Pub Date : 2022-10-03DOI: 10.1186/s40945-022-00148-z
Sabine Lang, Colin McLelland, Donnie MacDonald, David F Hamilton
Background: Home exercise regimes are a well-utilised rehabilitation intervention for many conditions; however, adherence to prescribed programmes remains low. Digital interventions are recommended as an adjunct to face-to-face interventions by the National Health Service in the UK and may offer increased exercise adherence, however the evidence for this is conflicting.
Method: A systematic review was undertaken using MEDLINE and CINAHL databases using the PRISMA guidelines. Randomised controlled trials in any clinical population evaluating the adherence to prescribed home exercise interventions with and without additional digital interventions were included. Publication quality was assessed using the Cochrane Risk of Bias tool.
Results: The search strategy returned a total of 1336 articles, of which 10 randomised controlled trials containing data for 1117 participants were eligible for inclusion. 565 participants were randomised to receive the interventions, and 552 to the control. Seven of the ten trials reported a significant difference in adherence between the control and intervention groups favouring an additional digital intervention. Three trials reported equivalent findings. These three reported longer-term outcomes, suggesting an interaction between adherence and duration of intervention. There was substantial heterogeneity in outcome assessment metrics used across the trials prohibiting formal meta-analysis. This included studies were of low to moderate quality in terms of risk of bias.
Conclusion: The addition of a digital interventions to prescribed home exercise programmes can likely increase exercise adherence in the short term, with longer term effects less certain.
背景:家庭锻炼制度是一种很好的康复干预措施,用于许多条件;然而,遵守规定方案的情况仍然很低。英国国家卫生服务机构(National Health Service)建议将数字干预作为面对面干预的辅助手段,并可能提高锻炼的依从性,然而,这方面的证据是相互矛盾的。方法:采用MEDLINE和CINAHL数据库,采用PRISMA指南进行系统评价。在任何临床人群中进行随机对照试验,评估有或没有额外的数字干预对规定的家庭锻炼干预的依从性。使用Cochrane偏倚风险工具评估出版物质量。结果:检索策略共返回1336篇文章,其中10篇随机对照试验包含1117名受试者的数据符合纳入条件。565名参与者被随机分配到干预组,552人被随机分配到对照组。10项试验中有7项报告了对照组和干预组之间支持额外数字干预的依从性的显着差异。三个试验报告了相同的结果。这三个报告了较长期的结果,表明依从性和干预持续时间之间存在相互作用。在禁止正式荟萃分析的试验中使用的结果评估指标存在实质性的异质性。这包括低到中等偏倚风险的研究。结论:在规定的家庭锻炼计划中增加数字干预可能会在短期内增加锻炼依从性,但长期效果不太确定。
{"title":"Do digital interventions increase adherence to home exercise rehabilitation? A systematic review of randomised controlled trials.","authors":"Sabine Lang, Colin McLelland, Donnie MacDonald, David F Hamilton","doi":"10.1186/s40945-022-00148-z","DOIUrl":"https://doi.org/10.1186/s40945-022-00148-z","url":null,"abstract":"<p><strong>Background: </strong>Home exercise regimes are a well-utilised rehabilitation intervention for many conditions; however, adherence to prescribed programmes remains low. Digital interventions are recommended as an adjunct to face-to-face interventions by the National Health Service in the UK and may offer increased exercise adherence, however the evidence for this is conflicting.</p><p><strong>Method: </strong>A systematic review was undertaken using MEDLINE and CINAHL databases using the PRISMA guidelines. Randomised controlled trials in any clinical population evaluating the adherence to prescribed home exercise interventions with and without additional digital interventions were included. Publication quality was assessed using the Cochrane Risk of Bias tool.</p><p><strong>Results: </strong>The search strategy returned a total of 1336 articles, of which 10 randomised controlled trials containing data for 1117 participants were eligible for inclusion. 565 participants were randomised to receive the interventions, and 552 to the control. Seven of the ten trials reported a significant difference in adherence between the control and intervention groups favouring an additional digital intervention. Three trials reported equivalent findings. These three reported longer-term outcomes, suggesting an interaction between adherence and duration of intervention. There was substantial heterogeneity in outcome assessment metrics used across the trials prohibiting formal meta-analysis. This included studies were of low to moderate quality in terms of risk of bias.</p><p><strong>Conclusion: </strong>The addition of a digital interventions to prescribed home exercise programmes can likely increase exercise adherence in the short term, with longer term effects less certain.</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9527092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40389626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.1186/s40945-022-00147-0
Claudia Spiegl, Natalia Schiefermeier-Mach, Erika Schifferegger, Claudia Wiederin, Barbara Scheiber
Background: The implementation of standardized assessments in physiotherapeutic practice strongly supports diagnostic and treatment plans. Previous studies reported insufficient usage of standardized assessments due to lack of time, lack of knowledge, lack of resources and other barriers. Physiotherapy in outpatient settings became essential for the rehabilitation of patients with post COVID-19 condition but it remains unknown to what extent assessments are implemented into the evaluation of these patients. In this study, we explored the current use and barriers regarding the implementation of physiotherapeutic assessments to evaluate patients with post COVID-19 condition.
Methods: A cross-sectional online survey was carried out among 180 physiotherapists working in outpatient settings in Austria and South Tyrol.
Results: The majority of physiotherapists (88%) indicated that standardized assessments are useful, though less than a fifth of participants actually implement assessments in practice. Among implementation barriers, "insufficient experience" (41.8%) and "lack of knowledge" (36.6%) were mentioned most often. Concerning specific post COVID-19 assessments, the evaluation of "physical and respiratory function", "quality of life" and "activities of daily living" were stated to be of particular relevance.
Conclusions: Our study revealed a low implementation rate and identified the main barriers regarding the non-usage of standardized assessments for post COVID-19 patients.
Trial registration: The Private University for Health Sciences and Health Technology (UMIT TIROL), and the Research Committee for Scientific Ethical Questions granted approval for the survey (RCSEQ, Hall in Tirol, Austria, Number 2834).
{"title":"Physiotherapeutic evaluation of patients with post COVID-19 condition: current use of measuring instruments by physiotherapists working in Austria and South Tyrol.","authors":"Claudia Spiegl, Natalia Schiefermeier-Mach, Erika Schifferegger, Claudia Wiederin, Barbara Scheiber","doi":"10.1186/s40945-022-00147-0","DOIUrl":"https://doi.org/10.1186/s40945-022-00147-0","url":null,"abstract":"<p><strong>Background: </strong>The implementation of standardized assessments in physiotherapeutic practice strongly supports diagnostic and treatment plans. Previous studies reported insufficient usage of standardized assessments due to lack of time, lack of knowledge, lack of resources and other barriers. Physiotherapy in outpatient settings became essential for the rehabilitation of patients with post COVID-19 condition but it remains unknown to what extent assessments are implemented into the evaluation of these patients. In this study, we explored the current use and barriers regarding the implementation of physiotherapeutic assessments to evaluate patients with post COVID-19 condition.</p><p><strong>Methods: </strong>A cross-sectional online survey was carried out among 180 physiotherapists working in outpatient settings in Austria and South Tyrol.</p><p><strong>Results: </strong>The majority of physiotherapists (88%) indicated that standardized assessments are useful, though less than a fifth of participants actually implement assessments in practice. Among implementation barriers, \"insufficient experience\" (41.8%) and \"lack of knowledge\" (36.6%) were mentioned most often. Concerning specific post COVID-19 assessments, the evaluation of \"physical and respiratory function\", \"quality of life\" and \"activities of daily living\" were stated to be of particular relevance.</p><p><strong>Conclusions: </strong>Our study revealed a low implementation rate and identified the main barriers regarding the non-usage of standardized assessments for post COVID-19 patients.</p><p><strong>Trial registration: </strong>The Private University for Health Sciences and Health Technology (UMIT TIROL), and the Research Committee for Scientific Ethical Questions granted approval for the survey (RCSEQ, Hall in Tirol, Austria, Number 2834).</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9473730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9182498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To determine the effect of sustained natural apophyseal glide (SNAG) on Flexion Rotation Test, pain intensity, and functionality in subjects with Cervicogenic Headache (CH).
Methods: The research was conducted on five computerized databases PubMed/Medline, Web of Science, PEDro, Lilacs, and Cochrane Library (CENTRAL), using the keywords combination: (sustained natural apophyseal glide OR SNAG OR joint mobilization OR Mulligan) AND (cervicogenic headache) according to PRISMA guidelines. The methodological quality of the included studies was analyzed using the Physiotherapy Evidence Database (PEDro) scale.
Results: Eight articles fulfilled the eligibility criteria and were included in the review. The selected studies had a methodological quality of 6.6/10 on the PEDro scale and included a total of 357 participants. The SNAG significantly improved pain, Flexion Rotation Test and reduced functional symptoms.
Conclusion: The available evidence suggests that SNAG may be a relevant intervention for CH.
目的:探讨持续自然椎体滑动(SNAG)对颈源性头痛(CH)患者屈曲旋转试验、疼痛强度和功能的影响。方法:在PubMed/Medline、Web of Science、PEDro、Lilacs和Cochrane Library (CENTRAL) 5个计算机数据库中进行研究,根据PRISMA指南,使用关键词组合:(持续自然椎体滑动或SNAG或关节活动或Mulligan)和(颈源性头痛)。采用物理治疗证据数据库(PEDro)量表对纳入研究的方法学质量进行分析。结果:8篇文章符合入选标准,被纳入综述。所选研究在PEDro量表上的方法学质量为6.6/10,总共包括357名参与者。SNAG显著改善了疼痛、屈曲旋转试验和功能症状。结论:现有证据表明,SNAG可能是CH的相关干预措施。
{"title":"The effectiveness of Sustained Natural Apophyseal Glide on Flexion Rotation Test, pain intensity, and functionality in subjects with Cervicogenic Headache: A Systematic Review of Randomized Trials.","authors":"Ricardo Cardoso, Adérito Seixas, Sandra Rodrigues, Isabel Moreira-Silva, Nuno Ventura, Joana Azevedo, Filippo Monsignori","doi":"10.1186/s40945-022-00144-3","DOIUrl":"https://doi.org/10.1186/s40945-022-00144-3","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effect of sustained natural apophyseal glide (SNAG) on Flexion Rotation Test, pain intensity, and functionality in subjects with Cervicogenic Headache (CH).</p><p><strong>Methods: </strong>The research was conducted on five computerized databases PubMed/Medline, Web of Science, PEDro, Lilacs, and Cochrane Library (CENTRAL), using the keywords combination: (sustained natural apophyseal glide OR SNAG OR joint mobilization OR Mulligan) AND (cervicogenic headache) according to PRISMA guidelines. The methodological quality of the included studies was analyzed using the Physiotherapy Evidence Database (PEDro) scale.</p><p><strong>Results: </strong>Eight articles fulfilled the eligibility criteria and were included in the review. The selected studies had a methodological quality of 6.6/10 on the PEDro scale and included a total of 357 participants. The SNAG significantly improved pain, Flexion Rotation Test and reduced functional symptoms.</p><p><strong>Conclusion: </strong>The available evidence suggests that SNAG may be a relevant intervention for CH.</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9434842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40335337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-15DOI: 10.1186/s40945-022-00143-4
Zohreh Jafarian Tangrood, Gisela Sole, Daniel Cury Ribeiro
Background: Scapular dyskinesis is reported as one of the potential factors contributing to the presentation of pain in subacromial shoulder pain. In clinical practice, the evaluation and control of scapular dyskinesis is considered important for managing the subacromial shoulder pain. The aim is to determine the association between changes in pain or function and changes in scapular rotations in participants with subacromial shoulder pain.
Method: Pain, function and scapular rotations were measured in 25 participants with subacromial shoulder pain at baseline and after 8 weeks. Pain was measured with Numeric Pain Rating Scale (NPRS) and function was measured with Patient Specific Functional Scale (PSFS). Scapular rotations were measured with a scapular locator at 60°, 90° and 120° of scapular arm elevation. Spearman rank correlations (rs) were used to assess the association between variables.
Findings: No association was observed between changes in pain or function scores with changes in scapular upward/downward rotations (rs = 0.03 to 0.27 for pain and - 0.13 to 0.23 for function) and scapular anterior/posterior tilt (rs = - 0.01 to 0.23 for pain and - 0.13 to 0.08 for function) of arm at 60°, 90° and 120° elevation. Data associated with scapular internal/external rotation was not reported due to low reliability.
Conclusion: These findings reject associations between changes in pain or function scores and scapular rotations. Future observational study is warranted using a multifactorial approach to understand potential factors that contribute to the presentation of subacromial shoulder pain.
{"title":"Association between changes in pain or function scores and changes in scapular rotations in patients with subacromial shoulder pain: a prospective cohort study.","authors":"Zohreh Jafarian Tangrood, Gisela Sole, Daniel Cury Ribeiro","doi":"10.1186/s40945-022-00143-4","DOIUrl":"https://doi.org/10.1186/s40945-022-00143-4","url":null,"abstract":"<p><strong>Background: </strong>Scapular dyskinesis is reported as one of the potential factors contributing to the presentation of pain in subacromial shoulder pain. In clinical practice, the evaluation and control of scapular dyskinesis is considered important for managing the subacromial shoulder pain. The aim is to determine the association between changes in pain or function and changes in scapular rotations in participants with subacromial shoulder pain.</p><p><strong>Method: </strong>Pain, function and scapular rotations were measured in 25 participants with subacromial shoulder pain at baseline and after 8 weeks. Pain was measured with Numeric Pain Rating Scale (NPRS) and function was measured with Patient Specific Functional Scale (PSFS). Scapular rotations were measured with a scapular locator at 60°, 90° and 120° of scapular arm elevation. Spearman rank correlations (r<sub>s</sub>) were used to assess the association between variables.</p><p><strong>Findings: </strong>No association was observed between changes in pain or function scores with changes in scapular upward/downward rotations (r<sub>s</sub> = 0.03 to 0.27 for pain and - 0.13 to 0.23 for function) and scapular anterior/posterior tilt (r<sub>s</sub> = - 0.01 to 0.23 for pain and - 0.13 to 0.08 for function) of arm at 60°, 90° and 120° elevation. Data associated with scapular internal/external rotation was not reported due to low reliability.</p><p><strong>Conclusion: </strong>These findings reject associations between changes in pain or function scores and scapular rotations. Future observational study is warranted using a multifactorial approach to understand potential factors that contribute to the presentation of subacromial shoulder pain.</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9377126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40612366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1186/s40945-022-00142-5
Christopher M Wilson, Sara K Arena, Lori E Boright
Introduction: Safe aging in place (SAIP) is when an older adult can successfully and comfortably remain in their home despite increasing barriers, including falls. Various physical, medical, psychological, and psychosocial factors may individually or cumulatively impact an older adult's ability to safely age in place. Physiotherapists should assess not only items traditionally considered within their scope of practice but should select efficient and effective outcome measures to quantify other domains of health. A comprehensive geriatric assessment (CGA) is an evidence-based clinical assessment which identifies medical, psychosocial, and functional limitations of an older person. The CGA is useful to dictate individualized exercise/intervention prescription to address identified areas of increased risk.
Purpose and importance to practice: The purpose of this Masterclass is to describe key screening, assessments, and interventions to facilitate SAIP and to provide overviews of currently available programming and care delivery models applicable to physiotherapist practice. There are a wide variety of outcome measures and interventions that vary in depth, validity, and reliability. Measures selected for inclusion in this Masterclass were chosen based upon their clinical utility with respect to time and resource constraints and ease of administration during a comprehensive assessment for SAIP in community-dwelling older adults. Measures recommended for assessing physical function were the Short Physical Performance Battery, the Timed-Up-and-Go, the 30 second chair rise test, and the Four Test Balance Scale. Additionally, measures from the heath domain (e.g., Functional Comorbidity Index) and the environmental domain (e.g., Home FAST) are recommended. Relative to interventions, the Otago Exercise Program, motivational interviewing, home modifications, and leveraging technology are recommended. Partnerships with community-facing organizations facilitate utilization of resources for sustainable SAIP. The Home-based Older Person Upstreaming Prevention Physical Therapy (HOP-UP-PT) program is one approach led by physiotherapists framed in the screening, assessments, and interventions discussed in this Masterclass with strong scientific grounding.
Conclusion: Programs integrating both community and healthcare approaches have the strongest evidence for their utility; however, implementation for these preventative approaches are lagging behind the increased need due to the substantial population growth of those over 65 years.
{"title":"State of the Art Physiotherapist-Led Approaches to Safe Aging in Place.","authors":"Christopher M Wilson, Sara K Arena, Lori E Boright","doi":"10.1186/s40945-022-00142-5","DOIUrl":"https://doi.org/10.1186/s40945-022-00142-5","url":null,"abstract":"<p><strong>Introduction: </strong>Safe aging in place (SAIP) is when an older adult can successfully and comfortably remain in their home despite increasing barriers, including falls. Various physical, medical, psychological, and psychosocial factors may individually or cumulatively impact an older adult's ability to safely age in place. Physiotherapists should assess not only items traditionally considered within their scope of practice but should select efficient and effective outcome measures to quantify other domains of health. A comprehensive geriatric assessment (CGA) is an evidence-based clinical assessment which identifies medical, psychosocial, and functional limitations of an older person. The CGA is useful to dictate individualized exercise/intervention prescription to address identified areas of increased risk.</p><p><strong>Purpose and importance to practice: </strong>The purpose of this Masterclass is to describe key screening, assessments, and interventions to facilitate SAIP and to provide overviews of currently available programming and care delivery models applicable to physiotherapist practice. There are a wide variety of outcome measures and interventions that vary in depth, validity, and reliability. Measures selected for inclusion in this Masterclass were chosen based upon their clinical utility with respect to time and resource constraints and ease of administration during a comprehensive assessment for SAIP in community-dwelling older adults. Measures recommended for assessing physical function were the Short Physical Performance Battery, the Timed-Up-and-Go, the 30 second chair rise test, and the Four Test Balance Scale. Additionally, measures from the heath domain (e.g., Functional Comorbidity Index) and the environmental domain (e.g., Home FAST) are recommended. Relative to interventions, the Otago Exercise Program, motivational interviewing, home modifications, and leveraging technology are recommended. Partnerships with community-facing organizations facilitate utilization of resources for sustainable SAIP. The Home-based Older Person Upstreaming Prevention Physical Therapy (HOP-UP-PT) program is one approach led by physiotherapists framed in the screening, assessments, and interventions discussed in this Masterclass with strong scientific grounding.</p><p><strong>Conclusion: </strong>Programs integrating both community and healthcare approaches have the strongest evidence for their utility; however, implementation for these preventative approaches are lagging behind the increased need due to the substantial population growth of those over 65 years.</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-15DOI: 10.1186/s40945-022-00141-6
Tony Adebero, Pavlos Bobos, Lyndsay Somerville, James Howard, Edward M Vasarhelyi, Brent Lanting, Susan W Hunter
Background: Research has demonstrated an increased risk of falls after total hip arthroplasty (THA). Yet, people's knowledge on falls risk factors and how falls prevention strategies are being used after THA have not been examined. If a person's knowledge of falls and self-efficacy about falls prevention strategies is low this would indicate a pressing need for interventions to lessen risk. The study objectives were: 1) to determine the falls knowledge and what fall prevention strategies people used after (THA) and 2) to determine the outcomes of a falls risk assessment at 12-months after unilateral THA.
Methods: Overall, 108 people completed the Falls Risk for Older People - Community Setting (FROP-Com) scale, a falls questionnaire (covered occurrence of falls, knowledge on falls risk factors, falls prevention strategies implemented after THA surgery), 6-m Walk Test (6mWT), 30-Second Chair Stand Test (30CST), Timed-up and Go (TUG) Test, and Activities-specific Balance Confidence Scale (ABC).
Results: Twenty-five (23.2%) people fell at least once in the 12 months after THA. Scores on the FROP-Com ranged from 2-20 with an average of 8.2 ± 3.6 indicating a mild falls risk. The importance of falling compared to other health concerns was rated as moderate to high (6.8 ± 2.9) and the majority of participants (n = 98, 90.7%) believed falls can be prevented after THA. Total scores on the ABC scale ranged from 30.6% to 100.0% with an average score of 84.4 ± 15.5%, indicating high function. Only 47 people (43.5%) reported receiving falls prevention education. A total of 101 falls prevention strategies were completed by 67 people (62%), the most common strategy was environmental modifications (e.g., installation of grab bars) at 37.4%, while exercise was mentioned by only 2%. The majority of people had functional deficits in 30CST (62%) and TUG (76.9%) at 12-months after unilateral THA.
Conclusions: Almost a quarter of the sample had experienced a fall in the 12-months after THA and functional deficits were common. The majority of the sample had proactively implemented falls prevention strategies after the surgery. Yet importantly, people after THA had limited exposure to falls prevention education and implemented a limited range of prevention strategies.
{"title":"Implementation of falls risk evaluation at one-year after total hip arthroplasty: a cross-sectional study.","authors":"Tony Adebero, Pavlos Bobos, Lyndsay Somerville, James Howard, Edward M Vasarhelyi, Brent Lanting, Susan W Hunter","doi":"10.1186/s40945-022-00141-6","DOIUrl":"https://doi.org/10.1186/s40945-022-00141-6","url":null,"abstract":"<p><strong>Background: </strong>Research has demonstrated an increased risk of falls after total hip arthroplasty (THA). Yet, people's knowledge on falls risk factors and how falls prevention strategies are being used after THA have not been examined. If a person's knowledge of falls and self-efficacy about falls prevention strategies is low this would indicate a pressing need for interventions to lessen risk. The study objectives were: 1) to determine the falls knowledge and what fall prevention strategies people used after (THA) and 2) to determine the outcomes of a falls risk assessment at 12-months after unilateral THA.</p><p><strong>Methods: </strong>Overall, 108 people completed the Falls Risk for Older People - Community Setting (FROP-Com) scale, a falls questionnaire (covered occurrence of falls, knowledge on falls risk factors, falls prevention strategies implemented after THA surgery), 6-m Walk Test (6mWT), 30-Second Chair Stand Test (30CST), Timed-up and Go (TUG) Test, and Activities-specific Balance Confidence Scale (ABC).</p><p><strong>Results: </strong>Twenty-five (23.2%) people fell at least once in the 12 months after THA. Scores on the FROP-Com ranged from 2-20 with an average of 8.2 ± 3.6 indicating a mild falls risk. The importance of falling compared to other health concerns was rated as moderate to high (6.8 ± 2.9) and the majority of participants (n = 98, 90.7%) believed falls can be prevented after THA. Total scores on the ABC scale ranged from 30.6% to 100.0% with an average score of 84.4 ± 15.5%, indicating high function. Only 47 people (43.5%) reported receiving falls prevention education. A total of 101 falls prevention strategies were completed by 67 people (62%), the most common strategy was environmental modifications (e.g., installation of grab bars) at 37.4%, while exercise was mentioned by only 2%. The majority of people had functional deficits in 30CST (62%) and TUG (76.9%) at 12-months after unilateral THA.</p><p><strong>Conclusions: </strong>Almost a quarter of the sample had experienced a fall in the 12-months after THA and functional deficits were common. The majority of the sample had proactively implemented falls prevention strategies after the surgery. Yet importantly, people after THA had limited exposure to falls prevention education and implemented a limited range of prevention strategies.</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40505657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-07DOI: 10.1186/s40945-022-00140-7
Shahzada Aadil Rashid, Mohammad Ejaz Hussain, Pooja Bhati, Zubia Veqar, Adila Parveen, Insha Amin, Shahzada Mudasir Rashid
Objective: To compare the effects of neuromuscular training (NMT) to a quadriceps strength training (QT) program on co-contraction index (CCI) of knee muscles in patients with knee osteoarthritis (OA).
Methods: Sixty-six knee OA patients with varus malalignment were recruited from the physiotherapy outpatient department of the university. After baseline measurements, they were randomly assigned into two groups: NMT (n = 33) and QT (n = 33). Patients in NMT group received neuromuscular exercises whereas QT group received conventional strengthening exercises for a period of 12 weeks, three times per week. Electromyographic (EMG) activity of quadriceps, hamstring and gastrocnemius muscle was evaluated during treadmill walking before and after 12 weeks of intervention period and CCI of medial quadriceps-medial hamstring (med QH), lateral quadriceps-lateral hamstring (lat QH), medial quadriceps-medial gastrocnemius (med QG) and, lateral quadriceps and lateral gastrocnemius (lat QG) was calculated.
Results: There was a significantly greater reduction in CCI of med QH (p = 0.02) and lat QH (p = 0.01) in the NMT group than the QT group. Whereas both NMT and QT led to statistically similar reductions in CCI of med QG (p = 0.08) and lat QG (p = 0.66).
Conclusion: Findings of this study suggest that NMT led to a greater reduction in CCI of knee muscles than QT which indicates that enhanced sensori-motor control attained by NMT could reduce knee loading in knee OA patients with varus malalignment.
{"title":"Muscle activation patterns around knee following neuromuscular training in patients with knee osteoarthritis: secondary analysis of a randomized clinical trial.","authors":"Shahzada Aadil Rashid, Mohammad Ejaz Hussain, Pooja Bhati, Zubia Veqar, Adila Parveen, Insha Amin, Shahzada Mudasir Rashid","doi":"10.1186/s40945-022-00140-7","DOIUrl":"https://doi.org/10.1186/s40945-022-00140-7","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effects of neuromuscular training (NMT) to a quadriceps strength training (QT) program on co-contraction index (CCI) of knee muscles in patients with knee osteoarthritis (OA).</p><p><strong>Methods: </strong>Sixty-six knee OA patients with varus malalignment were recruited from the physiotherapy outpatient department of the university. After baseline measurements, they were randomly assigned into two groups: NMT (n = 33) and QT (n = 33). Patients in NMT group received neuromuscular exercises whereas QT group received conventional strengthening exercises for a period of 12 weeks, three times per week. Electromyographic (EMG) activity of quadriceps, hamstring and gastrocnemius muscle was evaluated during treadmill walking before and after 12 weeks of intervention period and CCI of medial quadriceps-medial hamstring (med QH), lateral quadriceps-lateral hamstring (lat QH), medial quadriceps-medial gastrocnemius (med QG) and, lateral quadriceps and lateral gastrocnemius (lat QG) was calculated.</p><p><strong>Results: </strong>There was a significantly greater reduction in CCI of med QH (p = 0.02) and lat QH (p = 0.01) in the NMT group than the QT group. Whereas both NMT and QT led to statistically similar reductions in CCI of med QG (p = 0.08) and lat QG (p = 0.66).</p><p><strong>Conclusion: </strong>Findings of this study suggest that NMT led to a greater reduction in CCI of knee muscles than QT which indicates that enhanced sensori-motor control attained by NMT could reduce knee loading in knee OA patients with varus malalignment.</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40479168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-15DOI: 10.1186/s40945-022-00139-0
Rachel C Stockley, Danielle L Christian
Background: Intensive training can significantly reduce upper-limb impairments after stroke but delivering interventions of sufficiently high intensity is extremely difficult in routine practice. The MindPod Dolphin® system is a novel neuroanimation experience which provides motivating and intensive virtual reality based training for the upper-limb. However several studies report that health professionals have reservations about using technology in rehabilitation. Therefore, this study sought to explore the views of therapists who had used this novel neuroanimation therapy (NAT) in a clinical centre to deliver intensive for the upper-limb of people after stroke in a phase 2 trial (SMARTS2).
Methods: Four therapists (three female, two physical and two occupational therapists) who delivered NAT participated in a focus group conducted by two independent researchers. The theoretical domains framework and COM-B behaviour change models informed the discussion schedule for the focus group. An inductive approach to content analysis was used. Recordings were transcribed, coded and thematically analysed. Generated key themes were cross-checked with participants.
Results: Whilst therapists had some initial concerns about using NAT, these were reduced by training, reference materials and face-to-face technical support. Therapists noted several significant benefits to using NAT including multi-system involvement, carry-over to functional tasks and high levels of patient engagement.
Conclusions: These findings illuminate key areas that clinicians, technology developers and researchers should consider when designing, developing and implementing NAT. Specifically, they highlight the importance of planning the implementation of rehabilitation technologies, ensuring technologies are robust and suggest a range of benefits that might be conferred to patients when using intensive NAT as part of rehabilitation for the upper-limb after stroke.
{"title":"A focus group study of therapists' views on using a novel neuroanimation virtual reality game to deliver intensive upper-limb rehabilitation early after stroke.","authors":"Rachel C Stockley, Danielle L Christian","doi":"10.1186/s40945-022-00139-0","DOIUrl":"10.1186/s40945-022-00139-0","url":null,"abstract":"<p><strong>Background: </strong>Intensive training can significantly reduce upper-limb impairments after stroke but delivering interventions of sufficiently high intensity is extremely difficult in routine practice. The MindPod Dolphin® system is a novel neuroanimation experience which provides motivating and intensive virtual reality based training for the upper-limb. However several studies report that health professionals have reservations about using technology in rehabilitation. Therefore, this study sought to explore the views of therapists who had used this novel neuroanimation therapy (NAT) in a clinical centre to deliver intensive for the upper-limb of people after stroke in a phase 2 trial (SMARTS2).</p><p><strong>Methods: </strong>Four therapists (three female, two physical and two occupational therapists) who delivered NAT participated in a focus group conducted by two independent researchers. The theoretical domains framework and COM-B behaviour change models informed the discussion schedule for the focus group. An inductive approach to content analysis was used. Recordings were transcribed, coded and thematically analysed. Generated key themes were cross-checked with participants.</p><p><strong>Results: </strong>Whilst therapists had some initial concerns about using NAT, these were reduced by training, reference materials and face-to-face technical support. Therapists noted several significant benefits to using NAT including multi-system involvement, carry-over to functional tasks and high levels of patient engagement.</p><p><strong>Conclusions: </strong>These findings illuminate key areas that clinicians, technology developers and researchers should consider when designing, developing and implementing NAT. Specifically, they highlight the importance of planning the implementation of rehabilitation technologies, ensuring technologies are robust and suggest a range of benefits that might be conferred to patients when using intensive NAT as part of rehabilitation for the upper-limb after stroke.</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9199178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47765086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1186/s40945-022-00138-1
G. H. Hotta, R. K. Alaiti, D. C. Ribeiro, K. McQuade, A. S. de Oliveira
{"title":"Causal mechanisms of a scapular stabilization intervention for patients with subacromial pain syndrome: a secondary analysis of a randomized controlled trial","authors":"G. H. Hotta, R. K. Alaiti, D. C. Ribeiro, K. McQuade, A. S. de Oliveira","doi":"10.1186/s40945-022-00138-1","DOIUrl":"https://doi.org/10.1186/s40945-022-00138-1","url":null,"abstract":"","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42650824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-16DOI: 10.1186/s40945-022-00137-2
Florian Naye, S. Décary, Y. Tousignant-Laflamme
{"title":"Development and content validity of a rating scale for the pain and disability drivers management model","authors":"Florian Naye, S. Décary, Y. Tousignant-Laflamme","doi":"10.1186/s40945-022-00137-2","DOIUrl":"https://doi.org/10.1186/s40945-022-00137-2","url":null,"abstract":"","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41350565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}