Benefits Of Physical Therapy Research Articles

Physical therapy registries worldwide: A systematic review.

Nowadays, the demand for physical therapy services has grown significantly over the last few decades due to an aging population, a rise in chronic conditions, and increased awareness of the benefits of physical therapy for injury recovery and managing various health issues. Collecting and managing data from physical therapy services is highly significant and beneficial. One of the information management systems that facilitates data collection related to physical therapy services is a physical therapy registry. In this systematic review, we aimed to identify physical therapy registries worldwide and examine the characteristics and data elements of each registry. PubMed, Scopus, Web of Science, and IEEE databases were searched from inception until March 19, 2023 by using keywords and Medical Subject Headings (MeSH) terms regarding "registries" and "physical therapy." The criteria for inclusion in the study were: (1) studies with the English language; (2) original studies, and online access to the physical therapy registry is available; (3) full-text available; (4) studies related to the aims of the study, and (5) studies that have sufficient available information regarding the minimum datasets and other characteristics physical therapy registry. The methodological quality of the included studies was independently assessed by two reviewers using the Effective Public Health Practice Project's (EPHPP) quality assessment tool. Sixteen studies were eligible to be included. The findings of this review indicated that the oldest physical therapy registry was established in 1992, while the newest one was established in 2017. The USA has the highest number of physical therapy registries (n = 7). Ten registries were funded by the government, and the data source for most registries was collected in clinics (n = 11). The geographical coverage of 10 registries was national. All registries collected administrative data (such as sociodemographic data, healthcare provider's data, and others) and clinical data (such as diagnosis, type of physical therapy intervention, pain location, comorbidities, and others) through web-based systems. The data collection method in half of the registries was retrospective (n = 8 out of 16). According to the EPHPP quality assessment tool, 11 studies (73%) were rated as moderate, 3 (20%) as weak, and 1 (7%) as strong. This systematic review found that most developed countries have implemented web-based physical therapy registries to collect administrative and clinical data at the national level. It is recommended that developing countries design and implement similar registries based on these characteristics and extracted data elements. Additionally, these registries should be designed to enable data sharing and interoperability with other international health information systems.

Effects of Physical Therapy and Dalfampridine on Function and Quality of Life in Nonambulatory Individuals With Multiple Sclerosis: A Randomized Controlled Trial.

Decreases in mobility, quality of life (QOL) and cognition are commonly seen in people with multiple sclerosis (MS). Physical therapy (PT) and exercise have been shown to improve many symptoms in ambulatory individuals with MS; however, evidence in nonambulatory people with MS is lacking. Dalfampridine is a US Food and Drug Administration-approved medication for MS that treats impaired ambulation by enhancing nerve conduction. To our knowledge, no study has examined the combined effect of PT and dalfampridine and very few studies have examined dalfampridine's effect on function in individuals with more progressive disease. The purpose of this study was to examine the effectiveness of PT combined with dalfampridine or a placebo on function, QOL, and cognition in nonambulatory individuals with MS. In addition, we explored the benefits of PT in all participants to increase the extremely limited research in this population. Adults with MS were randomly assigned to receive dalfampridine (n = 13) or placebo (n = 14) for 12 weeks in conjunction with PT treatment 2 times a week. Function, QOL, and cognition were assessed at baseline, 6 weeks, and 12 weeks. There was a significant time × group interaction for the Multiple Sclerosis Quality of Life-54 favoring the placebo group. Both groups significantly improved on the 9-Hole Peg Test (left arm only), sitting lateral reach (right), transferring from wheelchair to mat, and repeated sit to stand. The addition of dalfampridine to physical therapy did not improve function, QOL, or cognitive processing speed. Importantly, this study demonstrated an overall benefit in function and QOL with physical therapy 2 times a week for 12 weeks for nonambulatory individuals with MS.

Effectiveness of Nonpharmacological Measures on Improving Headache Score, Strength, Pain, and Quality of Life in Cervicogenic Headaches: A Systematic Review.

Cervicogenic headache (CGH) is a common condition affecting a significant portion of the population and is effectively managed through various interventions, including nonpharmacological approaches. Physical therapy plays a crucial role in CGH management, with numerous studies supporting its effectiveness. This systematic review aimed to evaluate the effectiveness of specific nonpharmacological physical therapy interventions for CGH. A comprehensive search was conducted across various databases (PubMed, Medline, PEDro, and Cochrane Library) for randomized controlled trials (RCTs) published between January 2017 and January 2023 investigating the effectiveness of specific nonpharmacological physical therapy interventions for CGH. We employed manual searches to capture potentially missed studies. Independent reviewers screened all studies based on predefined eligibility criteria. Extracted data included methodology, specific interventions, outcome measures (headache score, strength, pain, and quality of life (QOL)), and study conclusions. Eight RCTs were identified as meeting all inclusion criteria and were thus included in the data synthesis. The findings from these trials revealed a diverse range of nonpharmacological physical therapy interventions, including but not limited to manual therapy, exercise therapy, and multimodal approaches. Specifically, the interventions demonstrated significant improvements in headache scores, strength, pain levels, and overall QOL among individuals with CGH. These results underscore the multifaceted benefits of physical therapy in managing CGH and highlight its potential as a comprehensive treatment option. This review identified eight relevant RCTs investigating nonpharmacological interventions for CGH. Despite the promising findings, this review acknowledges several limitations, including the limited sample size and the heterogeneity of interventions across studies. These limitations emphasize the necessity for further research to elucidate optimal intervention strategies and refine treatment protocols. Nevertheless, the comprehensive analysis presented herein reinforces the pivotal role of physical therapy in not only alleviating pain but also enhancing function and improving the QOL for individuals suffering from CGH.

INTERVENTION OF PHYSIOTHERAPY IN THE TREATMENT OF CICATRIC FIBROSIS IN THE POST-SURGERY OF AESTHETIC SURGERY

Fibrosis is a change that occurs in the postoperative period, it is the formation or excessive development of fibrous tissue that occurs after a trauma, presenting itself as a reparative process. Among the main resources used for treatment, there are: Manual Lymphatic Drainage (DLM) and manual massage, kinesiotherapy, US, therapeutic laser, radiofrequency Objective: To search bibliographic references to show benefits of physical therapy in the treatment of Cicatricial Fibrosis in the postoperative period of plastic surgery. Methodology: This is a literature review. Articles (published between 2008 to 2019) researched in the Google Academic, Lilacs and Scielo virtual libraries were used. Results: Eight articles published between 2008 and 2019 were found where all demonstrated the effectiveness of physiotherapy in modulating the inflammatory and scar response, acting in the treatment of cicatricial fibrosis. Conclusion: A thorough evaluation of the tissue by the physiotherapist was perceived to be extremely important in order to choose the most appropriate method for the case, guaranteeing a quick and efficient surgical recovery.

INTERVENTION OF PHYSIOTHERAPY IN THE TREATMENT OF CICATRIC FIBROSIS IN THE POST-SURGERY OF AESTHETIC SURGERY

Fibrosis is a change that occurs in the postoperative period, it is the formation or excessive development of fibrous tissue that occurs after a trauma, presenting itself as a reparative process. Among the main resources used for treatment, there are: Manual Lymphatic Drainage (DLM) and manual massage, kinesiotherapy, US, therapeutic laser, radiofrequency Objective: To search bibliographic references to show benefits of physical therapy in the treatment of Cicatricial Fibrosis in the postoperative period of plastic surgery. Methodology: This is a literature review. Articles (published between 2008 to 2019) researched in the Google Academic, Lilacs and Scielo virtual libraries were used. Results: Eight articles published between 2008 and 2019 were found where all demonstrated the effectiveness of physiotherapy in modulating the inflammatory and scar response, acting in the treatment of cicatricial fibrosis. Conclusion: A thorough evaluation of the tissue by the physiotherapist was perceived to be extremely important in order to choose the most appropriate method for the case, guaranteeing a quick and efficient surgical recovery.

About the benefits of physical therapy during antitumor therapy in patients with non-small cell lung cancer

BACKGROUND: The data available today show the positive impact of increased physical activity on the patient’s condition, helping not only to improve physical health, but also psycho-emotional state, reducing stress and anxiety. Comprehensive rehabilitation programs can significantly improve the overall well-being of cancer patients and contribute to their return to an active social life. AIM: To study the effect of increased physical activity in the form of physical therapy on the overall result of antitumor treatment, the level of quality of life of patients with non-small cell lung cancer receiving immunotherapy both alone and in combination with cytostatics. MATERIALS AND METHODS: The study involved 56 patients who were divided into two groups: main (n=30) and control (n=26). The study included patients with ECOG status 1–3. In both groups, patients received standard antitumor therapy ― immunotherapy with pembrolizumab 400 mg every 42 days or 200 mg every 21 days as monotherapy, or in combination with cytotoxic therapy (carboplatin plus paclitaxel or pemetrexed). In addition to drug treatment, patients from the main group also regularly engaged in therapeutic exercises with an instructor. RESULTS: From the presented data and visualization it is clear that after treatment with the addition of physical education, the average level of quality of life in patients increased, the results highlight the significant positive impact of the rehabilitation program on the quality of life of cancer patients, reducing stress levels and improving functional indicators. CONCLUSION: The study shows that regular practice of therapeutic exercises can improve stress levels and improve emotional well-being, help reduce fatigue and reduce general weakness. A reduction in symptoms of depression and anxiety has been clearly demonstrated. Exercise therapy leads to increased muscle strength, which is especially important for recovery from intensive cancer treatments.

The Relationship Between Scoliosis, Spinal Bone Density, and Truncal Muscle Strength in Familial Dysautonomia Patients.

This combined retrospective and prospective study aimed to investigate the relationship between scoliosis, spinal bone mineral density (BMD), and truncal muscle strength in patients with familial dysautonomia (FD). A total of 79 FD patients (40 male, 39 female) aged 5-44years were included. The severity of scoliosis, lumbar spine BMD (Z-score), and truncal muscle strength were assessed. Correlations were analyzed using Pearson's correlation coefficient. Inverse correlations were observed between scoliosis severity and BMD (r = -0.328, p = 0.001), as indicated by increasingly negative Z-score values with worsening osteoporosis. There were also inverse correlations between scoliosis and truncal muscle strength (r = -0.595, p < 0.001). The correlation between scoliosis and age was notable up to 22years (r = 0.421, p = 0.01), but not in the older age group (22-44years). Our study identified inverse correlations between osteoporosis and scoliosis, as well as between scoliosis and truncal muscle strength, in FD patients. These findings suggest that there may be a relationship between bone density, muscle strength, and the severity of spinal curvature in this population. While our results highlight the potential importance of early diagnosis and management of osteoporosis, and possibly the benefits of physical therapy to strengthen truncal muscles, further research is needed to determine the direct impact of these interventions on preventing the progression of scoliosis and its associated complications in FD patients. A long-term longitudinal study could provide more insights into these relationships and inform treatment strategies for FD patients.

Global perceived improvement and health-related quality of life after physical therapy in Lebanese patients with chronic non-specific low back pain.

The effectiveness of physical therapy (PT) in patients with chronic non-specific low back pain (CNSLBP) is mainly evaluated through pain, disability, and health-related quality of life (HRQOL). However, recent studies have recommended the consideration of improvement from patients' perspectives. This study aimed to investigate the relationship between the global perception of improvement in Lebanese patients with CNSLBP who have undergone PT, the HRQOL levels, as well as pain intensity. 132 patients with CNSLBP who have undergone PT completed a questionnaire consisting of sociodemographic and CNSLBP characteristics questions, pain intensity numeric scale (NRS), 12-Item Short-Form Health Survey (SF-12), and the Global Perceived Effect scale (GPE). Binary logistic regressions and Pearson correlation coefficient were used for analyses. Global perceived improvement of PT varies according to HRQOL levels. A significant correlation was found between pain intensity after PT, perceived improvement from PT, and HRQOL. Educational level and pain irradiation have been shown to be predictive factors of perceived improvement after PT. Pain and HRQOL are interrelated and contributed to elucidating the global perception of improvement after PT in patients with CNSLBP. The findings suggest that patients' global perception of improvement should be considered in evaluating the benefits of physical therapy in addition to pain and HRQOL.

The Impact of Physical Therapy After Lumbar Fusion Surgery.

Retrospective Cohort. To determine if outcomes varied between patients based on physical therapy (PT) attendance after lumbar fusion surgery. The literature has been mixed regarding the efficacy of postoperative PT to improve disability and back pain, as measured by patient-reported outcome measures. Given the prevalence of PT referrals and lack of high-quality evidence, there is a need for additional studies investigating the efficacy of PT after lumbar fusion surgery to aid in developing robust clinical guidelines. We retrospectively identified patients receiving lumbar fusion surgery by current procedural terminology codes and separated them into 2 groups based on whether PT was prescribed. Electronic medical records were reviewed for patient and surgical characteristics, PT utilization, and surgical outcomes. Patient-reported outcome measures (PROMs) were identified and compared preoperatively, at 90 days postoperatively and one year postoperatively. The two groups had similar patient characteristics and comorbidities and demonstrated no significant differences between readmission, complication, and revision rates after surgery. Patients that attended PT had significantly more fused levels (1.41 ± 0.64 vs. 1.32 ± 0.54, P =0.027), longer operative durations (234 ± 96.4 vs. 215 ± 86.1min, P =0.012), and longer postoperative hospital stays (3.35 ± 1.68 vs. 3.00 ± 1.49 days, P =0.004). All groups improved similarly by Oswestry Disability Index, short form-12 physical and mental health subsets, and back and leg pain by Visual Analog Scale at 90-day and 1-year follow-up. Our data suggest that physical therapy does not significantly impact PROMs after lumbar fusion surgery. Given the lack of data suggesting clear benefit of PT after lumbar fusion, surgeons should consider more strict criteria when recommending physical therapy to their patients after lumbar fusion surgery. Level-Ⅲ.

The benefits of physical therapy in juvenile idiopathic arthritis.

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children and an important cause of short-term and long-term disability. Recommended physiotherapy activity programs are essential for controlling JIA associated complications such as stiffness, deformity, muscle contractures, and cramps. It is uncertain if physiotherapy (PT) can significantly enhance prognosis and quality of life (QOL). In this review we focused on the specific effects of various PT on JIA manifestations. To conduct a literature review, the databases PubMed, Scopus, and DOAJ (last access in June 2023) were searched. The PubMed search returned a total of 952 articles, Scopus returned 108, and DOAJ returned no results. After screening, the final list included 18 papers on PT treatment for JIA patients. In children with JIA, targeted PT exercise may have the ability to improve strength, posture, aerobic conditioning, gait, functional mobility, and reduce pain.

Diagnosis and referrals to physical therapy among caregivers of children with genetic disorders: a qualitative inquiry

Purpose Genetic disorders are common in Saudi Arabia. Impaired motor development is one of the major characteristics associated with genetic disorders. Early identifications and referrals are key to receiving physical therapy. This study aims to explore caregivers of children with genetic disorders’ experience with early identification and referrals to physical therapy. Materials and methods An inductive qualitative design of 16 caregivers of children with genetic disorders was done to investigate the identification and referral process to physical therapy. A thematic analysis was used to analyze the data and multiple coders coded the data to increase the trustworthiness of the analysis. Results The analysis led to emergence of four main themes. Caregivers revealed their struggle with the detection process. They struggled with the vague information related to their children’s condition. They also expressed a desperate need for guidance to clarify the process for genetic testing, counseling, and rehabilitation. Although their overall experience with physical therapy was satisfactory, they encountered a number of issues related to scheduling appointments, delayed referrals, and unconfirmed diagnoses. Conclusion The results of this study could indicate that more efforts are required to expedite and elucidate the identification and referral of children with genetic disorders in Saudi Arabia. IMPLICATIONS FOR REHABILITATION The process of referring children with genetic disorders to physical therapy (PT) is not clearly understood by caregivers. Providing caregivers with information about the benefits of PT for children with genetic disorders is needed to encourage adherence to PT sessions and rehabilitation plan. Caregivers expressed the need for further education on the wide spectrum of genetic disorders. Caregivers experienced costly and lengthy genetic testing process that often lead to inconclusive results which could delay the referral process. Alternative solutions should be considered to provide these children with early access to rehabilitation services including PT. One of these solutions could be implementing regular screening and monitoring as well as parent education to aid in detecting delays and expedite the referral process.

Effects of Whole-Body Vibration and Manually Assisted Locomotor Therapy on Neurotrophin-3 Expression and Microglia/Macrophage Mobilization Following Thoracic Spinal Cord Injury in Rats

Microglial cells play an important role in neuroinflammation and secondary damages after spinal cord injury (SCI). Progressive microglia/macrophage inflammation along the entire spinal axis follows SCI, and various factors may determine the microglial activation profile. Neurotrophin-3 (NT-3) is known to control the survival of neurons, the function of synapses, and the release of neurotransmitters, while also stimulating axon plasticity and growth. We examined the effects of whole-body vibration (WBV) and forms of assisted locomotor therapy, such as passive flexion-extension (PFE) therapy, at the neuronal level after SCI, with a focus on changes in NT-3 expression and on microglia/macrophage reaction, as they play a major role in the reconstitution of CNS integrity after injury and they may critically account for the observed structural and functional benefits of physical therapy. More specifically, the WBV therapy resulted in the best overall functional recovery when initiated at day 14, while inducing a decrease in Iba1 and the highest increase in NT-3. Therefore, the WBV therapy at the 14th day appeared to be superior to the PFE therapy in terms of recovery. Functional deficits and subsequent rehabilitation depend heavily upon the inflammatory processes occurring caudally to the injury site; thus, we propose that increased expression of NT-3, especially in the dorsal horn, could potentially be the mediator of this favorable outcome.

Benefits of physical therapy in improving quality of life and pain associated with endometriosis: A systematic review and meta-analysis.

To assess whether non-pharmacologic conservative therapeutic interventions are beneficial in improving pain intensity and quality of life in women with endometriosis compared with placebo. A systematic review with meta-analysis was designed. A literature search was performed in the following databases: PubMed, PEDro, Embase, CINAHL, Isi Web of Science, Enfispo, and Cochrane. Randomized controlled trials included women with endometriosis treated with conservative treatment versus placebo. The quality of the studies was assessed using the PEDro scale, and the risk of bias of the individual studies was assessed using the Cochrane Risk of Bias tool. For the overall quality of the studies, the GRADE guidelines were used. Meta-analysis included six studies. Significant results were obtained for pain intensity (standardized mean difference [SMD] -0.89; 95% confidence interval [CI] -1.21 to -0.57; I2 69%) and concerning quality of life, significant results were only obtained for the sub-variable physical function (SMD -1.49; 95% CI -2.88 to -0.10; I2 95%). No statistically significant differences were found for the rest of the variables analyzed. Non-pharmacologic conservative therapies are a therapeutic option for women with endometriosis for improving pain intensity and physical function.

Mechatronics Design of a Gait-Assistance Exoskeleton for Therapy of Children with Duchenne Muscular Dystrophy

This paper presents a mechatronics design of a gait-assistance exoskeleton for therapy in children with Duchenne muscular dystrophy (DMD). This type of muscular dystrophy is a severe condition that causes muscle wasting, which results in a progressive loss of mobility. Clinical studies have shown the benefits of physical therapy in prolonging the mobility of patients with DMD. However, the therapy sessions are exhaustive activities executed by highly qualified rehabilitation personnel, which makes providing appropriate treatment for every patient difficult. This paper develops a mechatronics design of a gait-assistance exoskeleton to automate therapy sessions. The exoskeleton design uses adaptable mechanisms to adjust the device to the patient’s needs and includes the design of a series-elastic actuator to reduce the effects of nonalignment of the rotation axis between the exoskeleton and the patient. A mathematical dynamic hybrid model of the exoskeleton and a child’s body is developed using anthropometry of a population of six-year-old children. The hybrid model is used to design a nonlinear control strategy, which uses differential geometry to perform feedback linearization and to guarantee stable reference tracking. The proposed control law is numerically validated in a simulation to evaluate the control system’s performance and robustness under parameter variation during therapy with trajectory-tracking routines.

"The Benefits of Physical Therapy in the Rehabilitation of Flat Feet in Autism Students between the ages of 10 and 14"

"Introduction: Autism is a syndrome, the causes of which are still being studied. All children are born with flexible flat feet and decrease in flatness with age, but it is not known how flat they should be with each increase in age. Methods: The research was carried out on 10 subjects, aged between 10-14 years, with autism and flat feet. In the rehabilitation program we used: massage of the lower limb, walking exercises, resistance exercises from the positions: supine, prone, sitting and standing, isometric contractions, varied walking and light running, exercises of relaxation combined with breathing exercises, cycling and athletic elements. Results: The results of the averages obtained at the two initial and final tests, an increase in the values at the final test can be observed, both in the left leg and in the right leg. The manual testing of the muscle strength registered averages between 86% - 94% at the initial testing and improved values at the final testing between 94% - 99%. Feiss line testing results show close means for both the left and right legs, and the standard deviation shows a spread of 0.66 at initial testing and 0.67 at final testing for the left leg and 0.55 and respectively 0.56 on the right leg. Discussion: Considering that studies show the connection between flat feet and overweight, the results of our study indicate that autistic students, despite having flat feet, are in the normal weight category. This aspect can be considered favorable in the approach of applied kinetic treatment. The problem of flat feet in subjects with intellectual deficiency is insufficiently studied; therefore our study could constitute an important landmark in this scientific approach. Conclusions: Analyzing the comparative results, it can be concluded that through physical therapy and the associated means, the muscle deficit can be recovered; the joint balance can be improved, reaching a correct posture while walking in autism flatfeet students"

Profile of users of Basic Health Public Unity in the Eastern District of Foz do Iguaçu with UI: Field Research

Background: Panorama: Women with Urinary Incontinence treatment use them as Basic Units (BHU) due to the lack of perspective on the level of care. Objective: To identify the profile of women with UI in the Basic Health Units of the East District of Foz do Iguaçu and the impact of UI on these women's quality of life. Method: Data collection with women waiting to attend the Basic Health Units of the District of Foz do Iguaçu, applying a question with objective questions about age, weight, type of delivery, type of UI and whether they are aware of physical therapy to solve this problem. problem. Results: Interviewed 82 women aged 19 to 80 years. As for UI, 34.1 reported some type: Stress UI 17.1% and Urgent UI 31.7%, about physical therapy, 61.0% were unaware. Conclusion: Many users of Basic Health Units are aware of UI treatment units, thus being necessary for the creation of treatment and promotion programs on UI to solve this problem as well as the benefits of physical therapy.

A Preliminary Analysis of the Costs and Benefits of Physical Therapy and Strength Training for Fighter Pilots.

BACKGROUND: Occupational hazards facing high performance aircraft pilots ("fighter" pilots) can cause injury, time lost from flying, and voluntary or involuntary career termination. The high cost of training and retaining fighter pilots has spurred interest in the cost effectiveness of preventative and rehabilitative health solutions.METHODS: We investigated the potential cost effectiveness of a 5-yr, $24.9M U.S. preventative health program using equivalent annual worth (EAW) analysis. The program benefits were assessed with a combination of actual and estimated medical cost data and projected pilot retention improvement rates. Sensitivity analysis of variables such as discount rate, medical cost avoidance, and pilot retention improvement rate was conducted.RESULTS: Annualized costs of approximately $5M U.S. were used as the basis of comparison for annualized benefits. A medical cost database was searched to find expected annual direct medical (outpatient) costs related to injury of roughly $531K U.S. for the pilots covered by the program. Using Centers for Disease Control recommendations, approximately $4.7M U.S. was estimated to be the annual work loss cost. The program would presumably reduce a significant portion of these annual costs, but not all. Assuming various proportions of reduced costs by the program, the EAW was found to be consistently negative. However, when pilot retention improvement is included, EAW is positive using conservative assumptions.DISCUSSION: While outpatient and work loss costs will unlikely be completely covered by preventative health programs in this context, a minor improvement in pilot retention (about 1-3 additional retentions per year) produces a net positive annual benefit.Erneston CG, Fass RD, Ritschel JD, Cox AM. A preliminary analysis of the costs and benefits of physical therapy and strength training for fighter pilots. Aerosp Med Hum Perform. 2022; 93(8):637-642.

Avaliação do desenvolvimento motor e do efeito da intervenção fisioterapêutica em recém-nascidos cirúrgicos em Unidade de Terapia Intensiva Neonatal

ABSTRACT This study aimed to verify the applicability of the Test of Infant Motor Performance (TIMP) in surgical neonates as a tool for evaluating motor performance and to evaluate the benefit of physical therapy. Surgical neonates, divided into group without physical therapy (n=38) and group with motor physical therapy (n=38), were evaluated by TIMP and reasssment two weeks later. The physical therapy group performed standardized exercises for motor sensory stimulation once a day, whereas the other group received the usual care from the Neonatal Intensive Care Unit. The predominant surgical diagnosis in both groups was gastroschisis, followed by congenital diaphragmatic hernia. In the initial evaluation, motor performance was equal between the groups, classified as “below average” for age, with z-score=−1.28 (p=0.992). In the reassessment, the physical therapy group presented better scores (p&lt;0.001) and a higher difference in z-score (p&lt;0.001), higher percentage of neonates classified as “within average” (44% in the physical therapy group and 2.6% in the no physical therapy group), as well as a higher weight gain percentage (p=0.038). We found a worsening of motor performance in 10.5% of the no physical therapy group (p&lt;0.001) in the reassment. Motor performance improved in 81.6% of the physical therapy group and in only 13.2% of the no physical therapy group individuals (p&lt;0.001). Conclusion: TIMP was safely and effectively applied to newborns; notably, the test must be performed by professionals experienced in care of neonates. Motor intervention was beneficial, significantly improving motor performance, and if applied early, it may adequate the motor development of these neonates, even before hospital discharge.

Physical Therapy and Nusinersen Impact on Spinal Muscular Atrophy Rehabilitative Outcome

Spinal muscular atrophy (SMA) is a progressive neurological disease with autosomal recessive transmission that affects motor neurons, causing their loss and resulting in muscle waste and motor deficiency. Nusinersen, the first SMN2 pre-mRNA targeted therapy approved by the Food and Drug Administration and the European Medicines Agency, has demonstrated high efficacy in improving motor function, as well as respiratory and nutritional statuses. We observed 55 patients (children/adolescents) diagnosed with spinal muscular atrophy (SMA), who received nusinersen therapy. To investigate the benefits of physical therapy on rehabilitation outcomes, we compared the motor evolution of patients who received nusinersen and performed daily physical therapy (study group) to those of the control group, who received only nusinersen therapy. Motor skill improvements were statistically significantly (p < 0.001) higher in the study group, being almost four times better (12.66%), effect size, in comparison to the control group (3.18%). Physical therapy has provided superior results for those who receive it on a regular basis. These results include the correction of posture, reduction in stiffness, expansion of the range of motion and strengthening of muscles, thus allowing patients to do more movements and boosting their ability to perform everyday tasks.

Acceptability and barriers to adopting physical therapy and rehabilitation as standard of care in hernia disease: a prospective national survey of providers and preliminary data.

Physical therapy (PT) and rehabilitation are widely utilized in a variety of disease processes to improve function, return to activities of daily living (ADLs), and promote overall recovery. However, hernia repair has struggled to adopt this practice despite operations occurring in one of the most dynamic parts of the body - the abdominal core. This study sought to understand perspectives and perceived barriers regarding the incorporation of PT and rehabilitation in hernia care. A standardized rehabilitation protocol was developed by the Abdominal Core Health Quality Collaborative (ACHQC), a national quality improvement initiative specific to hernia disease, and launched in 2019. Empiric data from the ACHQC was then obtained to describe preliminary utilization. A prospective electronic survey was then deployed to all surgeons participating in the ACHQC to aid in interpreting the identified trends. The survey included questions regarding the current use of PT in their practice, as well as further opinions on the functionality, benefit, and barriers to its use. We identified 1,544 patients who were listed as receiving some form of postoperative rehabilitation, of which 992 (64.2%) had a primary diagnosis of ventral hernia and 552 (35.8%) had an inguinal hernia. Among patients who had a ventral hernia, 863 (87.0%) received self-directed rehabilitation exercises compared to 488 (88.4%) of inguinal hernia patients. The subsequent survey exploring these trends was completed by 46 ACHQC surgeons (10.2%). More than half (52%) reported using PT for hernia patients, primarily in abdominal wall reconstruction cases (92%). Of those who did not report using PT, 50% cited unknown clinical benefit and another 27% cited unknown PT resources. PT utilization was typically concentrated to the postoperative period (58%), while 42% reported also using it preoperatively. Despite 72% of respondents citing a perceived benefit of PT in hernia patients, overall use of PT was primarily reported as 'occasional' by 42%, with another 27% reporting 'rarely.' Perceived benefits of PT included increased core strength, stability, mobility, patient satisfaction, education, independence, earlier return to work and ADLs, overall improved recovery, and decreased risk of postoperative issues. Reported barriers to implementing PT in practice or adapting the ACHQC Rehabilitation Protocol included lack of education, lack of evidence of clinical benefit, and difficulties operationalizing the protocol. A national survey of hernia surgeons demonstrated willingness to adopt PT and rehabilitation protocols in their clinical practices and noted a high perceived benefit to patients. However, lack of education and evidence regarding the protocol may represent important barriers to overcome in widely disseminating these resources to patients. These gaps can be addressed through dedicated educational venues and additional studies establishing PT and rehabilitation as critical future adjuncts for the recovery of hernia repair patients.