Comprehensive Physical Therapy Research Articles

The role of quick pain management treatments in clinical physiotherapy practice in India: Advantages, disadvantages, and recommendations

Quick pain management treatments in physiotherapy play a vital role in addressing immediate musculoskeletal or movement-related issues, providing short-term relief to patients. This article explores the reasons why patients seek quick treatments, outlines their advantages and disadvantages, and provides recommendations for a more comprehensive physiotherapy approach. The content is based on a synthesis of current literature, including scholarly articles, clinical guidelines, and textbooks in physiotherapy, pain management, and rehabilitation. Patients often seek quick treatments for reasons such as immediate relief from pain and discomfort, convenience, shorter duration, cost considerations, a preference for rapid solutions, and concerns about more invasive procedures. However, relying solely on quick treatments may mask symptoms, delay overall recovery, and increase the risk of recurrent problems. The article emphasizes the importance of education, setting realistic expectations, developing comprehensive treatment plans, empowering patients, continuous monitoring and adjustment, evidence-based practice, addressing patient concerns, and promoting long-term health goals. Physiotherapists and patients should collaborate to strike a balance between quick treatments for short-term relief and a more comprehensive approach for long-term recovery and prevention. The recommendations provided aim to enhance patient understanding, engagement, and satisfaction, ultimately contributing to improved overall outcomes in physiotherapy.

Analysis of the effects of physical therapy on knee osteoarthritis

Among all degenerative joint diseases, Knee Osteoarthritis (KOA) has the highest incidence rate. However, common surgical and pharmaceutical treatments come with side effects. In comparison to surgery and medication, physical therapy is more cost-effective and safer. The purpose of this article is to conduct a systematic review of domestic and international studies on the effectiveness of physical therapy for patients The results show that physical therapy plays a crucial role in KOA, including manual therapy, physical factor therapy, exercise therapy. Manual therapy aids in improving joint function and alleviating pain, physical factor therapy can be used to manage pain, exercise therapy enhances muscle strength and stability. Personalized treatment plans typically combine various methods to meet the needs of patients. Comprehensive physical therapy approaches offer hope for KOA patients, improving their quality of life and alleviating pain. However, there is relatively limited research on physical therapy, and the elucidation of mechanisms is not yet sufficiently clear and in-depth, which could become a focal point for future studies.

Comprehensive Physiotherapy Approaches for Children With Cerebral Palsy: Overview and Contemporary Trends

Comprehensive Physiotherapy Approaches for Children With Cerebral Palsy: Overview and Contemporary Trends

Overcoming the Challenges of Prolonged Ventilation and Critical Illness Polyneuropathy in Severe ARDS Patients Due to Extensive Viral Pneumonia: A Case Report

ARDS is a life-threatening condition requiring intensive care unit monitoring. We present a 46-year-old male patient with ARDS and its complications, ventilator-associated pneumonia (VAP) and critcal illness polyneuropathy after extensive bilateral viral pneumonia. The objective of this case report is to understand better and manage the complications of ARDS. This study addresses ARDS and its complications, providing a comprehensive clinical understanding. It details a 46-year-old male patient’s case, treatment strategies, complications, weaning processes, and rehabilitation and emphasises the importance of physical therapy. This case report discusses the successful management and weaning of a patient with extensive viral pneumonia complicated with acute respiratory distress syndrome (ARDS), impending organ dysfunction, and critical illness polyneuropathy. The patient had a medical history of diabetes, hypertension, and dyslipidemia. Initial treatment involved oxygen therapy, nebulization, and empirical antiviral for seasonal flu. However, the patient required invasive ventilation with sedation and muscle relaxants following the ARDSNET protocol due to worsening respiratory status and extensive lung infiltrates. Secondary bacterial infections were also identified and treated accordingly. The weaning process was initiated but was complicated by re-intubation and the development of critical illness polyneuropathy. After successful weaning and recovery from ARDS and associated lung infections, physical therapy was provided for polyneuropathy regularly to overcome the manifest weakness all over the body muscles, including respiratory muscle weakness. The case report highlights the successful management of a patient with viral pneumonia, ARDS, and critical illness polyneuropathy, highlighting the importance of comprehensive treatment and physical therapy.

ASSESSMENT AND DETERMINATION OF MOTIVATIONAL FACTORS FOR WEIGHT LOSS AND INDICATORS OF THE FUNCTIONAL STATE OF OBESE WOMEN IN THE REHABILITATION PROCESS

Resume
 The rapid spread of obesity emphasizes the relevance of studying this issue and requires a detailed investigation, justification, and development of an appropriate physiotherapeutic intervention program tailored to the individual needs of each patient. Therefore, we have decided to dedicate our research to determining the motivational factors for weight loss in these women and analyzing the indicators of their functional status before undergoing a physiotherapeutic intervention program.
 The aim of the research is to develop a comprehensive program of physiotherapeutic interventions for women with obesity based on the study of motivational factors and analysis of existing approaches to obesity treatment, as well as to evaluate its effectiveness.
 Materials and methods. The study included a theoretical analysis of scientific and methodological literature, as well as instrumental examination methods using the remote body composition measuring method BC-418MA TANITA. A total of 68 women aged between 36 and 55 years (mature age) with different degrees of obesity participated in the research. They were divided into two groups: the control group (CG, n=34) and the experimental group (EG, n=34). The control group received rehabilitation measures following the standard treatment protocol, which included dietary №8 and physical exercises. The experimental group participated in a developed and pilot-tested physiotherapeutic intervention program, which included a complex of exercises aimed at improving the functional status of women, considering individual preferences, a modified method of dietary therapy (based on dietary table №8 according to Pevzner), and keeping a motivational journal. The study was conducted at the Sport Life fitness club in Kyiv, located at Mayakovskogo Avenue, 46, Troieshchyna district. The research course lasted for three months.
 Research results. Based on the obtained data, it is evident that both groups experienced a decrease in total body weight and a reduction in specific weight of adipose tissue by the end of the 3rd month. However, it is noteworthy that the level of BMI reduction after the developed program was significantly higher in the experimental group. After completing the course of comprehensive physical therapy, significant reductions in body mass index (BMI) were observed in both groups, with the control group showing a BMI of 29,66 ± 0,9 kg/m2 and the experimental group showing a BMI of 28,03 ± 0,5 kg/m2, (p<0,05).
 Conclusions. The results of the survey of the studied group of women indicate that the vast majority of respondents – 73,0% chose the health factor as the main motivator for losing weight. For 54,4% of women, having a good appearance, especially physical attractiveness, can be achieved by correcting body weight.. The results of the conducted research give grounds for asserting that the use of the diet therapy method and kinesiotherapy exercises developed by us as part of the physical rehabilitation program developed for women of the second mature age with obesity, led to a safe reduction of body weight and the fat component, and the achievement of individually planned results of figure correction. The advantages of the developed program are confirmed by the results of own research.

Physiotherapy Rehabilitation for Accelerating the Recovery of Patient with Anterior Cruciate Ligament Total Reconstruction and Meniscal Repair: A Case Report

Background: The Anterior Cruciate Ligament (ACL) is a ligament that functions to limit the movement of the tibia toward the anterior and excessive rotation, while the meniscus serves as shock absorption, load transmission, and the stabilizer of the knee joint. About 22% to 86% meniscal tear incidences occurring along with ACL injuries is. The study aims to determine the role of physiotherapists in the postoperative rehabilitation process of patients of ACL Reconstruction (ACLR) and meniscal repair in preventing postoperative complications and functional abilities of patients. Case Report: The patient was a 35-year-old adult male who suffered a complete tear in the ACL and meniscus of the left knee. The patient underwent ACLR and meniscal repair with arthroscopic surgery 2 years after injury with Bone-Pattelar tendon-bone autograph. 2 weeks post-surgery the patient visited the physiotherapy polyclinic with medical conditions of difficulty in bending and straightening the knee, still feeling pain and thick in the knee area. Results: The physiotherapist program was conducted three times and it was a home program-based exercise. The physiotherapist program and outcomes used in the first phase focused on exercises to improve ROM (Goniometer), oedema management (Medline), pain reduction (Numerical Rating Scale), activation exercises, and surrounding muscle strength (Sphygmomanometer), and improve functional ability (Tegner Lysholm Knee Scale) as well as the provision of home programs Performed by regular monitoring of exercise intensity using isometric, isotonic, and isokinetic exercises, which were given according to the concept of progressive loading. Conclusion: This case study shows that surgery combined with a comprehensive physiotherapy program plan in ACLR and meniscal repair cases, as well as adding home-based exercise programs with intense monitoring, generate more effective results. Keywords: physiotherapy rehabilitation, anterior cruciate ligament total, meniscal repair Correspondence: Suryo Saputra Perdana. Physiotherapist Profession Education Department, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Sukoharjo, Central Java, Indonesia. Email: suryo.saputra@ums.ac.id. Mobile: +6281298563988.

What more comprehensive physiotherapy techniques than pelvic floor muscles training should be investigated in the context of post-prostatectomy? A narrative review

In a previous article, we have underlined the emerging level of evidence for the effectiveness of a more comprehensive functional physical therapy than solely pelvic floor muscles training (PFMT) for men after radical prostatectomy (RP). More and more authors suggest that physiotherapy programs should not focus only on the side effect of continence, but more generally on the interaction of continence disorders with all other side effects related to patient's physical and emotional functioning. The aims of this narrative review are to highlight rehabilitation approaches unrelated to analytical PFMT that would seem relevant to consider in the future for post-RP men. Our narrative review sought to map the body of literature relevant to the primary objective (non-PFMT), supplementing the data from our previous review with additional recent articles that were not eligible due to not meeting the inclusion criteria for a systematic review. After full text screening, 13 interventional studies have been selected. Intervention strategies were based on five major type of exercises: flexibility, synergism & co-activation, coordination & movement control, strength & endurance, aerobic & games therapy. Most of the studies of this narrative review focused on synergies, co-activations and movement control techniques that emphasized the deep abdominal muscles and PFMs reflexive activation. The wide variety of countries represented in the 13 studies with consistent results point to the potential effectiveness and replicability across various socio-cultural, ethnical, or religious contexts. We found 13 studies from 9 different countries that provide a more complete rehabilitation approach than PFMT alone in men post-RP. Intervention strategies were built around five main types of exercises, with the majority of them emphasizing synergies, co-activations, and movement control techniques. In light of these data, we hope that future research will enable us to offer the most relevant and patient-centered physiotherapy treatment.

Application of deep oscillation therapy in the treatment of peripheral arterial diseases

Intermittent claudication is a common symptom of peripheral arterial disease, affecting up to 50% of patients over the age of 50, which is characterized by pain, discomfort, and cramping in the leg muscles during physical activity. Intermittent claudication is a common symptom of lower extremity arterial disease (LEAD), which significantly impacts patients’ quality of life and drives healthcare costs. Current treatments for intermittent claudication are often inadequate, leading to a need for more effective treatments. Developing new treatments is critical to improve outcomes for patients and address the public health implications of LEAD. This study’s aim was to present the impact of comprehensive physiotherapy, conducted independently, with the supervision of a physiotherapist, for 14 weeks, on a patient with intermittent claudication caused by peripheral arterial disease. The therapy included bicycle training in a form of physical therapy at home, combined with deep oscillation therapy. Deep oscillation therapy involved the use of an electrostatic field with a frequency of 5 to 250 Hz. The field was applied following the lymphatic drainage methodology. In the discussed case, a statistically significant and favourable increase in the measured variables was observed, such as the increase of bone-brachial index from 0.65 to 0.8, the increase of tissue perfusion, measured by laser Doppler flowmetry, from 12.3% to 61%, depending on the measurement site, and the increase in pain-free walking distance by 451%. TcPO2 measurement in the affected leg increased from 31 to 48 mmHg. The use of physical therapy at home combined with deep oscillation showed improvements in pain-free walking distance, Ankle Brachial Index, and other measures in patients with peripheral arterial disease. Deep oscillation therapy demonstrated potential analgesic effects but also raised concerns about possible nerve damage. The study indicated that physical therapy at home might serve as an alternative to supervised exercise therapy, but it had limitations like a small sample size and lack of direct comparisons.

Intervention of Refractory Arthrofibrosis After Anterior Cruciate Ligament Reconstruction: A Case Report.

Although nonsurgical and surgical management of knee arthrofibrosis has been reported in the literature, there is little information on the effect of procedural treatment modalities of refractory arthrofibrosis on clinical outcomes. The purpose of this case report is to describe the intervention of refractory knee arthrofibrosis after anterior cruciate ligament reconstruction and investigate long-term clinical outcomes after procedural intervention. A 27-year-old male presented with decreased range of motion (ROM), patellar mobility, strength, and knee joint function following anterior cruciate ligament reconstruction of his left knee. After failed conservative management, the patient underwent manipulation under anesthesia (MUA) to release scar tissue. Following MUA, the emphasis of comprehensive physiotherapy was on decreasing inflammation, relieving pain, and maintaining patellar mobility while increasing knee joint ROM and strength. Knee ROM, patellofemoral motion, gait, and quadriceps recruitment were measured 3, 6, 12, and 24months after MUA. At 2-year follow-up after MUA, the patient continued to present with decreased ROM and quadriceps strength compared to the contralateral knee, but had returned to a running program and reported knee joint dysfunction no longer interfered with his daily activities. This case report demonstrates signs and symptoms that could indicate knee arthrofibrosis and introduces procedural intervention for refractory arthrofibrosis after anterior cruciate ligament reconstruction.

Physiotherapy for pain, jaw mobility, and oral health-related quality of life in patient with trismus following radiation therapy for jaw cancer: A case report

Background: Trismus is a painful condition that restricts the temporomandibular joint range of motion (ROM) causing difficulty in eating, chewing, speaking, etc., affecting the oral health-related quality of life (OHRQOL). It often presents as a complication during pre-malignancy stage or after oral cancer treatment. Its prevalence is between 28% and 79%, and it is 8 times more common in edentulous patients. Case Presentation: The 57-year-old male complained of continuous tongue and jaw pain with difficulty in chewing, eating, and speaking 1 year before and gradually developed small ulcers over the right jaw. After complete investigation, the patient was diagnosed with jaw cancer and underwent radiotherapy for 2 months. This patient came with complaints of pain, difficulty in mouth opening to physiotherapy department, 3 months following radiotherapy, diagnosed as a case of trismus. A comprehensive physiotherapy protocol including LASER, mobilization, Myofascial release, active exercises for the period of 4 weeks was given. Outcomes for pain, jaw mobility, and OHRQOL were evaluated at baseline and 4 weeks. Conclusion: Four weeks of comprehensive physiotherapy protocol was found effective in reducing pain and improving jaw mobility and OHRQOL in patients with trismus following radiation therapy.

Post Laminectomy Physiotherapy Management of Cervical Canal Stenosis: A Case Study

This case study presents the comprehensive post-laminectomy physiotherapy management of Saroj Devi, a 47-year-old female patient diagnosed with cervical canal stenosis. Following a laminectomy procedure to alleviate spinal cord and nerve root compression, Saroj experienced persistent neck pain, reduced mobility, upper limb weakness, and sensory deficits. The aim of this case study was to describe the assessment findings, goal setting, treatment interventions, and outcomes of Saroj's physiotherapy intervention. The treatment approach included pain management techniques, range of motion exercises, strengthening exercises, sensory re-education, endurance training, and patient education. Over the course of several weeks, Saroj demonstrated remarkable improvements in pain reduction, neck mobility, upper limb strength, sensory function, and endurance. This case study emphasizes the importance of physiotherapy in post-operative management of cervical canal stenosis, highlighting its role in enhancing functional recovery and improving the quality of life for patients like Saroj Devi.

Effects of a Comprehensive Physical Therapy Program on Functional performance profile in Young men with a History of Osgood Schlatter Disease

Effects of a Comprehensive Physical Therapy Program on Functional performance profile in Young men with a History of Osgood Schlatter Disease

Efficacy evaluation of symptom-complex physiotherapy in polymorbidity based on randomized comparative studies

To evaluate the efficacy of comprehensive physical therapy (CPT) in PM in the age aspect on the basis of correlation analysis and ANOVA indicators (OR, RR, Q, x2, r2), as well as evidence-based medicine (EBM), in particular randomized comparative study (RCS). A number of patients with PM equal 554 underwent CPT, of which 204 (36.8%) were male and 350 (63.2%) female. The identified age cohorts were following: the 1st group - 188 (33.9%) patients aged from 45 to 59; the 2nd group - 366 (66.1%) patients aged from 60 to 74. The ratio of middle-aged and elderly patients was 1.9:1. The efficacy of CPT in patients with PM was judged, first of all, by documentary (medical histories and medical records of patients) and mathematical data (OR, RR, Q, x2, r2). The evidence level of CPT effect was determined on the basis of the analysis of the particular method's study results. The incidence of positive CPT result in middle-aged patients was higher than in elderly. The positive strong statistical correlation between comprehensive physical therapy and the endpoint in most classes of diseases of patients with PM. The comparative assessment of CPT efficacy based on the EBM principles revealed the advantages of their use for elderly patients relative to middle-aged group.

Quantifying muscle strength, size, and neuromuscular activation in adolescent and young adult survivors of musculoskeletal sarcoma: Identifying correlates and responses to functional strengthening

BackgroundMedical and surgical treatment for musculoskeletal sarcoma (MSS) place survivors at risk for impairments in muscle properties including muscle strength, muscle size, and neuromuscular activation. The purpose of this study was to explore muscle properties, gross motor performance, and quality of life (QoL) and the changes in response to a 6-week functional strengthening intervention (PT-STRONG) in MSS survivors of childhood cancer (CCS). MethodsEight lower extremity MSS CCS (13–23 years old) performed baseline testing and three completed PT-STRONG. Participants completed measurements of knee extension strength using handheld dynamometry, vastus lateralis (VL) and rectus femoris (RF) muscle thickness using ultrasonography at rest, and neuromuscular activation using electromyography during strength testing and a step-up task. Participants also completed gross motor and QoL assessments. ResultsCompared with the non-surgical limb, MSS CCS had lower surgical limb knee extension strength, VL muscle thickness, and RF step-up muscle rate of activation (RoA). Compared with normative values, MSS CCS had decreased bilateral knee extension strength, gross motor performance, and physical QoL. Positive correlations among muscle strength, muscle thickness, and gross motor performance were identified. After PT-STRONG, MSS CCS had improvements in VL muscle thickness, VL and RF RoA duing step-up, gross motor performance, and physical QoL. ConclusionsPositive association between larger muscle thickness with greater knee extension strength, and higher knee extension strength with better gross motor performance indicate that comprehensive physical therapy assessment and interventions that identify and target impairments in muscle properties to guide clinical decision making should be considered for MSS CCS into survivorship.

Comparing the effect of physiotherapy and physiotherapy plus corticosteroid injection on pain intensity, disability, quality of life, and treatment effectiveness in patients with Subacromial Pain Syndrome: a randomized controlled trial

PurposeTo compare the short and medium-term effects of physiotherapy plus corticosteroid injection (combined) with physiotherapy alone on pain intensity, disability, Quality of Life (QoL), and treatment effectiveness in patients with Subacromial Pain Syndrome (SAPS).MethodsIn this double-blind, parallel Randomized Controlled Trial (RCT), 50 patients with SAPS were randomly assigned into combined (N = 25, a single injection 3–6 days before physiotherapy) and physiotherapy alone group (N = 25). Pain, disability, QoL, and treatment-effectiveness were measured at pre-intervention, post-intervention, and 3 and 6-month follow-up with Visual Analog Scale (VAS), Shortened Disability of the Arm, Shoulder, and Hand (Quick-DASH), Shoulder Pain and Disability Index (SPADI) (primary outcome measure), Western Ontario Rotator Cuff (WORC), and Global Rating of Change (GRC) respectively. A 2 × 4 (group × time) mixed model analysis of variance (ANOVA) was applied for analysis.ResultsThe ANOVA revealed statistically significant group-in-time interaction for all outcome measures (p-value < 0.05). The independent t-test showed more effectiveness in the combined group at medium-term, as the mean scores of almost all outcome measures were substantially lesser (p < 0.01). Moreover, in short-time, despite a greater number of patients stating “completely recovered” in the combined group, there was no statistically significant difference between groups.ConclusionsEffects of physiotherapy plus corticosteroid injection could be more long-lasting than physiotherapy alone in improving pain intensity, disability, QoL, and treatment effectiveness in patients with SAPS. Trial registration numberIRCT20201010048980N1.IMPLICATIONS FOR REHABILITATIONShoulder pain is common, persistent, and predominantly results from subacromial pain syndrome (SAPS).Physiotherapy and corticosteroid injections are effective interventions for this condition.Comprehensive physiotherapy alone can be as effective as corticosteroid injection combined with physiotherapy in the short term.A combined approach versus physiotherapy alone may have more medium-term effects on SAPS patients’ pain, disability, quality of life, and treatment effectiveness.

The Role of Physical Therapy in Reducing the Recurrence of Clogged Milk Ducts and Subsequent Mastitis

Background: The World Health Organization supports and recognizes the benefits of breastfeeding, at least 6 months or more, for both a mother and her baby. A common cause for cessation of breastfeeding is the development of mastitis typically caused by a clogged milk duct. Literature is limited on physical therapy's role in reducing clogged milk ducts and subsequent mastitis. Study Design: A case report Case Description: This case describes a 33-year-old woman who was referred to physical therapy following unsuccessful treatment for breastfeeding complications that included daily bilateral clogged milk ducts and mastitis. The patient participated in a comprehensive physical therapy approach consisting of patient education, moist heat, therapeutic ultrasound, manual techniques, and cryotherapy. Outcomes: A retrospective review of 5 physical therapy visits over 3 weeks was completed. The patient reported no recurrence of mastitis and the ability to manage and decrease the recurrence of clogged milk ducts. The patient's number of daily clogged milk ducts and reported success with breastfeeding improved. At 6 months post-discharge, the patient reported she was able to continue breastfeeding and had no recurrence of mastitis. Discussion: Physical therapists may have a potential role in treating clogged milk ducts and subsequent mastitis in postpartum women where there is a lack of availability of lactation resources. A video abstract is available (see Supplemental Digital Content 1, available at: https://links.lww.com/JWHPT/A84).

Effect of innovative vs. usual care physical therapy in subacute rehabilitation after stroke. A multicenter randomized controlled trial

Research on stroke rehabilitation often addresses common difficulties such as gait, balance or physical activity separately, a fragmentation contrasting the complexity in clinical practice. Interventions aiming for recovery are needed. The purpose of this study was to investigate effects of a comprehensive low-cost physical therapy intervention, I-CoreDIST, vs. usual care on postural control, balance, physical activity, gait and health related quality of life during the first 12 weeks post-stroke. This prospective, assessor-masked randomized controlled trial included 60 participants from two stroke units in Norway. Participants, who were randomized to I-CoreDIST (n = 29) or usual care physical therapy (n = 31), received 5 sessions/week when in-patients or 3 sessions/week as out-patients. Primary outcomes were the Trunk Impairment Scale-modified Norwegian version (TISmodNV) and activity monitoring (ActiGraphsWgt3X-BT). Secondary outcomes were the Postural Assessment Scale for Stroke, MiniBesTEST, 10-meter walk test, 2-minute walk test, force-platform measurements and EQ5D-3L. Stroke specific quality of life scale was administered at 12 weeks. Linear regression and non-parametric tests were used for statistical analysis. Five participants were excluded and seven lost to follow-up, leaving 48 participants in the intention-to-treat analysis. There were no significant between-group effects for primary outcomes: TIS-modNV (p = 0,857); daily average minutes of sedative (p = 0.662), light (p = 0.544) or moderate activity (p = 0.239) and steps (p = 0.288), or secondary outcomes at 12 weeks except for significant improvements on EQ5D-3L in the usual care group. Within-group changes were significant for all outcomes in both groups except for activity levels that were low, EQ5D-3L favoring the usual care group, and force-platform data favoring the intervention group. Physical therapy treatment with I-CoreDIST improved postural control, balance, physical activity and gait during the first 12 weeks after a stroke but is not superior to usual care.

A systematic review of supervised comprehensive functional physiotherapy after radical prostatectomy

Radical prostatectomy (RP) can generate multidimensional physiological changes, like decrease in physical and emotional functioning, as well as Health Related Quality of Life (HRQoL). However, only pelvic floor muscle training (PFMT) is commonly recommended as conservative treatment after RP. More comprehensive interventions than only PFMT, such as physiotherapy promoting general coordination, flexibility, strength, endurance, fitness and functional capacity may seem more relevant and patient-centered. Our aim was to evaluate whether a more Comprehensive Functional Physical Therapy (CFPT) than PFMT alone, focused on lower limb and lumbo-pelvic exercises, would improve physical capacities and functions (including urinary continence (UI)), emotional functions and HRQoL in patients after RP. A systematic review was performed in accordance with the PRISMA reporting guidelines. A literature search was conducted in PubMed, PEDro, Web of Science and Cochrane Library databases from inception to January 2022. The PICO approach was used to determine the eligibility criteria. According to the quality of selected studies, levels of evidence were given. Eight clinical trials met the eligibility criteria. Regarding UI, all the studies reported positive outcomes for CFPT between pre- and post-physiotherapy (P<0.05). The selected studies reported positive outcomes for physical capacities as well as for physical and emotional functioning, and for HRQoL (P<0.05). Current literature indicates that CFPT was shown to be safe, non-invasive, and particularly effective in terms of UI recovery. CFPT could result in more positive outcomes, including physical capacities, physical and emotional functioning and HRQoL, than PFMT alone. Further standardized, physiotherapist-guided and well-designed clinical trials conducted by experienced multidisciplinary clinicians are still called for.

Comprehensive Physiotherapy Program for Children with Erb’s Paralysis Cases: Case Report

Obstetric Brachial Plexus Injury (OBPI) is a condition of brachial plexus lesions that occur during childbirth which can cause paralysis of the upper extremities which are divided into 3 categories based on the location of the lesion, namely, lesions of the upper plexus C5-C6 (Erb’s Palsy), lesions of the lower plexus C7-T1 (Klumpke’s palsy) and lesions on the upper &amp; lower plexus C5-T1 which is a combination of the two. In this case the patient diagnosed Erb’s Palsy dextra due to several factors such as macrosomia with a Birth Weight 4800 gr, shoulder distortion, breech, Diabetes Milletus in the mother, and a long second stage of labor. This causes the patient to have a “waiter’s tip hand” deformity pattern and cry loudly when the hand is moved in any direction. The physiotherapy treatment provided is the provision of Infra-Red (IR), Neurosensory Motor Reflex Integration (NMRI) and Passive Range of Motion Exercise. After 4 times of therapy, the result showed a decrease in pressure pain from T0: 5 to T4: 4, a decrease in motion pain from T0: 10 to T4: 8 measured using the Wong-Baker FACES Pain Rating Scale, Primitive Reflexes from T0: negative to T4: positive, and an increase upper limb range of motion from T0: 2 to T4: 3 assessed using the Active Movement Scale (AMS). The results showed that Infra-Red, NMRI and Passive ROM Exercise were effective in the case of Erb’s Palsy.

Arthroscopic Posterior Capsular Release Effectively Reduces Pain and Restores Terminal Knee Extension in Cases of Recalcitrant Flexion Contracture

PurposeTo 1) evaluate the clinical efficacy of arthroscopic posterior capsular release for improving range of motion (ROM) in cases of recalcitrant flexion contracture and 2) determine patient-reported outcomes (PROs) postoperatively.MethodsRetrospective chart review was performed to identify patients who underwent arthroscopic posterior capsular release due to persistent extension deficit of the knee despite comprehensive nonoperative physical therapy between 2008 and 2021. Knee ROM and PROs (International Knee Documentation Committee [IKDC], Tegner, and visual analog scale [VAS]) were collected at final follow-up.ResultsOverall, 22 patients were included with a median age of 37 years (interquartile range [IQR]: 20.5-44.3). Of these, 8 (36%) were male and 14 (64%) were female, and average follow-up was 3.7 ± 3.3 years. The most common etiology was knee flexion contracture after anterior cruciate ligament (ACL) reconstruction (59%). All patients failed a minimum of 3 months of nonoperative management. Prior to operative intervention, 100% of patients received physical therapy, 64% received extension knee bracing or casting, and 36% received corticosteroid injection. Median preoperative extension was 15° (IQR: 10-25) compared to 2° (IQR: 0-5) postoperatively (P < .001). At final follow-up, median extension was 0° (IQR: 0-3.5). Postoperative VAS pain scores at rest (2 vs 0; P = .001) and with use (5 vs 1.8; P = .017) improved at final contact, and most (94%) patients reported maintaining their extension ROM. Patients with ACL-related extension deficit reported better IKDC (81 vs 51.3; P = .008), Tegner (5.8 vs 3.6; P = .007), and VAS pain scores (rest: 0.2 vs 1.8; P = .008; use: 1.3 vs 5; P = .004) compared to other etiologies.ConclusionArthroscopic posterior capsular release for recalcitrant flexion contracture provides an effective means for reducing pain and restoring terminal extension. The improvement in extension postoperatively was maintained for most (94%) patients at final follow-up with a 14% reoperation rate.