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Do digital interventions increase adherence to home exercise rehabilitation? A systematic review of randomised controlled trials. 数字干预是否增加了家庭运动康复的依从性?随机对照试验的系统综述。
Q2 Medicine Pub Date : 2022-10-03 DOI: 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。
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引用次数: 11
Physiotherapeutic evaluation of patients with post COVID-19 condition: current use of measuring instruments by physiotherapists working in Austria and South Tyrol. COVID-19后患者的物理治疗评估:奥地利和南蒂罗尔物理治疗师目前使用的测量仪器。
Q2 Medicine Pub Date : 2022-09-15 DOI: 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).

背景:物理治疗实践中标准化评估的实施有力地支持了诊断和治疗计划。以前的研究报告说,由于缺乏时间、缺乏知识、缺乏资源和其他障碍,标准化评估的使用不足。门诊物理治疗对于COVID-19后患者的康复至关重要,但目前尚不清楚在这些患者的评估中实施了多大程度的评估。在这项研究中,我们探讨了目前使用物理治疗评估来评估COVID-19后病情的患者的使用和障碍。方法:横断面在线调查进行了180名物理治疗师在门诊设置工作在奥地利和南蒂罗尔。结果:大多数物理治疗师(88%)表示标准化评估是有用的,尽管不到五分之一的参与者在实践中实际实施评估。在实施障碍中,“经验不足”(41.8%)和“缺乏知识”(36.6%)被提及最多。关于COVID-19后的具体评估,据称对“身体和呼吸功能”、“生活质量”和“日常生活活动”的评估特别相关。结论:我们的研究揭示了COVID-19后患者不使用标准化评估的执行率低,并确定了主要障碍。试验登记:卫生科学和卫生技术私立大学(UMIT TIROL)和科学伦理问题研究委员会批准了该调查(RCSEQ,奥地利蒂罗尔大厅,2834号)。
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引用次数: 1
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. 持续自然椎体滑动对颈源性头痛受试者屈曲旋转试验、疼痛强度和功能的有效性:随机试验的系统回顾。
Q2 Medicine Pub Date : 2022-09-01 DOI: 10.1186/s40945-022-00144-3
Ricardo Cardoso, Adérito Seixas, Sandra Rodrigues, Isabel Moreira-Silva, Nuno Ventura, Joana Azevedo, Filippo Monsignori

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。
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引用次数: 2
Association between changes in pain or function scores and changes in scapular rotations in patients with subacromial shoulder pain: a prospective cohort study. 肩峰下肩痛患者疼痛或功能评分变化与肩胛骨旋转变化的相关性:一项前瞻性队列研究
Q2 Medicine Pub Date : 2022-08-15 DOI: 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.

背景:据报道,肩胛骨运动障碍是导致肩峰下肩关节疼痛的潜在因素之一。在临床实践中,评估和控制肩胛骨运动障碍被认为是治疗肩峰下肩痛的重要方法。目的是确定肩峰下肩痛患者疼痛或功能变化与肩胛骨旋转变化之间的关系。方法:在基线和8周后测量25名肩峰下肩痛患者的疼痛、功能和肩胛骨旋转。采用数字疼痛评定量表(NPRS)测量疼痛,采用患者特异性功能量表(PSFS)测量功能。肩胛骨定位器在肩胛骨臂抬高60°、90°和120°处测量肩胛骨旋转。Spearman秩相关(rs)用于评估变量之间的相关性。研究结果:疼痛或功能评分的变化与肩胛骨向上/向下旋转(疼痛的rs = 0.03至0.27,功能的rs = - 0.13至0.23)和肩胛骨前后倾斜(疼痛的rs = - 0.01至0.23,功能的rs = - 0.13至0.08)在手臂60°、90°和120°升高时的变化没有关联。由于可靠性低,没有报道与肩胛骨内/外旋转相关的数据。结论:这些发现否定了疼痛或功能评分变化与肩胛骨旋转之间的关联。未来的观察性研究需要采用多因素方法来了解导致肩峰下肩痛的潜在因素。
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引用次数: 0
State of the Art Physiotherapist-Led Approaches to Safe Aging in Place. 最先进的物理治疗师领导的方法安全老化到位。
Q2 Medicine Pub Date : 2022-08-01 DOI: 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.

安全就地养老(SAIP)是指老年人能够成功地、舒适地留在家中,尽管障碍越来越多,包括跌倒。各种身体、医学、心理和社会心理因素可能单独或累积地影响老年人安全老去的能力。物理治疗师不仅应该评估传统上认为属于其执业范围的项目,还应该选择高效和有效的结果措施来量化健康的其他领域。综合老年评估(CGA)是一种基于证据的临床评估,可确定老年人的医疗、心理社会和功能限制。CGA有助于制定个性化的运动/干预处方,以解决已确定的风险增加区域。目的和对实践的重要性:本大师班的目的是描述关键的筛选、评估和干预措施,以促进SAIP,并提供当前可用的规划和适用于物理治疗师实践的护理交付模式的概述。有各种各样的结果测量和干预措施,其深度、有效性和可靠性各不相同。在对社区居住的老年人SAIP进行综合评估时,选择纳入本大师班的措施是基于它们在时间和资源限制方面的临床效用以及管理的便利性。推荐的评估身体机能的方法有短时间物理性能测试、计时起身测试、30秒椅子上升测试和四项测试平衡量表。此外,建议从健康领域(例如,功能共病指数)和环境领域(例如,Home FAST)采取措施。在干预措施方面,建议采用奥塔哥运动计划、动机性访谈、家庭改造和利用技术。与面向社区的组织建立伙伴关系有助于利用资源实现可持续的公共卫生方案。以家庭为基础的老年人逆流预防物理治疗(HOP-UP-PT)项目是由物理治疗师领导的一种方法,在本大师班中讨论了筛选,评估和干预措施,具有很强的科学基础。结论:结合社区和医疗保健方法的项目有最有力的证据证明其效用;然而,由于65岁以上人口的大量增长,这些预防措施的实施落后于需求的增加。
{"title":"State of the Art Physiotherapist-Led Approaches to Safe Aging in Place.","authors":"Christopher M Wilson,&nbsp;Sara K Arena,&nbsp;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}
引用次数: 0
Implementation of falls risk evaluation at one-year after total hip arthroplasty: a cross-sectional study. 全髋关节置换术后一年跌倒风险评估的实施:一项横断面研究。
Q2 Medicine Pub Date : 2022-07-15 DOI: 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.

背景:研究表明全髋关节置换术(THA)后跌倒的风险增加。然而,人们对跌倒危险因素的了解以及在THA后如何使用跌倒预防策略尚未得到调查。如果一个人对跌倒的知识和对跌倒预防策略的自我效能感很低,这将表明迫切需要采取干预措施来降低风险。该研究的目的是:1)确定人们在(THA)后使用的跌倒知识和预防跌倒的策略;2)确定单侧THA后12个月跌倒风险评估的结果。方法:总共有108人完成了老年人跌倒风险-社区环境(FROP-Com)量表、跌倒问卷(包括跌倒的发生、跌倒危险因素的知识、THA手术后实施的跌倒预防策略)、6米步行测试(6mWT)、30秒椅子站立测试(30CST)、计时器和Go (TUG)测试和特定活动平衡信心量表(ABC)。结果:25例(23.2%)患者在THA术后12个月内至少跌倒一次。FROP-Com评分范围为2-20,平均8.2±3.6分表明有轻度跌倒风险。与其他健康问题相比,跌倒的重要性被评为中至高(6.8±2.9),大多数参与者(n = 98, 90.7%)认为THA后可以预防跌倒。ABC量表总分为30.6% ~ 100.0%,平均分为84.4±15.5%,为高功能。只有47人(43.5%)报告接受了预防跌倒教育。67人(62%)完成了101项预防跌倒的策略,最常见的策略是改变环境(例如安装抓杆)(37.4%),而只有2%的人提到锻炼。大多数人在单侧THA术后12个月30CST(62%)和TUG(76.9%)存在功能缺陷。结论:几乎四分之一的样本在THA后的12个月内经历了跌倒,功能缺陷很常见。大多数样本在手术后都主动实施了预防跌倒的策略。然而重要的是,全髋关节置换术后的人接受预防跌倒教育的机会有限,实施的预防策略范围有限。
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引用次数: 1
Muscle activation patterns around knee following neuromuscular training in patients with knee osteoarthritis: secondary analysis of a randomized clinical trial. 膝关节骨性关节炎患者神经肌肉训练后膝关节周围肌肉激活模式:随机临床试验的二次分析。
Q2 Medicine Pub Date : 2022-07-07 DOI: 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.

目的:比较神经肌肉训练(NMT)与股四头肌力量训练(QT)对膝关节骨性关节炎(OA)患者膝关节肌肉共收缩指数(CCI)的影响。方法:选取我院物理治疗门诊部66例膝内翻畸形OA患者。基线测量后,他们被随机分为两组:NMT (n = 33)和QT (n = 33)。NMT组给予神经肌肉锻炼,QT组给予常规强化锻炼,每周3次,为期12周。在干预期12周前后的跑步机行走中,评估股四头肌、腘绳肌和腓肠肌的肌电图(EMG)活动,计算股四头肌内侧-腘绳肌内侧(med QH)、股四头肌外侧-腘绳肌外侧(QH)、股四头肌内侧-腓肠肌内侧(med QG)、股四头肌外侧和腓肠肌外侧(QH)的CCI。结果:NMT组QH中期CCI (p = 0.02)和QH晚期CCI (p = 0.01)明显低于QT组。然而,NMT和QT均导致QG中期CCI下降(p = 0.08)和QG后期CCI下降(p = 0.66),统计学上相似。结论:本研究结果表明,NMT比QT更能降低膝关节肌肉CCI,这表明NMT增强的感觉-运动控制可以减轻膝内翻错位患者的膝关节负荷。
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引用次数: 0
A focus group study of therapists' views on using a novel neuroanimation virtual reality game to deliver intensive upper-limb rehabilitation early after stroke. 一项关于治疗师使用新型神经动画虚拟现实游戏在中风后早期进行强化上肢康复的观点的焦点小组研究
IF 2.1 Q1 REHABILITATION Pub Date : 2022-06-15 DOI: 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.

背景:强化训练可明显减轻中风后上肢的损伤,但在日常实践中,提供足够高强度的干预措施极为困难。MindPod Dolphin® 系统是一种新颖的神经模拟体验,可为上肢提供基于虚拟现实的激励性强化训练。然而,一些研究报告指出,医疗专业人员对在康复中使用技术持保留态度。因此,本研究试图探讨曾在临床中心使用过这种新型神经模拟疗法(NAT)的治疗师的观点,以便在第二阶段试验(SMARTS2)中为中风后的患者提供上肢强化训练:四名提供 NAT 的治疗师(三名女性,两名物理治疗师和两名职业治疗师)参加了由两名独立研究人员主持的焦点小组。焦点小组的讨论安排参考了理论领域框架和 COM-B 行为改变模型。采用归纳法进行内容分析。对记录进行了转录、编码和主题分析。生成的关键主题与参与者进行了交叉核对:虽然治疗师最初对使用 NAT 有一些顾虑,但通过培训、参考资料和面对面的技术支持,这些顾虑得到了缓解。治疗师注意到了使用 NAT 的几大好处,包括多系统参与、功能性任务的延续以及患者的高度参与:这些发现阐明了临床医生、技术开发人员和研究人员在设计、开发和实施 NAT 时应考虑的关键领域。具体而言,这些研究结果强调了规划康复技术实施的重要性,确保了技术的稳定性,并提出了使用强化 NAT 作为中风后上肢康复的一部分时可能给患者带来的一系列益处。
{"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}
引用次数: 0
Causal mechanisms of a scapular stabilization intervention for patients with subacromial pain syndrome: a secondary analysis of a randomized controlled trial 肩峰下疼痛综合征患者肩胛骨稳定干预的因果机制:一项随机对照试验的二次分析
Q2 Medicine Pub Date : 2022-06-01 DOI: 10.1186/s40945-022-00138-1
G. H. Hotta, R. K. Alaiti, D. C. Ribeiro, K. McQuade, A. S. de Oliveira
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引用次数: 2
Development and content validity of a rating scale for the pain and disability drivers management model 疼痛和残疾司机管理模型评定量表的开发和内容效度
Q2 Medicine Pub Date : 2022-05-16 DOI: 10.1186/s40945-022-00137-2
Florian Naye, S. Décary, Y. Tousignant-Laflamme
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引用次数: 3
期刊
Archives of physiotherapy
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