Journal of Physiotherapy最新文献

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In adults with chronic obstructive pulmonary disease, long-term telerehabilitation and unsupervised home-based treadmill training reduced hospitalisations and emergency department presentations compared with usual care [commentary] 对于患有慢性阻塞性肺疾病的成人，与常规护理相比，长期远程康复和无监督的家庭跑步机训练减少了住院和急诊科就诊。

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.008

Claire M Nolan

引用次数: 0

Appraisal of Clinical Practice Guideline: Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: 2018 临床实践评价指南:择期结直肠手术围手术期护理指南:增强术后恢复(ERAS)学会推荐:2018。

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.007

Ianthe Boden

引用次数: 0

Active pelvic movements on a Swiss ball reduced labour duration, pain, fatigue and anxiety in parturient women: a randomised trial 在瑞士球上积极的骨盆运动减少了产妇的分娩时间、疼痛、疲劳和焦虑:一项随机试验。

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.11.001

Alexandre Delgado , Melania M Amorim , Andreza do Amaral Paraiba Oliveira , Keytte Camilla Souza Amorim , Marina Wanderley Selva , Yasmin Eduarda Silva , Andrea Lemos , Leila Katz

Question

How much do active pelvic movements on a Swiss ball during labour affect maternal and neonatal outcomes?

Method

A randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis.

Participants

Two-hundred parturient women.

Intervention

The experimental group performed pelvic anteversion and retroversion, lateral pelvic tilts and circular hip movements according to individual obstetric evaluation (foetal station and position, cervical dilatation and the presence of early pushing urge) on a Swiss ball. The control group received usual care. Both groups were permitted to walk and shower.

Outcome measures

The primary outcome was the duration of the first stage of labour. The secondary outcomes were the duration of the second stage of labour, pain intensity, delivery mode, medication use, local swelling, fatigue, anxiety, satisfaction and neonatal outcomes.

Results

The experimental intervention reduced the duration of labour by 179 minutes (95% CI 146 to 213) in stage one and 19 minutes (95% CI 13 to 25) in stage two. It decreased pain by approximately 2 points (95% CI 2 to 2) on a 0-to-10 scale at 30, 60 and 90 minutes. It reduced the risk of a caesarean section (ARR 0.14, 95% CI 0.03 to 0.25; NNT 7, 95% CI 4 to 32) and vulvar swelling (ARR 0.11, 95% CI 0.03 to 0.19; NNT 9, 95% CI 5 to 31). It reduced fatigue by 18 points (95% CI 16 to 21) on a 15-to-75-point scale and anxiety by 9 points (95% CI 8 to 11) on an 18-to-72-point scale. Other effects were negligible or unclear.

Conclusion

Active pelvic movements on a Swiss ball during labour reduced the duration of labour, pain intensity, and maternal fatigue and anxiety; they also lowered the risk of caesarean section and vulvar swelling. Several effects exceeded the smallest worthwhile effect.

Registration

NCT04124835.

问题:分娩时在瑞士球上的盆腔活动对产妇和新生儿的结局有多大影响?方法:采用隐式分配、盲法评估和意向治疗分析的随机试验。参与者:200名产妇。干预:实验组根据个人产科评估(胎位、胎位、宫颈扩张、有无早期推压冲动)，在瑞士球上进行盆腔前倾和后倾、盆腔外侧倾斜和髋关节圆周运动。对照组接受常规护理。两组人都被允许散步和淋浴。观察指标:主要观察指标为第一产程持续时间。次要结局是第二产程持续时间、疼痛强度、分娩方式、药物使用、局部肿胀、疲劳、焦虑、满意度和新生儿结局。结果:实验干预在第一阶段减少了179分钟(95% CI 146至213)，在第二阶段减少了19分钟(95% CI 13至25)。在30分钟、60分钟和90分钟时，疼痛在0到10分的范围内减少了大约2分(95% CI 2到2)。它降低了剖宫产的风险(ARR 0.14, 95% CI 0.03 ~ 0.25;NNT 7, 95% CI 4 ~ 32)和外阴肿胀(ARR 0.11, 95% CI 0.03 ~ 0.19;NNT 9, 95% CI 5 ~ 31)。在15到75分的量表上，它减少了18分(95% CI 16到21)的疲劳，在18到72分的量表上减少了9分(95% CI 8到11)的焦虑。其他影响可以忽略不计或不清楚。结论:分娩时在瑞士球上的主动盆腔运动减少了分娩时间、疼痛强度、产妇疲劳和焦虑;它们还降低了剖腹产和外阴肿胀的风险。有几个效果超过了最小的有价值的效果。注册:NCT04124835。

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引用次数: 0

Preoperative respiratory muscle training reduces the risk of pulmonary complications and the length of hospital stay after cardiac surgery: a systematic review 术前呼吸肌训练可降低心脏手术后肺部并发症的风险和住院时间:一项系统综述。

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.012

José Francisco Cursino de Moura , Crystian Bitencourt Oliveira , Ana Paula Coelho Figueira Freire , Mark Russell Elkins , Francis Lopes Pacagnelli

Questions

What is the effect of preoperative respiratory muscle training (RMT) on the incidence of postoperative pulmonary complications (PPCs) after open cardiac surgery? What is the effect of RMT on the duration of mechanical ventilation, postoperative length of stay and respiratory muscle strength?

Design

Systematic review of randomised trials with meta-analysis.

Participants

Adults undergoing elective open cardiac surgery.

Intervention

The experimental groups received preoperative RMT and the comparison groups received no intervention.

Outcome measures

The primary outcomes were PPCs, length of hospital stay, respiratory muscle strength, oxygenation and duration of mechanical ventilation. The methodological quality of studies was assessed using the PEDro scale and the overall certainty of the evidence was assessed using the GRADE approach.

Results

Eight trials involving 696 participants were included. Compared with the control group, the respiratory training group had fewer PPCs (RR 0.51, 95% CI 0.38 to 0.70), less pneumonia (RR 0.44, 95% CI 0.25 to 0.78), shorter hospital stay (MD −1.7 days, 95% CI −2.4 to −1.1) and higher maximal inspiratory pressure values at the end of the training protocol (MD 12 cmH₂O, 95% CI 8 to 16). The mechanical ventilation time was similar in both groups. The quality of evidence was high for pneumonia, length of hospital stay and maximal inspiratory pressure.

Conclusion

Preoperative RMT reduced the risk of PPCs and pneumonia after cardiac surgery. The training also improved the maximal inspiratory pressure and reduced hospital stay. The effects on PPCs were large enough to warrant use of RMT in this population.

Registration

CRD42021227779

问题:术前呼吸肌训练(RMT)对心脏直视手术后肺部并发症(PPCs)的发生率有何影响?RMT对机械通气时间、术后停留时间和呼吸肌力量有何影响?设计:采用荟萃分析对随机试验进行系统评价。参与者:接受择期心脏直视手术的成年人。干预:实验组术前行RMT治疗，对照组不进行干预。结局指标:主要结局为PPCs、住院时间、呼吸肌力量、氧合和机械通气持续时间。使用PEDro量表评估研究的方法学质量，使用GRADE方法评估证据的总体确定性。结果:纳入8项试验，696名受试者。与对照组相比，呼吸训练组PPCs发生率较低(RR 0.51, 95% CI 0.38 ~ 0.70)，肺炎发生率较低(RR 0.44, 95% CI 0.25 ~ 0.78)，住院时间较短(MD -1.7天，95% CI -2.4 ~ -1.1)，训练方案结束时最大吸气压力值较高(MD 12 cmH2O, 95% CI 8 ~ 16)。两组患者机械通气时间相似。肺炎、住院时间和最大吸气压力的证据质量较高。结论:术前RMT可降低心脏手术后PPCs和肺炎的发生风险。该训练还提高了最大吸气压力，缩短了住院时间。对PPCs的影响足够大，足以保证在该人群中使用RMT。注册:CRD42021227779。

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引用次数: 0

Research Note: Discrete choice experiments to elicit preferences for decision-making in physiotherapy 研究说明：通过离散选择实验得出物理治疗决策偏好

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.11.004

Rakhee Raghunandan, Kirsten Howard

引用次数: 0

Research from low-income and middle-income countries will benefit global health and the physiotherapy profession, but it requires support 来自低收入和中等收入国家的研究将有利于全球健康和理疗行业，但这需要支持。

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.08.013

Saurab Sharma , Arianne P Verhagen , Mark Elkins , Jean-Michel Brismée , George D Fulk , Jakub Taradaj , Lois Steen , Alan Jette , Ann Moore , Aimee Stewart , Barbara J Hoogenboom , Anne Söderlund , Michele Harms , Rafael Zambelli Pinto

引用次数: 0

Cover image and highlights 封面图片和亮点

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/S1836-9553(23)00133-9

引用次数: 0

Correspondence re: de Best et al 关于 de Best 等人的通信

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.11.008

Hendrikus Antonius Kranenburg , Roger Kerry , Alan Taylor , Firas Mourad , Emilio Puentedura , Nathan Hutting

引用次数: 0

Students experienced near peer-led simulation in physiotherapy education as valuable and engaging: a mixed methods study 学生在物理治疗教育中体验到的近乎同伴引导的模拟有价值且有吸引力：一项混合方法研究

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.11.006

Catherine L Granger, Aiden Smart, Karen Donald, Jennifer L McGinley, Jessica Stander, David Kelly, Natalie Fini, Georgina A Whish-Wilson, Selina M Parry

Questions

What is the student experience of near peer-led simulation in physiotherapy education from the perspectives of students (near peer learners and near peer teachers)? What are their expectations, perceptions and engagement in this as a teaching and learning activity? Are there any short-term benefits?

Design

Convergent mixed-methods study.

Participants

From a graduate entry Doctor of Physiotherapy course, 111 first-year and 20 second-year students participated.

Intervention

Near peer-led simulation was delivered within first-year cardiorespiratory, musculoskeletal and neurological physiotherapy curricula and as a precursor to second-year clinical placements. First-year students were near peer learners. Second-year students were near peer teachers and the simulated patients.

Outcome measures

Focus groups, pre/post-simulation questionnaires and direct observation. Data were triangulated and presented in overall themes.

Results

Five themes emerged: near peer-led simulation improved the students’ confidence and the opportunity to make mistakes in a supportive and safe environment was valued; peer feedback was an integral part of the learning process that enriched the learning experience; the authenticity and realism created seriousness, promoted engagement and facilitated perceived knowledge transfer; there were benefits for learning for both peer learners and peer teachers; and the anticipation and emotional impact was evident.

Conclusion

Near peer-led simulation was viewed by students as a valuable and engaging activity. Students perceived a broad range of benefits on their learning, especially from peer feedback (giving and receiving) on their performance, and had increased confidence following simulation. Peer-led simulation is an authentic and valuable component of entry-to-practice physiotherapy education.

问题从学生（近距离同伴学习者和近距离同伴教师）的角度来看，物理治疗教育中近距离同伴引导的模拟教学给学生带来了怎样的体验？他们对这种教学活动的期望、看法和参与度如何？干预措施近距离同伴指导模拟在一年级心肺、肌肉骨骼和神经理疗课程中进行，是二年级临床实习的前奏。一年级学生是近距离同伴学习者。结果测量焦点小组、模拟前后调查问卷和直接观察。结果出现了五个主题：近距离同伴引导的模拟提高了学生的自信心，在支持性和安全的环境中犯错误的机会得到了重视；同伴反馈是学习过程中不可或缺的一部分，丰富了学习体验；真实性和现实性创造了严肃性，促进了参与并促进了感知的知识转移；同伴学习者和同伴教师都能从中受益；预期和情感影响显而易见。学生们认为自己的学习受益匪浅，尤其是从同伴对其表现的反馈（给予和接受）中受益匪浅，并在模拟后增强了自信心。同龄人主导的模拟活动是入门物理治疗教育中一个真实而有价值的组成部分。

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引用次数: 0

Critically appraised paper: In children with overweight or obesity, an aerobic plus resistance exercise program improved cardiometabolic but not mental health [Commentary] 批判性评价论文:在超重或肥胖儿童中，有氧加抗阻运动计划改善了心脏代谢，但没有改善心理健康[评论]。

IF 12.1 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy

Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.002

Margarita D Tsiros

引用次数: 0

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