-masked, randomized, controlled clinical trial.

Setting: Outpatient Clinics of Faculty of Physical Therapy, Cairo University and Center for Physical Medicine, Rehabilitation and Rheumatology, Al-Agouza Hospital, Giza, Egypt.

Population: Forty children with UCP, ranging in age from 8 to 12 years, were randomly allocated to two groups equal in numbers.

Method: Children were allocated to receive conventional therapy (CONV-group; n = 20) or plyometric exercises (PLYO-group; n = 20) for 45 min. In addition, children of both groups received selected physical and occupational therapy programs (each lasted for 30 min) twice a week over 3-month. The intervention was delivered on non-consecutive days. Upper extremity function, SMC and HGS were assessed by using quality of upper extremity skills test (QUEST), Test of arm selective control and pneumatic squeeze bulb dynamometer, respectively.

Results: Overall, 35 children (18 in the CONV-group, 17 in the PLYO-group) completed data collection and treatment. With-in group comparison showed significant improvement in the study groups while post-treatment comparisons revealed a significant difference from mean difference in upper extremity function is 9.55 (8.71:10.39), SMC is 2.12 (1.51:2.72) and HGS is 2.91 (2.13:3.68) (p < 0.05; 95% Confidence interval) in favor of the PLYO-group.

Conclusions: Plyometric exercises have the capability to enhance upper extremity function and strength in children with UCP.

Background and purpose: Community mobility post-stroke is important for gaining independence in daily activities. Walking devices can facilitate mobility, but it remains unclear whether individuals who use a walking device walk as many daily steps as those who do not require a device. It is also unclear whether these groups differ in their independence in daily living. This study aimed (1) to compare daily steps, walking tests, and independence in basic and instrumental activities of daily living (IADL) six months post-stroke between individuals who walk independently and individuals who use a walking device, (2) within each group to assess correlations between daily steps and walking tests, independence in basic and IADL.

Methods: Thirty-seven community-dwelling individuals with chronic stroke; 22 participants used a walking-device and 15 participants walked independently. Daily steps were calculated as a 3-day mean by hip accelerometers. Clinical walking tests included the 10-m-walk-test, Timed Up & Go and 'Walking While Talking'. Daily living was assessed using the Functional-Independence Measure and the IADL questionnaire.

Results: Daily steps of the device-users were significantly lower than the independent-walkers (195-8068 versus 147-14010 steps/day) but independence in daily living was not significantly different. Different walking tests correlated with daily steps for device-users and independent-walkers.

Conclusions: This preliminary investigation in chronic stroke revealed that device-users walk significantly fewer daily steps but are as independent in daily living as independent-walkers. Clinicians should differentiate between individuals with and without a walking device and the use of different clinical walking tests to explain daily steps should be considered. Further research is needed to assess the impact of a walking device post-stroke.

Background: Cardiac rehabilitation is recommended for patients undergoing open-heart surgery (OHS). During the hospital admission, these patients suffer from reduced cardiopulmonary performance and decreased psychological health, leading to poor physical function, depression, and morbidity. To prevent post-operative pulmonary complications, a pre and post-operative physical therapy intervention is recommended for patients undergoing heart surgery. Virtual reality (VR) promotes the health status of healthy individuals and those with health conditions. However, few studies have reported the beneficial effects of VR exercise programs on the pulmonary performance and mental health status of patients undergoing OHS.

Objectives: To determine whether by using training enhanced by VR, patients who have undergone OHS can more effectively attain cardiopulmonary performance and improve depression than through conventional physical therapy.

Method: 60 participants were randomly assigned to a conventional physical therapy and VR exercise program. Each session was conducted once daily until discharge from the hospital. Cardiorespiratory performance and depression were evaluated before surgery and at the time of discharge from the hospital. A two-way mixed ANOVA was performed to compare within (i.e., pre and post-operation) and between (i.e., VR and conventional physical therapy) groups.

Results: No significant cardiopulmonary performance gains were detected in patients receiving the VR exercise program when compared with those who participated in conventional physical therapy prior to post-operative OHS (p > 0.05). However, the conventional physical therapy group showed significantly higher depression scores than the VR group (∆4.00 ± 0.98 vs. ∆1.68 ± 0.92). However, cardiopulmonary performance did not differ in both VR exercise and conventional physical therapy.