Physiotherapy Research International最新文献

Background and purpose: As health systems come under increasing pressure, supporting patients to self-manage their own condition is becoming increasingly important. A shift towards a more holistic, person-centred approach to healthcare in the hospital setting, through enhancing self-management support (SMS), is required to empower patients to increase independence in managing their own conditions. The study aim was to explore how physiotherapists perceive and implement SMS with patients in hospital inpatient settings.

Methods: A qualitative study approach was taken using semi-structured interviews (n = 8). Physiotherapists with at least 6 months experience working in the inpatient hospital setting were invited to participate. Interview data were analysed using the General Inductive Approach.

Results: Four themes were identified: (1) physiotherapists understanding and perceptions of implementation of SMS in the hospital, (2) SMS facilitates a person-centred and collaborative approach to healthcare, (3) SMS is beneficial to patients, physiotherapists, and the healthcare system, and (4) perceived challenges and potential solutions for SMS implementation.

Discussion: Overall, physiotherapists value the use of self-management support in the hospital. SMS was implemented by partnering with patients, facilitating patients to problem solve and providing education so that patients could play an active role in decision making and independently participate in their rehabilitation. However, there appears to be scope to improve physiotherapists' knowledge of SMS to enable implementation of a wider range of SMS tools in clinical practice. A limitation of this study is that most participants were New Zealand European and, therefore, the findings are not generalisable to all physiotherapists working in New Zealand.

Implications for physiotherapy practice: Physiotherapists perceive SMS to have a place in the inpatient hospital setting and can lead to better patient outcomes and reduce burden on the healthcare system. Enhancing physiotherapists' understanding of SMS and exploring other ways to implement SMS in hospital settings, may help to facilitate appropriate implementation.

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.

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 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).

Background: Urinary Incontinence (UI) is a global health issue that mainly affects the female population worldwide. Different approaches have been sought for the management of UI including Pelvic floor muscle training (PFMT) using Virtual Reality (VR) gaming. We conducted this study to evaluate the effectiveness of VR gaming for rehabilitation of pelvic floor muscles (PFM) and improving urinary symptoms in patients with UI.

Method: We've included studies that contain any type of VR in all geographic locations and settings with no restrictions on the date of publication, age, or gender. Our exclusion criteria include reviews, case series, case reports, unextractable data, unavailable full text, abstract only articles, and studies don't show the effects of VR as a treatment for UI. A pre-specified search term was used and modified according to the requirements of each of the following databases: PubMed, Web of Science, Scopus, Cochrane, Google scholar, and ScienceDirect. For risk of bias assessment, two assessment tools have been used: ROB 2.0 for RCTs and NIH for single arm studies.

Results: Of 915 papers identified from 6 databases, 341 papers were assigned for screening after removing duplicates, 11 papers were eligible for full text screening, and 4 papers were finally included. The qualitative analysis of the results identifies six outcomes grouped into three primary categories: PFM, urinary symptoms, and quality of life. Only urinary loss outcome was eligible for meta-analysis. The net effect between Game therapy + PFMT and PFMT reached MD = -5.49, 95% CI [-12.36:1.38] (heterogeneity; I² = 95%, p < 0.01).

Conclusion: Our research underscores the potential of VR gaming as a valuable adjunctive therapy for pelvic floor muscle rehabilitation in patients with UI. However, further studies are needed to explore its long-term effectiveness, optimal therapy parameters, and cost-effectiveness.

Registration: Our protocol has been registered in PROSPERO (CRD42022384500).

Objective: No reports on factors or Clinical prediction rules (CPRs) associated with walking independence among patients with vertebral compression fractures (VCFs) are available. Evidence regarding epidemiological walking independence rates is also sparse. Here, we sought to (i) obtain epidemiological data on the probability of inpatients with VCFs achieving walking independence, and (ii) develop and validate a CPR to determine walking independence in hospitalized patients with VCFs.

Patients and methods: We conducted a retrospective cross-sectional observational study of patients aged ≥60 years who were hospitalized for VCF at four hospitals in Japan in 2019-2022. The outcome was walking independence at discharge. We performed a binomial logistic regression analysis to assess predictors of walking independence. Five independent variables were entered: age, American Society of Anesthesiologists physical status, cognitive function, Berg Balance Scale (BBS), and 10-m walking test. Among the independent variables that were significant, we converted the continuous variables to binary data by calculating cut-off values and then created the CPR. The area under the curve (AUC) was calculated as the measure of the CPR's diagnostic accuracy, and internal validation was conducted by bootstrapping.

Results: Of the 240 patients, 188 (78.3%) achieved walking independence. Cognitive function and the BBS score (with a cut-off of 45 points) were identified as significant predictors. We created a CPR using these two items (0-2 points). The CPR's AUC was 0.92 (0.874-0.967), and internal validation by bootstrapping yielded a mean AUC of 0.919 with a slope of 0.965.

Conclusion: The walking independence rate of patients with a VCF during hospitalization was 78.3%, with cognitive function and BBS being predictors. The developed CPR performed well enough to retrospectively predict walking independence in VCF patients. The BBS cut-off value and the CPR may serve as useful indicators for clinicians to predict VCF patients' walking independence.

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.

Objectives: The objective of the study was to compare the effectiveness of combined exercise training during different menstrual phases on pain, quality of life and menstrual symptoms.

Methods: A total of 72 participants for the study were randomly assigned into three groups: Group 1 (N = 24), Group 2 (N = 24) and Group 3 (N = 24) which had undergone combined exercise training during the follicular, luteal and bleeding phases of their menstrual cycle, respectively. The treatment programme included combined exercise training involving deep breathing exercises, Kegel exercises, core strengthening exercises and stretching exercises. Exercises were repeated 5 times with hold duration of 15 s with total of 30-40 min session with 5-10 min of warm-up and cooldown sessions. Demographic data and outcome measures (Visual Analogue Scale [VAS], Menstrual Symptom Questionnaire [MSQ], and Working ability, Location, Intensity, Days, Duration [WaLIDD]) were assessed at baseline and assessed again during the first menstrual cycle after the completion of the treatment programme. One-way ANOVA was used for between-group comparisons of the normally distributed data.

Results: Within-group comparison of the outcome variables except VAS in group 3 showed a statistically significant difference in all groups. Comparison of post-intervention results of the outcome measures of all the groups revealed a statistically significant difference for the VAS, while there was no statistically significant difference for in between the comparison of the WaLIDD and MSQ scoring.

Conclusion: Combined exercise training is effective in reducing pain only when performed during follicular and luteal phases and significantly improve quality of life and menstrual symptoms in all phases of the menstrual cycle.